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Sample records for clinician information des

  1. Information management for clinicians.

    Science.gov (United States)

    Mehta, Neil B; Martin, Stephen A; Maypole, Jack; Andrews, Rebecca

    2016-08-01

    Clinicians are bombarded with information daily by social media, mainstream television news, e-mail, and print and online reports. They usually do not have much control over these information streams and thus are passive recipients, which means they get more noise than signal. Accessing, absorbing, organizing, storing, and retrieving useful medical information can improve patient care. The authors outline how to create a personalized stream of relevant information that can be scanned regularly and saved so that it is readily accessible. Copyright © 2016 Cleveland Clinic.

  2. Architecture, des normes et des systèmes d'information libres, phase ...

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

    Architecture, des normes et des systèmes d'information libres, phase II (OASIS II) - Renforcement des capacités dans l'ensemble de l'Afrique. Sur presque tout le continent africain, la prestation des services de santé est limitée en raison des maigres ressources disponibles et de la charge de morbidité de plus en plus ...

  3. Information Needs, Infobutton Manager Use, and Satisfaction by Clinician Type: A Case Study

    Science.gov (United States)

    Collins, Sarah A.; Currie, Leanne M.; Bakken, Suzanne; Cimino, James J.

    2009-01-01

    To effectively meet clinician information needs at the point of care, we must understand how their needs are dependent on both context and clinician type. The Infobutton Manager (IM), accessed through a clinical information system, anticipates the clinician's questions and provides links to pertinent electronic resources. We conducted an observational usefulness case study of medical residents (MDs), nurse practitioners (NPs), registered nurses (RNs), and a physician assistant (PA), using the IM in a laboratory setting. Generic question types and success rates for each clinician's information needs were characterized. Question type frequency differed by clinician type. All clinician types asked for institution-specific protocols. The MDs asked about unfamiliar domains, RNs asked about physician order rationales, and NPs asked questions similar to both MDs and RNs. Observational data suggest that IM success rates may be improved by tailoring anticipated questions to clinician type. Clinicians reported that a more visible Infobutton may increase use. PMID:18952943

  4. Hospital clinicians' information behaviour and attitudes towards the 'Clinical Informationist': an Irish survey.

    LENUS (Irish Health Repository)

    Flynn, Maura G

    2012-02-01

    BACKGROUND: Hospital clinicians are increasingly expected to practice evidence-based medicine (EBM) in order to minimize medical errors and ensure quality patient care, but experience obstacles to information-seeking. The introduction of a Clinical Informationist (CI) is explored as a possible solution. AIMS: This paper investigates the self-perceived information needs, behaviour and skill levels of clinicians in two Irish public hospitals. It also explores clinicians\\' perceptions and attitudes to the introduction of a CI into their clinical teams. METHODS: A questionnaire survey approach was utilised for this study, with 22 clinicians in two hospitals. Data analysis was conducted using descriptive statistics. RESULTS: Analysis showed that clinicians experience diverse information needs for patient care, and that barriers such as time constraints and insufficient access to resources hinder their information-seeking. Findings also showed that clinicians struggle to fit information-seeking into their working day, regularly seeking to answer patient-related queries outside of working hours. Attitudes towards the concept of a CI were predominantly positive. CONCLUSION: This paper highlights the factors that characterise and limit hospital clinicians\\' information-seeking, and suggests the CI as a potentially useful addition to the clinical team, to help them to resolve their information needs for patient care.

  5. Foraging for Information in the EHR: The Search for Adherence Related Information by Mental Health Clinicians.

    Science.gov (United States)

    Gibson, Bryan; Butler, Jorie; Zirkle, Maryan; Hammond, Kenric; Weir, Charlene

    2016-01-01

    In this project we sought to qualitatively describe clinician's search for information related to the complex construct of adherence. Nineteen think aloud observations and semi-structured interviews were conducted with mental health providers as they prepared for a patient visit. The transcripts were coded according to constructs from information foraging theory (information goal, patch, scent, enrichment, and opportunity cost). The search strategies uncovered were complicated: provider's searches were sometimes multi-staged (e.g. a search of the EHR led to further enquiry when interviewing the patient), and involved multiple 'patches' (i.e. data from the EHR, the patient and other providers were all sought out). In addition, some information that providers considered relevant to understand adherence related questions was non-obvious (e.g. the absence of specific information was considered a useful cue). Providers' information search strategies for complex constructs are at times non-intuitive; implications for the design of EHR summarization tools are discussed.

  6. Notifications of hospital events to outpatient clinicians using health information exchange: a post-implementation survey

    Directory of Open Access Journals (Sweden)

    Richard Altman

    2013-09-01

    Full Text Available Background The trend towards hospitalist medicine can lead to disjointed patient care. Outpatient clinicians may be unaware of patients’ encounters with a disparate healthcare system. Electronic notifications to outpatient clinicians of patients’ emergency department (ED visits and inpatient admissions and discharges using health information exchange can inform outpatient clinicians of patients’ hospital-based events.Objective Assess outpatient clinicians’ impressions of a new, secure messaging-based, patient event notification system.Methods Twenty outpatient clinicians receiving notifications of hospital-based events were recruited and 14 agreed to participate. Using a semi-structured interview, clinicians were asked about their use of notifications and the impact on their practices.Results Nine of 14 interviewed clinicians (64% thought that without notifications, they would have heard about fewer than 10% of ED visits before the patient’s next visit. Nine clinicians (64% thought that without notifications, they would have heard about fewer than 25% of inpatient admissions and discharges before the patient’s next visit. Six clinicians (43% reported that they call the inpatient team more often because of notifications. Eight users (57% thought that notifications improved patient safety by increasing their awareness of the patients’ clinical events and their medication changes. Key themes identified were the importance of workflow integration and a desire for more clinical information in notifications.Conclusions The notification system is perceived by clinicians to be of value. These findings should instigate further message-oriented use of health information exchange and point to refinements that can lead to even greater benefits.

  7. Employment-related information for clients receiving mental health services and clinicians.

    Science.gov (United States)

    King, Joanne; Cleary, Catherine; Harris, Meredith G; Lloyd, Chris; Waghorn, Geoff

    2011-01-01

    Clients receiving public mental health services and clinicians require information to facilitate client access to suitable employment services. However, little is known about the specific employment-related information needs of these groups. This study aimed to identify employment-related information needs among clients, clinicians and employment specialists, with a view to developing a new vocational information resource. Employment-related information needs were identified via a series of focus group consultations with clients, clinicians, and employment specialists (n=23). Focus group discussions were guided by a common semi-structured interview schedule. Several categories of information need were identified: countering incorrect beliefs about work; benefits of work; disclosure and managing personal information; impact of earnings on welfare entitlements; employment service pathways; job preparation, planning and selection; and managing illness once working. Clear preferences were expressed about effective means of communicating the key messages in written material. This investigation confirmed the need for information tailored to clients and clinicians in order to activate clients' employment journey and to help them make informed decisions about vocational assistance.

  8. Inexperienced clinicians can extract pathoanatomic information from MRI narrative reports with high reproducability for use in research/quality assurance

    DEFF Research Database (Denmark)

    Kent, Peter; Briggs, Andrew M; Albert, Hanne Birgit

    2011-01-01

    Background Although reproducibility in reading MRI images amongst radiologists and clinicians has been studied previously, no studies have examined the reproducibility of inexperienced clinicians in extracting pathoanatomic information from magnetic resonance imaging (MRI) narrative reports and t...

  9. Shared Decision Making: The Need For Patient-Clinician Conversation, Not Just Information.

    Science.gov (United States)

    Hargraves, Ian; LeBlanc, Annie; Shah, Nilay D; Montori, Victor M

    2016-04-01

    The growth of shared decision making has been driven largely by the understanding that patients need information and choices regarding their health care. But while these are important elements for patients who make decisions in partnership with their clinicians, our experience suggests that they are not enough to address the larger issue: the need for the patient and clinician to jointly create a course of action that is best for the individual patient and his or her family. The larger need in evidence-informed shared decision making is for a patient-clinician interaction that offers conversation, not just information, and care, not just choice. Project HOPE—The People-to-People Health Foundation, Inc.

  10. Malaria Cases in the U.S. Reach 40-Year High: Information and Guidance for Clinicians

    Centers for Disease Control (CDC) Podcasts

    This podcast is an overview of the Clinician Outreach and Communication Activity (COCA) Call: Malaria Cases in the U.S. Reach 40-Year High: Information and Guidance for Clinicians. The number of malaria cases reported in the United States in 2011 was the largest since 1971, representing a 14 percent increase from 2010 and a 48 percent increase from 2008. A CDC subject matter expert describes malaria prevention strategies aimed at reducing the risk of malaria in travelers, discusses the diagnosis of malaria in patients with suspect malaria, and explains the treatment options for confirmed malaria cases.

  11. Understanding students' and clinicians' experiences of informal interprofessional workplace learning: an Australian qualitative study.

    Science.gov (United States)

    Rees, Charlotte E; Crampton, Paul; Kent, Fiona; Brown, Ted; Hood, Kerry; Leech, Michelle; Newton, Jennifer; Storr, Michael; Williams, Brett

    2018-04-17

    While postgraduate studies have begun to shed light on informal interprofessional workplace learning, studies with preregistration learners have typically focused on formal and structured work-based learning. The current study investigated preregistration students' informal interprofessional workplace learning by exploring students' and clinicians' experiences of interprofessional student-clinician (IPSC) interactions. A qualitative interview study using narrative techniques was conducted. Student placements across multiple clinical sites in Victoria, Australia. Through maximum variation sampling, 61 participants (38 students and 23 clinicians) were recruited from six professions (medicine, midwifery, nursing, occupational therapy, paramedicine and physiotherapy). We conducted 12 group and 10 individual semistructured interviews. Themes were identified through framework analysis, and the similarities and differences in subthemes by participant group were interrogated. Six themes relating to four research questions were identified: (1) conceptualisations of IPSC interactions; (2) context for interaction experiences; (3) the nature of interaction experiences; (4) factors contributing to positive or negative interactions; (5) positive or negative consequences of interactions and (6) suggested improvements for IPSC interactions. Seven noteworthy differences in subthemes between students and clinicians and across the professions were identified. Despite the results largely supporting previous postgraduate research, the findings illustrate greater breadth and depth of understandings, experiences and suggestions for preregistration education. Educators and students are encouraged to seek opportunities for informal interprofessional learning afforded by the workplace. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. Measuring Practicing Clinicians' Information Literacy. An Exploratory Analysis in the Context of Panel Management.

    Science.gov (United States)

    Dixon, Brian E; Barboza, Katherine; Jensen, Ashley E; Bennett, Katelyn J; Sherman, Scott E; Schwartz, Mark D

    2017-02-15

    As healthcare moves towards technology-driven population health management, clinicians must adopt complex digital platforms to access health information and document care. This study explored information literacy, a set of skills required to effectively navigate population health information systems, among primary care providers in one Veterans' Affairs (VA) medical center. Information literacy was assessed during an 8-month randomized trial that tested a population health (panel) management intervention. Providers were asked about their use and comfort with two VA digital tools for panel management at baseline, 16 weeks, and post-intervention. An 8-item scale (range 0-40) was used to measure information literacy (Cronbach's α=0.84). Scores between study arms and provider types were compared using paired t-tests and ANOVAs. Associations between self-reported digital tool use and information literacy were measured via Pearson's correlations. Providers showed moderate levels of information literacy (M= 27.4, SD 6.5). There were no significant differences in mean information literacy between physicians (M=26.4, SD 6.7) and nurses (M=30.5, SD 5.2, p=0.57 for difference), or between intervention (M=28.4, SD 6.5) and control groups (M=25.1, SD 6.2, p=0.12 for difference). Information literacy was correlated with higher rates of self-reported information system usage (r=0.547, p=0.001). Clinicians identified data access, accuracy, and interpretability as potential information literacy barriers. While exploratory in nature, cautioning generalizability, the study suggests that measuring and improving clinicians' information literacy may play a significant role in the implementation and use of digital information tools, as these tools are rapidly being deployed to enhance communication among care teams, improve health care outcomes, and reduce overall costs.

  13. Clinicians, security and information technology support services in practice settings--a pilot study.

    Science.gov (United States)

    Fernando, Juanita

    2010-01-01

    This case study of 9 information technology (IT) support staff in 3 Australian (Victoria) public hospitals juxtaposes their experiences at the user-level of eHealth security in the Natural Hospital Environment with that previously reported by 26 medical, nursing and allied healthcare clinicians. IT support responsibilities comprised the entire hospital, of which clinician eHealth security needs were only part. IT staff believed their support tasks were often fragmented while work responsibilities were hampered by resources shortages. They perceived clinicians as an ongoing security risk to private health information. By comparison clinicians believed IT staff would not adequately support the private and secure application of eHealth for patient care. Preliminary data analysis suggests the tension between these cohorts manifests as an eHealth environment where silos of clinical work are disconnected from silos of IT support work. The discipline-based silos hamper health privacy outcomes. Privacy and security policies, especially those influencing the audit process, will benefit by further research of this phenomenon.

  14. Watson will see you now: a supercomputer to help clinicians make informed treatment decisions.

    Science.gov (United States)

    Doyle-Lindrud, Susan

    2015-02-01

    IBM has collaborated with several cancer care providers to develop and train the IBM supercomputer Watson to help clinicians make informed treatment decisions. When a patient is seen in clinic, the oncologist can input all of the clinical information into the computer system. Watson will then review all of the data and recommend treatment options based on the latest evidence and guidelines. Once the oncologist makes the treatment decision, this information can be sent directly to the insurance company for approval. Watson has the ability to standardize care and accelerate the approval process, a benefit to the healthcare provider and the patient.

  15. Malaria Cases in the U.S. Reach 40-Year High: Information and Guidance for Clinicians

    Centers for Disease Control (CDC) Podcasts

    2014-02-26

    This podcast is an overview of the Clinician Outreach and Communication Activity (COCA) Call: Malaria Cases in the U.S. Reach 40-Year High: Information and Guidance for Clinicians. The number of malaria cases reported in the United States in 2011 was the largest since 1971, representing a 14 percent increase from 2010 and a 48 percent increase from 2008. A CDC subject matter expert describes malaria prevention strategies aimed at reducing the risk of malaria in travelers, discusses the diagnosis of malaria in patients with suspect malaria, and explains the treatment options for confirmed malaria cases.  Created: 2/26/2014 by Center for Global Health (CGH); Malaria Branch; Emergency Risk Communication Branch (ERCB); Office of Public Health Preparedness and Response (OPHPR).   Date Released: 2/26/2014.

  16. How do practising clinicians and students apply newly learned causal information about mental disorders?

    Science.gov (United States)

    de Kwaadsteniet, Leontien; Kim, Nancy S; Yopchick, Jennelle E

    2013-02-01

    New causal theories explaining the aetiology of psychiatric disorders continuously appear in the literature. How might such new information directly impact clinical practice, to the degree that clinicians are aware of it and accept it? We investigated whether expert clinical psychologists and students use new causal information about psychiatric disorders according to rationalist norms in their diagnostic reasoning. Specifically, philosophical and Bayesian analyses suggest that it is rational to draw stronger inferences about the presence of a disorder when a client's presenting symptoms are from disparate locations in a causal theory of the disorder than when they are from proximal locations. In a controlled experiment, we presented experienced clinical psychologists and students with recently published causal theories for different disorders; specifically, these theories proposed how the symptoms of each disorder stem from a root cause. Participants viewed hypothetical clients with presenting proximal or diverse symptoms, and indicated either the likelihood that the client has the disorder, or what additional information they would seek out to help inform a diagnostic decision. Clinicians and students alike showed a strong preference for diverse evidence, over proximal evidence, in making diagnostic judgments and in seeking additional information. They did not show this preference in the control condition, in which they gave their own opinions prior to learning the causal information. These findings suggest that experienced clinical psychologists and students are likely to use newly learned causal knowledge in a normative, rational way in diagnostic reasoning. © 2011 Blackwell Publishing Ltd.

  17. Exploration des technologies de l'information et de la ...

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

    Exploration des technologies de l'information et de la communication au service ... IDRC “unpacks women's empowerment” at McGill University Conference ... a new funding opportunity aimed at fostering effective, long-term climate action to ...

  18. Structured cues or modafinil for fatigue amelioration in clinicians? A double-blind, randomized controlled trial of critical clinical information recall in fatigued clinicians.

    Science.gov (United States)

    Flindall, Ian; Leff, Daniel Richard; Goodship, Jonathan; Sugden, Colin; Darzi, Ara

    2016-04-01

    To evaluate the impact of modafinil on "free" and "cued" recall of clinical information in fatigued but nonsleep-deprived clinicians. Despite attempts to minimize sleep deprivation through redesign of the roster of residents and staff surgeons, evidence suggests that fatigue remains prevalent. The wake-promoting agent modafinil improves cognition in the sleep-deprived fatigued state and may improve information recall in fatigued nonsleep-deprived clinicians. Twenty-four medical undergraduates participated in a double-blind, parallel, randomized controlled trial (modafinil-200 mg:placebo). Medication was allocated 2 hours before a 90-minute fatigue-inducing, continuous performance task (dual 2-back task). A case history memorization task was then performed. Clinical information recall was assessed as "free"(no cognitive aids) and "cued"(using aid memoirs). Open and closed cues represent information of increasing specificity to aid the recall of clinical information. Fatigue was measured objectively using the psychomotor vigilance task at induction, before and after the dual 2-back task. Modafinil decreased false starts and lapses (modafinil = 0.50, placebo = 9.83, P recall (modafinil = 137.8, placebo = 106.0, P recalled with open (modafinil = 62.3, placebo = 52.8, P = .1) and closed cues (modafinil = 80.1, placebo = 75.9, P = .3). Modafinil attenuated fatigue and improved free recall of clinical information without improving cue-based recall under the design of our experimental conditions. Memory cues to aid retrieval of clinical information are convenient interventions that could decrease fatigue-related error without adverse effects of the neuropharmacology. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. [Italian physician's needs for medical information. Retrospective analysis of the medical information service provided by Novartis Pharma to clinicians].

    Science.gov (United States)

    Speroni, Elisabetta; Poggi, Susanna; Vinaccia, Vincenza

    2013-10-01

    The physician's need for medical information updates has been studied extensively in recent years but the point of view of the pharmaceutical industry on this need has rarely been considered. This paper reports the results of a retrospective analysis of the medical information service provided to Italian physicians by an important pharmaceutical company, Novartis Pharma, from 2004 to 2012. The results confirm clinicians' appreciation of a service that gives them access to tailored scientific documentation and the number of requests made to the network of medical representatives has been rising steadily, peaking whenever new drugs become available to physicians. The analysis confirms what -other international studies have ascertained, that most queries are about how to use the drugs and what their properties are. The results highlight some differences between different medical specialties: for example, proportionally, neurologists seem to be the most curious. This, as well as other interesting snippets, is worth further exploration. Despite its limits in terms of representativeness, what comes out of the study is the existence of an real unmet need for information by healthcare institutions and that the support offered by the pharmaceutical industry could be invaluable; its role could go well beyond that of a mere supplier to National Healthcare Systems, to that of being recognised as an active partner the process of ensuring balanced and evidence-based information. At the same time, closer appraisal of clinicians' needs could help the pharma industries to improve their communication and educational strategies in presenting their latest clinical research and their own products.

  20. A Multisite Survey Study of EMR Review Habits, Information Needs, and Display Preferences among Medical ICU Clinicians Evaluating New Patients.

    Science.gov (United States)

    Nolan, Matthew E; Cartin-Ceba, Rodrigo; Moreno-Franco, Pablo; Pickering, Brian; Herasevich, Vitaly

    2017-10-01

    The electronic chart review habits of intensive care unit (ICU) clinicians admitting new patients are largely unknown but necessary to inform the design of existing and future critical care information systems. We conducted a survey study to assess the electronic chart review practices, information needs, workflow, and data display preferences among medical ICU clinicians admitting new patients. We surveyed rotating residents, critical care fellows, advanced practice providers, and attending physicians at three Mayo Clinic sites (Minnesota, Florida, and Arizona) via email with a single follow-up reminder message. Of 234 clinicians invited, 156 completed the full survey (67% response rate). Ninety-two percent of medical ICU clinicians performed electronic chart review for the majority of new patients. Clinicians estimated spending a median (interquartile range (IQR)) of 15 (10-20) minutes for a typical case, and 25 (15-40) minutes for complex cases, with no difference across training levels. Chart review spans 3 or more years for two-thirds of clinicians, with the most relevant categories being imaging, laboratory studies, diagnostic studies, microbiology reports, and clinical notes, although most time is spent reviewing notes. Most clinicians (77%) worry about overlooking important information due to the volume of data (74%) and inadequate display/organization (63%). Potential solutions are chronologic ordering of disparate data types, color coding, and explicit data filtering techniques. The ability to dynamically customize information display for different users and varying clinical scenarios is paramount. Electronic chart review of historical data is an important, prevalent, and potentially time-consuming activity among medical ICU clinicians who would benefit from improved information display systems. Schattauer GmbH Stuttgart.

  1. Einfluss des Internets auf das Informations-, Einkaufs- und Verkehrsverhalten

    Science.gov (United States)

    Nerlich, Mark R.; Schiffner, Felix; Vogt, Walter

    Mit Daten aus eigenen Erhebungen können das einkaufsbezogene Informations- und Einkaufsverhalten im Zusammenhang mit den verkehrlichen Aspekten (Distanzen, Verkehrsmittel, Wegekopplungen) dargestellt werden. Die Differenzierung in die drei Produktkategorien des täglichen, mittelfristigen und des langfristigen Bedarfs berücksichtigt in erster Linie die Wertigkeit eines Gutes, die seine Erwerbshäufigkeit unmittelbar bestimmt. Der Einsatz moderner IKT wie das Internet eröffnet dem Endverbraucher neue Möglichkeiten bei Information und Einkauf. Die verkehrliche Relevanz von Online-Shopping wird deutlich, wenn man berücksichtigt, dass im Mittel rund 17% aller Online-Einkäufe, die die Probanden durchgeführt haben, Einkäufe in Ladengeschäften ersetzen. Dies gilt in verstärktem Maße für Online-Informationen: etwa die Hälfte hätte alternativ im stationären Einzelhandel stattgefunden. Da der Erwerb von Gütern des täglichen Bedarfs häufig nahräumlich und in relevantem Anteil nicht-motorisiert erfolgen kann, sind in diesem Segment - im Gegensatz zum mittel- und langfristigen Bedarf - nur geringe Substitutionseffekte zu beobachten.

  2. Parent and Adolescent Interest in Receiving Adolescent Health Communication Information From Primary Care Clinicians.

    Science.gov (United States)

    Ford, Carol A; Cheek, Courtney; Culhane, Jennifer; Fishman, Jessica; Mathew, Leny; Salek, Elyse C; Webb, David; Jaccard, James

    2016-08-01

    Patient-centered health care recognizes that adolescents and parents are stakeholders in adolescent health. We investigate adolescent and parent interest in receiving information about health topics and parent-teen communication from clinicians. Ninety-one parent-adolescent dyads in one practice completed individual interviews. Items assessed levels of interest in receiving health and health communication information from the adolescent's doctor about 18 topics, including routine, mental health, sexual health, substance use, and injury prevention issues. Analyses tested differences between parents and adolescents, within-dyad correlations, and associations with adolescent gender and age. Most parents were female (84%). Adolescents were evenly divided by gender; 36 were aged 12-13 years, 35 were aged 14-15 years, and 20 were aged 16-17 years. Adolescent race reflected the practice population (60% black; 35% white). The vast majority of parents and adolescents reported moderate or high levels of interest in receiving information about all 18 health issues and information to increase parent-teen communication about these topics. Parents' interest in receiving information varied by adolescent age when the expected salience of topics varied by age (e.g., acne, driving safety), whereas adolescents reported similar interest regardless of age. Adolescent gender influenced parent and adolescent interest. Level of interest in receiving information from doctors within adolescent-parent pairs was not significantly correlated for one-half of topics. Parents and adolescents want health care professionals to help them learn and talk about a wide range of adolescent health topics. Feasible primary care interventions that effectively improve parent-teen health communication, and specific adolescent health outcomes are needed. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  3. Sur la représentation des processus d’auto information des organisations sociales

    Directory of Open Access Journals (Sweden)

    Jean-Louis Le Moigne

    2010-02-01

    Full Text Available Toute représentation intentionnelle de l'organisation sociale et des processus informationnels qui la tissent repose sur quelques prémisses épistémologiques et paradigmatiques qu'il importe d'expliciter dès lors que l'on se propose de "bien conduire sa raison dans les affaires humaines". Le climat intellectuel dans lequel se sont développés les modèles de l'Entreprise depuis deux siècles postulait une épistémologie réductionniste et positiviste justifiant le paradigme énergétique; lequel invitait à représenter les organisations sociales par une physique sociale dérivée de la physique de la matière. On souligne les sévères limitations de cette problématique dès lors que les entreprises ont projet de se représenter dans leur complexité telle qu'elles la perçoivent. On propose de formuler, dans le référentiel aujourd'hui assuré d'une épistémologie constructiviste, un paradigme permettant de rendre compte de la correspondance information-organisation dont on postule qu'elle peut être constitutive de représentations "riches" de l'entreprise complexe : le paradigme inforgétique. Cette mise en forme est aujourd'hui suffisamment explicitée et argumentée pour libérer la modélisation de l'organisation sociale des contraintes réductrices qu'impose nécessairement le paradigme énergétique. On procède alors à un exercice d'ingénierie» inforgétique» appliquée à la représentation de l'entreprise-organisation ; on dégage ainsi dix propositions susceptibles de guider les diagnostics de conception et de gestion technologiques et organisationnels des systèmes d'opération, d'information et de décision des entreprises.

  4. Reducing Negative Outcomes of Online Consumer Health Information: Qualitative Interpretive Study with Clinicians, Librarians, and Consumers

    Science.gov (United States)

    Pluye, Pierre; Thoër, Christine; Rodriguez, Charo

    2018-01-01

    Background There has been an exponential increase in the general population’s usage of the internet and of information accessibility; the current demand for online consumer health information (OCHI) is unprecedented. There are multiple studies on internet access and usage, quality of information, and information needs. However, few studies explored negative outcomes of OCHI in detail or from different perspectives, and none examined how these negative outcomes could be reduced. Objective The aim of this study was to describe negative outcomes associated with OCHI use in primary care and identify potential preventive strategies from consumers’, health practitioners’, and health librarians’ perspectives. Methods This included a two-stage interpretive qualitative study. In the first stage, we recruited through a social media survey, a purposeful sample of 19 OCHI users who had experienced negative outcomes associated with OCHI. We conducted semistructured interviews and performed a deductive-inductive thematic analysis. The results also informed the creation of vignettes that were used in the next stage. In the second stage, we interviewed a convenient sample of 10 key informants: 7 health practitioners (3 family physicians, 2 nurses, and 2 pharmacists) and 3 health librarians. With the support of the vignettes, we asked participants to elaborate on (1) their experience with patients who have used OCHI and experienced negative outcomes and (2) what strategies they suggest to reduce these outcomes. We performed a deductive-inductive thematic analysis. Results We found that negative outcomes of OCHI may occur at three levels: internal (such as increased worrying), interpersonal (such as a tension in the patient-clinician relationship), and service-related (such as postponing a clinical encounter). Participants also proposed three types of strategies to reduce the occurrence of these negative outcomes, namely, providing consumers with reliable OCHI, educating

  5. Understanding Clinician Information Demands and Synthesis of Clinical Documents in Electronic Health Record Systems

    Science.gov (United States)

    Farri, Oladimeji Feyisetan

    2012-01-01

    Large quantities of redundant clinical data are usually transferred from one clinical document to another, making the review of such documents cognitively burdensome and potentially error-prone. Inadequate designs of electronic health record (EHR) clinical document user interfaces probably contribute to the difficulties clinicians experience while…

  6. A snapshot of health information exchange across five nations: an investigation of frontline clinician experiences in emergency care.

    Science.gov (United States)

    Klapman, Seth; Sher, Emily; Adler-Milstein, Julia

    2018-06-01

    Ensuring the ability to exchange patient information among disparate electronic health records systems is a top priority and a domain of substantial public investment across countries. However, we know little about the extent to which current capabilities meet the needs of frontline clinicians. We conducted in-person, semistructured interviews with emergency care physicians and nurses in select hospitals in Canada, Denmark, Finland, Germany, and the USA. We characterized the state of health information exchange (HIE) by country and used thematic analysis to identify the perceived benefits of access to complete past medical history (PMH), the conditions under which PMH is sought, and the challenges to accessing and using HIE capabilities. HIE approaches, and the information electronically accessible to clinicians, differed by country. Benefits of access to PMH included safer care, reduced patient length of stay, and fewer lab and imaging orders. Conditions under which PMH was sought included moderate-acuity patients, patients with chronic conditions, and instances where accessing PMH was convenient. Challenges to HIE access and use included difficulty knowing where information is located, delay in receiving information, and difficulty finding information within documents. Even with different HIE approaches across countries, all clinicians reported shortcomings in their country's approach. Notably, challenges were similar and shaped the conditions under which PMH was sought. As countries continue to pursue broad-based HIE, they appear to be facing similar challenges in realizing HIE value and therefore have an opportunity to learn from one another.

  7. Core information sets for informed consent to surgical interventions: baseline information of importance to patients and clinicians.

    Science.gov (United States)

    Main, Barry G; McNair, Angus G K; Huxtable, Richard; Donovan, Jenny L; Thomas, Steven J; Kinnersley, Paul; Blazeby, Jane M

    2017-04-26

    Consent remains a crucial, yet challenging, cornerstone of clinical practice. The ethical, legal and professional understandings of this construct have evolved away from a doctor-centred act to a patient-centred process that encompasses the patient's values, beliefs and goals. This alignment of consent with the philosophy of shared decision-making was affirmed in a recent high-profile Supreme Court ruling in England. The communication of information is central to this model of health care delivery but it can be difficult for doctors to gauge the information needs of the individual patient. The aim of this paper is to describe 'core information sets' which are defined as a minimum set of consensus-derived information about a given procedure to be discussed with all patients. Importantly, they are intended to catalyse discussion of subjective importance to individuals. The model described in this paper applies health services research and Delphi consensus-building methods to an idea orginally proposed 30 years ago. The hypothesis is that, first, large amounts of potentially-important information are distilled down to discrete information domains. These are then, secondly, rated by key stakeholders in multiple iterations, so that core information of agreed importance can be defined. We argue that this scientific approach is key to identifying information important to all stakeholders, which may otherwise be communicated poorly or omitted from discussions entirely. Our methods apply systematic review, qualitative, survey and consensus-building techniques to define this 'core information'. We propose that such information addresses the 'reasonable patient' standard for information disclosure but, more importantly, can serve as a spring board for high-value discussion of importance to the individual patient. The application of established research methods can define information of core importance to informed consent. Further work will establish how best to incorporate

  8. Influence des technologies d'information et de la communication sur ...

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

    Influence des technologies d'information et de la communication sur les mutations du marché du travail au Sénégal. Les technologies d'information et de la communication (TIC) sont devenues un élément-clé des stratégies de développement économique et réduction de la pauvreté au Sénégal. Cependant, quoique la ...

  9. Schéma directeur des Systèmes d'information 2012-2016

    OpenAIRE

    Institut National de Recherche Agronomique UAR 0776 Administration du siège

    2012-01-01

    Le schéma directeur des systèmes d’information de l’inra est le premier Schéma directeur dont l’institut se dote dans le champ des systèmes D’information. Il couvre la période 2012‐2016 du contrat d’objectifs Et s’inscrit dans les perspectives scientifiques dressées par le document D’orientation 2010‐2020

  10. Does the Internet provide patients or clinicians with useful information regarding faecal incontinence? An observational study.

    Science.gov (United States)

    Leo, C A; Murphy, J; Hodgkinson, J D; Vaizey, C J; Maeda, Y

    2018-01-01

    The Internet has become an important platform for information communication. This study aim to investigate the utility of social media and search engines to disseminate faecal incontinence information. We looked into Social media platforms and search engines. There was not a direct patient recruitment and any available information from patients was already on public domain at the time of search. A quantitative analysis of types and volumes of information regarding faecal incontinence was made. Twelve valid pages were identified on Facebook: 5 (41%) pages were advertising commercial incontinence products, 4 (33%) pages were dedicated to patients support groups and 3 (25%) pages provided healthcare information. Also we found 192 Facebook posts. On Twitter, 2890 tweets were found of which 51% tweets provided healthcare information; 675 (45%) were sent by healthcare professionals to patients, 530 tweets (35.3%) were between healthcare professionals, 201 tweets (13.4%) were from medical journals or scientific books and 103 tweets (7%) were from hospitals or clinics with information about events and meetings. The second commonest type of tweets was advertising commercial incontinence products 27%. Patients tweeted to exchange information and advice between themselves (20.5%). In contrast, search engines as Google/Yahoo/Bing had a higher proportion of healthcare information (over 70%). Internet appears to have potential to be a useful platform for patients to learn about faecal incontinence and share information; however, given one lack of focus of available data, patients may struggle to identify valid and useful information.

  11. The role of the national general medical journal: surveys of which journals UK clinicians read to inform their clinical practice.

    Science.gov (United States)

    Jones, Teresa H; Hanney, Stephen; Buxton, Martin J

    2008-12-01

    For biomedical research findings to contribute toward health gains they must reach clinicians. Academic journals have historically been considered important information sources. Birken and Parkin found seven journals to most consistently contain the best pediatric evidence and, of these seven, four were general medical journals. We surveyed clinicians in three UK medical specialties (psychiatry, surgery and pediatrics), asking which journals they read and which they considered important to inform their clinical practice. The readership of general medical journals, in comparison to specialty and sub-specialty journals, is widespread across the three UK medical specialties, although the importance of general medical journals varies widely. The BMJ is the most prominent general medical journal in terms of readership and importance but a dominant specialty or sub-specialty journal was usually more important for most groups. The Lancet is less widely read and less important, although more academics than non-academics consider it important. Overall, key general medical journals play an important role. Journal availability and cost, particularly in relation to membership for UK clinicians, and the position of academics and non-academics have to be considered in any analysis. Three of the four general medical journals containing the best pediatric evidence were found to be widely read by UK pediatricians and two UK-based general medical journals, the BMJ and The Lancet, were also considered important in our survey. Further investigation of the reasons for the importance of a journal and studies that would allow international comparisons would provide greater input to the discussion.

  12. A comparison of clinicians' access to online knowledge resources using two types of information retrieval applications in an academic hospital setting.

    Science.gov (United States)

    Hunt, Sevgin; Cimino, James J; Koziol, Deloris E

    2013-01-01

    The research studied whether a clinician's preference for online health knowledge resources varied with the use of two applications that were designed for information retrieval in an academic hospital setting. The researchers analyzed a year's worth of computer log files to study differences in the ways that four clinician groups (attending physicians, housestaff physicians, nurse practitioners, and nurses) sought information using two types of information retrieval applications (health resource links or Infobutton icons) across nine resources while they reviewed patients' laboratory results. From a set of 14,979 observations, the authors found statistically significant differences among the 4 clinician groups for accessing resources using the health resources application (Pinformation-seeking behavior of clinicians may vary in relation to their role and the way in which the information is presented. Studying these behaviors can provide valuable insights to those tasked with maintaining information retrieval systems' links to appropriate online knowledge resources.

  13. La diffusion spatiale des technologies de l'information géographique en France

    Directory of Open Access Journals (Sweden)

    Stéphane Roche

    1999-03-01

    Full Text Available La diffusion des technologies de l'information géographique sur le territoire français s'inscrit dans les modèles classiques «centre-périphérie» de diffusion des innovations technologiques. Pourtant, au-delà de ces grandes dynamiques nationales, la distribution spatiale des TIG reflète les caractéristiques institutionnelles, culturelles et spatiales spécifiques d'un secteur géomatique en plein développement.

  14. What information on measurement uncertainty should be communicated to clinicians, and how?

    Science.gov (United States)

    Plebani, Mario; Sciacovelli, Laura; Bernardi, Daniela; Aita, Ada; Antonelli, Giorgia; Padoan, Andrea

    2018-02-02

    The communication of laboratory results to physicians and the quality of reports represent fundamental requirements of the post-analytical phase in order to assure the right interpretation and utilization of laboratory information. Accordingly, the International Standard for clinical laboratories accreditation (ISO 15189) requires that "laboratory reports shall include the information necessary for the interpretation of the examination results". Measurement uncertainty (MU) is an inherent property of any quantitative measurement result which express the lack of knowledge of the true value and quantify the uncertainty of a result, incorporating the factors known to influence it. Even if the MU is not included in the report attributes of ISO 15189 and cannot be considered a post-analytical requirement, it is suggested as an information which should facilitate an appropriate interpretation of quantitative results (quantity values). Therefore, MU has two intended uses: for laboratory professionals, it gives information about the quality of measurements, providing evidence of the compliance with analytical performance characteristics; for physicians (and patients) it may help in interpretation of measurement results, especially when values are compared with reference intervals or clinical decision limits, providing objective information. Here we describe the way that MU should be added to laboratory reports in order to facilitate the interpretation of laboratory results and connecting efforts performed within laboratory to provide more accurate and reliable results with a more objective tool for their interpretation by physicians. Copyright © 2018 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  15. The discrepancy between patients and informants on clinician-rated measures in major depressive disorder: implications for clinical trials and clinical practice.

    Science.gov (United States)

    Peselow, Eric D; Karamians, Reneh; Lord, Marie; Tobia, Gabriel; IsHak, Waguih William

    2014-03-01

    Clinician-rated measures are used in clinical trials and measurement-based clinical care settings to assess baseline symptoms and treatment outcomes of major depressive disorder (MDD), with a widely held dictum that they are sufficient in assessing the patient's clinical status. In this study, we examined clinician-rated measures of depressive and global symptom severity, obtained by interviewing patients as well as informants in an attempt to examine the potential difference or similarity between these two sources of information. The sample consisted of 89 treatment seeking, DSM-IV diagnosed MDD outpatients treated between 1995 and 2004. The clinician-rated measures used included the Montgomery Åsberg Depression Rating Scale (MADRS), and the Clinical Global Impression Scale (CGI) for Severity. The scores of the clinician-rated measures collected from patients' interviews were compared with those collected from informants' interviews. Clinician-rated scores, collected by interviewing patients, were significantly higher and indicative of greater symptom severity when compared with those collected by interviewing informants. This was true for both the MADRS before (Ppractical in MDD clinical trials or everyday clinical care. The discrepancies observed between the clinician-rated scores obtained from patients and informants emphasize the importance of incorporating collateral information during the assessment and rating of depressive symptom severity in both clinical trials as well as in clinical practice.

  16. Approaches to ascertaining comorbidity information: validation of routine hospital episode data with clinician-based case note review.

    Science.gov (United States)

    Soo, Martin; Robertson, Lynn M; Ali, Tariq; Clark, Laura E; Fluck, Nicholas; Johnston, Marjorie; Marks, Angharad; Prescott, Gordon J; Smith, William Cairns S; Black, Corri

    2014-04-21

    In clinical practice, research, and increasingly health surveillance, planning and costing, there is a need for high quality information to determine comorbidity information about patients. Electronic, routinely collected healthcare data is capturing increasing amounts of clinical information as part of routine care. The aim of this study was to assess the validity of routine hospital administrative data to determine comorbidity, as compared with clinician-based case note review, in a large cohort of patients with chronic kidney disease. A validation study using record linkage. Routine hospital administrative data were compared with clinician-based case note review comorbidity data in a cohort of 3219 patients with chronic kidney disease. To assess agreement, we calculated prevalence, kappa statistic, sensitivity, specificity, positive predictive value and negative predictive value. Subgroup analyses were also performed. Median age at index date was 76.3 years, 44% were male, 67% had stage 3 chronic kidney disease and 31% had at least three comorbidities. For most comorbidities, we found a higher prevalence recorded from case notes compared with administrative data. The best agreement was found for cerebrovascular disease (κ = 0.80) ischaemic heart disease (κ = 0.63) and diabetes (κ = 0.65). Hypertension, peripheral vascular disease and dementia showed only fair agreement (κ = 0.28, 0.39, 0.38 respectively) and smoking status was found to be poorly recorded in administrative data. The patterns of prevalence across subgroups were as expected and for most comorbidities, agreement between case note and administrative data was similar. Agreement was less, however, in older ages and for those with three or more comorbidities for some conditions. This study demonstrates that hospital administrative comorbidity data compared moderately well with case note review data for cerebrovascular disease, ischaemic heart disease and diabetes, however there was

  17. Capturing sexual assault data: An information system designed by forensic clinicians and healthcare researchers.

    Science.gov (United States)

    Mukhtar, S Aqif; Smith, Debbie A; Phillips, Maureen A; Kelly, Maire C; Zilkens, Renate R; Semmens, James B

    2018-01-01

    The Sexual Assault Resource Center (SARC) in Perth, Western Australia provides free 24-hour medical, forensic, and counseling services to persons aged over 13 years following sexual assault. The aim of this research was to design a data management system that maintains accurate quality information on all sexual assault cases referred to SARC, facilitating audit and peer-reviewed research. The work to develop SARC Medical Services Clinical Information System (SARC-MSCIS) took place during 2007-2009 as a collaboration between SARC and Curtin University, Perth, Western Australia. Patient demographics, assault details, including injury documentation, and counseling sessions were identified as core data sections. A user authentication system was set up for data security. Data quality checks were incorporated to ensure high-quality data. An SARC-MSCIS was developed containing three core data sections having 427 data elements to capture patient's data. Development of the SARC-MSCIS has resulted in comprehensive capacity to support sexual assault research. Four additional projects are underway to explore both the public health and criminal justice considerations in responding to sexual violence. The data showed that 1,933 sexual assault episodes had occurred among 1881 patients between January 1, 2009 and December 31, 2015. Sexual assault patients knew the assailant as a friend, carer, acquaintance, relative, partner, or ex-partner in 70% of cases, with 16% assailants being a stranger to the patient. This project has resulted in the development of a high-quality data management system to maintain information for medical and forensic services offered by SARC. This system has also proven to be a reliable resource enabling research in the area of sexual violence.

  18. Perspectives of patients with haematological cancer on how clinicians meet their information needs: "Managing" information versus "giving" it.

    Science.gov (United States)

    Atherton, Kirsten; Young, Bridget; Kalakonda, Nagesh; Salmon, Peter

    2018-03-23

    Practitioners treating patients with haematological cancers have extensive clinical information available to give to patients, and patients need to be informed. However, many patients want to be protected from having information that is too detailed or threatening. To illuminate how practitioners can address this dilemma and help patients feel appropriately informed, we explored patients' experience of feeling informed or uninformed. Semi-structured interviews were conducted with 20 patients who had been diagnosed with haematological cancer and had recently received results from clinical investigations or from evaluations of treatment response. Inductive and interpretive analysis of the transcribed audio-recorded interviews drew on constant comparison. Patients described the need for practitioners carefully to manage the information that they provided, and many felt alarmed by information that they did not experience as having been managed for them. A few patients who had difficulty trusting practitioners were not content with the information provided. These findings can be understood using attachment theory, whereby practitioners' careful management of information demonstrates their care for patients, and patients' trust in the practitioner enables them to feel informed. It follows that, when patients do not feel informed, the solution will not necessarily be more information but might be to help patients feel more secure in a caring clinical relationship. Copyright © 2018 John Wiley & Sons, Ltd.

  19. Ensembles de donnees nationales : sources d'information sur la garde des enfants au Canada

    OpenAIRE

    Forer, Barry; Hertzman, Clyde; Kohen, Dafna

    2006-01-01

    La presente etude fournit une description des differents ensembles de donnees canadiennes qui pourraient etre utilises pour examiner des questions relatives au recours aux services de garde. Les ensembles de donnees nationales qui traitent des tendances de l'emploi, de l'emploi du temps, des revenus familiaux, du soutien social ainsi que des mesures de la sante des enfants, des adolescents et des adultes ont ete inclus. On a conclu que de nombreuses questions demeurent sans reponse en ce qui ...

  20. Le rôle de l'information en droit des entreprises en difficulté

    OpenAIRE

    Ould Eba, Moussa

    2013-01-01

    L’information est un moyen de gestion fiable et une garantie indispensable pour la protection des intérêts des acteurs de l’activité économique. Elle joue un rôle important dans la prévention et le traitement des difficultés des entreprises. En effet, à la lumière des informations comptables, financières et sociales, les dirigeants peuvent prévenir les difficultés et prendre les décisions adaptées à la situation de l’entreprise. Toutefois, en cas de procédures collectives, le besoin de protec...

  1. Etude des mécanismes d'interopérabilité des systèmes d'information ...

    African Journals Online (AJOL)

    MECHERI KARIMA

    le problème d'hétérogénéité est pallié à l'aide d'une infrastructure de ... des langages orientés objets construits à partir d‟une analyse des .... sont : le service de médiation de données, le service de médiation fonctionnelle et le service de.

  2. Effects of clinical communication interventions in hospitals: a systematic review of information and communication technology adoptions for improved communication between clinicians.

    Science.gov (United States)

    Wu, Robert C; Tran, Kim; Lo, Vivian; O'Leary, Kevin J; Morra, Dante; Quan, Sherman D; Perrier, Laure

    2012-11-01

    To conduct a systematic review of the literature to identify, describe and assess interventions of information and communication technology on the processes of communication and associated patient outcomes within hospital settings. Studies published from the years 1996 to 2010 were considered and were selected if they described an evaluation of information and communication technology interventions to improve clinical communication within hospitals. Two authors abstracted data from full text articles, and the quality of individual articles were appraised. Results of interventions were summarized by their effect. There were 18 identified studies that evaluated the use of interventions that included alphanumeric paging, hands-free communication devices, mobile phones, smartphones, task management systems and a display based paging system. Most quantitative studies used a before and after study design and were of lower quality. Of all the studies, there was only one prospective randomized study, but this study used only simulated communication events. Quantitative studies identified improved perceptions of communication and some improvement in communication metrics. Qualitative studies described improvements in efficiency of communication but also issues of loss of control and reliability. Despite the rapid advancement in information and communications technology over the last decade, there is limited evidence suggesting improvements in the ability of health professionals to communicate effectively. Given the critical nature of communication, we advocate further evaluation of information and communication technology designed to improve communication between clinicians. Outcome measures should include measures of patient-oriented outcomes and efficiency for clinicians. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  3. PUBLICATION D'INFORMATIONS SUR LES RISQUES ET COMPORTEMENT DES INVESTISSEURS : ÉTUDE EMPIRIQUE DE LA POLITIQUE D'INFORMATION DES SOCIÉTÉS FRANÇAISES

    OpenAIRE

    Ghozzi, Khaled

    2005-01-01

    International audience; Selon les travaux de Hamada (1972), Ryan (1997) et Pae (2002), l'incertitude des investisseurs sur la valeur est liée aux sources de risques sectoriels et inhérents. Depuis, peu de travaux se sont intéressées à la relation entre les informations liées aux sources de risques et le marché (Linsmeir et al 2002). Cet article place cette relation dans le cadre de la théorie de publication (Verrecchia 2001) afin d'étudier l'effet des informations liées aux sources et mécanis...

  4. The power of clinicians' affective communication: how reassurance about non-abandonment can reduce patients' physiological arousal and increase information recall in bad news consultations. An experimental study using analogue patients

    NARCIS (Netherlands)

    Sep, Milou S. C.; van Osch, Mara; van Vliet, Liesbeth M.; Smets, Ellen M. A.; Bensing, Jozien M.

    2014-01-01

    The diagnosis of incurable cancer may evoke physiological arousal in patients. Physiological arousal can negatively impact patients' recall of information provided in the medical consultation. We aim to investigate whether clinicians' affective communication during a bad news consultation will

  5. A Delphi study among internal medicine clinicians to determine which therapeutic information is essential to record in a medical record.

    Science.gov (United States)

    van Unen, Robert J; Tichelaar, Jelle; Nanayakkara, Prabath W B; van Agtmael, Michiel A; Richir, Milan C; de Vries, Theo P G M

    2015-12-01

    Several studies have demonstrated that using a template for recording general and diagnostic information in the medical record (MR) improves the completeness of MR documentation, communication between doctors, and performance of doctors. However, little is known about how therapeutic information should be structured in the MR. The aim of this study was to investigate which specific therapeutic information registrars and consultants in internal medicine consider essential to record in the MR. Therefore, we carried out a 2-round Internet Delphi study. Fifty-nine items were assessed on a 5-point scale; an item was considered important if ≥ 80% of the respondents awarded it a score of 4 or 5. In total, 26 registrars and 30 consultants in internal medicine completed both rounds of the study. Overall, they considered it essential to include information about 11 items in the MR. Subgroup analyses revealed that the registrars considered 8 additional items essential, whereas the consultants considered 1 additional item essential to record. Study findings can be used as a starting point to develop a structured section of the MR for therapeutic information for both paper and electronic MRs. This section should contain at least 11 items considered essential by registrars and clinical consultants in internal medicine. © 2015, The American College of Clinical Pharmacology.

  6. Ubiquitous Adoption of Innovative and Supportive Information and Communications Technology Across Health and Social Care Needs Education for Clinicians.

    Science.gov (United States)

    Procter, Paula M

    2017-01-01

    The paper presents the development, use and evaluation of an on-line undergraduate module delivering an academic-led programme of eHealth learning within nursing, midwifery, allied health professional and social work courses. The health information technology competency frameworks are explored along with an overview of the resulting module. The need for an academically led module will be made along with a description of the management required to maintain validity of content materials. A review of student evaluations will be presented. In conclusion the positive change in attitude and understanding of academic staff members towards health information technology through the inclusion of the module across all of the undergraduate courses will be explored.

  7. Sommaires des demandes d'accès à l'information complétées ...

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

    ... à ces demandes, veuillez envoyer un courriel à ATIP-AIPRP@crdi.ca ou écrire à l'adresse suivante: Coordonnatrice de l'accès à l'information et de la protection des renseignements personnels. Bureau du secrétaire et conseiller juridique. Centre de recherches pour le développement international 150, rue Kent CP 8500

  8. Examination of Routine Practice Patterns in the Hospital Information Data Warehouse: Use of OLAP and Rough Set Analysis with Clinician Feedback

    Science.gov (United States)

    Grant, Andrew; Grant, Gwyneth; Gagné, Jean; Blanchette, Carl; Comeau, Émilie; Brodeur, Guillaume; Dionne, Jonathon; Ayite, Alphonse; Synak, Piotr; Wroblewski, Jakub; Apanowitz, Cas

    2001-01-01

    The patient centred electronic patient record enables retrospective analysis of practice patterns as one means to assist clinicians adjust and improve their practice. An interrogation of the data-warehouse linking test use to Diagnostic Related Group (DRG) of one years data of the Sherbrooke University Hospital showed that one-third of patients used two-thirds of these diagnostic tests. Using RoughSets analysis, zones of repeated tests were demonstrated where results remained within stable limits. It was concluded that 30% of fluid and electrolyte testing was probably unnecessary. These findings led to an endorsement of changing the test request formats in the hospital information system from profiles to individual tests requiring justification.

  9. Clinicians' perceptions of organizational readiness for change in the context of clinical information system projects: insights from two cross-sectional surveys.

    Science.gov (United States)

    Paré, Guy; Sicotte, Claude; Poba-Nzaou, Placide; Balouzakis, George

    2011-02-28

    The adoption and diffusion of clinical information systems has become one of the critical benchmarks for achieving several healthcare organizational reform priorities, including home care, primary care, and integrated care networks. However, these systems are often strongly resisted by the same community that is expected to benefit from their use. Prior research has found that early perceptions and beliefs play a central role in shaping future attitudes and behaviors such as negative rumors, lack of involvement, and resistance to change. In this line of research, this paper builds on the change management and information systems literature and identifies variables associated with clinicians' early perceptions of organizational readiness for change in the specific context of clinical information system projects. Two cross-sectional surveys were conducted to test our research model. First, a questionnaire was pretested and then distributed to the future users of a mobile computing technology in 11 home care organizations. The second study took place in a large teaching hospital that had approved a budget for the acquisition of an electronic medical records system. Data analysis was performed using partial least squares. Scale items used in this study showed adequate psychometric properties. In Study 1, four of the hypothesized links in the research model were supported, with change appropriateness, organizational flexibility, vision clarity, and change efficacy explaining 75% of the variance in organizational readiness. In Study 2, four hypotheses were also supported, two of which differed from those supported in Study 1: the presence of an effective project champion and collective self-efficacy. In addition to these variables, vision clarity and change appropriateness also helped explain 75% of the variance in the dependent variable. Explanations for the similarities and differences observed in the two surveys are provided. Organizational readiness is arguably a key

  10. Le systeme d’information des reseaux de sante: la reorganisation de la medecine en e-sante

    Directory of Open Access Journals (Sweden)

    Maryline Margueritte

    2013-01-01

    Full Text Available Les réseaux de santé ont développé depuis plusieurs années des dispositifs permettant une prise en charge coordonnée des patients en France, tant sur les plans médical que médico-psycho-social et humain. Certains ont développé des dossiers de santé partagés informatisés permettant la mise en commun d’informations utiles à la coordination et à la continuité des soins. Depuis 2009 avec la réforme de l’hôpital on veut installer des modes de fonctionnement coopératifs entre les professionnels et avec les usagers du système de santé. La mise en œuvre d’un système d’information de santé pour assurer d’une part, la transversalité du processus métier avec le patient et d’autre part pouvoir mesurer les résultats médicaux et économiques de cette évolution d’un système complexe d’information. Dans ce contexte, les possibilités offertes par les technologies de l’information et de la communication (TIC permettent la mise en place d’applications favorisant une augmentation de la participation « on line » des citoyens. Le « virage ambulatoire » exporte la santé hors des murs. C’est une médecine innovante qui permet au patient de rester dans son « chez soi ». En France, ce re-engeneering repose sur quatre domaines : un dossier médical informatisé, une prise en charge collective par les professions médicales et paramédicales, une autonomisation et une mise en réseau du secteur de santé.

  11. Un système d'aide au traitement des informations de veille stratégique : concepts, méthode et résultats

    NARCIS (Netherlands)

    Rouibah, K.

    2001-01-01

    RÉSUMÉ Cette recherche s¿inscrit dans le cadre du traitement des informations fragmentaires et incertaines (IFI) de veille stratégique. Le traitement des IFI est un problème peu structuré, pour lequel il existe peu de recherches utiles aux dirigeants d¿entreprises. Devenu un axe de recherche assez

  12. 1. round table. Information and knowledge sharing; 1. table ronde - information et partage des connaissances

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-07-01

    The law from December 30, 1991, precisely defines 3 axes of researches for the management of high level and long-lived radioactive wastes: separation/transmutation, surface storage and underground disposal. A global evaluation report about these researches is to be supplied in 2006 by the French government to the Parliament. A first synthesis of the knowledge gained after 14 years of research has led the national commission of the public debate (CNDP) to organize a national debate about the general options of management of high-level and long-lived radioactive wastes before the 2006 date line. The debate comprises 4 public hearings (September 2005: Bar-le-Duc, Saint-Dizier, Pont-du-Gard, Cherbourg), 12 round-tables (October and November 2005: Paris, Joinville, Caen, Nancy, Marseille), a synthesis meeting (December 2005, Dunkerque) and a closing meeting (January 2006, Lyon). This document is the synthesis of the first round table debates about the information dissemination and the sharing of knowledge which took place at Caen. The main discussions of this session concerns the political decisions and the information of the public, and the transparency of this information as it should be in a western democracy. (J.S.)

  13. Approches par points de vue pour l’ingénierie des Systèmes d’information

    Directory of Open Access Journals (Sweden)

    Brahim Lahna

    2009-07-01

    Full Text Available Les concepts de point de vue, de rôle, de perspective et de vue ont été largement étudiés et utilisés dans de nombreux travaux, dans divers domaines de l’informatique. On retrouve ces notions dans les Systèmes de Représentation de Connaissances par Objets, les Bases de Données Orientées Objets, les Méthodes de Conception, la Programmation Orientée Objets, etc. Chaque domaine lui donne sa propre définition et l’utilise dans son propre contexte. La notion de vue se développe indépendamment dans ces différentes disciplines. Bien que les propositions différent, elles sont confrontées aux mêmes problèmes : établir des relations entre vues et garantir la cohérence des vues entre elles ou vis-à-vis d'un modèle de référence. Nous présentons dans cet article des travaux relatifs aux notions de vues et points de vue dans différentes disciplines informatiques en insistant sur une proposition originale pour une nouvelle ingénierie des systèmes d’information orientée perspectives et composants multivues réutilisables.

  14. Visualizing thesauri in the field of information retrieval; Visualisierung von Thesauri im Bereich des Information Retrieval

    Energy Technology Data Exchange (ETDEWEB)

    Riemer, J

    2007-10-09

    This thesis was written in the course of an International Atomic Energy Agency (IAEA) project aimed at visualizing the thesaurus used in the International Nuclear Information System (INIS) online database. The first part of the paper comprises a brief historical review of the development of thesauri, providing an overview of tools for categorizing knowledge and covering a spectrum from wordnets to folksonomies. The second part discusses existing strategies for displaying thesauri and explores basic considerations concerning the technical realization of visualizing a thesaurus as a Web application. A problem experienced by users when navigating through hierarchical thesauri is the quasi-standard to display word blocks in tabular form. Starting from a top term all word block terms (e.g. narrower, broader, related, forbidden terms, etc.) are listed vertically. Human perception however is much better suited to grasp relationships by spatial clustering of items within a context. The shortcoming of the tabular approach is further amplified by the widespread practise of putting the top term in alphabetical context to other top terms in order to assist navigation. However, using an alphabetical index for this purpose contradicts the paradigm of hierarchical thesauri in most cases. It is only in the domain of linguistic thesauri where the visualisation deviates from the classical tabular data view in favour of more intuitive visualisation paradigms. Yet in those cases applications always fall back on additional software that needs to be installed into the Web browser. The approach chosen in the present project tries to solve both problem areas and provides an intuitively usable visualisation technique for hierarchical thesauri which runs on any current web browser natively i.e. without any additional software needed. A considerable portion of the publication is devoted to the concrete implementation of the INIS project. Special attention is given to the methodologies and

  15. Google maps - Google entre dans le monde des systèmes d'information géographique

    OpenAIRE

    Ingensand, Jens

    2005-01-01

    Avec Google Maps, le mammouth de la recherche sur l'internet riposte aux services de cartes existants, comme Yahoo Maps, Mapquest, Map24, etc. Ces services permettent notamment de consulter des cartes présentant de multiples fonctionnalités de recherche et de visualisation d'informations. Google vient par ailleurs de lancer sur le marché Google Earth - un programme qui reproduit les données de Google Maps en trois dimensions.

  16. Engaging clinicians in health informatics projects.

    Science.gov (United States)

    Caballero Muñoz, Erika; Hullin Lucay Cossio, Carola M

    2010-01-01

    This chapter gives an educational overview of: * The importance of the engagement of clinicians within a health informatics project * Strategies required for an effective involvement of clinicians throughout a change management process within a clinical context for the implementation of a health informatics project * The critical aspects for a successful implementation of a health informatics project that involves clinicians as end users * Key factors during the administration of changes during the implementation of an informatics project for an information system in clinical practice.

  17. Data processing in gamma spectrometry. Application to the decay schemes study; Traitement des informations en spectrometrie gamma application a l'etude de schemas de desintegration

    Energy Technology Data Exchange (ETDEWEB)

    Boulanger, J P [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires, departement d' electronique generale, service d' instrumentation nucleaire

    1968-06-01

    The purpose of this thesis is the processing of the data issued from a gamma spectrometer, and its applications to the decay schemes study. The mathematical analysis of the full energy peaks, in connection with the very good resolution of semi-conductor detectors, leads to a very accurate determination of the energies. The resolution of complex spectra by the least squares method, completed by a spectra generating process, allows the calculation of branching ratios. Then, the handling of the two dimensional experiments permits the coincidence exam. For each of these methods, the calculation principle, then the systematics tests realized in order to prove their validity and to determine their application ranges as well as some experimental results appropriate to illustrate their possibilities, are presented. The energies of some nuclides, frequently used as standards have been thus measured and the decay schemes of {sup 134}Cs and {sup 110m}Ag determined precisely. (author) [French] Cette these est consacree aux methodes de traitement des informations issues d'un spectrometre {gamma}, et a leur application a l'etude des schemas de desintegration: l'analyse mathematique des pics d'absorption totale, conjuguee avec l'excellent pouvoir de resolution des detecteurs semi-conducteurs, conduit a une determination tres precise des energies. La decomposition des spectres complexes par la methode des moindres carres, completee par un procede de generation de spectres, autorise le calcul des rapports de branchement. Enfin le depouillement des experiences biparametriques permet l'examen des coincidences. Pour chacune de ces methodes, on expose le principe des calculs et les essais systematiques effectues afin d'eprouver leur validite et de definir leurs domaines d'application, ainsi que quelques resultats experimentaux propres a illustrer leurs possibilites. Les energies de quelques isotopes utilises couramment comme etalons ont ainsi ete mesurees, et les schemas de

  18. Comment comprendre la nouvelle structure d’entreprise l’impact des technologies de l’information sur les principes organisationnels (How to reveal the new enterprises structure the impact of information technologies on organisational principles)

    OpenAIRE

    Chrystelle Gaujard

    2006-01-01

    Quelles sont les conséquences de l’application des technologies de l’information et de la communication sur l’organisation et les individus ? Comment peut-on caractériser, voire vulgariser les nouveaux agencements des entreprises, suite à cette rupture technologique ? Quelles sont les clefs de la motivation des individus ? Quel type de management doit être adopté ? Dans le passé, certains gestionnaires et sociologues se sont penchés sur les difficultés et les limites de la modélisation des en...

  19. Le CERN fait equipe avec des leaders des technologies de l'information pour construire une gigantesque grille de calcul

    CERN Multimedia

    CERN Press Office. Geneva

    2001-01-01

    PR11.01 24.09.2001 CERN teams up CERN*, the European Organization for Nuclear Research, in Geneva, Switzerland announced today the creation of the CERN openlab for DataGrid applications. Three leading Information Technology firms: Enterasys Networks, Intel and KPNQwest have joined CERN to push forward this groundbreaking project in advanced distributed computing. Each company will invest 2.5 MCHF ($1.5M) over a period of 3 years to help CERN achieve its ambitious objectives.

  20. The role of technology in clinician-to-clinician communication.

    Science.gov (United States)

    McElroy, Lisa M; Ladner, Daniela P; Holl, Jane L

    2013-12-01

    Incomplete, fragmented and poorly organised communications contribute to more than half the errors that lead to adverse and sentinel events. Meanwhile, communication software and devices with expanding capabilities are rapidly proliferating and being introduced into the healthcare setting. Clinicians face a large communication burden, which has been exacerbated by the additional challenge of selecting a mode of communication. In addition to specific communication devices, some hospitals have implemented advanced technological systems to assist with communication. However, few studies have provided empirical evidence of the specific advantages and disadvantages of the different devices used for communication. Given the increasing quantities of information transmitted to and by clinicians, evaluations of how communication methods and devices can improve the quality, safety and outcomes of healthcare are needed.

  1. Primary caregivers' satisfaction with clinicians' response to them as informal carers of young people with first-episode psychosis: a qualitative study.

    Science.gov (United States)

    McCann, Terence V; Lubman, Dan I; Clark, Eileen

    2012-01-01

    To explore first-time primary caregivers' experience of the way mental health nurses and other mental health clinicians respond to them as carers of young people with first-episode psychosis. Caregivers have a key role in supporting family members/relatives with mental illness, but their contribution is undervalued frequently by mental health nurses and other mental health clinicians. Design.  Qualitative interpretative phenomenological analysis. A qualitative interpretative design was undertaken, using semi-structured, audio-recorded interviews. Twenty primary caregivers were recruited through Orygen Youth Health, a first-episode psychosis centre in Melbourne. Interpretative phenomenological analysis was used to identify themes in the data. Two competing themes were identified in the data, highlighting caregivers' contrasting experience with mental health nurses and other mental health clinicians. First, most clinical staff were approachable and supportive. Second, several carers felt their contribution was undervalued by some clinical staff. This was as a consequence of being excluded from clinical deliberations because of clinical staffs' concerns and young people's requests about maintaining confidentiality regarding treatment, as well as carers feeling their role was not taken seriously by clinical staff. First-time primary carers have positive and negative experiences with first-episode psychosis mental health nurses and other clinicians, and these competing events are interrelated. Experiences are affected directly by the manner they are treated by clinical staff and this may, in turn, affect carers' commitment to caring, the way they engage with clinical staff on subsequent occasions and towards the first-episode psychosis service generally. Greater appreciation is needed of the contribution, experience and difficulties caregivers encounter in their role and in engaging with mental health nurses and other clinicians. Additional training is required for

  2. Mutations des métiers de l'information-documentation : vers l'émergence d'une culture de l'information numérique

    OpenAIRE

    Thiault , Florence

    2012-01-01

    National audience; Les sciences de l'information s'intéressent plus particulièrement à la construction des systèmes d'information, leurs usages et à la diffusion des savoirs par les moyens technologiques. L'inscription dans cette discipline des professions documentaires enrichit le cadre explicatif d'activités de nature technique. Les documents se sont diversifiés, la documentation est devenue un ensemble complexe de processus, reposant sur les anciennes méthodes bibliothéconomiques, mais int...

  3. Grappes des technologies de l'information et de la communication ...

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

    La Fundación Comisión Asesora de Alta Tecnología (CAATEC) du Costa Rica dirigera le projet et collaborera avec une équipe de chercheurs locaux en Argentine et en Uruguay. La section des affaires communautaires de Microsoft cofinance le projet par l'entremise de sa contribution à telecentre.org, un projet antérieur.

  4. Tentative d'évaluation du systéme d'information marketing au niveau des banques publiques Algériennes

    OpenAIRE

    Hassaine-kazi-tani, Amel

    2014-01-01

    Le premier chapitre présente les fondements théoriques relatifs au marketing, marketing des services et notamment le marketing bancaire.dans le deuxiéme chapitre seront développées les notions de base du concept d'information et celui de systéme d'information et puis le systéme d'information marketing.le troisiéme chapitre pratique présente une étude de cas auprés des banques publiques Algériennes.

  5. Sommaires des demandes d'accès à l'information complétées en 2016

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

    Liste de tous les contrats émis par le Centre de recherches pour le développement international durant la période du 1er avril 2015 au 31 mars 2016, y compris a) les noms des fournisseurs; b) les numéros de référence des contrats; c) les dates des contrats; d) la description des services fournis; e) les dates de livraison; ...

  6. The power of clinicians' affective communication: how reassurance about non-abandonment can reduce patients' physiological arousal and increase information recall in bad news consultations. An experimental study using analogue patients.

    Science.gov (United States)

    Sep, Milou S C; van Osch, Mara; van Vliet, Liesbeth M; Smets, Ellen M A; Bensing, Jozien M

    2014-04-01

    The diagnosis of incurable cancer may evoke physiological arousal in patients. Physiological arousal can negatively impact patients' recall of information provided in the medical consultation. We aim to investigate whether clinicians' affective communication during a bad news consultation will decrease patients' physiological arousal and will improve recall. Healthy women (N=50), acting as analogue patients, were randomly assigned to watch one out of the two versions of a scripted video-vignette of a bad news consultation in which clinician's communication differed: standard vs. affective communication. Participants' skin conductance levels were obtained during video-watching, and afterwards their recall was assessed. While the diagnosis increased skin conductance levels in all analogue patients, skin conductance levels during the remainder of the consultation decreased more in the affective communication condition than in the standard condition. Analogue patients' recall was significantly higher in the affective condition. Breaking bad news evokes physiological arousal. Affective communication can decrease this evoked physiological arousal and might be partly responsible for analogue patients' enhanced information recall. Although our findings need to be translated to clinical patients, they suggest that clinicians need to deal with patients' emotions before providing additional medical information. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  7. A Comparison of Participation Patterns in Selected Formal, Non-formal, and Informal Online Learning Environments / Comparaison des modes de participation dans des environnements formels, non formels et informels d'apprentissage en ligne

    Directory of Open Access Journals (Sweden)

    Richard Schwier

    2012-11-01

    Full Text Available Does learner participation vary depending on the learning context? Are there characteristic features of participation evident in formal, non-formal, and informal online learning environments? Six online learning environments were chosen as epitomes of formal, non-formal, and informal learning contexts and compared. Transcripts of online discussions were analyzed and compared employing Transcript Analysis Tools for measures of density, intensity, and reciprocity of participation (Fahy, Crawford, & Ally, 2001, and mean reply depth (Wiley, n.d.. This paper provides an initial description and comparison of participation patterns in a formal, non-formal, and informal learning environment, and discusses the significance of differences observed. La participation des apprenants varie-t-elle en fonction du contexte d'apprentissage? Existe-t-il des caractéristiques de participation spécifiques aux environnements formels, non formels et informels d'apprentissage en ligne? Six environnements d'apprentissage en ligne ont été sélectionnés pour illustrer les contextes formels, non formels et informels d'apprentissage et ont été comparés. Les transcriptions des discussions en ligne ont été analysées et comparées à l’aide des Transcript Analysis Tools pour mesurer la densité, l'intensité et la réciprocité de la participation (Fahy, Crawford, et Ally, 2001, ainsi que la profondeur moyenne de réponse (John Wiley & Sons, nd. Cet article décrit et compare les modes de participation dans un environnement formel, non formel et informel d'apprentissage, et discute la portée des différences observées.

  8. Data processing in gamma spectrometry. Application to the decay schemes study; Traitement des informations en spectrometrie gamma application a l'etude de schemas de desintegration

    Energy Technology Data Exchange (ETDEWEB)

    Boulanger, J.P. [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires, departement d' electronique generale, service d' instrumentation nucleaire

    1968-06-01

    The purpose of this thesis is the processing of the data issued from a gamma spectrometer, and its applications to the decay schemes study. The mathematical analysis of the full energy peaks, in connection with the very good resolution of semi-conductor detectors, leads to a very accurate determination of the energies. The resolution of complex spectra by the least squares method, completed by a spectra generating process, allows the calculation of branching ratios. Then, the handling of the two dimensional experiments permits the coincidence exam. For each of these methods, the calculation principle, then the systematics tests realized in order to prove their validity and to determine their application ranges as well as some experimental results appropriate to illustrate their possibilities, are presented. The energies of some nuclides, frequently used as standards have been thus measured and the decay schemes of {sup 134}Cs and {sup 110m}Ag determined precisely. (author) [French] Cette these est consacree aux methodes de traitement des informations issues d'un spectrometre {gamma}, et a leur application a l'etude des schemas de desintegration: l'analyse mathematique des pics d'absorption totale, conjuguee avec l'excellent pouvoir de resolution des detecteurs semi-conducteurs, conduit a une determination tres precise des energies. La decomposition des spectres complexes par la methode des moindres carres, completee par un procede de generation de spectres, autorise le calcul des rapports de branchement. Enfin le depouillement des experiences biparametriques permet l'examen des coincidences. Pour chacune de ces methodes, on expose le principe des calculs et les essais systematiques effectues afin d'eprouver leur validite et de definir leurs domaines d'application, ainsi que quelques resultats experimentaux propres a illustrer leurs possibilites. Les energies de quelques isotopes utilises couramment comme etalons ont ainsi ete

  9. Des Connaissances Aux Politiques

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

    Les synergies ont été mises en commun au fur et à mesure des progrès de la recherche. .... Recherche normative (sur le rôle et la performance des institutions .... Système national d'information sur la gestion environnementale connecté à 19 ...... Un fort contrôle centralisé sur l'élaboration des politiques nationales peut ...

  10. Rapport d’étape – Le Système canadien hospitalier d’information et de recherche en prévention des traumatismes : un système de surveillance des blessures dynamique et novateur

    Directory of Open Access Journals (Sweden)

    J. Crain

    2016-01-01

    Full Text Available Ce rapport d’étape sur le Système canadien hospitalier d’information et de recherche en prévention des traumatismes (SCHIRPT, un système de surveillance des blessures et des empoisonnements utilisé par les services d’urgence, décrit le résultat de la migration d’un processus d’entrée et de codage des données centralisé vers le processus décentralisé de l’eSCHIRPT, réalisée en 2011. Ce système sécurisé accroît la souplesse et la rapidité globales du SCHIRPT, attributs clés d’un système de surveillance efficace. La plate-forme intégrée de l’eSCHIRPT permet une entrée de données et un accès aux données en temps quasi réel, comprend des outils conviviaux de gestion et d’analyse des données et facilite la communication et la connectivité au sein du réseau du SCHIRPT grâce à un centre de collaboration en ligne. L’essai pilote mené actuellement sur les outils automatisés de contrôle de données et d’analyse des tendances – destinés à surveiller et à mettre en évidence les données d’entrée à partir de critères prédéfinis (par exemple un nouveau produit de consommation – révèle le potentiel de détection rapide des nouveaux dangers, enjeux et tendances que possède l’eSCHIRPT.

  11. DES-ncRNA: A knowledgebase for exploring information about human micro and long noncoding RNAs based on literature-mining

    KAUST Repository

    Salhi, Adil

    2017-04-07

    Noncoding RNAs (ncRNAs), particularly microRNAs (miRNAs) and long ncRNAs (lncRNAs), are important players in diseases and emerge as novel drug targets. Thus, unraveling the relationships between ncRNAs and other biomedical entities in cells are critical for better understanding ncRNA roles that may eventually help develop their use in medicine. To support ncRNA research and facilitate retrieval of relevant information regarding miRNAs and lncRNAs from the plethora of published ncRNA-related research, we developed DES-ncRNA ( www.cbrc.kaust.edu.sa/des_ncrna ). DES-ncRNA is a knowledgebase containing text- and data-mined information from public scientific literature and other public resources. Exploration of mined information is enabled through terms and pairs of terms from 19 topic-specific dictionaries including, for example, antibiotics, toxins, drugs, enzymes, mutations, pathways, human genes and proteins, drug indications and side effects, mutations, diseases, etc. DES-ncRNA contains approximately 878,000 associations of terms from these dictionaries of which 36,222 (5,373) are with regards to miRNAs (lncRNAs). We provide several ways to explore information regarding ncRNAs to users including controlled generation of association networks as well as hypotheses generation. We show an example how DES-ncRNA can aid research on Alzheimer\\'s disease and suggest potential therapeutic role for Fasudil. DES-ncRNA is a powerful tool that can be used on its own or as a complement to the existing resources, to support research in human ncRNA. To our knowledge, this is the only knowledgebase dedicated to human miRNAs and lncRNAs derived primarily through literature-mining enabling exploration of a broad spectrum of associated biomedical entities, not paralleled by any other resource.

  12. DES-ncRNA: A knowledgebase for exploring information about human micro and long noncoding RNAs based on literature-mining

    KAUST Repository

    Salhi, Adil; Essack, Magbubah; Alam, Tanvir; Bajic, Vladan P.; Ma, Lina; Radovanovic, Aleksandar; Marchand, Benoit; Schmeier, Sebastian; Zhang, Zhang; Bajic, Vladimir B.

    2017-01-01

    Noncoding RNAs (ncRNAs), particularly microRNAs (miRNAs) and long ncRNAs (lncRNAs), are important players in diseases and emerge as novel drug targets. Thus, unraveling the relationships between ncRNAs and other biomedical entities in cells are critical for better understanding ncRNA roles that may eventually help develop their use in medicine. To support ncRNA research and facilitate retrieval of relevant information regarding miRNAs and lncRNAs from the plethora of published ncRNA-related research, we developed DES-ncRNA ( www.cbrc.kaust.edu.sa/des_ncrna ). DES-ncRNA is a knowledgebase containing text- and data-mined information from public scientific literature and other public resources. Exploration of mined information is enabled through terms and pairs of terms from 19 topic-specific dictionaries including, for example, antibiotics, toxins, drugs, enzymes, mutations, pathways, human genes and proteins, drug indications and side effects, mutations, diseases, etc. DES-ncRNA contains approximately 878,000 associations of terms from these dictionaries of which 36,222 (5,373) are with regards to miRNAs (lncRNAs). We provide several ways to explore information regarding ncRNAs to users including controlled generation of association networks as well as hypotheses generation. We show an example how DES-ncRNA can aid research on Alzheimer's disease and suggest potential therapeutic role for Fasudil. DES-ncRNA is a powerful tool that can be used on its own or as a complement to the existing resources, to support research in human ncRNA. To our knowledge, this is the only knowledgebase dedicated to human miRNAs and lncRNAs derived primarily through literature-mining enabling exploration of a broad spectrum of associated biomedical entities, not paralleled by any other resource.

  13. DES-ncRNA: A knowledgebase for exploring information about human micro and long noncoding RNAs based on literature-mining.

    Science.gov (United States)

    Salhi, Adil; Essack, Magbubah; Alam, Tanvir; Bajic, Vladan P; Ma, Lina; Radovanovic, Aleksandar; Marchand, Benoit; Schmeier, Sebastian; Zhang, Zhang; Bajic, Vladimir B

    2017-07-03

    Noncoding RNAs (ncRNAs), particularly microRNAs (miRNAs) and long ncRNAs (lncRNAs), are important players in diseases and emerge as novel drug targets. Thus, unraveling the relationships between ncRNAs and other biomedical entities in cells are critical for better understanding ncRNA roles that may eventually help develop their use in medicine. To support ncRNA research and facilitate retrieval of relevant information regarding miRNAs and lncRNAs from the plethora of published ncRNA-related research, we developed DES-ncRNA ( www.cbrc.kaust.edu.sa/des_ncrna ). DES-ncRNA is a knowledgebase containing text- and data-mined information from public scientific literature and other public resources. Exploration of mined information is enabled through terms and pairs of terms from 19 topic-specific dictionaries including, for example, antibiotics, toxins, drugs, enzymes, mutations, pathways, human genes and proteins, drug indications and side effects, mutations, diseases, etc. DES-ncRNA contains approximately 878,000 associations of terms from these dictionaries of which 36,222 (5,373) are with regards to miRNAs (lncRNAs). We provide several ways to explore information regarding ncRNAs to users including controlled generation of association networks as well as hypotheses generation. We show an example how DES-ncRNA can aid research on Alzheimer disease and suggest potential therapeutic role for Fasudil. DES-ncRNA is a powerful tool that can be used on its own or as a complement to the existing resources, to support research in human ncRNA. To our knowledge, this is the only knowledgebase dedicated to human miRNAs and lncRNAs derived primarily through literature-mining enabling exploration of a broad spectrum of associated biomedical entities, not paralleled by any other resource.

  14. « Société de l'information », deuxième époque ? Transformation du statut de l'usage des TIC au travers des nouvelles propriétés des objets communicants

    OpenAIRE

    Weygand, Félix

    2007-01-01

    Notre contribution présente brièvement ce qu'on décrit actuellement comme de nouvelles ruptures techniques en cours dans les TIC. Il s'agira d'une part de repérer les « effets de mode » contenus dans ces descriptions, qui reprennent des appréhensions ou des enthousiasmes récurrents dès que l'on est confronté à des ruptures techniques, d'autre part de s'interroger sur la pertinence de nos outils d'analyse des innovations face à ces éventuelles ruptures. En effet, indépendamment de l'opinion op...

  15. La Rivière Seudre: intégration des données relatives à la qualité des eaux dans un système d'information géographique

    OpenAIRE

    Giraud, Sophie

    1999-01-01

    Dans le cadre d'un stage de D.E.S.S. effectué à l'IFREMER La Tremblade, j'ai mis en forme un cenains nombre de données environnementales dans un S.I.G. Ces informations concernaient: l'agriculture, l'ostréiculture, la qualité de l'eau, les réseaux de suivi IFREMER, les stations d'épuration etc ... Pour recueillir ces informations, j'ai contacté les administrations décentralisées de l'Etat, et d'autres organismes. L'état des lieux du bassin versant de la Seudre et la structuration des informat...

  16. Optimal management of the power distribution network. A novel network information system; Optimale Verwaltung des Versorgungsnetzes. Ein neues Netzinformationssystem

    Energy Technology Data Exchange (ETDEWEB)

    Kiesel, U. [HEW AG, Hamburg (Germany); Korri, P. [Tekla Qyj, Eschborn (Germany). Energieversorgung

    2000-12-01

    In June 200, the German electric utility Hamburgische Electricitaets-Werke AG (HEW) has bought and installed a high-performance, PC-based information system for all purposes of distribution network management tasks for their medium and low-voltage grids. The standard software Xpower of the Finnish software house Tekla Oyj has been streamlined with the requirements of the utility and is described with respect to the applications on site. (orig./CB) [German] Mit der Einfuehrung eines Netzinformationssystems (NIS) steht der Hamburgischen Electricitaets-Werke AG (HEW) seit Juni 2000 ein leistungsstarkes PC-basiertes Informationssystem zur Verfuegung, das langfristig die Projektierung und die Betriebsfuehrung der Mittel- und Niederspannungsnetze unterstuetzt und dokumentiert. Die Standardsoftware Xpower des finnischen Spezialisten Tekla Oyj wurde an die Anforderungen der HEW angepasst. (orig./CB)

  17. Crytosystem Program Planning for Securing Data/Information of the Results of Research and Development using Triple DES Algorithm

    International Nuclear Information System (INIS)

    Tumpal P; Naga, Dali S.; David

    2004-01-01

    This software is a cryptosystem that uses triple DES algorithm and uses ECB (Electronic Code Book) mode. This cryptosystem can send a file with any extension whether it is encrypted or not, encrypt the data that representing the picture of bitmap file or text, as well as view the calculation that can be written. Triple DES is an efficient and effective developments of DES because same algorithm but the three times repeated operation causing the key become 168 bit from 56 bit. (author)

  18. Agent des systèmes d'information financière (h/f) | CRDI - Centre de ...

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

    Répondre directement aux demandes des utilisateurs formulées par courriel ou par téléphone ou par l'entremise du système de gestion des appels de dépannage. Communiquer au besoin avec les fournisseurs de logiciels et le personnel responsable des TI pour régler les problèmes rencontrés par les utilisateurs finaux ...

  19. L'inégalité des sexes et la révolution de l'information en Afrique

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

    La prise en compte des femmes dans la politique des pays africains sur les ..... les stratégies visant à intégrer l'égalité des sexes dans les politiques africaines sur les TIC, .... À son avis, les entreprises de télécommunications devraient créer une ...... de vulgarisation agricole doivent former et recruter davantage de femmes.

  20. Transthoracic Ultrasonography for Clinicians

    Directory of Open Access Journals (Sweden)

    Morné Johan Vorster

    2015-04-01

    Full Text Available Transthoracic ultrasonography (US has become an essential tool for respiratory, emergency, and critical care physicians. It can be performed with basic equipment and by personnel with minimum training as a modality for the evaluation of a wide range of thoracic pathologies. Its advantages include immediate application at the point of care, low cost, and lack of radiation. The main indications for transthoracic US are the qualitative and quantitative assessment of pleural effusions, pleural thickening, diaphragmatic pathology, as well as chest wall and pleural tumors. Transthoracic US is also useful in visualizing pulmonary pathologies that abut the pleura, such as pneumonic consolidation and interstitial syndromes, including pulmonary edema. Transthoracic US is more sensitive than the traditional chest radiograph in the detection of pneumothoraces, and it is useful in diagnosing skeletal abnormalities such as rib fractures. It is the ideal tool to guide transthoracic procedures, including thoracocentesis and pleural biopsy. Moreover, transthoracic US-guided procedures can be performed by a single clinician with no sedation and minimal monitoring. Transthoracic US-guided fine needle aspiration and/or cutting needle biopsy of extrathoracic lymph nodes and lesions arising from the chest wall, pleura, peripheral lung, and mediastinum are safe to perform and have a high yield in the of hands of experienced clinicians. Transthoracic US can also potentially guide the aspiration and biopsy of diffuse pulmonary infiltrates, consolidations, and lung abscesses. Moreover, transthoracic US may be used in the detection of pulmonary embolism

  1. Disseminating effective clinician communication techniques: Engaging clinicians to want to learn how to engage patients.

    Science.gov (United States)

    Pollak, Kathryn I; Back, Anthony L; Tulsky, James A

    2017-10-01

    Patient-clinician communication that promotes patient engagement enhances health care quality. Yet, disseminating effective communication interventions to practicing clinicians remains challenging. Current methods do not have large and sustainable effects. In this paper, we argue that both top-down approaches (mandated by institutions) should be coupled with bottom-up approaches that address clinician motivation, confidence, and barriers. We need to engage clinicians in the same way we ask them to engage patients - strategically and with empathy. We discuss potentially innovative strategies to integrate top-down and bottom-up approaches in ways that fit clinicians' busy schedules and can inform policy. Copyright © 2017. Published by Elsevier B.V.

  2. Renforcement des systèmes d'information nationaux sur la ...

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

    Nommée Health Research Web (HRWeb), cette source d'information ... Building National Health Research Information System - COHRED : health research web; final ... A new website and resource library will help improve developing country ...

  3. 'Learning Organizations': a clinician's primer.

    Science.gov (United States)

    O'Connor, Nick; Kotze, Beth

    2008-06-01

    Most clinicians are poorly informed in relation to the key concepts of organizational learning. Yet the paradigm may offer clinicians a powerful method for using their knowledge and skills to respond to the demands of a changing environment through experimentation and learning. The concept is critically examined. Organizational learning principles are presented, including a conceptual framework for assessing health services as Learning Organizations. Barriers to organizational learning and strategies to overcome these are discussed. The seminal works of Argyris and Senge are reviewed and a framework for assessing organizational learning in health services is proposed. Current area health service actions are evaluated against the 'diagnostic' framework for a Learning Organization. Although critical examination reveals a poor empirical basis for the concept, the metaphor of the Learning Organization provides a useful conceptual framework and tools for individuals and organizations to apply in developing knowledge and effecting change. The Clinical Practice Improvement and Root Cause Analysis programs being conducted across NSW area health services meet the criteria for effective organizational learning. Key concepts from organizational learning theory provide a diagnostic framework for evaluating area health services as Learning Organizations and support two current strategies for overcoming barriers to organizational learning.

  4. Turning attention to clinician engagement in Victoria.

    Science.gov (United States)

    Jorm, Christine; Hudson, Robyn; Wallace, Euan

    2017-11-16

    The engagement of clinicians with employing organisations and with the broader health system results in better safer care for patients. Concerns about the adequacy of clinician engagement in the state of Victoria led the Victorian Department of Health and Human Services to commission a scoping study. During this investigation more than 100 clinicians were spoken with and 1800 responded to surveys. The result was creation of a clear picture of what engagement and disengagement looked like at all levels - from the clinical microsystem to state health policy making. Multiple interventions are possible to enhance clinician engagement and thus the care of future patients. A framework was developed to guide future Victorian work with four elements: setting the agenda, informing, involving and empowering clinicians. Concepts of work or employee engagement that are used in other industries don't directly translate to healthcare and thus the definition of engagement chosen for use centred on involvement. This was designed to encourage system managers to ensure clinicians are full participants in design, planning and evaluation and in all decisions that affect them and their patients.

  5. Statistical treatment of data. Application to nuclear electronics; Traitement des informations en regime statistique. Applications a l'electronique nucleaire

    Energy Technology Data Exchange (ETDEWEB)

    Sicard, F [Commissariat a l' Energie Atomique, Saclay (France).Centre d' Etudes Nucleaires

    1960-07-01

    In this report the data of probability calculations are applied to the analyses of counting losses in experiments on chance events encountered in nuclear physics. The distribution of time intervals according to Poisson's law is studied and various applications of this are given: calculation of counting losses on a scale preceded by a fast de-multiplying circuit, decrease of the counting rate on the multichannel selectors, recording of statistical distribution phenomena on magnetic bands. (author) [French] Ce rapport applique les donnees du calcul des probabilites a l'analyse des pertes de comptage dans les experiences sur des evenements aleatoires rencontres en physique nucleaire. La distribution des intervalles de temps suivant une loi de Poisson est etudiee et differentes applications en sont donnees: calcul des pertes de comptage sur une echelle precedee d'un circuit de demultiplication rapide, diminution du taux de comptage sur les selecteurs multicanaux, enregistrement de phenomenes a distribution statistique sur bandes magnetiques. (auteur)

  6. Dental Encounter System (DES)

    Data.gov (United States)

    Department of Veterans Affairs — Dental Encounter System (DES) is an automated health care application designed to capture critical data about the operations of VA Dental Services. Information on...

  7. De l'Exploitation des liens hypertexte en recherche d'information ...

    African Journals Online (AJOL)

    Using The Hypertext links Within The Information retrieval. This paper discusses different approachs of the Information Serching using the hypertext structure of the items constituting one collection (web pages for instance) in addition to the analysis of their text content. Our purpose is to test the action of the use of Hypertext ...

  8. L'Apport des Nouvelles Technologies de l'Information et de la ...

    African Journals Online (AJOL)

    25 oct. 2016 ... Nowadays, new information and communication technologies (NICTs) ... 2Senior Lecturer, Audiovisual Translation and Computer Assisted Translation, ASTI, University of ... touche les produits et services en ligne (Internet).

  9. IQM-Reifegradmodell für die Bewertung und Verbesserung des Information Lifecycle Management Prozesses

    Science.gov (United States)

    Baškarada, Saša; Gebauer, Marcus; Koronios, Andy; Gao, Jing

    Heutige Organisationen produzieren und speichern mehr Informationen als je zuvor. Der resultierende Informationsüberfluss, zusammen mit einem Mangel an Qualitätssicherung für das Information Lifecycle Management, führt zu einem unsicheren Status der Informationsqualität in vielen Organisationen. Weiterhin hat sich herausgestellt, dass das Bewerten, Verbessern und Steuern der Informationsqualität ein offenkundig schwieriges Unterfangen ist. Dieses Kapitel stellt ein Modell zur Bewertung und Verbesserung der Information Quality Management Capability Maturity (IQM-Reifegrad) vor. Es wird ein Satz von Kriterien vorgestellt, der aus Literaturrecherche und Fallstudien abgeleitet wurde. Die Reifegradindikatoren werden validiert und in einem mehrstufigen Reifegradmodell durch eine Delphi-Studie gruppiert. Das abgeleitete IQM-Reifegradmodell hilft Organisationen ihre bestehenden Praktiken im IQM zu bewerten und potentielle Lücken und Verbesserungsstrategien zu ermitteln.

  10. Guidelines for patient information in nuclear medicine;Guide pour l'information des patients en medecine nucleaire

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    2010-02-15

    This guide for patients information in nuclear medicine is organised in the following manner: what is a medical examination in nuclear medicine, the preparation and the duration of the examination, the possible risks and the radiation doses, pregnancy, delayed menstruation and nursing and what to do after the examination. (N.C.)

  11. Personalized Information Service for Clinicians: Users Like It. A Review of: Jerome, Rebecca N., Nunzia Bettinsoli Giuse, S. Trent Rosenbloom, and Patrick G. Arbogast. “Exploring Clinician Adoption of a Novel Evidence Request Feature in an Electronic Medical Record System.” Journal of the Medical Library Association 96.1 (Jan. 2008: 34-41, with online appendices.

    Directory of Open Access Journals (Sweden)

    Gale G. Hannigan

    2008-09-01

    Full Text Available Objective – To examine physician use of an Evidence-Based Medicine (EBM literature request service available to clinicians through the institution’s electronic medical record system (EMR. Specifically, the authors posed the following questions: 1 Did newly implemented marketing and communication strategies increase physicians’ use of the service? 2 How did clinicians rate the relevance of the information provided? 3 How was the information provided used and shared? Design – Ten-month, prospective, observational study employing a questionnaire, statistics, a focus group, and a “before and after marketing intervention” analysis.Setting – Adult primary care outpatient clinic in an academic medical centre.Subjects – Forty-eight attending and 89 resident physicians.Methods – In 2003, a new service was introduced that allowed physicians in the Adult Primary Care Center clinic to request evidence summaries from the library regarding complex clinical questions. Contact with the library was through the secure messaging feature of the institution’s electronic medical record (EMR. From March through July 2005, the librarian employed “standard” publicity methods (email, flyers, posters, demonstrations to promote the service. A focus group in July 2005 provided feedback about the service as well as recommendations about communicating its availability and utility. New communication methods were implemented, including a monthly electronic “current awareness” newsletter, more frequent visits by the librarian during resident clinic hours, and collaborations between the librarian and residents preparing for morning report presentations. At the end of the study period, a 25-item Web-based questionnaire was sent to the 137 physicians with access to the service. Main Results – During the 10-month study period, 23 unique users submitted a total of 45 questions to the EBM Literature RequestService. More questions were from attending

  12. Commerce et système d'information : le cas des vendeurs de ...

    African Journals Online (AJOL)

    This paper seeks to establish the impact of information and communication technologies (ICTs) on the trade in wrapper cloth in Brazzaville, Congo. The study focused on access, use and impact and concluding that the level of access is low in general and for men and women taken separately, although men have more ...

  13. Clinicians and journalists responding to disasters.

    Science.gov (United States)

    Newman, Elana; Shapiro, Bruce

    2014-02-01

    Mass casualty events pose dilemmas for community clinicians, often challenging their existing clinical toolkits. However, few clinicians were trained to be experts in explaining the unfolding events to the community, creating resources, and interacting with journalists. The objective of this article is to explain knowledge, skills, and attitudes that mental health professionals need to consider when working with journalists, especially those covering children affected by disaster. In service of these objectives, this article reviews controversies, evidence, and best practices to facilitate effective collaborations and consultations with journalists. Advice includes information on how to be a good source to journalists. Clinicians can ethically and effectively help journalists tell accurate and compelling stories about the psychological effects of disasters when they understand and respect the aims, culture, and ethics of journalism.

  14. Outil d'évaluation de l'application des lois sur l'accès à l'information ...

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

    Des essais pilotes de l'IAT ont été réalisés en Afrique du Sud, au Bangladesh et au Mexique, avec l'appui de la Fondation William et Flora Hewlett. Ce financement permettra de réaliser d'autres essais dans jusqu'à sept pays, y compris les trois pays pilotes. Dans les sept pays, on fera appel au commissaire à l'information ...

  15. Clinicians' Knowledge and Perception of Telemedicine Technology.

    Science.gov (United States)

    Ayatollahi, Haleh; Sarabi, Fatemeh Zahra Pourfard; Langarizadeh, Mostafa

    2015-01-01

    Telemedicine is an application of information and communication technology in the healthcare environment. This study aimed to compare knowledge and perceptions of telemedicine technology among different groups of clinicians. This survey study was conducted in 2013. The potential participants included 532 clinicians who worked in two hospitals and three clinics in a northern province of Iran. Data were collected using a five-point Likert-scale questionnaire. The content validity of the questionnaire was checked, and the reliability was calculated using Cronbach's alpha coefficient (α = 0.73). The results showed that most of the clinicians (96.1 percent) had little knowledge about telemedicine. They perceived the advantages of telemedicine at a moderate level and its disadvantages at a low level. The knowledge of dentists about this technology was less than that of other groups, and as a result they were less positive about the advantages of telemedicine compared to nurses, general physicians, and specialists. The limited knowledge of clinicians about telemedicine seems to have influenced their perceptions of the technology. Therefore, providing healthcare professionals with more information about new technologies in healthcare, such as telemedicine, can help to gain a more realistic picture of their perceptions.

  16. Adoption obligatoire des IFRS et asymétrie d’information dans le contexte français : effet modérateur de l’endettement

    Directory of Open Access Journals (Sweden)

    Hela Turki

    2017-03-01

    Full Text Available Cette étude examine les bienfaits de la décision d’imposition des IFRS sur la qualité informationnelle des chiffres comptables publiés. En appréhendant cette qualité par l’asymétrie d’information et en s’intéressant au contexte français, les résultats montrent que l’adoption obligatoire des IFRS a réduit significativement le coût de capital ainsi que l’erreur et la dispersion des prévisions des analystes financiers, ceci permet de déduire que la pertinence informationnelle des chiffres comptables s’est améliorée après l’application des ces normes. En examinant aussi l’effet modérateur de l’endettement, cette étude montre que l’adoption obligatoire des IFRS est plus bénéfique dans les entreprises les plus endettées.

  17. Photonique des Morphos

    CERN Document Server

    Berthier, Serge

    2010-01-01

    La photonique est déjà présente dans notre vie quotidienne, et on attend maintenant que la manipulation des photons permette aussi le traitement logique des informations. Cependant, l’élément de base qui permet cette manipulation de la lumière, le cristal photonique, est d’une réalisation complexe et mal contrôlée. Dans la course à la maîtrise de la lumière, les structures photoniques naturelles ont beaucoup à nous apprendre. C’est ce que nous montre Serge Berthier qui étudie dans ce livre la structure des écailles des Morphos. Tenant compte de l’essor récent des approches biomimétiques, il présente de manière détaillée plus de dix-huit techniques expérimentales utilisées pour ses analyses, ainsi que les diverses approches théoriques développées pour la modélisation de structures multi-échelles complexes. Première étude quasi-exhaustive des structures fines d’un genre et des propriétés optiques ainsi que colorimétriques générées, ce livre fournit aux entomologiste...

  18. Information processing in the deregulated market. Consequences of competition for gas utilities; Informationsverarbeitung im liberalisierten Markt. Konsequenzen des Wettbewerbs fuer Gasversorgungsunternehmen

    Energy Technology Data Exchange (ETDEWEB)

    Roeckerath, M. [Rhenag Rheinische Energie AG, Koeln (Germany)

    2001-11-01

    The liberation of the gas market gives rise to a fundamental rearrangement of the utilities companies information processing, accompanied by important changes in the organisational structures and processes of the enterprises. The application of new technologies, new contract management and changes in the enterprises product spectrum, as well as far-reaching changes in controlling, necessitate immediate action, while at the same time exploiting the opportunities presented by the Internet. (orig.) [German] Die Liberalisierung des Gasmarktes fuehrt zu einem grundlegenden Revirement in der Informationsverarbeitung der Versorgungsunternehmen, die begleitet wird von erheblichen Aenderungen in der Aufbau- und Ablauforganisation der Unternehmen. Der Einsatz neuer Techniken, ein neues Vertragsmanagement und eine geaenderte Produktpalette der Unternehmen sowie weitgehende Aenderungen im Controlling machen ein umgehendes Handeln dringend erforderlich, wobei gleichzeitig die Chancen des Internets zu wahren sind. (orig.)

  19. Clinicians completion rate of radiology request card in a Nigerian ...

    African Journals Online (AJOL)

    The importance of adequately completing the radiology request card by the clinicians, in management of patient cannot be overemphasized. Omission of information on the request card may lead to reporting error. This study investigated the compliance rate of filling the radiology request card by clinicians received in a ...

  20. Dimensions of personality: clinicians' perspectives

    NARCIS (Netherlands)

    Mullins-Sweatt, S.N.; Smit, V.; Verheul, R.; Oldham, J.; Widiger, T.A.

    2009-01-01

    Objective: To obtain the opinions and preferences of practising clinicians about the clinical utility of personality scales included within 8 alternative dimensional models of personality disorder for inclusion within an official diagnostic nomenclature. Method: Psychiatrists (n = 226) and

  1. Usages des TIC et socialisation professionnelle des enseignants-chercheurs

    OpenAIRE

    Lavielle-Gutnik, Nathalie; Massou, Luc

    2013-01-01

    En prenant appui sur une nouvelle analyse des données recueillies dans l’enquête Tec-Meus (2008-2011, MSH Lorraine) sur la place accordée par des enseignants-chercheurs en sciences humaines et sociales aux technologies de l’information et de la communication (TIC) dans leur activité d’enseignement, nous souhaitons nous focaliser dans cet article sur la compréhension des processus de socialisation professionnelle en jeu dans leur usage déclaré des TIC. Par socialisation professionnelle, nous e...

  2. Innovation, apprentissage et cadres institutionnels dans des ...

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

    Trois secteurs de transformation des ressources naturelles - ceux des pâtes et ... devrait déboucher sur des recommandations concrètes pour l'élaboration de ... bibliothèque de ressources aideront à améliorer les systèmes d'information et ...

  3. Evaluating radiotherapy patients' need for information: a study using a patient information booklet; Evaluation des besoins en information des patients suivis en radiotherapi: etude effectuee sur la base du livret de la radiotherapie

    Energy Technology Data Exchange (ETDEWEB)

    Bonnet, V.; Romestaing, P.; Gerard, J.P.; Mornex, F. [Centre Hospitalier Universitaire Lyon-Sud, Dept. d' Oncologie-Radiotherapie, 69 - Pierre-Benite (France); Couvreur, C. [Institut Gustave Roussy, Dept. d' Oncologie-Radiotherapie, 94 - Villejuif (France); Demachy, P. [Centre Hospitalier V. Dupouy, Centre de Radiologie et de Traitement des Tumeurs, 95 - Argenteuil (France); Kimmel, F. [Centre de Radiologie et de Traitement des Tumeurs, 92 - Meudon-la-Foret (France); Milan, H. [Centre Georges-Francois-Leclerc, 21 - Dijon (France); Noel, D. [Hopital Pitie-Salpetriere, Dept. d' Oncologie-Radiotherapie, 75 - Paris (France); Pace, M. [Hopital d' Annecy, Dept. d' Oncologie-Radiotherapie, 74 - Annecy (France); Raison, C. [Centre Catherine-de-Sienne, 44 - Nantes (France); Compagnon, C. [Ligue Nationale Contre le Cancer, 75 -Paris (France); Pigeon, P. [Isis Research, 69 - Lyon (France)

    2000-08-01

    The French Radiotherapy-Oncology Society (SFRO) and the National Trade of Radiotherapists-Oncologists (SNRO) elaborated and published a patient information booklet on radiotherapy, in 1999. This present study appraises the pertinence of the form and substance of this booklet one year after its release. Eight radiotherapy centers participated in this research which evaluated 162 patients at treatment initiation. The conclusions of this study demonstrated the importance of clearly informing patients of their disease, treatment, and the secondary effects of treatment. It is essential to emphasize that 97% of the patients declared that an information booklet is a real necessity, and that the one provided by the SFRO responds to the majority of their concerns. Obtaining technical and practical knowledge resulted in a reassurance about their treatment. The most revealing result is that 87% requested direct communication about their illness, and that cancer be named by this word and not other, evasive terms. Seventy-two percent of the patients requested more information about their cancer, different treatment options, and quality of life issues in an attempt to psychologically prepare themselves to face an illness for which they have little control. Patients refuse to be passive, and claim the right to become 'partners' of the medical teams, concerning their treatment and recovery. (authors)

  4. Processing of data issued from a {gamma} spectrometer; Traitement des informations issues d'un spectrometre {gamma}

    Energy Technology Data Exchange (ETDEWEB)

    Boulanger, J P [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

    1966-03-01

    The purpose of the following report is the study of computation method applied to analysis by gamma spectrometry. We first study quantitative analysis by the least-squares method, improved by a gain-shift correction. Then the single full-energy peaks and the resolution of complex peaks are dealt with. In both cases, the calculation principle, then the systematic tests achieved in order to-prove their validity and determine their application ranges are described and finally some experimental results appropriate to illustrate their possibilities are presented. (author) [French] Le present rapport a pour objet l'etude de methodes de calcul applicables a l'analyse par spectrometrie gamma. On etudie d'abord l'analyse quantitative par la methode des moindres carres, completee par une correction de derive du gain. Puis on examine les pics d'absorption totale simples et la resolution des pics complexes. Dans les deux cas, on expose le principe des calculs et les essais systematiques effectues pour eprouver leur validite et definir leurs domaines d'application, ainsi que quelques resultats experimentaux propres a illustrer leurs possibilites.

  5. Data Science Meets the Clinician: Challenges and Future Directions.

    Science.gov (United States)

    Charitos, Efstratios I; Wilbring, Manuel; Treede, Hendrik

    2018-01-01

    In the last three decades a profound transformation of the medical profession has taken place. The modern clinician is required to consume vast amounts of information from clinical studies, critically reviewing evidence that may or may not lead to changes in clinical practice. The present article presents some challenges that this era of information poses to clinicians and patients. Georg Thieme Verlag KG Stuttgart · New York.

  6. REFLECT: Logiciel de restitution des reflectances au sol pour l'amelioration de la qualite de l'information extraite des images satellitales a haute resolution spatiale

    Science.gov (United States)

    Bouroubi, Mohamed Yacine

    Multi-spectral satellite imagery, especially at high spatial resolution (finer than 30 m on the ground), represents an invaluable source of information for decision making in various domains in connection with natural resources management, environment preservation or urban planning and management. The mapping scales may range from local (finer resolution than 5 m) to regional (resolution coarser than 5m). The images are characterized by objects reflectance in the electromagnetic spectrum witch represents the key information in many applications. However, satellite sensor measurements are also affected by parasite input due to illumination and observation conditions, to the atmosphere, to topography and to sensor properties. Two questions have oriented this research. What is the best approach to retrieve surface reflectance with the measured values while taking into account these parasite factors? Is this retrieval a sine qua non condition for reliable image information extraction for the diverse domains of application for the images (mapping, environmental monitoring, landscape change detection, resources inventory, etc.)? The goals we have delineated for this research are as follow: (1) Develop software to retrieve ground reflectance while taking into account the aspects mentioned earlier. This software had to be modular enough to allow improvement and adaptation to diverse remote sensing application problems; and (2) Apply this software in various context (urban, agricultural, forest) and analyse results to evaluate the accuracy gain of extracted information from remote sensing imagery transformed in ground reflectance images to demonstrate the necessity of operating in this way, whatever the type of application. During this research, we have developed a tool to retrieve ground reflectance (the new version of the REFLECT software). This software is based on the formulas (and routines) of the 6S code (Second Simulation of Satellite Signal in the Solar Spectrum

  7. Les nouvelles perspectives d'analyse spatiale des nuisances sonores. Le projet SIGAUR (Système d'Information Géographique et Acoustique URbaine

    Directory of Open Access Journals (Sweden)

    Erwan Quesseveur

    1999-06-01

    Full Text Available Ce rapport présente un projet de recherche sur l’intégration d’une couche d’information de nuisances acoustiques dans un système d’information géographique.Après un développement sur l’état de la pollution et des moyens aujourd’hui en vigueur pour la combattre, on va montrer les nouvelles perspectives offertes pour l’analyse spatiale du bruit. En confrontant cette nuisance aux enjeux du territoire, elle peut devenir un véritable critère de décision en aménagement du territoire.Ce projet résulte d’une collaboration entre le Centre Scientifique et Technique du Bâtiment C.S.T.B. et l’équipe " S.I.G. " de l'Institut de Géographie Alpine (IGA

  8. Le système d’information sur la biodiversité de l’administration des parcs nationaux argentins

    Directory of Open Access Journals (Sweden)

    Leonidas Lizarraga

    2014-06-01

    Full Text Available Introduction Le système d’information sur la biodiversité (SIB, Sistema de Información de Biodiversidad de l’administration des parcs nationaux argentins (APN, Administración de Parques Nacionales a été lancé en 2002, avec le soutien du Global Environment Fund (GEF dans le cadre du Projet de préservation de la biodiversité mené par l’État argentin. Le dispositif, abrégé en SIB-APN, est composé d’un ensemble de bases de données thématiques et d’un système d’information géographique : son ob...

  9. Comparison of alphabetical versus categorical display format for medication order entry in a simulated touch screen anesthesia information management system: an experiment in clinician-computer interaction in anesthesia

    Directory of Open Access Journals (Sweden)

    Marian Anil A

    2012-05-01

    Full Text Available Abstract Background Anesthesia information management system (AIMS records should be designed and configured to facilitate the accurate and prompt recording of multiple drugs administered coincidentally or in rapid succession. Methods We proposed two touch-screen display formats for use with our department’s new EPIC touch-screen AIMS. In one format, medication “buttons” were arranged in alphabetical order (i.e. A-C, D-H etc.. In the other, buttons were arranged in categories (Common, Fluids, Cardiovascular, Coagulation etc.. Both formats were modeled on an iPad screen to resemble the AIMS interface. Anesthesia residents, anesthesiologists, and Certified Registered Nurse Anesthetists (n = 60 were then asked to find and touch the correct buttons for a series of medications whose names were displayed to the side of the entry screen. The number of entries made within 2 minutes was recorded. This was done 3 times for each format, with the 1st format chosen randomly. Data were analyzed from the third trials with each format to minimize differences in learning. Results The categorical format had a mean of 5.6 more drugs entered using the categorical method in two minutes than the alphabetical format (95% confidence interval [CI] 4.5 to 6.8, P  Conclusions The use of touch-screen user interfaces in healthcare is increasingly common. Arrangement of drugs names in a categorical display format in the medication order-entry touch screen of an AIMS can result in faster data entry compared to an alphabetical arrangement of drugs. Results of this quality improvement project were used in our department’s design of our final intraoperative electronic anesthesia record. This testing approach using cognitive and usability engineering methods can be used to objectively design and evaluate many aspects of the clinician-computer interaction in electronic health records.

  10. Mentoring for clinician-educators.

    Science.gov (United States)

    Farrell, Susan E; Digioia, Natalie M; Broderick, Kerry B; Coates, Wendy C

    2004-12-01

    Mentorship has been shown to have a positive impact on academic faculty members in terms of career advancement. The guidance of a mentor has been shown to increase academic outcome measures such as peer-reviewed publications and grant support for junior academic faculty. In addition, career satisfaction of mentored faculty is greater than those with no mentorship. There is little research on the effects of mentorship on the careers of clinician-educators. This group has also been reported to have a lower scholarly productivity rate than the typical research-based faculty. This article addresses the current state of mentorship as it applies specifically to clinician-educators, offers advice on how a potential protégé might seek out a potential mentor, and finally, suggests a possible mentoring system for academic emergency physicians who are focusing on careers in medical education.

  11. Clinician search behaviors may be influenced by search engine design.

    Science.gov (United States)

    Lau, Annie Y S; Coiera, Enrico; Zrimec, Tatjana; Compton, Paul

    2010-06-30

    Searching the Web for documents using information retrieval systems plays an important part in clinicians' practice of evidence-based medicine. While much research focuses on the design of methods to retrieve documents, there has been little examination of the way different search engine capabilities influence clinician search behaviors. Previous studies have shown that use of task-based search engines allows for faster searches with no loss of decision accuracy compared with resource-based engines. We hypothesized that changes in search behaviors may explain these differences. In all, 75 clinicians (44 doctors and 31 clinical nurse consultants) were randomized to use either a resource-based or a task-based version of a clinical information retrieval system to answer questions about 8 clinical scenarios in a controlled setting in a university computer laboratory. Clinicians using the resource-based system could select 1 of 6 resources, such as PubMed; clinicians using the task-based system could select 1 of 6 clinical tasks, such as diagnosis. Clinicians in both systems could reformulate search queries. System logs unobtrusively capturing clinicians' interactions with the systems were coded and analyzed for clinicians' search actions and query reformulation strategies. The most frequent search action of clinicians using the resource-based system was to explore a new resource with the same query, that is, these clinicians exhibited a "breadth-first" search behaviour. Of 1398 search actions, clinicians using the resource-based system conducted 401 (28.7%, 95% confidence interval [CI] 26.37-31.11) in this way. In contrast, the majority of clinicians using the task-based system exhibited a "depth-first" search behavior in which they reformulated query keywords while keeping to the same task profiles. Of 585 search actions conducted by clinicians using the task-based system, 379 (64.8%, 95% CI 60.83-68.55) were conducted in this way. This study provides evidence that

  12. Multimedia reviews: multimedia convergence for clinicians.

    Science.gov (United States)

    Taintor, Zebulon

    2003-12-01

    Introduction by the column editor: In this final column of the year, Dr. Taintor provides an overview of exciting technological developments via his report on the 2003 annual meeting of the American Association for Technology in Psychiatry (AATP). Advances-and convergences-in technology are providing clinicians with increasingly useful tools to enhance the effectiveness of their treatments, increase access to care, reduce errors, and save time. As Dr. Taintor notes, AATP's meeting is traditionally held in conjunction with the annual meeting of the American Psychiatric Association (APA). I hope that his report will encourage APA's members to attend some of next year's informative sessions.

  13. Renforcement de l'autonomie des collectivités au moyen des ...

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

    Cette subvention permettra au ministère des Communications et des Technologies de l'information de l'Égypte ainsi qu'au fonds spécial réservé aux TI de consolider le modèle actuel des clubs de TI en Égypte, par l'entremise de services d'assistance sur demande, d'activités de formation à l'intention du personnel des ...

  14. Examining Informal Learning using Mobile Devices in the Healthcare Workplace / Examen de l’apprentissage informel par l’utilisation d’appareils mobiles dans le milieu des soins de santé

    Directory of Open Access Journals (Sweden)

    Dorothy (Willy Fahlman

    2013-12-01

    Full Text Available The study of workplace learning and informal learning are not new to adult education and pedagogy. However, the use of mobile devices as learning tools for informal learning in the workplace is an understudied area. Using theories on informal learning and constructivism as a framework, this paper explores informal learning of registered nurses using mobile devices to meet their learning needs for continuing professional education, professional development, and continuing competence within the challenging healthcare workplace. In this mixed methods study, participants used their devices for self-directed informal learning with non-collaborative strategies/processes for evidence-based support, new procedures/treatments, professional development, patient/client teaching, and maintaining competency. Positive perceptions were articulated. Minimal differences were associated to the nurses’ age. However, workplace-related influences were relevant to the informal learning experiences with the mobile devices. L'étude de l'apprentissage en milieu de travail et de l’apprentissage informel n’est pas nouvelle dans le domaine de l'éducation des adultes et de la pédagogie. Cependant, l'utilisation d'appareils mobiles comme outils pour l'apprentissage informel en milieu de travail est un domaine peu étudié. En utilisant comme cadre d’analyse des théories de l'apprentissage informel et le constructivisme, cet article examine l'apprentissage informel des infirmières utilisant des appareils mobiles pour répondre à leurs besoins d'apprentissage en contexte de formation professionnelle continue, de perfectionnement professionnel et de maintien de leurs compétences dans le milieu difficile de la santé. Dans cette étude à méthodologies mixtes, les participants ont utilisé leurs appareils pour un apprentissage autodirigé informel à l’aide de stratégies et de processus non collaboratifs permettant un appui sur des données factuelles, pour

  15. Comparison of alphabetical versus categorical display format for medication order entry in a simulated touch screen anesthesia information management system: an experiment in clinician-computer interaction in anesthesia.

    Science.gov (United States)

    Marian, Anil A; Dexter, Franklin; Tucker, Peter; Todd, Michael M

    2012-05-29

    Anesthesia information management system (AIMS) records should be designed and configured to facilitate the accurate and prompt recording of multiple drugs administered coincidentally or in rapid succession. We proposed two touch-screen display formats for use with our department's new EPIC touch-screen AIMS. In one format, medication "buttons" were arranged in alphabetical order (i.e. A-C, D-H etc.). In the other, buttons were arranged in categories (Common, Fluids, Cardiovascular, Coagulation etc.). Both formats were modeled on an iPad screen to resemble the AIMS interface. Anesthesia residents, anesthesiologists, and Certified Registered Nurse Anesthetists (n = 60) were then asked to find and touch the correct buttons for a series of medications whose names were displayed to the side of the entry screen. The number of entries made within 2 minutes was recorded. This was done 3 times for each format, with the 1st format chosen randomly. Data were analyzed from the third trials with each format to minimize differences in learning. The categorical format had a mean of 5.6 more drugs entered using the categorical method in two minutes than the alphabetical format (95% confidence interval [CI] 4.5 to 6.8, P < 0.0001). The findings were the same regardless of the order of testing (i.e. alphabetical-categorical vs. categorical - alphabetical) and participants' years of clinical experience. Most anesthesia providers made no (0) errors for most trials (N = 96/120 trials, lower 95% limit 73%, P < 0.0001). There was no difference in error rates between the two formats (P = 0.53). The use of touch-screen user interfaces in healthcare is increasingly common. Arrangement of drugs names in a categorical display format in the medication order-entry touch screen of an AIMS can result in faster data entry compared to an alphabetical arrangement of drugs. Results of this quality improvement project were used in our department's design of our final intraoperative electronic

  16. Importance des indices dans la récupération de l’information en mémoire: cas des élèves de 4ème année primaire, suivant le sexe et la classe d’âge

    Directory of Open Access Journals (Sweden)

    Florence Gheloube Épouse Ndong Obiang

    2017-06-01

    Full Text Available La présente étude montre l’importance des indices dans la récupération de l’information en mémoire à court terme (MCT, car la mémoire des apprenants est constamment sollicitée lors des apprentissages. La tâche de rappel indicé a été administrée à 111 élèves de 4ème année des écoles primaires de Libreville. Le traitement de données a été effectué à l’aide du logiciel Statistica. L’analyse de variance indique que, quels que soient le sexe et l’âge il n’y a pas de différence. Mais, Alloway (2006 souligne que la MCT verbale évolue avec l’âge. L’analyse de corrélation révèle qu’il y a une corrélation fortement négative lorsqu’on compare les scores obtenus au rappel indicé correct (RICO, à ceux du rappel indicé incorrect (RINONCO et au nombre d’essais (RIESSAIS. Il est donc essentiel que les enseignants et les élèves aient connaissance et appliquent ces données pour permettre d’améliorer les pratiques des enseignants et les performances des élèves.

  17. REPRISE DES COURS - Yoga

    CERN Multimedia

    Club de Yoga

    2015-01-01

    REPRISE DES COURS – Venez nombreux ! Yoga, Sophrologie, Tai Chi La liste des cours pour le semestre allant du 1er septembre 2015 au 31 janvier 2016 est disponible sur notre site web : http://club-yoga.web.cern.ch Lieu Les cours ont lieu dans la salle des clubs, à l’entresol du restaurant No 2, Bât. 504 (dans la salle no 3 pour la Sophrologie). Prix des cours Le prix pour le semestre (environ 18 leçons) est fixé à 220 CHF plus 10 CHF d’adhésion annuelle au Club. Couple : 200 CHF par personne. 2 cours par semaine : 400 CHF. Inscriptions Les inscriptions aux cours seront prises directement auprès du professeur, lors de la 1ère séance. Avant de s’inscrire pour le semestre, il est possible d’essayer une séance gratuitement. Informations : http://club-yoga.web.cern.ch ----------------------------------------- cern.ch/club-yoga/

  18. Oral Cancer Knowledge Assessment: Newly Graduated versus Senior Dental Clinicians

    Science.gov (United States)

    Salgado de Souza, Ricardo; Gallego Arias Pecorari, Vanessa; Lauria Dib, Luciano

    2018-01-01

    The present study assessed the level of dentists' knowledge regarding oral cancer in the city of São Paulo, Brazil. A questionnaire was used to compare the level of knowledge among newly graduated and senior clinicians. A total of 20,154 e-mails were correctly delivered to the dentists registered in the database of the Regional Dentistry Council of São Paulo, and 477 (2.36%) responses were received. This sample consisted of 84 newly graduated clinicians and 105 senior clinicians. For the statistical analysis, the chi-square test and the logistic regression analysis were performed with α = 0.05, and the results were described herein. According to their knowledge level, the results were statistically different between the groups, since 19% of the newly graduated clinicians were evaluated with knowledge grade A (excellent) in comparison to 6.7% of the senior clinicians. In spite of the results indicated that newly graduated clinicians' knowledge regarding oral cancer was 2.1 times higher, 34.5% of the professionals in this group had regular or poor knowledge on the subject, and several questions relating to clinical characteristics and risk factors indicated that there still exist some knowledge gaps, demonstrating that there is a need for further studies and information activities addressing oral cancer. PMID:29666649

  19. Information derived from French studies and achievements in the field of uranium isotope separation; Enseignements tires des etudes et realisations francaises relatives a la separation des isotopes de l'uranium

    Energy Technology Data Exchange (ETDEWEB)

    Frejacques, C; Galley, R [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

    1964-07-01

    The work carried out in the field of uranium isotope separation, by gaseous diffusion and by ultracentrifugation, is reviewed. An economic estimate of the various parameters involved in the cost is given, and it is shown that only very large gaseous diffusion plants, corresponding to a programme of enriched uranium reactors of at least 4000 MWe to be installed yearly, can give an economically acceptable enriched uranium production. (authors) [French] La communication passe en revue les realisations effectuees dans le domaine de la separation des isotopes de l'uranium, par diffusion gazeuse et par ultracentrifugation. Elle donne une estimation economique des differents parametres intervenant dans les couts et met en evidence que seules les tres grandes usines de diffusion gazeuse, correspondant a un programme d'installation de reacteurs a uranium enrichi d'au moins 4000 MWe nouveaux par an, peuvent conduire a des productions d'uranium enrichi economiquement acceptables. (auteurs)

  20. Normal tissue complication probability (NTCP), the clinician,s perspective

    International Nuclear Information System (INIS)

    Yeoh, E.K.

    2011-01-01

    Full text: 3D radiation treatment planning has enabled dose distributions to be related to the volume of normal tissues irradiated. The dose volume histograms thus derived have been utilized to set NTCP dose constraints to facilitate optimization of treatment planning. However, it is not widely appreciated that a number of important variables other than DYH's which determine NTCP in the individual patient. These variables will be discussed under the headings of patient and treatment related as well as tumour related factors. Patient related factors include age, co-morbidities such as connective tissue disease and diabetes mellitus, previous tissue/organ damage, tissue architectural organization (parallel or serial), regional tissue/organ and individual tissue/organ radiosensitivities as well as the development of severe acute toxicity. Treatment related variables which need to be considered include dose per fraction (if not the conventional 1.8012.00 Gy/fraction, particularly for IMRT), number of fractions and total dose, dose rate (particularly if combined with brachytherapy) and concurrent chemotherapy or other biological dose modifiers. Tumour related factors which impact on NTCP include infiltration of normal tissue/organ usually at presentation leading to compromised function but also with recurrent disease after radiation therapy as well as variable tumour radiosensitivities between and within tumour types. Whilst evaluation of DYH data is a useful guide in the choice of treatment plan, the current state of knowledge requires the clinician to make an educated judgement based on a consideration of the other factors.

  1. Des Ogle's old stump

    International Nuclear Information System (INIS)

    Jones, M.; Sutton, D.; Wallace, R.

    1998-01-01

    On 17 October 1997 Sylvia Bryan of RD4 Kaitaia wrote to 'Dear Somebody-Everybody' at the Anthropology Department, University of Auckland, urging further examination of an adzed stump found by Des Ogle during planting out of the Te Aupouri forest. The authors have since sought out relevant information and present it here for the interests of our readers. (author). 7 refs., 1 fig

  2. The clinician and the thyroid

    Energy Technology Data Exchange (ETDEWEB)

    Biersack, H.J.; Hotze, A. (Bonn Univ. (Germany, F.R.). Inst. fuer Klinische und Experimentelle Nuklearmedizin)

    1991-09-01

    The goiter prevalence in iodine-deficient regions is up to 25%-54%. The most frequent disease in these endemic areas is non-toxic goiter, which is, however, oftentimes connected with autonomously functioning thyroid tissue leading to borderline or overt hyperthyroidism. Other thyroid diseases like cancer, thyroiditis and hypothyroidism play only a miner role in a thyroid clinic, while cases of Graves' disease may be observed more frequently. The most cost-effective tools to evaluate thyroid patients are the hand, ear and mouth of the thyroid clinician. The differential diagnosis of thyroid disorders may be evaluated by a battery of diagnostic tools like in-vitro tests and high performance imaging modalities. Once the diagnosis is established, the appropriate therapeutic procedures (drugs, radioiodine, surgery) have to be chosen. This review should be considered as a guideline for the diagnosis and treatment of thyroid diseases. In addition, special problems concerning elderly patients and pregnant women are discussed, including the differential diagnosis of thyroid diseases. (orig.).

  3. The clinician and the thyroid

    International Nuclear Information System (INIS)

    Biersack, H.J.; Hotze, A.

    1991-01-01

    The goiter prevalence in iodine-deficient regions is up to 25%-54%. The most frequent disease in these endemic areas is non-toxic goiter, which is, however, oftentimes connected with autonomously functioning thyroid tissue leading to borderline or overt hyperthyroidism. Other thyroid diseases like cancer, thyroiditis and hypothyroidism play only a miner role in a thyroid clinic, while cases of Graves' disease may be observed more frequently. The most cost-effective tools to evaluate thyroid patients are the hand, ear and mouth of the thyroid clinician. The differential diagnosis of thyroid disorders may be evaluated by a battery of diagnostic tools like in-vitro tests and high performance imaging modalities. Once the diagnosis is established, the appropriate therapeutic procedures (drugs, radioiodine, surgery) have to be chosen. This review should be considered as a guideline for the diagnosis and treatment of thyroid diseases. In addition, special problems concerning elderly patients and pregnant women are discussed, including the differential diagnosis of thyroid diseases. (orig.)

  4. 16. national conference of the presidents of the local commissions of information (C.L.I.) around nuclear facilities; 16. conference nationale des presidents de commissions locales d'information (CLI) autour des installations nucleaires

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-07-01

    This conference contained two plenary sessions. The first one concerned the epidemiology with the following subjects: the epidemiology, its contributions and its limits; the epidemiological surveillance of cancers in France: role of registers within the device; the aggregates of leukaemia near the nuclear installations; perception and management of the risk; the point of view of the scientific committee of the A.N.C.L.I.; Followed a work in a workshop on the subjects relative to the functioning of the C.L.I. (Organization, relations, information) then the second plenary session with as subjects: organization and functioning of C.L.I., relations and links with A.N.C.L.I., information received and diffused by the C.L.I. (N.C.)

  5. Patients' Contexts and Their Effects on Clinicians' Impressions of Conduct Disorder Symptoms

    Science.gov (United States)

    De Los Reyes, Andres; Marsh, Jessecae K.

    2011-01-01

    The purpose of this study was to examine whether contextual information about patients' clinical presentations affected clinicians' judgments of conduct disorder symptoms. Forty-five clinicians read vignettes describing hypothetical patients who displayed one conduct disorder symptom alongside information about the patients' home, school, and peer…

  6. Additional application areas of the 3D process information display; Weiterfuehrende Einsatzgebiete des 3-D-Prozessinformationsdisplays

    Energy Technology Data Exchange (ETDEWEB)

    Meissner, K. [Institut fuer Automatisierung und Informatik GmbH, Zentrum fuer industrielle Forschung und Entwicklung, Wernigerode (Germany); Hensel, H. [Hochschule Harz, Fachbereich Automatisierung und Informatik, Wernigerode (Germany)

    2007-07-01

    The current technological progress in the process industry results in a significant increase of the complexity of control systems. The amount of supervised information grows constantly for each operator because of a higher level of automation and an optimized information acquisition of the control systems. This development results in a cognitive overload of the operator which causes incorrect behaviour and responses in alert situations. In technical literature, several approaches are discussed to counteract this problem. This paper presents the newly developed 3-D Process Information Display (3D-PID) and describes which additional application areas as a primary representation method to the supervision of complex process conditions are imaginable. The 3D-PID is based on a cognitive scenic representation of the process values within a 3-D process room. Particularly the problem of the overview and detail presentation known from the literature is discussed. (orig.)

  7. Sommaires des demandes d'accès à l'information complétées en 2013

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

    Institut Pembina, communiqués en réponse à la demande d'accès à l'information 2012-01. Disposition : Communication partielle. Nombre de pages communiquées : 349. Numéro de la demande : A-2013-04. Sommaire : Fournissez une copie ...

  8. La rivière Seudre : intégration des données relatives au bassin versant de la Seudre dans un système d'information géographique

    OpenAIRE

    Giraud, Sophie

    1999-01-01

    La préparation du S.A.G.E. Seudre se poursuit. Il doit permettre dans un premier temps d'informer, de communiquer, de faire un état des lieux de l'existant concernant les aspects environnementaux et socio-économique, la gestion de l'eau, de sa qualité ou d'autres points. L'IFREMER, qui a récemment acquis un logiciel de système d'information géographique l'a exploité pour réaliser un «début d'atlas» sur la Seudre. Cet atlas est donc mis à disposition des utilisateurs potentiels par l'IFREMER, ...

  9. Model of critical diagnostic reasoning: achieving expert clinician performance.

    Science.gov (United States)

    Harjai, Prashant Kumar; Tiwari, Ruby

    2009-01-01

    Diagnostic reasoning refers to the analytical processes used to determine patient health problems. While the education curriculum and health care system focus on training nurse clinicians to accurately recognize and rescue clinical situations, assessments of non-expert nurses have yielded less than satisfactory data on diagnostic competency. The contrast between the expert and non-expert nurse clinician raises the important question of how differences in thinking may contribute to a large divergence in accurate diagnostic reasoning. This article recognizes superior organization of one's knowledge base, using prototypes, and quick retrieval of pertinent information, using similarity recognition as two reasons for the expert's superior diagnostic performance. A model of critical diagnostic reasoning, using prototypes and similarity recognition, is proposed and elucidated using case studies. This model serves as a starting point toward bridging the gap between clinical data and accurate problem identification, verification, and management while providing a structure for a knowledge exchange between expert and non-expert clinicians.

  10. Cartographie prévisionnelle des sols sensibles à la sécheresse en France: un outil d'information préventive

    Directory of Open Access Journals (Sweden)

    Marcel TOULEMONT

    1994-12-01

    Full Text Available La cartographie des sols sensibles à la sécheresse, établie à partir de l’analyse des dommages causés aux constructions par l’événement climatique 1989-1992, montre que les risques qui peuvent en résulter doivent être pris en compte sur une grande partie du territoire de la France métropolitaine urbanisé et urbanisable.

  11. ANALYSE DES PERCEPTIONS LOCALES ET DES FACTEURS ...

    African Journals Online (AJOL)

    AISA

    1Faculté des Sciences Agronomiques (FSA), Université d'Abomey-Calavi (UAC), 01 BP 526 Cotonou Bénin. Email : cgbemavo@yahoo.fr. 2Institut National des Recherches Agricoles du Bénin, Centre de Recherches Agricoles d'Agonkanmey (CRA-A),. Laboratoire des Sciences du Sol, Eau et Environnement (LSSEE).

  12. Analyse des opinions dans les portails d’informations pour personnaliser les systèmes de recommandation.

    OpenAIRE

    Meguebli , Youssef

    2015-01-01

    Online news websites are becoming one of the most popular and influential social media platforms allowing people to easily access information about daily life topics, share their opinions on different issues, and give feedback on published content. The tremendous increase of published news requires effective recommendation techniques that help users to find interesting news articles that match with their interests. Thus, users are continuously encouraged to participate to online news websites...

  13. Postoperative Pain Management: Clinicians' Knowledge and ...

    African Journals Online (AJOL)

    Postoperative Pain Management: Clinicians' Knowledge and Practices on Assessment and Measurement at Moi Teaching and Referral Hospital. ... A standardized questionnaire was administered to 236 hospital – based clinicians including medical doctors, nurses and clinical officers. The questionnaire consisted of ...

  14. GENOMIQUE ET LIPIDES Génomique et métabolisme des lipides des plantes

    Directory of Open Access Journals (Sweden)

    Delseny Michel

    2002-03-01

    Full Text Available Il existe dans les bases de données publiques une énorme quantité de séquences d’ADN dérivées de plantes, et notamment la séquence complète du génome d’Arabidopsis thaliana, une plante modèle pour les oléagineux, proche parente du colza. Ces données constituent une ressource importante non seulement pour la compréhension de métabolisme lipidique et de sa régulation, mais aussi pour la sélection et le développement de variétés nouvelles d’oléagineux produisant davantage d’huiles ou des huiles de composition nouvelle. Cette abondance de séquences peut être exploitée, en utilisant les recherches d’homologies, pour identifier les gènes, pour obtenir des informations sur leur fonction, comme pour repérer des gènes candidats codant des fonctions nouvelles. L’analyse de ces bases de données a révélé que la majeure partie des gènes codant des enzymes impliquées dans le métabolisme lipidique appartient à des petites familles multigéniques, reflétant la diversification des fonctions des isoformes. Une analyse du catalogue des ADNc séquencés en aveugle reflète les niveaux d’expression des différents gènes et fournit un aperçu des régulations des flux au travers des voies métaboliques conduisant à la biosynthèse des lipides de réserve. La disponibilité de mutants et de lignées transgéniques d’Arabidopsis et le développement de puces à ADN qui permettent l’analyse simultanée de plusieurs milliers de gènes conduiront à une meilleure compréhension des facteurs qui régulent le métabolisme des huiles dans les graines. Une telle connaissance facilitera la manipulation de la composition des huiles et des quantités produites dans les graines.

  15. Bed occupancy monitoring: data processing and clinician user interface design.

    Science.gov (United States)

    Pouliot, Melanie; Joshi, Vilas; Goubran, Rafik; Knoefel, Frank

    2012-01-01

    Unobtrusive and continuous monitoring of patients, especially at their place of residence, is becoming a significant part of the healthcare model. A variety of sensors are being used to monitor different patient conditions. Bed occupancy monitoring provides clinicians a quantitative measure of bed entry/exit patterns and may provide information relating to sleep quality. This paper presents a bed occupancy monitoring system using a bed pressure mat sensor. A clinical trial was performed involving 8 patients to collect bed occupancy data. The trial period for each patient ranged from 5-10 weeks. This data was analyzed using a participatory design methodology incorporating clinician feedback to obtain bed occupancy parameters. The parameters extracted include the number of bed exits per night, the bed exit weekly average (including minimum and maximum), the time of day of a particular exit, and the amount of uninterrupted bed occupancy per night. The design of a clinical user interface plays a significant role in the acceptance of such patient monitoring systems by clinicians. The clinician user interface proposed in this paper was designed to be intuitive, easy to navigate and not cause information overload. An iterative design methodology was used for the interface design. The interface design is extendible to incorporate data from multiple sensors. This allows the interface to be part of a comprehensive remote patient monitoring system.

  16. Modelisation des effets physico-techniques pour la conception des ...

    African Journals Online (AJOL)

    automatisation dans les installations industrielles a besoin d'une régulation automatique des commandes des processus technologiques pour lesquelles certaines contraintes sont à relever compte tenu des exigences des innovations scientifiques de ...

  17. Improving clinicians' access to cost data.

    Science.gov (United States)

    Kenagy, John; Shah, Ben

    2014-08-01

    Bringing clinical and financial data together is critical to effectively running and operating service lines. Helping clinicians use cost data to make decisions requires a shared vision and a partnership between finance leaders and physicians. Hosting a "jam session" of technical, financial, and clinical experts can accelerate an organization's business intelligence strategy. Labor and supply costs represent the most actionable cost data for clinicians. Clinician buy-in hinges on education and support. It is important to focus on easy wins at the beginning of the project.

  18. Communicating prognosis with parents of critically ill infants: direct observation of clinician behaviors.

    Science.gov (United States)

    Boss, R D; Lemmon, M E; Arnold, R M; Donohue, P K

    2017-11-01

    Delivering prognostic information to families requires clinicians to forecast an infant's illness course and future. We lack robust empirical data about how prognosis is shared and how that affects clinician-family concordance regarding infant outcomes. Prospective audiorecording of neonatal intensive care unit family conferences, immediately followed by parent/clinician surveys. Existing qualitative analysis frameworks were applied. We analyzed 19 conferences. Most prognostic discussion targeted predicted infant functional needs, for example, medications or feeding. There was little discussion of how infant prognosis would affect infant/family quality of life. Prognostic framing was typically optimistic. Most parents left the conference believing their infant's prognosis to be more optimistic than did clinicians. Clinician approach to prognostic disclosure in these audiotaped family conferences tended to be broad and optimistic, without detail regarding implications of infant health for infant/family quality of life. Families and clinicians left these conversations with little consensus about infant prognosis.

  19. Clinicians' management strategies for patients with dyspepsia: a qualitative approach

    Directory of Open Access Journals (Sweden)

    Ohlsson Bodil

    2005-05-01

    Full Text Available Abstract Background Symptoms from the upper gastrointestinal tract are frequently encountered in clinical practice and may be of either organic or functional origin. For some of these conditions, according to the literature, certain management strategies can be recommended. For other conditions, the evidence is more ambiguous. The hypothesis that guided our study design was twofold: Management strategies and treatments suggested by different clinicians vary considerably, even when optimal treatment is clear-cut, as documented by evidence in the literature. Clinicians believe that the management strategies of their colleagues are similar to their own. Methods Simulated case histories of four patients with symptoms from the upper gastrointestinal tract were presented to 27 Swedish clinicians who were specialists in medical gastroenterology, surgery, and general practice and worked at three hospitals in the southern part of Sweden. The patients' histories contained information on the patient's sex and age and the localisation of the symptoms, but descriptions of subjective symptoms and findings from examinations differed from history to history. Interviews containing open-ended questions were conducted. Results For the same patient, the management strategies and treatments suggested by the clinicians varied widely, as did the strategies suggested by clinicians in the same speciality. Variation was more pronounced if the case history noted symptoms but no organic findings than if the case history noted unambiguous findings and symptoms. However, even in cases with a consensus in the scientific literature on treatment, the variations in clinicians' opinion on management were pronounced. Conclusion Despite these variations, the clinicians believed that the decisions made by their colleagues would be similar to their own. The overall results of this study indicate that we as researchers must make scientific evidence comprehensible and communicate

  20. Les frameworks au coeur des applications web

    OpenAIRE

    Moro, Arielle; Daehne, Peter

    2010-01-01

    Depuis quelques années, Internet est vraiment entré dans les mœurs : tant dans les entreprises qu’au sein de chaque foyer. En effet, Internet permet de communiquer à travers le monde en quelques secondes, de vendre toute sorte de produits en déployant des solutions e-commerce facilement et bien d’autres choses. Internet est donc un véritable vecteur de communication, de commerce et à présent, avec le Web 2.0, un vrai berceau d’informations (tant des informations personnelles que des informati...

  1. Perancangan Enkripsi Pada Citra Bitmap Dengan Algoritma Des, Triple Des, dan Idea

    Directory of Open Access Journals (Sweden)

    Agustinna Yosanny

    2010-12-01

    Full Text Available Rapid development of Information Technology causes information can access easier without space boundaries. Image is a form of information, which contains many information. Some image contains confidential information that cannot distribute to unauthorized persons. Therefore, image encryption application is create to encrypt part of image that has confidential information. The image encryption application is encrypt image by applying DES, Triple DES, and IDEA algorithms. The research was applying analysis and design methodology. The analysis methodology was undertaken through literature study and algorithm research and testing. The design methodology was undertaken through database, features, system, and screen layout design. Results of the research are image encryption application that can encrypt part of image and or all of image by applying three algorithms such as DES, Triple DES, and IDEA. This application is show comparation of these algorithms. In conclusion, method of encryption can apply to image, so that confidential information of the image can protect from unauthorized person. 

  2. Séparation des ondes P et S à l'aide de la matrice spectrale avec informations à priori The Separation of P and S Waves Using the Spectral Matrix with a Priori Information

    Directory of Open Access Journals (Sweden)

    Mari J. L.

    2006-11-01

    Full Text Available Classiquement, la technique de filtrage utilisant la matrice spectrale proposée par Mermoz ne permet une séparation automatique des ondes au sens des indicatrices sismiques que dans certains cas particuliers, à savoir lorsque les ondes à séparer sont naturellement alignées sur les vecteurs propres de la matrice spectrale. Dans les autres cas, nous montrons que l'introduction d'information a priori sur la vitesse apparente de quelques ondes et une limitation de la durée temporelle de ces dernières permettent d'estimer leurs vecteurs d'ondes. L'utilisation de ces vecteurs et une technique de projection au sens des moindres carrés conduit à une extraction optimale de ces ondes, sans dégrader les autres ondes. La technique de filtrage proposée a été appliquée sur des données sismiques de type PSV (profil sismique vertical déporté. Le PSV a été enregistré dans un puits entre les cotes 1050 m et 1755 m; la source est déportée de 654 m par rapport à la tête de puits. L'outil utilisé est un géophone de puits à trois composantes. Le puits traverse une structure géologique complexe. Le traitement réalisé a mis en évidence des réflexions sismiques d'ondes de compression et de cisaillement, associées à des marqueurs fortement pentés (10 à 25°. Après estimation des champs de vitesse et des pendages à l'aide d'abaques, la migration en profondeur des horizons temps pointés a permis d'obtenir un modèle structural faillé. Detailed structural analysis can be achieved by using 3-component vertical seismic profiling method which gives structural information at several hundred meters from the wellhead. The use of an offset VSP on the Auzance structure has led to obtain a structural model composed by faulted dipping reflectors. This is due to the robust nature of the wave separation method which is based on the spectral matrix and uses an a priori information. This method preserves the true amplitude and the local apparent

  3. Essential laboratory knowledge for the clinician

    African Journals Online (AJOL)

    As clinicians place huge emphasis on the numerical values obtained from the clinical ... where clinical management is based on medical decision limits that ... One area of laboratory medicine in which standardisation has been difficult to ...

  4. Verona Coding Definitions of Emotional Sequences (VR-CoDES): Conceptual framework and future directions.

    Science.gov (United States)

    Piccolo, Lidia Del; Finset, Arnstein; Mellblom, Anneli V; Figueiredo-Braga, Margarida; Korsvold, Live; Zhou, Yuefang; Zimmermann, Christa; Humphris, Gerald

    2017-12-01

    To discuss the theoretical and empirical framework of VR-CoDES and potential future direction in research based on the coding system. The paper is based on selective review of papers relevant to the construction and application of VR-CoDES. VR-CoDES system is rooted in patient-centered and biopsychosocial model of healthcare consultations and on a functional approach to emotion theory. According to the VR-CoDES, emotional interaction is studied in terms of sequences consisting of an eliciting event, an emotional expression by the patient and the immediate response by the clinician. The rationale for the emphasis on sequences, on detailed classification of cues and concerns, and on the choices of explicit vs. non-explicit responses and providing vs. reducing room for further disclosure, as basic categories of the clinician responses, is described. Results from research on VR-CoDES may help raise awareness of emotional sequences. Future directions in applying VR-CoDES in research may include studies on predicting patient and clinician behavior within the consultation, qualitative analyses of longer sequences including several VR-CoDES triads, and studies of effects of emotional communication on health outcomes. VR-CoDES may be applied to develop interventions to promote good handling of patients' emotions in healthcare encounters. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Les sciences de l’information et de la communication face à l’émergence d’internet :vers un renouveau de la construction du public. Approche théorique et méta-analyse des publics d’internet/The information and communication sciences facing the emergence of internet :towards a revival of the construction of the audience. Theoretical approach and meta-analysis of the internet audiences

    OpenAIRE

    Patriarche, Geoffroy

    2005-01-01

    Cette dissertation doctorale entend contribuer au renouveau des sciences de l’information et de la communication (SIC) et plus particulièrement de la construction du « public » dans un contexte caractérisé par une remise en question des savoirs théoriques et méthodologiques associée à l’émergence d’internet. Cette problématique est développée en trois temps. Dans un premier temps, nous effectuons une synthèse des constructions du public dans la recherche sur les médias classiques. Les mult...

  6. Information note about the protection of nuclear facilities against aircraft crashes; Note d'information sur la protection des installations nucleaires contre les chutes d'avions

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-07-01

    The protection of nuclear facilities against external risks (earthquakes, floods, fires etc..) is an aspect of safety taken into consideration by the French authority of nuclear safety (ASN). Concerning the aircraft crashes, the fundamental safety rules make three categories of aircraft: the small civil aircraft (weight < 5.7 t), the military aircraft, and the commercial aircraft (w > 5.7 t). Nuclear facilities are designed to resist against crashes of aircraft from the first category only, because the probability of the accidental crash of a big aircraft are extremely low. This document comprises an information note about the protection of nuclear facilities against aircraft crashes, a dossier about the safety of nuclear facilities with respect to external risks in general (natural disasters and aircraft crashes), and an article about the protection of nuclear power plants against aircraft crashes (design, safety measures, regulation, surveillance, experience feedback). (J.S.)

  7. variabilite des productions et des revenus des exploitations

    African Journals Online (AJOL)

    3Centre de coopération internationale en recherche agronomique pour le développement (CIRAD), UMR Innovation,. Montpellier, France. Doubangolo COULIBALY, Email kone_b@yahoo.fr. RESUME. La durabilité des systèmes de production à base de coton dans un contexte de variabilité des prix aux producteurs et de ...

  8. Les sciences de l'information et de la communication face à l'émergence d'internet: vers un renouveau de la construction du "public" :approche théorique et méta-analyse des "publics" d'internet

    OpenAIRE

    Patriarche, Geoffroy

    2005-01-01

    Cette dissertation doctorale entend contribuer au renouveau des sciences de l’information et de la communication (SIC) et plus particulièrement de la construction du « public » dans un contexte caractérisé par une remise en question des savoirs théoriques et méthodologiques associée à l’émergence d’internet. Cette problématique est développée en trois temps. Dans un premier temps, nous effectuons une synthèse des constructions du public dans la recherche sur les médias classiques. Les multipl...

  9. Critical Appraisal of Information on the Web in Practice: Undergraduate Students’ Knowledge, Reported Use, and Behaviour / Évaluation critique de l’information sur la toile : une vision pratique : les connaissances des étudiants de premier cycle, leur uti

    Directory of Open Access Journals (Sweden)

    Neil R. Hogan

    2012-02-01

    Full Text Available Undergraduates use a wide range of information resources for academic and nonacademic purposes, including web sites that range from credible, peer reviewed, online journal sites, to biased and inaccurate promotional web sites. Students are taught basic critical appraisal skills, but do they apply these skills to make decisions about information in different web sites? In an experimental setting, undergraduate students examined pairs of web sites containing conflicting information based on different aspects of critical appraisal, namely credibility of the author of the information, purpose of the web site, and last update of the site, and answered multiple choice questions about the conflicting information. Results indicated that students failed to use critical appraisal criteria, and that while knowledge of and self-reported use of these criteria were related to each other, they were not related to behaviour. This research demonstrates the need for alternative strategies for critical appraisal instruction and assessment. Les étudiants de premier cycle consultent une vaste gamme de sources d’information à des fins universitaires et non universitaires, y compris des sites Web allant de revues en ligne crédibles et évaluées par des pairs à des sites Web promotionnels partials et inexacts. On enseigne aux étudiants des méthodes de base d’évaluation critique, mais mettent-ils ces méthodes en pratique pour prendre des décisions relativement à l’information tirée de différents sites Web? Dans un cadre expérimental, les étudiants de premier cycle ont étudié des paires de sites Web contenant des informations contradictoires en se fondant sur différents aspects de l’évaluation critique, notamment la crédibilité de l’auteur de l’information, l’intention du site Web et la dernière mise à jour du site, et ont répondu à des questions à choix multiples concernant les informations contradictoires. Les r

  10. The clinician's dilemma: two dimensions of ethical care.

    Science.gov (United States)

    Gillett, Grant; Chamberlain, Joshua

    2013-01-01

    There is a continuing intense medico-ethico-legal debate around legalized euthanasia and physician assisted suicide such that ethically informed clinicians often agree with the arguments but feel hesitant about the conclusion, especially when it may bring about a change in law. We argue that this confusion results from the convergence of two continua that underpin the conduct of a clinician and are especially prominent in psychiatry. The two continua concern the duty of care and the importance of patient autonomy and they do not quite map into traditional divides in debates about sanctity of life, paternalism, and autonomy. As ethical dimensions, they come into sharp focus in the psychological complexities of end-of-life care and they form two key factors in most ethical and legal or disciplinary deliberations about a clinician's actions. Whereas both dimensions are important when a clinician reflects on what s/he has done or should do, they need careful balancing in a request for euthanasia or physician assisted suicide where the patient wants to take a decisive role in his or her own end-of-life care. However, end-of-life is also a situation where clinicians often encounter 'cries for help' so that both continua are importantly in play. Balancing these two continua without using blunt legal instruments is often required in psychiatric care in such a way as to problematize the idea that patient decisions should dominate the care options available. A simplistic approach to that issue arguably plays into what has been called an 'impoverished construction of life and death' and, some would say, devalues the basic commitments fundamental to medical care. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. Clinicians' experiences of becoming a clinical manager: a qualitative study.

    Science.gov (United States)

    Spehar, Ivan; Frich, Jan C; Kjekshus, Lars Erik

    2012-11-22

    There has been an increased interest in recruiting health professionals with a clinical background to management positions in health care. We know little about the factors that influence individuals' decisions to engage in management. The aim of this study is to explore clinicians' journeys towards management positions in hospitals, in order to identify potential drivers and barriers to management recruitment and development. We did a qualitative study which included in-depth interviews with 30 clinicians in middle and first-line management positions in Norwegian hospitals. In addition, participant observation was conducted with 20 of the participants. The informants were recruited from medical and surgical departments, and most had professional backgrounds as medical doctors or nurses. Interviews were analyzed by systemic text condensation. We found that there were three phases in clinicians' journey into management; the development of leadership awareness, taking on the manager role and the experience of entering management. Participants' experiences suggest that there are different journeys into management, in which both external and internal pressure emerged as a recurrent theme. They had not anticipated a career in clinical management, and experienced that they had been persuaded to take the position. Being thrown into the position, without being sufficiently prepared for the task, was a common experience among participants. Being left to themselves, they had to learn management "on the fly". Some were frustrated in their role due to increasing administrative workloads, without being able to delegate work effectively. Path dependency and social pressure seems to influence clinicians' decisions to enter into management positions. Hospital organizations should formalize pathways into management, in order to identify, attract, and retain the most qualified talents. Top managers should make sure that necessary support functions are available locally, especially

  12. Analyste de la gestion des documents (h/f) | CRDI - Centre de ...

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

    Résumé des fonctions L'analyste de la gestion des documents est la ressource technique au sein de l'équipe de la Gestion de l'information et des documents. ... Se tenir également informé de toutes les pratiques exemplaires liées à la gestion de l'information et des documents électroniques et matériels que le CRDI doit ...

  13. Civili, langue des Baloango

    DEFF Research Database (Denmark)

    Mavoungou, Paul Achille; Ndinga-Koumba-Binza, Hugues Steve

    , Congo, Angola, etc.) issus de la décolonisation. Il présente de façon succincte quelques phénomènes historiques, phonologiques, morphosyntaxiques, homonymiques et analogiques de la langue. Des faits sémantiques des emprunts linguistiques y sont également décrits dans le cadre des changements...

  14. Les non-usages des TIC

    OpenAIRE

    Abid-Zarrouk, Sandoss Ben; Alava, Séraphin; Andrieu, Bernard; Audran, Jacques; Avanzini, Guy; Azzimani, Toufik; Béziat, Jacques; Bouamri, Abderrahmane; Boujelbène, Younes; Bréant, Françoise; Chauvel, Séverine; Daguet, Hervé; Daniel, Marie-France; Dessus, Philippe; Dupré, Damien

    2012-01-01

    Les ENT (Environnements Numériques de Travail), les plates formes d'EAD (Enseignement A Distance) et les logiciels éducatifs sont généralement étudiés dans la perspective de rendre compte des transformations des situations d'enseignement-apprentissage dans lequelles ils sont utilisés. Les recherches occultent ainsi, de façon non intentionnelle, tout ce qui reste dans l'ombre de l'introduction désormais massive des TIC (Technologies de l'Information et de la Communication), et qui explique pro...

  15. Des racines et des ailes

    Directory of Open Access Journals (Sweden)

    Stéphanie Vincent-Geslin

    2012-05-01

    Full Text Available Les mobilités pendulaires semblent être en augmentation en Europe depuis une dizaine d’années. Cette croissance du temps passé à se déplacer amène à remettre en question la conjecture de Zahavi et apparaît relativement inexplicable en regard du paradigme classique de l’acteur rationnel traditionnellement utilisé dans le champ des transports. Si, dans la littérature, les temps de déplacements sont principalement expliqués par le contexte résidentiel, la forme urbaine et le travail, ce cadre explicatif ne dit rien des processus de décision eux-mêmes qui amènent aux pendularités intensives.À partir d’une enquête qualitative menée auprès de pendulaires français, suisses et belges, cette contribution propose d’analyser les arbitrages et les éléments déterminants des processus de la grande pendularité. Les mobilités quotidiennes pendulaires apparaissent comme le résultat de compromis entre activité professionnelle, attachement résidentiel et choix de vie et prennent ainsi la forme de stratégies de conciliation entre vie privée et vie professionnelle. Ces mobilités spatiales permettent alors paradoxalement la préservation des ancrages résidentiels, sociaux et familiaux.Roots and wings. Long-distance commuting patterns, or how to conciliate professional and personal lifeLong-distance commuting patterns appear to be increasing in Europe over the last ten years. These raising mobility patterns lead to reappraise the Zahavi conjecture and appear largely inexplicable by the classical rational actor paradigm traditionally used in transportation research. In literature, commuting is mainly explained by residential contexts, urban forms and job. Nevertheless this theoretical frame says little about the decision-making processes themselves. Based on a qualitative survey conducted in three European countries - France, Belgium and Switzerland – among a population of high commuters, this paper proposes an analysis of

  16. AphasiaBank: a resource for clinicians.

    Science.gov (United States)

    Forbes, Margaret M; Fromm, Davida; Macwhinney, Brian

    2012-08-01

    AphasiaBank is a shared, multimedia database containing videos and transcriptions of ~180 aphasic individuals and 140 nonaphasic controls performing a uniform set of discourse tasks. The language in the videos is transcribed in Codes for the Human Analysis of Transcripts (CHAT) format and coded for analysis with Computerized Language ANalysis (CLAN) programs, which can perform a wide variety of language analyses. The database and the CLAN programs are freely available to aphasia researchers and clinicians for educational, clinical, and scholarly uses. This article describes the database, suggests some ways in which clinicians and clinician researchers might find these materials useful, and introduces a new language analysis program, EVAL, designed to streamline the transcription and coding processes, while still producing an extensive and useful language profile. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  17. The interplay between teamwork, clinicians' emotional exhaustion, and clinician-rated patient safety: a longitudinal study.

    Science.gov (United States)

    Welp, Annalena; Meier, Laurenz L; Manser, Tanja

    2016-04-19

    Effectively managing patient safety and clinicians' emotional exhaustion are important goals of healthcare organizations. Previous cross-sectional studies showed that teamwork is associated with both. However, causal relationships between all three constructs have not yet been investigated. Moreover, the role of different dimensions of teamwork in relation to emotional exhaustion and patient safety is unclear. The current study focused on the long-term development of teamwork, emotional exhaustion, and patient safety in interprofessional intensive care teams by exploring causal relationships between these constructs. A secondary objective was to disentangle the effects of interpersonal and cognitive-behavioral teamwork. We employed a longitudinal study design. Participants were 2100 nurses and physicians working in 55 intensive care units. They answered an online questionnaire on interpersonal and cognitive-behavioral aspects of teamwork, emotional exhaustion, and patient safety at three time points with a 3-month lag. Data were analyzed with cross-lagged structural equation modeling. We controlled for professional role. Analyses showed that emotional exhaustion had a lagged effect on interpersonal teamwork. Furthermore, interpersonal and cognitive-behavioral teamwork mutually influenced each other. Finally, cognitive-behavioral teamwork predicted clinician-rated patient safety. The current study shows that the interrelations between teamwork, clinician burnout, and clinician-rated patient safety unfold over time. Interpersonal and cognitive-behavioral teamwork play specific roles in a process leading from clinician emotional exhaustion to decreased clinician-rated patient safety. Emotionally exhausted clinicians are less able to engage in positive interpersonal teamwork, which might set in motion a vicious cycle: negative interpersonal team interactions negatively affect cognitive-behavioral teamwork and vice versa. Ultimately, ineffective cognitive

  18. Electronic medical records and communication with patients and other clinicians: are we talking less?

    Science.gov (United States)

    O'Malley, Ann S; Cohen, Genna R; Grossman, Joy M

    2010-04-01

    Commercial electronic medical records (EMRs) both help and hinder physician interpersonal communication--real-time, face-to-face or phone conversations--with patients and other clinicians, according to a new Center for Studying Health System Change (HSC) study based on in-depth interviews with clinicians in 26 physician practices. EMRs assist real-time communication with patients during office visits, primarily through immediate access to patient information, allowing clinicians to talk with patients rather than search for information from paper records. For some clinicians, however, aspects of EMRs pose a distraction during visits. Moreover, some indicated that clinicians may rely on EMRs for information gathering and transfer at the expense of real-time communication with patients and other clinicians. Given time pressures already present in many physician practices, EMR and office-work flow modifications could help ensure that EMRs advance care without compromising interpersonal communication. In particular, policies promoting EMR adoption should consider incorporating communication-skills training for medical trainees and clinicians using EMRs.

  19. Elder Abuse: What's a Clinician To Do?

    Science.gov (United States)

    Reis, Bruce E.

    Incidence rates are critically examined in light of varying definitions of what constitutes elder abuse. It is suggested that the clinician's position of mandatory reporting is an unrealistic response in many cases of elder abuse due to the lack of adequate support services for either the abuser or the elder. Outcome studies are used to support…

  20. Staff Clinician | Center for Cancer Research

    Science.gov (United States)

    The Neuro-Oncology Branch (NOB), Center for Cancer Research (CCR), National Cancer Institute (NCI), National Institutes of Health (NIH) is seeking staff clinicians to provide high-quality patient care for individuals with primary central nervous system (CNS) malignancies.  The NOB is comprised of a multidisciplinary team of physicians, healthcare providers, and scientists who

  1. Contribution de la télédétection et des systèmes d'information géographique à la prise en compte du risque de prolifération des Aedes dans les zones humides de Bizerte (Nord de la Tunisie

    Directory of Open Access Journals (Sweden)

    Noura Brahmi

    2010-10-01

    Full Text Available Cette recherche a pour objectif d'aider les services d'hygiène en matière de cartographie numérique des biotopes potentiels à gîtes larvaires d'Aedes tout autour des zones humides de la région de Bizerte (Nord de la Tunisie. Ces zones humides subissent souvent des invasions inopinées de ces moustiques qui peuvent transmettre à l'homme des affections virales, microbiennes ou parasitaires (malaria, fièvre jaune, dengue…. Ces invasions posent des problèmes importants de nuisance qu'il importe d'analyser précisément si l'on veut se donner des chances de les enrayer. Pour lutter efficacement contre ces Aedes, il est nécessaire d'avoir une bonne connaissance de leur milieu et de leur écologie. C'est pourquoi, dans un premier temps, nous avons créé une base de données intégrée dans un système d'information géographique (SIG afin de définir, de localiser et d'analyser, par la superposition de plusieurs couches d'informations relatives au milieu naturel, les biotopes potentiels de prolifération des gîtes larvaires d'Aedes sur la carte d'aléa. Celle-ci constitue une source d'information nécessaire pour préciser le lien existant entre l'environnement et la nuisance, l'élément jugé vulnérable étant la population humaine. La carte du risque de nuisance est alors obtenue par croisement des cartes d'aléa et de vulnérabilité. La classe où le risque est fort concerne Menzel Bourguiba, Menzel Jmil, Menzel Abderrahmen, Tinja and Ghar el Melh. La classe correspondant à un risque moyen englobe toutes les villes et villages aux alentours du lac Ichkeul. La classe ne présentant pratiquement pas de risque couvre le bassin de l'oued Sejnene et la Garaât el Mabtouha.The major objective of this research is to provide concrete solutions numerical cartography of the potential biotopes to larval lodgings of Aedes all around the wetlands of the area of Bizerte (Northern of Tunisia. These zones are presented in the form of favourable

  2. Knowledge management strategies: Enhancing knowledge transfer to clinicians and patients.

    Science.gov (United States)

    Roemer, Lorrie K; Rocha, Roberto A; Del Fiol, Guilherme; Bradshaw, Richard L; Hanna, Timothy P; Hulse, Nathan C

    2006-01-01

    At Intermountain Healthcare (Intermountain), executive clinical content experts are responsible for disseminating consistent evidence-based clinical content throughout the enterprise at the point-of-care. With a paper-based system it was difficult to ensure that current information was received and was being used in practice. With electronic information systems multiple applications were supplying similar, but different, vendor-licensed and locally-developed content. These issues influenced the consistency of clinical practice within the enterprise, jeopardized patient and clinician safety, and exposed the enterprise and its employees to potential financial penalties. In response to these issues Intermountain is developing a knowledge management infrastructure providing tools and services to support clinical content development, deployment, maintenance, and communication. The Intermountain knowledge management philosophy includes strategies guiding clinicians and consumers of health information to relevant best practice information with the intention of changing behaviors. This paper presents three case studies describing different information management problems identified within Intermountain, methods used to solve the problems, implementation challenges, and the current status of each project.

  3. The nature of excellent clinicians at an academic health science center: a qualitative study.

    Science.gov (United States)

    Mahant, Sanjay; Jovcevska, Vesna; Wadhwa, Anupma

    2012-12-01

    To understand the nature of excellent clinicians at an academic health science center by exploring how and why excellent clinicians achieve high performance. From 2008 to 2010, the authors conducted a qualitative study using a grounded theory approach. Members of the Clinical Advisory Committee in the Department of Pediatrics at the University of Toronto nominated peers whom they saw as excellent clinicians. The authors then conducted in-depth interviews with the most frequently nominated clinicians. They audio-recorded and transcribed the interviews and coded the transcripts to identify emergent themes. From interviews with 13 peer-nominated, excellent clinicians, a model emerged. Dominant themes fell into three categories: (1) core philosophy, (2) deliberate activities, and (3) everyday practice. Excellent clinicians are driven by a core philosophy defined by high intrinsic motivation and passion for patient care and humility. They refine their clinical skills through two deliberate activities-reflective clinical practice and scholarship. Their high performance in everyday practice is characterized by clinical skills and cognitive ability, people skills, engagement, and adaptability. A rich theory emerged explaining how excellent clinicians, driven by a core philosophy and engaged in deliberate activities, achieve high performance in everyday practice. This theory of the nature of excellent clinicians provides a holistic perspective of individual performance, informs medical education, supports faculty career development, and promotes clinical excellence in the culture of academic medicine.

  4. Regroupement des statistiques sur le secteur des TIC et analyse ...

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

    La présence et l'influence des technologies de l'information et de la communication (TIC) continuent de s'élargir et de s'accroître, tout comme leurs répercussions sur le développement économique. Toutefois, il reste encore beaucoup de travail à faire avant de pouvoir comprendre d'une manière systématique et ...

  5. How can clinician-educator training programs be optimized to match clinician motivations and concerns?

    Science.gov (United States)

    McCullough, Brendan; Marton, Gregory E; Ramnanan, Christopher J

    2015-01-01

    Several medical schools have implemented programs aimed at supporting clinician-educators with formal mentoring, training, and experience in undergraduate medical teaching. However, consensus program design has yet to be established, and the effectiveness of these programs in terms of producing quality clinician-educator teaching remains unclear. The goal of this study was to review the literature to identify motivations and perceived barriers to clinician-educators, which in turn will improve clinician-educator training programs to better align with clinician-educator needs and concerns. Review of medical education literature using the terms "attitudes", "motivations", "physicians", "teaching", and "undergraduate medical education" resulted in identification of key themes revealing the primary motivations and barriers involved in physicians teaching undergraduate medical students. A synthesis of articles revealed that physicians are primarily motivated to teach undergraduate students for intrinsic reasons. To a lesser extent, physicians are motivated to teach for extrinsic reasons, such as rewards or recognition. The key barriers deterring physicians from teaching medical students included: decreased productivity, lack of compensation, increased length of the working day, patient concerns/ethical issues, and lack of confidence in their own ability. Our findings suggest that optimization of clinician-educator training programs should address, amongst other factors, time management concerns, appropriate academic recognition for teaching service, and confidence in teaching ability. Addressing these issues may increase the retention of clinicians who are active and proficient in medical education.

  6. An overview of meta-analysis for clinicians.

    Science.gov (United States)

    Lee, Young Ho

    2018-03-01

    The number of medical studies being published is increasing exponentially, and clinicians must routinely process large amounts of new information. Moreover, the results of individual studies are often insufficient to provide confident answers, as their results are not consistently reproducible. A meta-analysis is a statistical method for combining the results of different studies on the same topic and it may resolve conflicts among studies. Meta-analysis is being used increasingly and plays an important role in medical research. This review introduces the basic concepts, steps, advantages, and caveats of meta-analysis, to help clinicians understand it in clinical practice and research. A major advantage of a meta-analysis is that it produces a precise estimate of the effect size, with considerably increased statistical power, which is important when the power of the primary study is limited because of a small sample size. A meta-analysis may yield conclusive results when individual studies are inconclusive. Furthermore, meta-analyses investigate the source of variation and different effects among subgroups. In summary, a meta-analysis is an objective, quantitative method that provides less biased estimates on a specific topic. Understanding how to conduct a meta-analysis aids clinicians in the process of making clinical decisions.

  7. An overview of meta-analysis for clinicians

    Science.gov (United States)

    Lee, Young Ho

    2018-01-01

    The number of medical studies being published is increasing exponentially, and clinicians must routinely process large amounts of new information. Moreover, the results of individual studies are often insufficient to provide confident answers, as their results are not consistently reproducible. A meta-analysis is a statistical method for combining the results of different studies on the same topic and it may resolve conflicts among studies. Meta-analysis is being used increasingly and plays an important role in medical research. This review introduces the basic concepts, steps, advantages, and caveats of meta-analysis, to help clinicians understand it in clinical practice and research. A major advantage of a meta-analysis is that it produces a precise estimate of the effect size, with considerably increased statistical power, which is important when the power of the primary study is limited because of a small sample size. A meta-analysis may yield conclusive results when individual studies are inconclusive. Furthermore, meta-analyses investigate the source of variation and different effects among subgroups. In summary, a meta-analysis is an objective, quantitative method that provides less biased estimates on a specific topic. Understanding how to conduct a meta-analysis aids clinicians in the process of making clinical decisions. PMID:29277096

  8. Brigitte SIMONOT et Gabriel GALLEZOT (2009) (dir.), L’entonnoir : Google sous la loupe des sciences de l’information et de la communication

    OpenAIRE

    Bonaccorsi, Julia

    2013-01-01

    Ce titre annonce d’emblée une posture critique et, plus largement, une promesse de dévoilement. L’approche communicationnelle, affirmée dès le sous-titre, saisit Google comme un objet de recherche à construire à distance des discours promotionnels ou pamphlétaires. La recherche collective prend appui sur une perspective sociotechnique, mais également sociopolitique du moteur de recherche et de ses usages, pour interroger la production de valeurs par la société Google. Le moteur est scruté au ...

  9. On a learning curve for shared decision making: Interviews with clinicians using the knee osteoarthritis Option Grid.

    Science.gov (United States)

    Elwyn, Glyn; Rasmussen, Julie; Kinsey, Katharine; Firth, Jill; Marrin, Katy; Edwards, Adrian; Wood, Fiona

    2018-02-01

    Tools used in clinical encounters to illustrate to patients the risks and benefits of treatment options have been shown to increase shared decision making. However, we do not have good information about how these tools are viewed by clinicians and how clinicians think patients would react to their use. Our aim was to examine clinicians' views about the possible and actual use of tools designed to support patients and clinicians to collaborate and deliberate about treatment options, namely, Option Grid decision aids. We conducted a thematic analysis of qualitative interviews embedded in the intervention phase of a trial of an Option Grid decision aid for osteoarthritis of the knee. Interviews were conducted with 6 participating clinicians before they used the tool and again after clinicians had used the tool with 6 patients. In the first interview, clinicians voiced concerns that the tool would lead to an increase in encounter duration, patient resistance regarding involvement in decision making, and potential information overload. At the second interview, after minimal training, the clinicians reported that the tool had changed their usual way of communicating, and it was generally acceptable and helpful to integrate it into practice. After experiencing the use of Option Grids, clinicians became more willing to use the tools in their clinical encounters with patients. How best to introduce Option Grids to clinicians and adopt their use into practice will need careful consideration of context, workflow, and clinical pathways. © 2016 John Wiley & Sons, Ltd.

  10. Enhancing shared decision making through assessment of patient-clinician concordance on decision quality

    DEFF Research Database (Denmark)

    Kaltoft, Mette Kjer; Selby, Warwick; Salkeld, Glenn

    to quantify, document, and suggest how future dyadic decisions can be enhanced by criterion prioritisation. Associations between patient’s MDQ-W before, and MDQ-R after consultation with their clinician were analysed along with patient scores from the Satisfaction With Decision (SWD) instrument. Results...... and clinician using the dually-personalised decomposable MyDecisionQuality (MDQ) instrument. This has the potential to guide future work on optimising dyad-specific patient-clinician communication for shared decision making and informed consent....

  11. Percussion use and training: a survey of music therapy clinicians.

    Science.gov (United States)

    Scheffel, Stephanie; Matney, Bill

    2014-01-01

    Percussion instruments are commonly used in music therapy practice; however, the body of published literature regarding music therapy-related percussion training and practice is limited. The purpose of our survey study was to describe: (a) clinician perspectives of their academic percussion training; (b) use of percussion testing during academic training; (c) clinician perspectives on relevance, adequacy, and importance of academic percussion training; (d) clinician perspectives of their nonacademic percussion training; and (e) current use of percussion in clinical practice. Through comparisons of these parameters, we sought to provide information that may inform future percussion use and training. Participants were selected using an email list from the Certification Board for Music Therapists. Board-certified music therapists (MT-BC) were provided with a researcher-created survey about academic percussion training, nonacademic percussion training, and use of percussion in clinical practice. Survey response rate was 14.4% (611/4234). We used demographic data to address potential nonresponse error and ensure population representation for region of residence and region of academic training. Results revealed concerns about perceived adequacy of percussion training received during music therapy education (14.6% reported receiving no academic percussion training; 40.6% reported training was not adequate), and absence of percussion-specific proficiency exams. Of the training received, 62.8% indicated that training was relevant; however, a majority (76.5%) recommended current music therapy students receive more percussion training on instruments and skills most relevant to clinical practice. Comparisons between academic training, perceived needs in academic training, and clinical usage may inform future training and clinical competency. We provide suggestions for developing future training, as well as for furthering clinical implementation and research. © the American

  12. Reviewing social media use by clinicians.

    Science.gov (United States)

    von Muhlen, Marcio; Ohno-Machado, Lucila

    2012-01-01

    Adoption studies of social media use by clinicians were systematically reviewed, up to July 26th, 2011, to determine the extent of adoption and highlight trends in institutional responses. This search led to 370 articles, of which 50 were selected for review, including 15 adoption surveys. The definition of social media is evolving rapidly; the authors define it broadly to include social networks and group-curated reference sites such as Wikipedia. Facebook accounts are very common among health science students (64-96%) and less so for professional clinicians (13-47%). Adoption rates have increased sharply in the past 4 years. Wikipedia is widely used as a reference tool. Attempts at incorporating social media into clinical training have met with mixed success. Posting of unprofessional content and breaches of patient confidentiality, especially by students, are not uncommon and have prompted calls for social media guidelines.

  13. Use of SERVQUAL to assess clinicians' satisfaction with the blood transfusion service.

    Science.gov (United States)

    Raspollini, E; Pappalettera, M; Riccardi, D; Parravicini, A; Sestili, S; Rebulla, P; Sirchia, G

    1997-01-01

    Limited information is available on the level of satisfaction of clinicians with services delivered by blood banks. The purpose of this study was to evaluate the satisfaction of clinicians with our blood transfusion service. We prepared a questionnaire based on SERVQUAL, a method used to measure customers' appreciation of quality of service, by assessing the gap between perceived and expected quality. The questionnaire consisted of 14 items grouped according to five dimensions of quality of service: assurance, empathy, responsiveness, reliability, tangibles. Clinicians were asked to give two scores on a scale from 1 to 7 for each item, score (e) representing what they expected from an 'excellent' service, score (r) how they graded the service received. We considered wide differences in scores of service expectation and receipt for a question to be indicative of either service above expected levels (r > e) or service below expectation (r SERVQUAL was useful to gather information on the level of clinicians' satisfaction with our transfusion service.

  14. Optimal Energy Management in Hybrid Electric Trucks Using Route Information Optimisation de la gestion de l’énergie dans des véhicules poids lourds électriques hybrides utilisant le guidage d’itinéraire

    Directory of Open Access Journals (Sweden)

    van Keulen T.

    2009-08-01

    Full Text Available To benchmark a hybrid vehicle’s Energy Management Strategy (EMS usually a given, often certified, velocity trajectory is exploited. In this paper it is reasoned that it is also beneficial to optimize the velocity trajectory. Especially optimizing the vehicle braking trajectories, through maximization of energy recuperation, results in considerable fuel savings on the same traveled distance. Given future route (target velocities as function of traveled distance/location, traffic, and possibly weather information, together with the vehicle’s road load parameters, the future power request trajectory can be estimated. Dynamic Programming (DP techniques can then be used to predict the optimal power split trajectory for the upcoming route, such that a desired state-of-charge at the end of the route is reached. The DP solution is re-calculated at a certain rate in order to adapt to changing conditions, e.g., traffic conditions, and used in a lower level real-time EMS to guarantee both battery state-of-charge as well as minimal fuel consumption. Pour évaluer la Stratégie de Gestion de l’Énergie (SGE d’un véhicule hybride, on exploite généralement un cycle de conduite donné, souvent certifié. Dans cet article, l’optimisation de l’itinéraire apparaît aussi comme nécessaire. L’optimisation, en particulier, des conditions de freinage du véhicule, par la maximisation de la récupération d’énergie, permet des économies considérables de combustible sur une même distance parcourue. Pour un itinéraire donné (vitesses cibles en fonction de la distance parcourue et de la position, compte tenu des conditions de circulation, des éventuelles données météorologiques et des paramètres de perte du véhicule, on peut estimer les besoins en puissance nécessaire pour le parcourir. Des techniques de Programmation Dynamique (PD peuvent alors être employées pour prévoir la répartition de puissance optimale pour un parcours donn

  15. How can clinician-educator training programs be optimized to match clinician motivations and concerns?

    Directory of Open Access Journals (Sweden)

    McCullough B

    2015-01-01

    Full Text Available Brendan McCullough, Gregory E Marton, Christopher J Ramnanan Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada Background: Several medical schools have implemented programs aimed at supporting clinician-educators with formal mentoring, training, and experience in undergraduate medical teaching. However, consensus program design has yet to be established, and the effectiveness of these programs in terms of producing quality clinician-educator teaching remains unclear. The goal of this study was to review the literature to identify motivations and perceived barriers to clinician-educators, which in turn will improve clinician-educator training programs to better align with clinician-educator needs and concerns. Methods: Review of medical education literature using the terms “attitudes”, “motivations”, “physicians”, “teaching”, and “undergraduate medical education” resulted in identification of key themes revealing the primary motivations and barriers involved in physicians teaching undergraduate medical students. Results: A synthesis of articles revealed that physicians are primarily motivated to teach undergraduate students for intrinsic reasons. To a lesser extent, physicians are motivated to teach for extrinsic reasons, such as rewards or recognition. The key barriers deterring physicians from teaching medical students included: decreased productivity, lack of compensation, increased length of the working day, patient concerns/ethical issues, and lack of confidence in their own ability. Conclusion: Our findings suggest that optimization of clinician-educator training programs should address, amongst other factors, time management concerns, appropriate academic recognition for teaching service, and confidence in teaching ability. Addressing these issues may increase the retention of clinicians who are active and proficient in medical education. Keywords: clinician-educators, teaching, undergraduate medical

  16. Assessment of mood: guides for clinicians.

    Science.gov (United States)

    Furukawa, Toshi A

    2010-06-01

    This article is one of the series of review articles aiming to present a convenient guideline for practicing clinicians in their selection of scales for clinical and research purposes. This article focuses on assessment scales for mood (depression, mania). After reviewing the basic principles of clinical psychometrics, we present a selective review of representative scales measuring depressed or manic mood. We reviewed and reported on reliability, validity, interpretability, and feasibility of the following rating scales: Patient Health Questionnaire-9 (PHQ-9), K6, Beck Depression Inventory II (BDI-II), and Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR) as self-report scales for depressed mood; Hamilton Rating Scale for Depression (HAM-D) and Montgomery-Asberg Depression Rating Scale (MADRS) as clinician-administered measure for depression; and Young Mania Rating Scale (YMRS) as a clinician-administered instrument for mania. Although the rating scales for mood represent a well-trodden terrain, this brief review of the most frequently used scales in the literature revealed there is still some room for improvement and for further research, especially with regard to their clinical interpretability. Copyright 2010 Elsevier Inc. All rights reserved.

  17. Canary: An NLP Platform for Clinicians and Researchers.

    Science.gov (United States)

    Malmasi, Shervin; Sandor, Nicolae L; Hosomura, Naoshi; Goldberg, Matt; Skentzos, Stephen; Turchin, Alexander

    2017-05-03

    Information Extraction methods can help discover critical knowledge buried in the vast repositories of unstructured clinical data. However, these methods are underutilized in clinical research, potentially due to the absence of free software geared towards clinicians with little technical expertise. The skills required for developing/using such software constitute a major barrier for medical researchers wishing to employ these methods. To address this, we have developed Canary, a free and open-source solution designed for users without natural language processing (NLP) or software engineering experience. It was designed to be fast and work out of the box via a user-friendly graphical interface.

  18. Complexities of emergency communication: clinicians' perceptions of communication challenges in a trilingual emergency department.

    Science.gov (United States)

    Pun, Jack Kh; Chan, Engle Angela; Murray, Kristen A; Slade, Diana; Matthiessen, Christian Mim

    2017-11-01

    To understand the challenges that clinicians face in communicating with patients and other clinicians within a Hong Kong trilingual emergency department. Effective communication has long been recognised as fundamental to the delivery of quality health care, especially in high-risk and time-constrained environments such as emergency departments. The issue of effective communication is particularly relevant in Hong Kong emergency departments, due to the high volume of patients and the linguistic complexity of this healthcare context. In Hong Kong, emergency department clinicians are native speakers of Chinese, but have received their medical training in English. The clinicians read and record virtually all of their medical documentation in English, yet they communicate verbally with patients in Cantonese and Mandarin. In addition, communication between clinicians occurs in spoken Cantonese, mixed with medical English. Thus, medical information is translated numerous times within one patient journey. This complex linguistic environment creates the potential for miscommunication. A mixed-methods design consisting of a quantitative survey with a sequential qualitative interview. Data were collected in a survey from a purposive sample of 58 clinicians and analysed through descriptive statistics. Eighteen of the clinicians were then invited to take part in semi-structured interviews, the data from which were then subjected to a manifest content analysis. Nearly half of the clinicians surveyed believed that medical information may be omitted or altered through repeated translation in a trilingual emergency department. Eighty-three per cent of clinicians stated that there are communication problems at triage. Over 40% said that they have difficulties in documenting medical information. Around 50% believed that long work hours reduced their ability to communicate effectively with patients. In addition, 34% admitted that they rarely or never listen to patients during a

  19. Évaluation des pratiques agricoles des légumes feuilles : le cas des ...

    African Journals Online (AJOL)

    SARAH

    30 sept. 2017 ... ... de Biochimie et Immunologie Appliquée, Centre de Recherche en Sciences Biologiques, Alimentaires et .... l'intoxication des agriculteurs et des consommateurs, ... source d'alimentation en eau et au pouvoir d'achat des.

  20. Quantification of the magnetization-transfer contrast effect: can it yield additional information in differentiation of musculoskeletal lesions particularly in separation of benign from malignant lesions; Quantifizierung des Magnetization Transfer Contrast (MTC) Effektes durch Berechnung von MT-Quotienten: Ergeben sich Zusatzinformationen fuer die Differenzierung benigner und maligner Erkrankungen des Bewegungsapparates?

    Energy Technology Data Exchange (ETDEWEB)

    Vahlensieck, M.; Traeber, F.; Schild, H. [Radiologische Universitaetsklinik Bonn (Germany); Gieseke, J. [Philips Medizinsysteme (Germany)

    1999-12-01

    Purpose: To investigate the potential information of the amount of magnetization-transfer effect in musculoskeletal lesions and to compare MT ratios from benign and malignant musculoskeletal lesions. Material and Method: 49 patients with malignant tumors (3 osteosarcoma, 3 malignant fibrous histiocytoma, 4 chondrosarcoma, 2 Ewing sarcomas) and benign lesions (8 chondroma, 2 fibrous dysplasia, 3 osteoid-osteoma, 6 ganglion cyst, 3 cyst, 3 osteomyelitis, 4 tendinitis, 3 rotator cuff tear, 5 scar tissue) were scanned using routine MRI protocols including T{sub 1}- and T{sub 2}-weighted spin echo as well as T{sub 2}*-weighted gradient echo (FFE) sequences at 1.5 Tesla (ACS II, Philips Medical). Additionally MTC images were generated by combining the FFE sequence and the off-resonance MT technique (-1500 Hz off-resonance frequency, 1770 flip angle and 50 ms pulse duration). MT ratios were calculated as SI{sub o}-SI{sub m}/SI{sub o}. Results: The MT ratio of benign lesions was 26{+-}15%, that of malignant lesions was 22{+-}6%. The difference was statistically not significant. As expected muscle showed a high MT ratio of 50{+-}8%. Scar tissue demonstrated an MT ratio of 39{+-}16% which was significantly higher than the tumor MT ratios. Conclusion: MTC (MT ratios) failed to show significant differences between benign and malignant lesions as was expected due to basic differences in cellularity, rate of mitosis and chromatin content. MTC might however gain more importance in separating scar tissue from recurrent tumor in the future. (orig.) [German] Zielsetzung: Durch die Quantifizierung des Magnetization Transfer Contrastes sollte untersucht werden, ob sich Zusatzinformationen in der Magnetresonanztomographie des Stuetz- und Bewegungsapparates ergeben. Insbesondere sollte ermittelt werden, ob gut- und boesartige Laesionen unterschiedliche MT-Quotienten aufweisen. Material und Methode: 49 Patienten mit boesartigen Tumoren (3 Osteosarkom, 4 Chondrosarkom, 3 Malignes

  1. Gestion des risques

    CERN Document Server

    Louisot, Jean-Paul

    2009-01-01

    Depuis le début du lie siècle, la gestion des risques connaît une véritable révolution culturelle. Jusqu'alors fonction technique, centrée autour de l'achat de couverture d'assurances, elle est devenue une discipline managériale et transversale : une valise d'instruments que chaque manager doit connaître et appliquer quels que soient son domaine de compétence et ses missions au sein de l'organisation. En effet, la gestion des risques est une culture qui doit être assimilée par chacun des acteurs. C'est précisément l'ambition des 101 questions rassemblées dans cet ouvrage : apporter à chaque manager d'entreprise, de collectivité, d'établissement de santé..., des réponses claires au " pourquoi " et au " comment " : Comment identifier les risques ? Comment analyser les risques ? Quels sont les objectifs de la gestion des risques ? Une carte des risques pour quoi faire ? Pourquoi faut-il financer les risques ? Les entreprises ont-elles des responsabilités pénales ? En quoi consiste la gestion...

  2. Clinicians' Choices in Selecting Orthodontic Archwires

    Directory of Open Access Journals (Sweden)

    Silvia-Izabella Pop

    2013-08-01

    Full Text Available Objective: The aim of this study was to assess the choices made by clinicians in selecting archwires during the initial, intermediate and final stages of orthodontic treatment with fixed appliances. Methods: We carried out a questionnaire-based study at the Orthodontics and Pedodontics Clinic Târgu Mureș, between March 2012 and September 2012. The questionnaires consisted of two parts: the first included questions related to the dimension, alloy used in fabrication, section (round or rectangular and manufacturer of the archwires used by the orthodontists in their orthodontic practice, the second part was concerned with their personal opinion about the physical properties and disadvantages of the archwires. Results: From a total number of 90 distributed questionnaires, 62 were returned. The majority of clinicians are using stainless steel (SS and nickel-titanium alloy (NiTi wires in their fixed orthodontic treatments, very few are using beta-titanium (Beta Ti, copper nickel-titanium (Co- NiTi and esthetic archwires. The preferred dimension seem to be 0.022 inches in the appliance system. Regarding the wire dimensions, 0.014, 0.016 inch wires are mostly used from the round section group and 0.016 × 0.022 inch, 0.017 × 0.025 inch from the rectangular ones. Conclusions: There is a general lack of agreement between the clinicians surveyed regarding the properties of an ideal archwire and the disadvantages of the used wires. The most frequently used alloys seemed to be the SS and NiTi

  3. Big brother is watching you : le rôle des technologies de l'information dans la stratégie de contrôle des réseaux de points de vente franchisés

    OpenAIRE

    Kalika, Michel; Boulay, Jacques

    2007-01-01

    Based on a study conducted in the setting of French franchise networks (sample: 428 franchisees), this research establishes the existence of a channel technological control that operates through a « panoptic effect ». The results suggest that information technologies have the capacity to support a more efficient channel control strategy.

  4. La gouvernance des risques naturels et la problematique des ...

    African Journals Online (AJOL)

    Depuis quelques années, la gouvernance des risques naturels dus aux inondations remet en cause les processus de mise en oeuvre des politiques urbaines et la qualité de la structure des aménagements dans les grandes villes du Golfe de Guinée. La perception de la gouvernance et l'application des politiques de ...

  5. un_focus - Les femmes et la terre : Des droits fonciers pour une ...

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

    1 janv. 2011 ... Étonnamment, il existe peu d'informations détaillées sur le rapport des femmes à la terre, et encore moins de données provenant des femmes elles-mêmes. Le présent livre, qui s'inspire des travaux de recherche financés par le CRDI au fil des ans, vise à combler ce vide. Multimédia : Une playlist YouTube.

  6. CHEST: Home of the Clinician-Educator.

    Science.gov (United States)

    Kelly, William F; Niven, Alexander S

    2018-03-01

    Many hands can build a house; it takes trust to make that house a home. Trust has two main components: credibility (worthiness based on preparation and past performance) and empathy (the ability to understand and share another person's values). CHEST has maintained its credibility and empathy as the global leader in clinical pulmonary, critical care, and sleep medical education. It follows that the leader in chest clinical education would also be the home of the clinician-educator. You are that educator. Published by Elsevier Inc.

  7. US Health Care Clinicians' Knowledge, Attitudes, and Practices Regarding Human Papillomavirus Vaccination: A Qualitative Systematic Review.

    Science.gov (United States)

    Rosen, Brittany L; Shepard, Allie; Kahn, Jessica A

    2018-03-01

    Clinicians' recommendation for the human papillomavirus (HPV) vaccine appears to be an important driver of parental decisions about vaccination. Our aim was to synthesize the best available evidence exploring the perceptions and experiences regarding HPV vaccination, from the perspective of the US clinician. We conducted a comprehensive literature search of Academic Search Complete, CINAHL Plus, Communication & Mass Media Complete, Consumer Health Complete (EBSCOhost), ERIC, Health and Psychosocial Instruments, MEDLINE with full text, and PsycINFO databases. We identified 60 eligible articles: 48 quantitative and 12 qualitative. We extracted the following information: study purpose, use of theory, location, inclusion criteria, and health care provider classification. Results were organized into 5 categories: 1) clinicians' knowledge and beliefs about HPV and the HPV vaccine, 2) clinicians' attitudes and beliefs about recommending HPV vaccines, 3) clinicians' intention to recommend HPV vaccines, 4) clinicians' professional practices regarding HPV vaccination, and 5) patient HPV vaccination rates. Although clinicians were generally supportive of HPV vaccination, there was a discrepancy between clinicians' intentions, recommendation practices, and patient vaccination rates. Studies reported that clinicians tended not to provide strong, consistent recommendations, and were more likely to recommend HPV vaccines to girls versus boys and to older versus younger adolescents. Analyses revealed a number of facilitating factors and barriers to HPV vaccination at the clinician, parent/patient, and systems levels, including clinician knowledge, clinician beliefs, and office procedures that promote vaccination. This review provides an evidence base for multilevel interventions to improve clinician HPV vaccine recommendations and vaccination rates. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  8. Stigma in the mental health workplace: perceptions of peer employees and clinicians.

    Science.gov (United States)

    Stromwall, Layne K; Holley, Lynn C; Bashor, Kathy E

    2011-08-01

    Informed by a structural theory of workplace discrimination, mental health system employees' perceptions of mental health workplace stigma and discrimination against service recipients and peer employees were investigated. Fifty-one peer employees and 52 licensed behavioral health clinicians participated in an online survey. Independent variables were employee status (peer or clinician), gender, ethnicity, years of mental health employment, age, and workplace social inclusion of peer employees. Analysis of covariance on workplace discrimination against service recipients revealed that peer employees perceived more discrimination than clinicians and whites perceived more discrimination than employees of color (corrected model F = 9.743 [16, 87], P = .000, partial ŋ (2) = .644). Analysis of covariance on workplace discrimination against peer employees revealed that peer employees perceived more discrimination than clinicians (F = 4.593, [6, 97], P = .000, partial ŋ (2) = .223).

  9. Application de la télédétection et des systèmes d'informations géographiques à l'etude des mouvements de terrain au Liban

    OpenAIRE

    Abdallah , Chadi

    2007-01-01

    Among the various natural hazards, mass movements (MM) are probably the most damaging to the natural and human environment in the Mediterranean countries, including Lebanon which represents a good case study of mountainous landscape. Although affecting vast areas in the country, the phenomenon was not studied at regional scale, and related maps are still lacking. Therefore, this research deals with the use of remote sensing and geographic information system (GIS) techniques in studying MM in ...

  10. Clinician's gaze behaviour in simulated paediatric emergencies.

    Science.gov (United States)

    McNaughten, Ben; Hart, Caroline; Gallagher, Stephen; Junk, Carol; Coulter, Patricia; Thompson, Andrew; Bourke, Thomas

    2018-03-07

    Differences in the gaze behaviour of experts and novices are described in aviation and surgery. This study sought to describe the gaze behaviour of clinicians from different training backgrounds during a simulated paediatric emergency. Clinicians from four clinical areas undertook a simulated emergency. Participants wore SMI (SensoMotoric Instruments) eye tracking glasses. We measured the fixation count and dwell time on predefined areas of interest and the time taken to key clinical interventions. Paediatric intensive care unit (PICU) consultants performed best and focused longer on the chest and airway. Paediatric consultants and trainees spent longer looking at the defibrillator and algorithm (51 180 ms and 50 551 ms, respectively) than the PICU and paediatric emergency medicine consultants. This study is the first to describe differences in the gaze behaviour between experts and novices in a resuscitation. They mirror those described in aviation and surgery. Further research is needed to evaluate the potential use of eye tracking as an educational tool. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  11. Understanding clinicians' attitudes toward a mobile health strategy to childhood asthma management: A qualitative study.

    Science.gov (United States)

    Hollenbach, Jessica P; Cushing, Anna; Melvin, Emilie; McGowan, Bryanna; Cloutier, Michelle M; Manice, Melissa

    2017-09-01

    Mobile technology for childhood asthma can provide real-time data to enhance care. What real-time adherence information clinicians want, how they may use it, and if the data meet their clinical needs have not been fully explored. Our goal was to determine whether pediatric primary care and pulmonary clinicians believe if a sensor-based mobile intervention is useful in caring for patients with asthma. We recruited participants from 3 urban, primary care and 1 pulmonary practice from July to September 2015 in Hartford, CT. Forty-one participated in four focus groups, which included a demonstration of the technology. Participants were probed with open-ended questions on the type, frequency, and format of inter-visit patient information they found useful. 41 participants (mean age 49 (±13.7) years) were board-certified clinicians (41% MDs and 20% mid-level practitioners), practiced medicine on an average of 19 (±14) years, were primarily white (59%) and women (78%). Clinicians wanted 1) adherence to prescribed inhaler therapy and 2) data on inhaler technique. Clinicians wanted it at the time of a scheduled clinic visit but also wanted inter-visit alerts for excessive use of rescue therapy. Pulmonologists liked the mobile spirometer's provision of inter-visit lung function data; pediatricians did not share this view. Concerns with data accuracy were raised due to families who shared inhalers, access to smartphones, and protection of health information. Overall, clinicians view an asthma mobile health technology as enhancing the patient-centered medical home. Pediatric primary care clinicians and pulmonologists want different information from a mobile app.

  12. Clinician preferences and the estimation of causal treatment differences

    OpenAIRE

    Korn, Edward L.; Baumrind, Sheldon

    1998-01-01

    Clinician treatment preferences affect the ability to perform randomized clinical trials and the ability to analyze observational data for treatment effects. In clinical trials, clinician preferences that are based on a subjective analysis of the patient can make it difficult to define eligibility criteria for which clinicians would agree to randomize all patients who satisfy the criteria. In addition, since each clinician typically has some preference for the choice of treatment for a given ...

  13. The effect of core clinician interpersonal behaviours on depression.

    Science.gov (United States)

    Barnicot, K; Wampold, B; Priebe, S

    2014-01-01

    It is well-established that core clinician interpersonal behaviours are important when treating depression, but few studies have evaluated whether outcome is determined by clinicians׳ general behaviour rather than by the perception of the individual being treated. In the NIMH TDCRP, 157 patients rated their clinician׳s genuineness, positive regard, empathy and unconditional regard during cognitive behavioural therapy, interpersonal therapy or clinical management with placebo. The association between averaged ratings for each of 27 clinicians and their patients׳ self- and observer-rated depression outcomes was evaluated, adjusting for the deviation of individual patient ratings from the average for their clinician and other potential confounders. Clinicians in the clinical management condition were rated on average as less genuine and less empathic than those in the psychotherapy conditions. Clinicians׳ average genuineness, positive regard and empathy were significantly associated with lower depression severity during treatment, but not with recovery from depression, after adjusting for the deviation of the individual patient׳s rating of their clinician from the average for that clinician, treatment condition and baseline depression severity. Clinician unconditional regard was not significantly associated with outcome. Using averaged ratings of clinician behaviour likely reduced statistical power. Clinicians׳ ability to demonstrate genuineness, positive regard and empathy may represent a stable personal characteristic that influences the treatment of depression beyond the individual clinician-patient relationship or an individual patient׳s perception of their clinician. However, clinicians׳ ability to demonstrate these behaviours may be poorer when delivering an intervention without a specific rationale or treatment techniques. Copyright © 2014 Elsevier B.V. All rights reserved.

  14. Information

    OpenAIRE

    Verdelhan-Bourgade, Michèle

    2013-01-01

    La publication de ces actes a pu se réaliser grâce au soutien des partenaires du colloque, notamment à celui du Rectorat de l'académie, de l'IUFM, de l'université Montpellier III, du Conseil Général de l'Hérault, de la Fédération des œuvres laïques et de la MAIF, qu'il convient de remercier tout particulièrement pour leur aide active et bienveillante. En raison de leur richesse et de leur variété, les actes de ce colloque sont publiés dans deux volumes distincts : un numéro double de TREMA, r...

  15. Droit des organisations internationales

    CERN Document Server

    Sorel, Jean-Marc; Ndior, Valère

    2013-01-01

    Cet ouvrage collectif offre aux enseignants et chercheurs en droit international, aux praticiens et aux étudiants, une analyse actualisée du droit des organisations internationales. Il dresse en cinq parties un tableau, illustré par des exemples variés, des problématiques que soulève le phénomène polymorphe d institutionnalisation de la société internationale. La première partie est consacrée au phénomène des « organisations internationales », sous l angle à la fois de l institutionnalisation progressive des relations internationales et de la difficulté à cerner une catégorie unifiée. La deuxième partie rend compte de la création, de la disparition et des mutations des organisations internationales, ici envisagées comme systèmes institutionnels et ordres juridiques dérivés. La troisième partie analyse l autonomie que l acquisition de la personnalité juridique et de privilèges et immunités, un organe administratif intégré, un personnel ou un budget propres confèrent aux organi...

  16. [Leadership and management courses for clinicians].

    Science.gov (United States)

    Wichelhaus, Daniel; Fischer, Peter

    2017-08-01

    The aim of the present study was to evaluate the benefit of Leadership and Management Courses for clinicians, specifically which leadership and management contents are beneficial to their daily clinical work and whether these contents support their individual career. E-mail invitations to participate in the study were sent to all 543 medical doctors of the University Hospital Hanover, Germany, who had taken part in one of the leadership and management courses offered between June 2005 and June 2015. The enquiry was carried out between June 1 and June 30, 2015. 84 e-mail addresses were no longer active; and so, N=459 clinicians actually received the invitation. Of these, 104 participated (22.7%). The study included 59 items. Six were free text items, twelve items were closed questions which could be answered by choosing from a drop down menu, and 41 were answered on a Likert scale from 0 (not fitting at all) to 10 (perfect fit). Based on the items answered on a Likert scale, the following scales and mean values were deduced: Job Satisfaction (M=7.44); Leadership (M=7.77); Trust (M=7.22); Striving for Power (M=7,45); negative Affect (M=4,91); Target Achievement Motivation (M=8.19); Communication (M=8.30) and Management (M=6.48). Regression analysis showed that Job- and Team Satisfaction can predict to what extent the participants regard themselves as good leaders. The study participants defined the following topics as very important: leadership and management style, managerial functions, team management, human resources development and project management. Further topics included rhetoric skills, presentation techniques, as well as basic economics such as understanding balance sheets, profit & loss statements and contribution margin calculation. 55% of the course contents were described as being directly applicable to their daily working environment. In the clinicians' view, the ideal leader acts as a role model (passing on values like respect, appreciation, honesty

  17. The making of expert clinicians: reflective practice.

    Science.gov (United States)

    Maestre, J M; Szyld, D; Del Moral, I; Ortiz, G; Rudolph, J W

    2014-05-01

    Debriefing is a rigorous reflection process which helps trainees recognize and resolve clinical and behavioral dilemmas raised by a clinical case. This approach emphasizes eliciting trainees'assumptions about the situation and their reasons for performing as they did (mental models). It analyses their impact on actions, to understand if it is necessary to maintain them or construct new ones that may lead to better performance in the future. It blends evidence and theory from education research, the social and cognitive sciences, and experience drawn from conducting and teaching debriefing to clinicians worldwide, on how to improve professional effectiveness through "reflective practice". Copyright © 2013 Elsevier España, S.L. All rights reserved.

  18. Rocky Mountain spotted fever: a clinician's dilemma.

    Science.gov (United States)

    Masters, Edwin J; Olson, Gary S; Weiner, Scott J; Paddock, Christopher D

    2003-04-14

    Rocky Mountain spotted fever is still the most lethal tick-vectored illness in the United States. We examine the dilemmas facing the clinician who is evaluating the patient with possible Rocky Mountain spotted fever, with particular attention to the following 8 pitfalls in diagnosis and treatment: (1) waiting for a petechial rash to develop before diagnosis; (2) misdiagnosing as gastroenteritis; (3) discounting a diagnosis when there is no history of a tick bite; (4) using an inappropriate geographic exclusion; (5) using an inappropriate seasonal exclusion; (6) failing to treat on clinical suspicion; (7) failing to elicit an appropriate history; and (8) failing to treat with doxycycline. Early diagnosis and proper treatment save lives.

  19. The 3LGM2-tool to support information management in health care / Der 3LGM2-Baukasten zur Unterstützung des Informationsmanagements im Gesundheitswesen

    Directory of Open Access Journals (Sweden)

    Winter, Alfred

    2011-01-01

    Full Text Available Hospital information systems (HIS as well as transinstitutional health information systems (tHIS are constructed like a (complex of building(s out of different and probably heterogeneous bricks and components. Like an architect the information manager needs a description or model for the information system’s architecture respectively the enterprise architecture. 3LGM2 as a meta model has been designed to describe information systems (IS by concepts on three layers. The meta model has been supplemented by the 3LGM2 tool. It enables information managers to graphically design even complex IS and provides means for analyzing information system’s quality and thus supports strategic, tactical and operational information management.

  20. Santé des adolescents et des jeunes au Burkina Faso : état des ...

    African Journals Online (AJOL)

    Il s'est agi d'une étude évaluative ayant utilisé une revue documentaire associée à une interview des acteurs clés et un atelier de validation et d'identification des interventions pertinentes pour un plan stratégique national. La situation de la santé des adolescents et des jeunes est caractérisée par des grossesses précoces ...

  1. Online Mental Health Resources in Rural Australia: Clinician Perceptions of Acceptability

    Science.gov (United States)

    Holloway, Kristi; Riley, Geoffrey; Auret, Kirsten

    2013-01-01

    Background Online mental health resources have been proposed as an innovative means of overcoming barriers to accessing rural mental health services. However, clinicians tend to express lower satisfaction with online mental health resources than do clients. Objective To understand rural clinicians’ attitudes towards the acceptability of online mental health resources as a treatment option in the rural context. Methods In-depth interviews were conducted with 21 rural clinicians (general practitioners, psychologists, psychiatrists, and clinical social workers). Interviews were supplemented with rural-specific vignettes, which described clinical scenarios in which referral to online mental health resources might be considered. Symbolic interactionism was used as the theoretical framework for the study, and interview transcripts were thematically analyzed using a constant comparative method. Results Clinicians were optimistic about the use of online mental health resources into the future, showing a preference for integration alongside existing services, and use as an adjunct rather than an alternative to traditional approaches. Key themes identified included perceptions of resources, clinician factors, client factors, and the rural and remote context. Clinicians favored resources that were user-friendly and could be integrated into their clinical practice. Barriers to use included a lack of time to explore resources, difficulty accessing training in the rural environment, and concerns about the lack of feedback from clients. Social pressure exerted within professional clinical networks contributed to a cautious approach to referring clients to online resources. Conclusions Successful implementation of online mental health resources in the rural context requires attention to clinician perceptions of acceptability. Promotion of online mental health resources to rural clinicians should include information about resource effectiveness, enable integration with existing

  2. A clinician-driven home care delivery system.

    Science.gov (United States)

    August, D A; Faubion, W C; Ryan, M L; Haggerty, R H; Wesley, J R

    1993-12-01

    The financial, entrepreneurial, administrative, and legal forces acting within the home care arena make it difficult for clinicians to develop and operate home care initiatives within an academic setting. HomeMed is a clinician-initiated and -directed home care delivery system wholly owned by the University of Michigan. The advantages of a clinician-directed system include: Assurance that clinical and patient-based factors are the primary determinants of strategic and procedural decisions; Responsiveness of the system to clinician needs; Maintenance of an important role for the referring physician in home care; Economical clinical research by facilitation of protocol therapy in ambulatory and home settings; Reduction of lengths of hospital stays through clinician initiatives; Incorporation of outcome analysis and other research programs into the mission of the system; Clinician commitment to success of the system; and Clinician input on revenue use. Potential disadvantages of a clinician-based system include: Entrepreneurial, financial, and legal naivete; Disconnection from institutional administrative and data management resources; and Inadequate clinician interest and commitment. The University of Michigan HomeMed experience demonstrates a model of clinician-initiated and -directed home care delivery that has been innovative, profitable, and clinically excellent, has engendered broad physician, nurse, pharmacist, and social worker enthusiasm, and has supported individual investigator clinical protocols as well as broad outcomes research initiatives. It is concluded that a clinician-initiated and -directed home care program is feasible and effective, and in some settings may be optimal.

  3. Diethylstilbestrol (DES) and Cancer

    Science.gov (United States)

    ... DES-exposed grandchildren have? Researchers are also studying possible health effects among women and men who are the children ... for unexposed men. In addition, researchers are studying possible health effects on the grandchildren of mothers who were exposed ...

  4. Table des illustrations

    OpenAIRE

    2016-01-01

    Tableaux Dates d’inauguration des grands hôtels japonais entre 1860 et 1945… 19 Histoire, tourisme et hôtellerie en Corée depuis les années 1870… 59-60 Dates d’inauguration des grands hôtels chinois depuis 1863… 84 Les hôtels de luxe et leurs capacités d’hébergement en Corée en 2000… 103 Les flux de personnes suscités par les hôtels « super luxe » de Séoul en 2000… 105 L’activité des grands hôtels à Séoul en 1999 (en wons)… 106 Propriété et gestion des grands hôtels à Séoul en 1999…. 110 La c...

  5. Direction des Publications

    African Journals Online (AJOL)

    Synthese

    potential and surface properties of their mixtures were investigated, in an ... suppose that the electrostatic repulsive interactions between the two anion ... concentration, et de la conformation des ..... proteins and polysaccharides in solutions,.

  6. 2011 "Cour des Contes" storytelling festival

    CERN Multimedia

    2011-01-01

    The "Cour des Contes" storytelling festival will take place in Plan-les-Ouates (Geneva) from 6 to 15 May 2011. This year, for the first time, stories will be told in English at 11 a.m. on Sunday, 15 May, at the "La Julienne" arts and culture centre.   More information  

  7. A qualitative study examining methods of accessing and identifying research relevant to clinical practice among rehabilitation clinicians.

    Science.gov (United States)

    Patel, Drasti; Koehmstedt, Christine; Jones, Rebecca; Coffey, Nathan T; Cai, Xinsheng; Garfinkel, Steven; Shaewitz, Dahlia M; Weinstein, Ali A

    2017-01-01

    Research examining the utilization of evidence-based practice (EBP) specifically among rehabilitation clinicians is limited. The objective of this study was to examine how various rehabilitative clinicians including physical therapists, occupational therapists, rehabilitation counselors, and physiatrists are gaining access to literature and whether they are able to implement the available research into practice. A total of 21 total clinicians were interviewed via telephone. Using NVivo, a qualitative analysis of the responses was performed. There were similarities found with respect to the information-seeking behaviors and translation of research across the different clinician types. Lack of time was reported to be a barrier for both access to literature and implementation of research across all clinician types. The majority of clinicians who reported having difficulty with utilizing the published literature indicated that the literature was not applicable to their practice, the research was not specific enough to be put into practice, or the research found was too outdated to be relevant. In addition, having a supportive work environment aided in the search and utilization of research through providing resources central to assisting clinicians in gaining access to health information. Our study identified several barriers that affect EBP for rehabilitation clinicians. The findings suggest the need for researchers to ensure that their work is applicable and specific to clinical practice for implementation to occur.

  8. La revolution des savants

    CERN Document Server

    Chavanne, A

    1989-01-01

    Premiere cassette : - 1666 : impact de la creation de l'Academie des Sciences par Colbert, trente ans apres le proces de Galile, et au moment des disparitions de Pascal, Descartes et Fermat. Elle dirigee par le hollandais Huyggens jusqu'a sa fuite de France au moment de la revocation de l'Edit de Nantes. - 1750 : l'Encyclopedie (ou "Dictionnaire raisonne des Sciences, des Arts et des Metiers") de Diderot et d'Alembert, soutenus par Malherbes, Buffon, Condorcet et Rousseau. - 1789 : Revolution francaise. - 8 aout 1793 : l'Assemblee, par une declaration de Marat, dissout l'Academie des Sciences. Celle-ci continue cependant ses travaux pour les poids et mesures jusqu'en 1795. - la Terreur : la condamnation a mort, pas au nom d'une "Revolution qui n'a pas besoin de savants" mais pour d'autres raisons, de trois grands hommes de science : Lavoisier, Bailly et Condorcet. - 1793-1794 : Au printemps 93, le Comite de Salut Publique s'inquiete du demi-million de soldats etrangers de toutes les pays frontaliers qui essai...

  9. Interactions between non-physician clinicians and industry: a systematic review.

    Directory of Open Access Journals (Sweden)

    Quinn Grundy

    2013-11-01

    Full Text Available BACKGROUND: With increasing restrictions placed on physician-industry interactions, industry marketing may target other health professionals. Recent health policy developments confer even greater importance on the decision making of non-physician clinicians. The purpose of this systematic review is to examine the types and implications of non-physician clinician-industry interactions in clinical practice. METHODS AND FINDINGS: We searched MEDLINE and Web of Science from January 1, 1946, through June 24, 2013, according to PRISMA guidelines. Non-physician clinicians eligible for inclusion were: Registered Nurses, nurse prescribers, Physician Assistants, pharmacists, dieticians, and physical or occupational therapists; trainee samples were excluded. Fifteen studies met inclusion criteria. Data were synthesized qualitatively into eight outcome domains: nature and frequency of industry interactions; attitudes toward industry; perceived ethical acceptability of interactions; perceived marketing influence; perceived reliability of industry information; preparation for industry interactions; reactions to industry relations policy; and management of industry interactions. Non-physician clinicians reported interacting with the pharmaceutical and infant formula industries. Clinicians across disciplines met with pharmaceutical representatives regularly and relied on them for practice information. Clinicians frequently received industry "information," attended sponsored "education," and acted as distributors for similar materials targeted at patients. Clinicians generally regarded this as an ethical use of industry resources, and felt they could detect "promotion" while benefiting from industry "information." Free samples were among the most approved and common ways that clinicians interacted with industry. Included studies were observational and of varying methodological rigor; thus, these findings may not be generalizable. This review is, however, the

  10. Interactions between non-physician clinicians and industry: a systematic review.

    Science.gov (United States)

    Grundy, Quinn; Bero, Lisa; Malone, Ruth

    2013-11-01

    With increasing restrictions placed on physician-industry interactions, industry marketing may target other health professionals. Recent health policy developments confer even greater importance on the decision making of non-physician clinicians. The purpose of this systematic review is to examine the types and implications of non-physician clinician-industry interactions in clinical practice. We searched MEDLINE and Web of Science from January 1, 1946, through June 24, 2013, according to PRISMA guidelines. Non-physician clinicians eligible for inclusion were: Registered Nurses, nurse prescribers, Physician Assistants, pharmacists, dieticians, and physical or occupational therapists; trainee samples were excluded. Fifteen studies met inclusion criteria. Data were synthesized qualitatively into eight outcome domains: nature and frequency of industry interactions; attitudes toward industry; perceived ethical acceptability of interactions; perceived marketing influence; perceived reliability of industry information; preparation for industry interactions; reactions to industry relations policy; and management of industry interactions. Non-physician clinicians reported interacting with the pharmaceutical and infant formula industries. Clinicians across disciplines met with pharmaceutical representatives regularly and relied on them for practice information. Clinicians frequently received industry "information," attended sponsored "education," and acted as distributors for similar materials targeted at patients. Clinicians generally regarded this as an ethical use of industry resources, and felt they could detect "promotion" while benefiting from industry "information." Free samples were among the most approved and common ways that clinicians interacted with industry. Included studies were observational and of varying methodological rigor; thus, these findings may not be generalizable. This review is, however, the first to our knowledge to provide a descriptive analysis

  11. TEDx Place Des Nations | 11 December

    CERN Multimedia

    2014-01-01

    On 11 December, Geneva will host the TEDxPlaceDesNations event.   TEDxPlaceDesNations, in the spirit of TED’s “Ideas Worth Spreading” principle, will involve innovators, humanitarians, entrepreneurs, scientists and peacemakers. The eleven speakers will share how their work can help find solutions to today’s challenges. Among the speakers will be Javier Serrano, a CERN physicist and electronics engineer. He is the co-author of the CERN Open Hardware License and the creator of the Open Hardware Repository, a web platform where companies, institutes and individuals can share their hardware designs for free. Additional information is available at the TEDxPlaceDesNations site. The detailed programme will be posted on 28 November. Seats are limited, so registration is essential. The event can be followed by live webcast here.

  12. [Quo vadis pathologia? An elderly clinicians meditations about autopsies].

    Science.gov (United States)

    Iványi, J

    1998-02-08

    Relying on his own experience and the relevant literature of the past 15 years, the author analyzes the causes of the decrease in the number of autopsies. He disagrees with those who, referring to the application of state-of-the art examination methods, dismiss "the ultimate audit" as unnecessary and only suggest selection. Careful autopsies can still be rendered an authentic and reliable picture of treatment of the deceased on the one hand, and provide information about diagnostic difficulties as well as the possible mistakes and errors on the other. This is especially true of the elderly deceased usually with multimorbidity. As well as several aspects of the cooperation between the pathologist and the clinician there is the didactic importance of autopsies that should also be emphasized.

  13. A clinician's artificial organ? Instant messaging applications in medical care.

    Science.gov (United States)

    Tazegul, Gokhan; Bozoglan, Humeyra; Ogut, Tahir S; Balcı, Mustafa K

    2017-09-15

    After the development of the first phone at the end of 19th century, communication technologies took a great leap forward in the 20th century. With the birth of the "smartphone" in the 21st century, communication technologies exponentially evolved and became an important part of our daily routine. Effective communications between clinicians is critical in medical care and miscommunications are a source of errors. Although telecommunication technologies have proliferated dramatically in the last decade, there is scarce evidence-based information on the use of this technology in medical care. For the purposes of medical communication, we can now consult each other about patients individually and within a group via instant messaging applications by using text messages, photos, audio messages and even videos. In this review, we examine the uses and drawbacks of instant messaging applications in medical communications.

  14. Examination of the relationship between management and clinician perception of patient safety climate and patient satisfaction.

    Science.gov (United States)

    Mazurenko, Olena; Richter, Jason; Kazley, Abby Swanson; Ford, Eric

    2017-04-25

    The aim of this study was to explore the relationship between managers and clinicians' agreement on deeming the patient safety climate as high or low and the patients' satisfaction with those organizations. We used two secondary data sets: the Hospital Survey on Patient Safety Culture (2012) and the Hospital Consumer Assessment of Healthcare Providers and Systems (2012). We used ordinary least squares regressions to analyze the relationship between the extent of agreement between managers and clinicians' perceptions of safety climate in relationship to patient satisfaction. The dependent variables were four Hospital Consumer Assessment of Healthcare Providers and Systems patient satisfaction scores: communication with nurses, communication with doctors, communication about medicines, and discharge information. The main independent variables were four groups that were formed based on the extent of managers and clinicians' agreement on four patient safety climate domains: communication openness, feedback and communication about errors, teamwork within units, and teamwork across units. After controlling for hospital and market-level characteristics, we found that patient satisfaction was significantly higher if managers and clinicians reported that patient safety climate is high or if only clinicians perceived the climate as high. Specifically, manager and clinician agreement on high levels of communication openness (β = 2.25, p = .01; β = 2.46, p = .05), feedback and communication about errors (β = 3.0, p = .001; β = 2.89, p = .01), and teamwork across units (β = 2.91, p = .001; β = 3.34, p = .01) was positively and significantly associated with patient satisfaction with discharge information and communication about medication. In addition, more favorable perceptions about patient safety climate by clinicians only yielded similar findings. Organizations should measure and examine patient safety climate from multiple perspectives and be aware that individuals

  15. Prediction of mandibular rotation: an empirical test of clinician performance.

    Science.gov (United States)

    Baumrind, S; Korn, E L; West, E E

    1984-11-01

    An experiment was conducted in an attempt to determine empirically how effective a number of expert clinicians were at differentiating "backward rotators" from "forward rotators" on the basis of head-film information which might reasonably have been available to them prior to instituting treatment for the correction of Class II malocclusion. As a result of a previously reported ongoing study, pre- and posttreatment head films were available for 188 patients treated in the mixed dentition for the correction of Class II malocclusion and for 50 untreated Class II subjects. These subjects were divided into 14 groups (average size of group, 17; range, 6 to 23) solely on the basis of type of treatment and the clinician from whose clinic the records had originated. From within each group, we selected the two or three subjects who had exhibited the most extreme backward rotation and the two or three subjects who had exhibited the most extreme forward rotation of the mandible during the interval between films. The sole criterion for classification was magnitude of change in the mandibular plane angle of Downs between the pre- and posttreatment films of each patient. The resulting sample contained 32 backward-rotator subjects and 32 forward-rotator subjects. Five expert judges (mean clinical experience, 28 years) were asked to identify the backward-rotator subjects by examination of the pretreatment films. The findings may be summarized as follows: (1) No judge performed significantly better than chance. (2) There was strong evidence that the judges used a shared, though relatively ineffective, set of rules in making their discriminations between forward and backward rotators. (3) Statistical analysis of the predictive power of a set of standard cephalometric measurements which had previously been made for this set of subjects indicated that the numerical data also failed to identify potential backward rotators at a rate significantly better than chance. We infer from these

  16. A qualitative analysis of oncology clinicians' perceptions and barriers for physical activity counseling in breast cancer survivors.

    Science.gov (United States)

    Fong, Angela J; Faulkner, Guy; Jones, Jennifer M; Sabiston, Catherine M

    2018-03-24

    Few breast cancer survivors (BCS) engage in sufficient physical activity (PA) to gain physical and mental health benefits. This may be due to a lack of appropriate PA information and support. While key messengers of PA information could be oncology clinicians, many do not consistently counsel their patients on PA. To examine factors affecting PA counseling in clinicians and inform future strategies. Focus groups were conducted with clinicians (N = 27) at four cancer hospitals to better understand factors that affect PA counseling. Focus group discussions were transcribed verbatim and analyzed using inductive thematic analysis. Clinicians perceived a lack of training and knowledge related to PA and BCS. Clinicians also discussed being unsure of when to integrate PA counseling into different phases of survivorship. Similarly, clinicians experienced barriers from hospital administration to maintain patient flow in-clinic, which decreased opportunities for PA counseling. Additionally, lack of awareness of community-based programs within large areas served by hospitals also decreased clinicians' self-efficacy for counseling. In order to facilitate PA counseling, clinicians wanted resources that promote patient-managed PA, available on multiple platforms (e.g., printed and online). Continued education, highlighting recent research and effective implementation of PA, was noted as an important facilitator. Researchers are encouraged to develop research agendas and test educational strategies that are integrated into current practice, empirically test barriers that developed from this study with a larger, representative sample to determine salient barriers and develop PA counseling strategies that are clinician-initiated but not dependent on clinicians.

  17. Les facteurs d’influence de l’indépendance de l’auditeur externe: une étude exploratoire auprès des préparateurs de l’information financière tunisiens

    Directory of Open Access Journals (Sweden)

    Omri Mohamed Ali Brahim

    2014-09-01

    Full Text Available Cette étude vise à déterminer les facteurs d’influence de l’indépendance perçue de l’auditeur externe. Afin d’atteindre notre objectif nous avons menée une analyse fondée sur une première phase qualitative et une deuxième quantitative. Cette dernière repose sur un questionnaire adressé à 87 préparateurs d’information financière tunisiens. Notre étude a révélé que les préparateurs de l’information financière construisent leurs perception en privilégiant essentiellement la réputation de l’auditeur externe, suivi par la taille du cabinet, le contrôle de la profession et la responsabilité juridique, les liens personnels, les incompatibilités, les honoraires, la dépendance financière et la rotation des auditeurs.

  18. Gatekeepers or intermediaries? The role of clinicians in commercial genomic testing.

    Directory of Open Access Journals (Sweden)

    Michelle L McGowan

    Full Text Available Many commentators on "direct-to-consumer" genetic risk information have raised concerns that giving results to individuals with insufficient knowledge and training in genomics may harm consumers, the health care system, and society. In response, several commercial laboratories offering genomic risk profiling have shifted to more traditional "direct-to-provider" (DTP marketing strategies, repositioning clinicians as the intended recipients of advertising of laboratory services and as gatekeepers to personal genomic information. Increasing popularity of next generation sequencing puts a premium on ensuring that those who are charged with interpreting, translating, communicating and managing commercial genomic risk information are appropriately equipped for the job. To shed light on their gatekeeping role, we conducted a study to assess how and why early clinical users of genomic risk assessment incorporate these tools in their clinical practices and how they interpret genomic information for their patients.We conducted qualitative in-depth interviews with 18 clinicians providing genomic risk assessment services to their patients in partnership with DNA Direct and Navigenics. Our findings suggest that clinicians learned most of what they knew about genomics directly from the commercial laboratories. Clinicians rely on the expertise of the commercial laboratories without the ability to critically evaluate the knowledge or assess risks.DTP service delivery model cannot guarantee that providers will have adequate expertise or sound clinical judgment. Even if clinicians want greater genomic knowledge, the current market structure is unlikely to build the independent substantive expertise of clinicians, but rather promote its continued outsourcing. Because commercial laboratories have the most "skin in the game" financially, genetics professionals and policymakers should scrutinize the scientific validity and clinical soundness of the process by which

  19. Gatekeepers or intermediaries? The role of clinicians in commercial genomic testing.

    Science.gov (United States)

    McGowan, Michelle L; Fishman, Jennifer R; Settersten, Richard A; Lambrix, Marcie A; Juengst, Eric T

    2014-01-01

    Many commentators on "direct-to-consumer" genetic risk information have raised concerns that giving results to individuals with insufficient knowledge and training in genomics may harm consumers, the health care system, and society. In response, several commercial laboratories offering genomic risk profiling have shifted to more traditional "direct-to-provider" (DTP) marketing strategies, repositioning clinicians as the intended recipients of advertising of laboratory services and as gatekeepers to personal genomic information. Increasing popularity of next generation sequencing puts a premium on ensuring that those who are charged with interpreting, translating, communicating and managing commercial genomic risk information are appropriately equipped for the job. To shed light on their gatekeeping role, we conducted a study to assess how and why early clinical users of genomic risk assessment incorporate these tools in their clinical practices and how they interpret genomic information for their patients. We conducted qualitative in-depth interviews with 18 clinicians providing genomic risk assessment services to their patients in partnership with DNA Direct and Navigenics. Our findings suggest that clinicians learned most of what they knew about genomics directly from the commercial laboratories. Clinicians rely on the expertise of the commercial laboratories without the ability to critically evaluate the knowledge or assess risks. DTP service delivery model cannot guarantee that providers will have adequate expertise or sound clinical judgment. Even if clinicians want greater genomic knowledge, the current market structure is unlikely to build the independent substantive expertise of clinicians, but rather promote its continued outsourcing. Because commercial laboratories have the most "skin in the game" financially, genetics professionals and policymakers should scrutinize the scientific validity and clinical soundness of the process by which these laboratories

  20. Systematic Heuristic Evaluation of Computerized Consultation Order Templates: Clinicians' and Human Factors Engineers' Perspectives.

    Science.gov (United States)

    Savoy, April; Patel, Himalaya; Flanagan, Mindy E; Weiner, Michael; Russ, Alissa L

    2017-08-01

    We assessed the usability of consultation order templates and identified problems to prioritize in design efforts for improving referral communication. With a sample of 26 consultation order templates, three evaluators performed a usability heuristic evaluation. The evaluation used 14 domain-independent heuristics and the following three supplemental references: 1 new domain-specific heuristic, 6 usability goals, and coded clinicians' statements regarding ease of use for 10 sampled templates. Evaluators found 201 violations, a mean of 7.7 violations per template. Minor violations outnumbered major violations almost twofold, 115 (57%) to 62 (31%). Approximately 68% of violations were linked to 5 heuristics: aesthetic and minimalist design (17%), error prevention (16%), consistency and standards (14%), recognition rather than recall (11%), and meet referrers' information needs (10%). Severe violations were attributed mostly to meet referrers' information needs and recognition rather than recall. Recorded violations yielded potential negative consequences for efficiency, effectiveness, safety, learnability, and utility. Evaluators and clinicians demonstrated 80% agreement in usability assessment. Based on frequency and severity of usability heuristic violations, the consultation order templates reviewed may impede clinical efficiency and risk patient safety. Results support the following design considerations: communicate consultants' requirements, facilitate information seeking, and support communication. While the most frequent heuristic violations involved interaction design and presentation, the most severe violations lacked information desired by referring clinicians. Violations related to templates' inability to support referring clinicians' information needs had the greatest potential negative impact on efficiency and safety usability goals. Heuristics should be prioritized in future design efforts.

  1. Use of laboratory test results in patient management by clinicians in Malawi.

    Science.gov (United States)

    Moyo, Kundai; Porter, Carol; Chilima, Ben; Mwenda, Reuben; Kabue, Mark; Zungu, Lutho; Sarr, Abdoulaye

    2015-11-18

    Malawi has a high burden of infectious disease. The expansion of programmes targeting these diseases requires a strong laboratory infrastructure to support both diagnosis and treatment. To assess the use of laboratory test results in patient management and to determine the requirements for improving laboratory services. A cross-sectional study was conducted in 2012 to survey practising clinicians. Two hospitals were purposively selected for observations of clinicians ordering laboratory tests. Twelve management-level key informants were interviewed. Descriptive statistics were conducted. A total of 242 clinicians were identified and 216 (89%) were interviewed. Of these, 189 (87%) reported doubting laboratory test results at some point. Clinicians most often doubted the quality of haematology (67%), followed by malaria (53%) and CD4 (22%) test results. A total of 151 (70%) clinicians reported using laboratory tests results in patient management. Use of laboratory test results at all times in patient management varied by the type of health facility ( P management. Key informants reported that the quality of laboratory services was good and useful, but that services were often unavailable. Gaps in the public laboratory system were evident. Key recommendations to enhance the use of laboratory test results in patient management were to strengthen the supply chain, reduce turn-around times, improve the test menu and improve the laboratory infrastructure.

  2. Bioethics for clinicians: 27. Catholic bioethics

    Science.gov (United States)

    Markwell, Hazel J.; Brown, Barry F.

    2001-01-01

    THERE IS A LONG TRADITION OF BIOETHICAL REASONING within the Roman Catholic faith, a tradition expressed in scripture, the writings of the Doctors of the Church, papal encyclical documents and reflections by contemporary Catholic theologians. Catholic bioethics is concerned with a broad range of issues, including social justice and the right to health care, the duty to preserve life and the limits of that duty, the ethics of human reproduction and end-of-life decisions. Fundamental to Catholic bioethics is a belief in the sanctity of life and a metaphysical conception of the person as a composite of body and soul. Although there is considerable consensus among Catholic thinkers, differences in philosophical approach have given rise to some diversity of opinion with respect to specific issues. Given the influential history of Catholic reflection on ethical matters, the number of people in Canada who profess to be Catholic, and the continuing presence of Catholic health care institutions, it is helpful for clinicians to be familiar with the central tenets of this tradition while respecting the differing perspectives of patients who identify themselves as Catholic. PMID:11501460

  3. Childhood agricultural injuries: an update for clinicians.

    Science.gov (United States)

    Wright, Suzanne; Marlenga, Barbara; Lee, Barbara C

    2013-02-01

    Every three days a child dies in an agriculture-related incident, and every day 45 children are injured in the United States. These tragedies should not be regarded as "accidents," as they often follow predictable and preventable patterns. Prevention is not only possible, but vital, since many of these injuries are almost immediately fatal. Major sources of fatal injuries are machinery, motor vehicles, and drowning. Tractor injuries alone account for one-third of all deaths. The leading sources of nonfatal injuries are structures and surfaces, animals (primarily horses), and vehicles (primarily all-terrain vehicles [ATVs]). Children living on farms are at a higher risk than hired workers, and are unprotected by child labor laws. Preschool children and older male youth are at the highest risk for fatal injury, while nonfatal injury was most common among boys aged 10-15 years. Multiple prevention strategies have been developed, yet economic and cultural barriers often impede their implementation. Educational campaigns alone are often ineffective, and must be coupled with re-engineering of machines and safety devices to reduce fatalities. Legislation has the potential to improve child safety, yet political and economic pressures often prohibit changes in child labor laws and mandated safety requirements. Clinicians play a pivotal role in injury prevention, and should actively address common rural risk-taking behaviors as part of the routine office visit in order to help prevent these tragedies. Copyright © 2013 Mosby, Inc. All rights reserved.

  4. Contribution des radios communautaires a l'education des ...

    African Journals Online (AJOL)

    Contribution des radios communautaires a l'education des populations rurales pour un developpement durable au Benin: etude de cas. ... Journal de la Recherche Scientifique de l'Université de Lomé. Journal Home · ABOUT THIS JOURNAL ...

  5. La convergence des rôles respectifs des relationnistes et des journalistes influence-t-elle la perception qu'ils ont les uns des autres?

    DEFF Research Database (Denmark)

    Valentini, Chiara

    2017-01-01

    la convergence des rôles respectifs des praticiens des relations publiques et des journalistes a un effet favorable sur la perception qu’ils ont les uns des autres. L’effet est plus marqué chez les praticiens des relations publiques, car leur vision de la profession en journalisme correspond à celle...

  6. Going Tobacco-Free: Predictors of Clinician Reactions and Outcomes of the NY State OASAS Tobacco-Free Regulation

    Science.gov (United States)

    de Tormes Eby, Lillian Turner; George, Kerrin; Brown, B. Lindsay

    2012-01-01

    In an effort to reduce patient tobacco dependence and create healthier work environments, New York State (NYS) mandated 100% tobacco-free addiction treatment programs for state funded or certified facilities in 2008. We present the results of a longitudinal study examining how local implementation features shape clinician reactions to the regulation and influence post-regulation clinician behavior and strain. A cohort of 147 clinicians associated with 13 treatment organizations throughout NYS completed a survey prior to the passage of the regulation and again approximately 1 year post-regulation. Findings reveal that local implementation features of clinician participation in the planning for change, the provision of change-related information, and perceived organizational support predicted perceptions of change management fairness, which in turn predicted clinical practice behaviors to support smoking cessation, as well as psychological and behavioral strain. In contrast, self-efficacy for change was neither related to local implementation or clinician outcomes. Practical implications are discussed. PMID:22959978

  7. Promouvoir l'entrepreneuriat inclusif des jeunes et des femmes ...

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

    Le projet vise à analyser la contribution réelle et potentielle de l'entrepreneuriat inclusif au bien-être des jeunes et des femmes en Côte d'Ivoire, au Burkina Faso et au Kenya. Après un état des lieux de la pratique de l'entrepreneuriat inclusif dans chacun des pays ciblés, l'équipe de recherche étudiera son incidence sur ...

  8. Actual legal questions and problems of the free access to information, especially in the environmental protection; Aktuelle Rechtsfragen und Probleme des freien Informationszugangs, insbesondere im Umweltschutz

    Energy Technology Data Exchange (ETDEWEB)

    Schroeder, Meinhard (ed.)

    2010-07-01

    Within the 26th Trier colloquium on the law governing environmental protection and technology at 5th to 7th September, 2010 in Trier (Federal Republic of Germany), the following lectures were held: (1) The environmental law in the light of federalism and Europeanization (Hans-Juergen Papier); (2) Information rights in the EU (Astrid Epiney); (3) Environmental policy by freedom of information (Friedrich Schoch); (4) The legal framework for the opening of the access to information as well as the appearance of accessible information under special consideration of the environmental information Directive 2003/4/EG and its implementation in the German Law (Joern Axel Kaemmerer); (5) The utilization of electronic media: REACh data bases, publication of authorizing procedures in the Internet and geo data mediation such as google maps (Indra Spiecker); (6) Protection position of companies in the right of access to information. The protection of business secrets and commercial confidentialities as well as application dossiers in the European and German law (Matthias Rossi); (7) Limited protection of business secrets and commercial confidentialities as a part of genetic engineering legal approval procedures (Hartwig Stiebler); (8) The NRW pipeline cadastre (Alexander Schink); (9) Legal protection by European and national courts under consideration of the European Ombudsman in his function in securing the access of information (Sabine Schlacke).

  9. La fabrique des sciences des institutions aux pratiques

    CERN Document Server

    Benninghoff, Martin; Crettaz von Roten, Fabienne; Merz, Martina

    2006-01-01

    Aujourd'hui, les façons de produire, d'organiser, d'évaluer et d'utiliser les savoirs sont en profond débat. De plus en plus, l'Etat, la société civile et l'économie tentent d'influencer les activités des universités et des laboratoires de recherche. Ces développements mettent à l'épreuve tout à la fois les fondements des systèmes d'enseignement supérieur et de recherche, l'autonomie des institutions scientifiques, la définition des frontières des savoirs et l'acceptation des sciences. Dans des contextes suisses et européens, cet ouvrage s'intéresse aux manières dont les sciences et les technologies sont fabriquées, en analysant leurs institutions et les pratiques. A partir d'une approche relationnelle, les sciences et les technologies sont conçues comme des phénomènes profondément sociaux, culturels et politiques. Une telle démarche déstabilise les visions parfois idéalisées et stéréotypées de la construction des savoirs. Des études de cas détaillées décrivent des phénomè...

  10. Effets des extraits vegetaux sur la dynamique de populations des ...

    African Journals Online (AJOL)

    La présente étude se propose de trouver une alternative de l'utilisation des pesticides chimiques en testant l'effet insecticide des extraits aqueux des feuilles de Hyptis suaveolens, graines de Ricinus communis et de Azadirachta indica contre les ravageurs du niébé en conditions de champ en utilisant le cyperméthrine ...

  11. Bioethics for clinicians: 25. Teaching bioethics in the clinical setting

    Science.gov (United States)

    McKneally, Martin F.; Singer, Peter A.

    2001-01-01

    BIOETHICS IS NOW TAUGHT IN EVERY CANADIAN MEDICAL SCHOOL. Canada needs a cadre of teachers who can help clinicians learn bioethics. Our purpose is to encourage clinician teachers to accept this important responsibility and to provide practical advice about teaching bioethics to clinicians as an integral part of good clinical medicine. We use 5 questions to focus the discussion: Why should I teach? What should I teach? How should I teach? How should I evaluate? How should I learn? PMID:11338804

  12. Patient-Clinician Communication About Pain: A Conceptual Model and Narrative Review.

    Science.gov (United States)

    Henry, Stephen G; Matthias, Marianne S

    2018-02-01

    Productive patient-clinician communication is an important component of effective pain management, but we know little about how patients and clinicians actually talk about pain in clinical settings and how it might be improved to produce better patient outcomes. The objective of this review was to create a conceptual model of patient-clinician communication about noncancer pain, review and synthesize empirical research in this area, and identify priorities for future research. A conceptual model was developed that drew on existing pain and health communication research. CINAHL, EMBASE, and PubMed were searched to find studies reporting empirical data on patient-clinician communication about noncancer pain; results were supplemented with manual searches. Studies were categorized and analyzed to identify crosscutting themes and inform model development. The conceptual model comprised the following components: contextual factors, clinical interaction, attitudes and beliefs, and outcomes. Thirty-nine studies met inclusion criteria and were analyzed based on model components. Studies varied widely in quality, methodology, and sample size. Two provisional conclusions were identified: contrary to what is often reported in the literature, discussions about analgesics are most frequently characterized by patient-clinician agreement, and self-presentation during patient-clinician interactions plays an important role in communication about pain and opioids. Published studies on patient-clinician communication about noncancer pain are few and diverse. The conceptual model presented here can help to identify knowledge gaps and guide future research on communication about pain. Investigating the links between communication and pain-related outcomes is an important priority for future research. © 2018 American Academy of Pain Medicine. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

  13. Oncology clinicians' defenses and adherence to communication skills training with simulated patients: an exploratory study.

    Science.gov (United States)

    Bernard, Mathieu; de Roten, Yves; Despland, Jean-Nicolas; Stiefel, Friedrich

    2012-06-01

    The aim of this exploratory study was to assess the impact of clinicians' defense mechanisms-defined as self-protective psychological mechanisms triggered by the affective load of the encounter with the patient-on adherence to a communication skills training (CST). The population consisted of oncology clinicians (N=31) who participated in a CST. An interview with simulated cancer patients was recorded prior and 6 months after CST. Defenses were measured before and after CST and correlated with a prototype of an ideally conducted interview based on the criteria of CST-teachers. Clinicians who used more adaptive defense mechanisms showed better adherence to communication skills after CST than clinicians with less adaptive defenses (F(1, 29) =5.26, p=0.03, d=0.42). Improvement in communication skills after CST seems to depend on the initial levels of defenses of the clinician prior to CST. Implications for practice and training are discussed. Communication has been recognized as a central element of cancer care [1]. Ineffective communication may contribute to patients' confusion, uncertainty, and increased difficulty in asking questions, expressing feelings, and understanding information [2, 3], and may also contribute to clinicians' lack of job satisfaction and emotional burnout [4]. Therefore, communication skills trainings (CST) for oncology clinicians have been widely developed over the last decade. These trainings should increase the skills of clinicians to respond to the patient's needs, and enhance an adequate encounter with the patient with efficient exchange of information [5]. While CSTs show a great diversity with regard to their pedagogic approaches [6, 7], the main elements of CST consist of (1) role play between participants, (2) analysis of videotaped interviews with simulated patients, and (3) interactive case discussion provided by participants. As recently stated in a consensus paper [8], CSTs need to be taught in small groups (up to 10

  14. Charte du Conseil des Gouverneurs

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

    Office 2004 Test Drive User

    7. favoriser des communications ouvertes et franches entre le personnel, la direction ..... de dresser le procès-verbal des réunions du Conseil et de ses comités et de veiller à ce ... et des résultats qu'il obtient, et non de sa gestion quotidienne.

  15. Le statut vitaminique des individus et des populations…

    Directory of Open Access Journals (Sweden)

    Icart Jean-Claude

    2000-05-01

    Full Text Available Comme le souligne un récent rapport du Haut comité de santé publique, le statut vitaminique des individus et des populations demeure une question d’actualité. Si les études ne révèlent plus de signes évocateurs de carence, au plus des problèmes de déficiences pour certains groupes à risque, des interrogations, demeurent malgré le contexte d’abondance, concernant la couverture des besoins, laquelle pourrait s’avérer inférieure aux valeurs considérées comme satisfaisantes.

  16. Les lueurs des sables

    CERN Multimedia

    Les lueurs des sables

    2013-01-01

    Two CERN ladies are getting ready for the “Trophée Roses des Sables” rally adventure: Julie and Laetitia are finalizing the last details before setting off on Monday 7th October 2013. Julie from EN-MEF group and Laetitia from DGS-SEE group, met at the CERN Rugby club. This year, they are participating in the 100 % female rally which will take place in Morocco from 10 to 20 October. They will be carrying along 100 kg of humanitarian donation for children such as some clothes, books and medical material. Do not hesitate to show your support at their farewell party to be held on Monday 7 October, from 4 to 6 pm in front of the St Genis-Pouilly Mairie (city Hall). Follow their exciting adventure on the blog leslueursdessables.trophee-roses-des-sables.org and on their association’s Facebook page Les Lueurs des Sables.

  17. Liste des auteurs

    OpenAIRE

    2016-01-01

    Madeleine Akrich      Ecole des Mines – Centre de Sociologie de l’innovation – Paris Noël Barbe      Association comtoise des Arts et Traditions populaires – Besançon Lucien Bernot      Ecole des hautes études en sciences sociales (EHESS) – Paris Anni Borzeix      Centre national de la recherche scientifique (CNRS) –     Groupement d’intérêt public (GIP) « Mutations industrielles » – Paris François Boudarias      Laboratoire d’Anthropologie et de sociologie de Tours (LAST) Dominique Boullier ...

  18. How do intake clinicians use patient characteristics to select treatment for patients with personality disorders?

    Science.gov (United States)

    van Manen, Janine; Kamphuis, Jan Henk; Visbach, Geny; Ziegler, Uli; Gerritsen, Ad; Van Rossum, Bert; Rijnierse, Piet; Timman, Reinier; Verheul, Roel

    2008-11-01

    Treatment selection in clinical practice is a poorly understood, often largely implicit decision process, perhaps especially for patients with personality disorders. This study, therefore, investigated how intake clinicians use information about patient characteristics to select psychotherapeutic treatment for patients with personality disorder. A structured interview with a forced-choice format was administered to 27 experienced intake clinicians working in five specialist mental health care institutes in the Netherlands. Substantial consensus was evident among intake clinicians. The results revealed that none of the presented patient characteristics were deemed relevant for the selection of the suitable treatment setting. The appropriate duration and intensity are selected using severity or personal strength variables. The theoretical orientation is selected using personal strength variables.

  19. Clinician researcher career pathway for registered nurses and midwives: A proposal.

    Science.gov (United States)

    Smith, Sheree; Gullick, Janice; Ballard, Jacqueline; Perry, Lin

    2018-06-01

    To consider clinician researcher career frameworks and propose a new pathway, integrating university and health service components to support research career progression within nursing and midwifery practice. Hospitals with research-active clinicians report fewer adverse events and better patient outcomes. Nursing clinician researcher career development is therefore an international priority, yet positions and expectations associated with this are not always well articulated, with nurses and midwives challenged to accommodate research and clinical careers. This discussion paper describes nurse/midwife clinician researcher career frameworks and a new pathway that aligns academic and nursing role descriptions. The new framework was informed by a brief literature search for international framework documents, three Australian state-based Nurses and Midwives Awards: the Australian Qualifications Framework, publically available University Academic (Research) Award schedules and academic staff descriptions, and state health department and health services publications. The implementation of research-based practice is a key element of nursing and midwifery roles and "advanced practice" position descriptions have well-defined research expectations. This paper considers structures to support their achievement. This paper provides a blueprint for clinician researcher career development. It elevates the research domain as an equal alongside clinical, managerial and educational clinical career development. © 2018 John Wiley & Sons Australia, Ltd.

  20. Increasing consumer demand for tobacco treatments: Ten design recommendations for clinicians and healthcare systems.

    Science.gov (United States)

    Woods, Susan Swartz; Jaén, Carlos Roberto

    2010-03-01

    Health professionals play an important role in addressing patient tobacco use in clinical settings. While there is clear evidence that identifying tobacco use and assisting smokers in quitting affects outcomes, challenges to improve routine, clinician-delivered tobacco intervention persist. The Consumer Demand Initiative has identified simple design principles to increase consumers' use of proven tobacco treatments. Applying these design strategies to activities across the healthcare system, we articulate ten recommendations that can be implemented in the context of most clinical systems where most clinicians work. The recommendations are: (1) reframe the definition of success, (2) portray proven treatments as the best care, (3) redesign the 5A's of tobacco intervention, (4) be ready to deliver the right treatment at the right time, (5) move tobacco from the social history to the problem list, (6) use words as therapy and language that makes sense, (7) fit tobacco treatment into clinical team workflows, (8) embed tobacco treatment into health information technology, (9) make every encounter an opportunity to intervene, and (10) end social disparities for tobacco users. Clinical systems need to change to improve tobacco treatment implementation. The consumer- and clinician-centered recommendations provide a roadmap that focuses on increasing clinician performance through greater understanding of the clinician's role in helping tobacco users, highlighting the value of evidence-based tobacco treatments, employing shared decision-making skills, and integrating routine tobacco treatment into clinical system routines. Published by Elsevier Inc.

  1. Usability testing of two e-learning resources: methods to maximize potential for clinician use.

    Science.gov (United States)

    Menon, Anita; Korner-Bitensky, Nicol; Chignell, Mark; Straus, Sharon

    2012-04-01

    Rigorous usability testing of e-learn-ing resources is an important prerequisite to their wide-spread use among clinicians. This study demonstrates the application of an evidence-based approach to usability testing of two stroke-related e-learning resources (StrokEngine). 14 stroke rehabilitation clinicians (occupational therapists and physiotherapists) from Ontario, Canada participated in a 1.5 h in-person testing session. Clinicians navigated StrokEngine in search of information to answer questions on stroke assessment/intervention. Their search patterns were observed and clinicians provided verbal/written feedback about StrokEngine. Content analysis was used to generate themes and categorize them under two broad categories: facilitators and barriers to use. Five key facilitators and three key barriers to Strok-Engine use were identified and related to screen format, layout/organization, ease of navigation, quality of content, likelihood of using StrokEngine in the future, and system dysfunctions. All 14 clinicians were very or extremely satisfied with the layout/organization, quality and clinical relevance of the content, stating that they were likely to use StrokEngine in the future. All identified barriers from this study were addressed with website modifications in order to maximize the usability and navigability of StrokEngine. This rigorous methodology for usability testing can be applied during the design process of any e-learning resource.

  2. Évaluation des pratiques agricoles des légumes feuilles : le cas des ...

    African Journals Online (AJOL)

    Face à ce constat, le défi de la recherche serait la détermination du niveau actuel de contamination des légumes feuilles et des eaux du barrage et celui de l'État serait l'initiation de programmes de sensibilisation des producteurs par rapport à une gestion plus rigoureuse des pesticides. Mots-clés : pratiques paysannes, ...

  3. Towards sustainable enterprises: Improving social and environmental practices starting from the informal economy Vers des entreprises durables : Améliorer les pratiques sociales et environnementales en commençant par l’économie informelle Hacia las empresas sostenibles: Mejora de las prácticas sociales y medioambientales a partir de la economía informal

    Directory of Open Access Journals (Sweden)

    Maria Sabrina De Gobbi

    2012-05-01

    Full Text Available The goal of this paper is to present tools which allow informal firms to improve their social and environmental performance and become sustainable enterprises. The paper first provides an overview of the informal economy and sustainable enterprises from the perspective of the International Labor Organization. The methodological part consists of a presentation of tools which can be used to facilitate the transition of informal businesses to formality. Tools are divided into two groups: Those which require the active participation of private partners, and others which are based on partnerships between public and private entities. Applications of tools from experiences in different developing countries and mainly from projects run by the International Labor Organization are presented and their achievements and limits discussed.The paper concludes that a more focused approach on the informal economy should be adopted if more positive results are to be achieved in terms of improved social and environmental performance of enterprises. In addition, it highlights that the impact of actions on informal firms should always be monitored and reported even when the focus of projects is not on the informal economy.L’objectif de cet article est de présenter les outils qui permettent aux entreprises informelles d’améliorer leurs performances sociales et environnementales afin de s’inscrire dans la durabilité. Cet article s’ouvre sur un aperçu de l’économie informelle et des entreprises durables du point de vue de l’Organisation Internationale du travail. Il se poursuit par une partie méthodologique qui consiste en une présentation des outils permettant d’aider les entreprises de passer de l’état informel à l’état formel. Ces outils se répartissent en deux groupes : ceux qui nécessitent la participation active de partenaires privés et ceux basés sur le partenariat entre entités publiques et privées. L’article présente ensuite

  4. Application des TIC à l'atténuation des effets des catastrophes dans ...

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

    L'Amérique centrale est souvent aux prises avec des inondations et des ... (SIG) et de traitement des images, afin de cartographier les dangers et de modéliser les ... de l'Institut d'étude du développement international de l'Université McGill.

  5. Comparisons of client and clinician views of the importance of factors in client-clinician interaction in hearing aid purchase decisions.

    Science.gov (United States)

    Poost-Foroosh, Laya; Jennings, Mary Beth; Cheesman, Margaret F

    2015-03-01

    the concepts understanding and meeting client needs, conveying device information by clinician, supporting choices and shared decision making, and factors in client readiness. Three concepts-understanding and meeting client needs, conveying device information by clinician, and supporting choices and shared decision making-were rated as more important by clients than by clinicians. One concept (ie, factors in client readiness) was rated as more important by clinicians than by clients. The concepts rated as most important by clients and clinicians are consistent with components of several existing models of client-centered and patient-centered care. These concepts reflect the clients' perception of the importance of their involvement in the decision-making process. A preliminary model of client-centered care within the hearing aid uptake process and implications for clinical audiology are described. American Academy of Audiology.

  6. What patient characteristics make clinicians recommend brief treatment?

    NARCIS (Netherlands)

    Schaefer, B. A.; Koeter, M. W. J.; Wouters, L.; Emmelkamp, P. M. G.; Schene, A. H.

    2003-01-01

    Objective: Assessing self-rated items that might have an impact on clinicians recommending brief treatment (BT) over unlimited or long-term treatment (ULT). Method: On the basis of patient self-report data we compared patients referred by clinicians to BT (n =71) with those referred to ULT (n =145).

  7. The clinician-educator track: training internal medicine residents as clinician-educators.

    Science.gov (United States)

    Smith, C Christopher; McCormick, Ian; Huang, Grace C

    2014-06-01

    Although resident-as-teacher programs bring postgraduate trainees' teaching skills to a minimum threshold, intensive, longitudinal training is lacking for residents who wish to pursue careers in medical education. The authors describe the development, implementation, and preliminary assessment of the novel track for future clinician-educators that they introduced in the internal medicine residency program at Beth Israel Deaconess Medical Center in 2010. Categorical medical interns with a career interest in medical education apply to participate in the clinician-educator track (CET) at the midpoint of their first postgraduate year. CET residents complete a 2.5-year curriculum in which they review foundations of medical education, design and assess new curricula, and evaluate learners and programs. They apply these skills in a variety of clinical settings and receive frequent feedback from faculty and peers. All CET residents design and implement at least one medical education research project. A comprehensive evaluation plan to assess the impact of the CET on resident teaching skills, scholarly productivity, career selection, and advancement is under way. A preliminary evaluation demonstrates high satisfaction with the track among the first cohort of CET residents, who graduated in 2012. Compared with residents in the traditional resident-as-teacher program, CET residents reported higher gains in their confidence in core medical education skills. Although these preliminary data are promising, data will be collected over the next several years to explore whether the additional curricular time, faculty time, and costs and potential expansion to other institutions are justified.

  8. PubMed searches: overview and strategies for clinicians.

    Science.gov (United States)

    Lindsey, Wesley T; Olin, Bernie R

    2013-04-01

    PubMed is a biomedical and life sciences database maintained by a division of the National Library of Medicine known as the National Center for Biotechnology Information (NCBI). It is a large resource with more than 5600 journals indexed and greater than 22 million total citations. Searches conducted in PubMed provide references that are more specific for the intended topic compared with other popular search engines. Effective PubMed searches allow the clinician to remain current on the latest clinical trials, systematic reviews, and practice guidelines. PubMed continues to evolve by allowing users to create a customized experience through the My NCBI portal, new arrangements and options in search filters, and supporting scholarly projects through exportation of citations to reference managing software. Prepackaged search options available in the Clinical Queries feature also allow users to efficiently search for clinical literature. PubMed also provides information regarding the source journals themselves through the Journals in NCBI Databases link. This article provides an overview of the PubMed database's structure and features as well as strategies for conducting an effective search.

  9. A Genome-Wide Association Study Primer for Clinicians

    Directory of Open Access Journals (Sweden)

    Tzu-Hao Wang

    2009-06-01

    Full Text Available Genome-wide association studies (GWAS use high-throughput genotyping technology to relate hundreds of thousands of genetic markers (genotypes to clinical conditions and measurable traits (phenotypes. This review is intended to serve as an introduction to GWAS for clinicians, to allow them to better appreciate the value and limitations of GWAS for genotype-disease association studies. The input of clinicians is vital for GWAS, since disease heterogeneity is frequently a confounding factor that can only really be solved by clinicians. For diseases that are difficult to diagnose, clinicians should ensure that the cases do indeed have the disease; for common diseases, clinicians should ensure that the controls are truly disease-free.

  10. Once a clinician, always a clinician: a systematic review to develop a typology of clinician-researcher dual-role experiences in health research with patient-participants

    Directory of Open Access Journals (Sweden)

    E. Jean C. Hay-Smith

    2016-08-01

    Full Text Available Abstract Background Many health researchers are clinicians. Dual-role experiences are common for clinician-researchers in research involving patient-participants, even if not their own patients. To extend the existing body of literature on why dual-role is experienced, we aimed to develop a typology of common catalysts for dual-role experiences to help clinician-researchers plan and implement methodologically and ethically sound research. Methods Systematic searching of Medline, CINAHL, PsycINFO, Embase and Scopus (inception to 28.07.2014 for primary studies or first-person reflexive reports of clinician-researchers’ dual-role experiences, supplemented by reference list checking and Google Scholar scoping searches. Included articles were loaded in NVivo for analysis. The coding was focused on how dual-role was evidenced for the clinician-researchers in research involving patients. Procedures were completed by one researcher (MB and independently cross-checked by another (JHS. All authors contributed to extensive discussions to resolve all disagreements about initial coding and verify the final themes. Results Database searching located 7135 records, resulting in 29 included studies, with the addition of 7 studies through reference checks and scoping searches. Two overarching themes described the most common catalysts for dual-role experiences – ways a research role can involve patterns of behaviour typical of a clinical role, and the developing connection that starts to resemble a clinician-patient relationship. Five subthemes encapsulated the clinical patterns commonly repeated in research settings (clinical queries, perceived agenda, helping hands, uninvited clinical expert, and research or therapy and five subthemes described concerns about the researcher-participant relationship (clinical assumptions, suspicion and holding back, revelations, over-identification, and manipulation. Clinician-researchers use their clinical skills in health

  11. Rôle des universités dans le renforcement des technologies de l ...

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

    Rôle des universités dans le renforcement des technologies de l'information et de la communication au service du développement (TIC-D) en Asie. Jusqu'à maintenant, les efforts déployés dans le secteur de l'enseignement supérieur ont surtout été axés sur le téléapprentissage, l'apprentissage électronique et différentes ...

  12. Renforcement des capacités d'évaluation dans le domaine des ...

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

    Les subtilités des interactions entre les technologies de l'information et de la communication (TIC) et les sociétés en développement exigent une évaluation réfléchie et systématique, axée sur l'utilité, les résultats et l'appropriation. Cette subvention permettra au projet de renforcement des capacités d'évaluation dans le ...

  13. TIC et microentreprises en milieu urbain : optimisation des ...

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

    La population des villes croît à un rythme plus rapide que l'ensemble de la population mondiale, surtout dans les pays en développement. Les technologies de l'information et de la communication (TIC), notamment la téléphonie mobile, semblent s'implanter partout très rapidement. On parle souvent des ...

  14. Professionnalisation de l'agriculture : Une alternative aux effets des ...

    African Journals Online (AJOL)

    La démarche méthodologique utilisée s'articule autour de la recherche documentaire et de la collecte des informations socio-économiques détaillées obtenues auprès des ménages sur les organisations professionnelles agricoles et sur le processus de professionnalisation de l'agriculture. Un diagnostic agroclimatique a ...

  15. Droit administratif international - amélioration des rapports ...

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

    Le nouveau site Web facilitera l'enregistrement des événements démographiques afin d'améliorer l'accès aux services pour tous. Le nouveau site Web et la nouvelle bibliothèque de ressources aideront à améliorer les systèmes d'information et d'enregistrement des faits d'état civil dans les pays en développement.

  16. Clinician Perspectives on an Electronic Portal to Improve Communication with Patients and Families in the Intensive Care Unit.

    Science.gov (United States)

    Bell, Sigall K; Roche, Stephanie D; Johansson, Anna C; O'Reilly, Kristin P; Lee, Barbara S; Sands, Kenneth E; Talmor, Daniel S; Brown, Samuel M

    2016-12-01

    Communication in the intensive care unit (ICU) often falls short of patient and family needs, putting them at risk for significant physical and emotional harm. As electronic patient portals rapidly evolve, one designed specifically for the ICU might potentially enhance communication among patients, family members, and clinicians; however, the views of frontline ICU staff on such technology are unknown. To identify clinician perspectives on the current state of communication among patients, families, and clinicians in the ICU, and assess their views on whether and how an electronic portal may address existing communication deficits and improve care. Three focus groups comprised altogether of 26 clinicians from 6 ICUs, representing several disciplines in an academic medical center in Boston, Massachusetts. Transcripts were analyzed inductively for major themes using grounded theory. We identified seven themes reflecting clinician perspectives on communication challenges and desired portal functionality: (1) comprehension and literacy; (2) results and updates; (3) patient and family preferences; (4) interclinician communication; (5) family informational needs; (6) the ICU as an unfamiliar environment; and (7) enhancing humanism through technology. Each theme included current gaps in practice, potential benefits and concerns related to an ICU communication portal, and participant recommendations. Benefits included enhanced education, patient/family engagement, and clinician workflow. Challenges included the stress and uncertainty of ICU care, fear of technology replacing human connection, existing interclinician communication failures, and the tension between informing families without overwhelming them. Overall, clinicians were cautiously supportive of an electronic portal to enhance communication in the ICU and made several specific recommendations for design and implementation. As new technologies expand opportunities for greater transparency and participation in

  17. Évaluation de l'information des femmes enceintes sur l'équilibre alimentaire et le gain pondéral

    OpenAIRE

    Singer, Melina

    2011-01-01

    A balanced diet is an essential condition for a safe pregnancy and for the health of both the mother and the infant. Complications may occur due to excessive weight during the pregnancy, the delivery and the postpartum period as the new-born. In our study, we have questioned pregnant women in the maternity wards of Port-Royal and Saint Vincent de Paul. We measured the information received and knowledge of pregnant women in the ideal weight gain and the risks of an excessive weight gain. Despi...

  18. Patient and Clinician Perspectives on Shared Decision-making in Early Adopting Lung Cancer Screening Programs: a Qualitative Study.

    Science.gov (United States)

    Wiener, Renda Soylemez; Koppelman, Elisa; Bolton, Rendelle; Lasser, Karen E; Borrelli, Belinda; Au, David H; Slatore, Christopher G; Clark, Jack A; Kathuria, Hasmeena

    2018-02-21

    Guidelines recommend, and Medicare requires, shared decision-making between patients and clinicians before referring individuals at high risk of lung cancer for chest CT screening. However, little is known about the extent to which shared decision-making about lung cancer screening is achieved in real-world settings. To characterize patient and clinician impressions of early experiences with communication and decision-making about lung cancer screening and perceived barriers to achieving shared decision-making. Qualitative study entailing semi-structured interviews and focus groups. We enrolled 36 clinicians who refer patients for lung cancer screening and 49 patients who had undergone lung cancer screening in the prior year. Participants were recruited from lung cancer screening programs at four hospitals (three Veterans Health Administration, one urban safety net). Using content analysis, we analyzed transcripts to characterize communication and decision-making about lung cancer screening. Our analysis focused on the recommended components of shared decision-making (information sharing, deliberation, and decision aid use) and barriers to achieving shared decision-making. Clinicians varied in the information shared with patients, and did not consistently incorporate decision aids. Clinicians believed they explained the rationale and gave some (often purposely limited) information about the trade-offs of lung cancer screening. By contrast, some patients reported receiving little information about screening or its trade-offs and did not realize the CT was intended as a screening test for lung cancer. Clinicians and patients alike did not perceive that significant deliberation typically occurred. Clinicians perceived insufficient time, competing priorities, difficulty accessing decision aids, limited patient comprehension, and anticipated patient emotions as barriers to realizing shared decision-making. Due to multiple perceived barriers, patient-clinician

  19. A qualitative study examining methods of accessing and identifying research relevant to clinical practice among rehabilitation clinicians

    Directory of Open Access Journals (Sweden)

    Patel D

    2017-12-01

    Full Text Available Drasti Patel,1 Christine Koehmstedt,1 Rebecca Jones,1 Nathan T Coffey,1 Xinsheng Cai,2 Steven Garfinkel,2 Dahlia M Shaewitz,2 Ali A Weinstein1 1Center for Study of Chronic Illness and Disability, College of Health and Human Services, George Mason University, Fairfax, VA, 2American Institutes for Research, Washington, DC, USA Purpose: Research examining the utilization of evidence-based practice (EBP specifically among rehabilitation clinicians is limited. The objective of this study was to examine how various rehabilitative clinicians including physical therapists, occupational therapists, rehabilitation counselors, and physiatrists are gaining access to literature and whether they are able to implement the available research into practice.Methods: A total of 21 total clinicians were interviewed via telephone. Using NVivo, a qualitative analysis of the responses was performed.Results: There were similarities found with respect to the information-seeking behaviors and translation of research across the different clinician types. Lack of time was reported to be a barrier for both access to literature and implementation of research across all clinician types. The majority of clinicians who reported having difficulty with utilizing the published literature indicated that the literature was not applicable to their practice, the research was not specific enough to be put into practice, or the research found was too outdated to be relevant. In addition, having a supportive work environment aided in the search and utilization of research through providing resources central to assisting clinicians in gaining access to health information.Conclusion: Our study identified several barriers that affect EBP for rehabilitation clinicians. The findings suggest the need for researchers to ensure that their work is applicable and specific to clinical practice for implementation to occur. Keywords: health information, information behavior, knowledge utilization

  20. Praxis des Klebens

    CERN Document Server

    Theuerkauff, Petra

    1989-01-01

    Bei diesem Buch handelt es sich um einen Leitfaden fur Klebepraktiker. Es werden die verschiedenen Einzelschritte beim kleben beschrieben, als auch die vorbereitenden Massnahmen und anschliessenden Prufverfahren auf Festigkeit behandelt. Das Buch sollte an keinem Arbeitsplatz fehlen, wo man sich mit Problemen der Fugetechnik des Klebens beschaftigt.

  1. Dimensions des stabulations 2018

    OpenAIRE

    Früh, Barbara; Maurer, Veronika; Schneider, Claudia; Schürmann, Stefan; Spengler Neff, Anet; Werne, Steffen

    2018-01-01

    Les «Dimensions des stabulations» contiennent toutes les dimensions pour les stabulations et les parcours pour la production animale en agriculture biologique. Cette liste sert d’instrument de planification pour les éleveurs, d’outil de travail pour la vulgarisation et d’ouvrage de référence pour le contrôle bio.

  2. Direction des Publications

    African Journals Online (AJOL)

    Synthese

    économique des services rendus par les écosystèmes marins. La richesse ... croissance plus rapide que la moyenne de l‟économie ...... services and natural capital. Nature. 387, 253-260. .... d‟interactions où l‟humain est partie prenante. In.

  3. La physique des infinis

    CERN Document Server

    Bernardeau, Francis; Laplace, Sandrine; Spiro, Michel

    2013-01-01

    Écrire l'histoire de l'Univers, tel est l'objectif commun des physiciens des particules et des astrophysiciens. Pour y parvenir, deux approches s'épaulent : la voie de l'infiniment petit, que l'on emprunte via de gigantesques accélérateurs de particules, et celle de l'infiniment grand, dont le laboratoire est l'Univers. Un Univers qui est bien loin d'avoir livré tous ses secrets. On connaît à peine 4,8 % de la matière qui le constitue, le reste étant composé de matière noire (25,8 %) et d'énergie noire (69,4 %), toutes deux de nature inconnue. Et si la récente découverte du boson de Higgs valide le Modèle standard de la physique des particules, celui-ci est toujours incomplet et doit être étendu à ou dépassé. Est-on arrivé au bout du jeu de poupées russes de la matière ? Quelles sont les particules manquantes ? Faut-il revoir les lois fondamentales ? Quels instruments faut-il mettre en œuvre pour accéder à cette « nouvelle physique » ? Comment parler de Super Big Science aux citoye...

  4. Des solutions communautaires au problème des déchets en Indonésie

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

    19 oct. 2010 ... Tant les collectivités que les divers ordres de gouvernement ont à leur disposition un outil appelé Informed Choice Catalogue (ICC), qui leur permet de faire ... Son personnel fournit donc des conseils sur les recherches nécessaires et sur l'exécution du projet HP3 et met à profit les enseignements tirés des ...

  5. Injectabilite des coulis de ciment dans des milieux fissures

    Science.gov (United States)

    Mnif, Thameur

    Le travail presente ici est un bilan du travaux de recherche effectues sur l'injectabilite des coulis de ciment dans lu milieux fissures. Un certain nombre de coulis a base de ciment Portland et microfin ont ete selectionnes afin de caracteriser leur capacite a penetrer des milieux fissures. Une partie des essais a ete menee en laboratoire. L'etude rheologique des differents melanges a permis de tester l'influence de l'ajout de superplastifiant et/ou de fumee de silice sur la distribution granulometrique des coulis et par consequent sur leur capacite a injecter des colonnes de sable simulant un milieu fissure donne. La classe granulometrique d'un coulis, sa stabilite et sa fluidite sont apparus comme les trois facteurs principaux pour la reussite d'une injection. Un facteur de finesse a ete defini au cours de cette etude: base sur la classe granulometrique du ciment et sa stabilite, il peut entrer dans la formulation theorique du debit d'injection avant application sur chantier. La deuxieme et derniere partie de l'etude presente les resultats de deux projets de recherche sur l'injection realises sur chantier. L'injection de dalles de beton fissurees a permis le suivi de l'evolution des pressions avec la distance au point d'injection. L'injection de murs de maconnerie a caractere historique a montre l'importance de la definition de criteres de performance des coulis a utiliser pour traiter un milieu donne et pour un objectif donne. Plusieurs melanges peuvent ainsi etre predefinis et mis a disposition sur le chantier. La complementarite des ciments traditionnels et des ciments microfins devient alors un atout important. Le choix d'utilisation de ces melanges est fonction du terrain rencontre. En conclusion, cette recherche etablit une methodologie pour la selection des coulis a base de ciment et des pressions d'injection en fonction de l'ouverture des fissures ou joints de construction.

  6. Competence centre for energy and information technology 1999 -2008 - Supervisory report; Betreuung des Kompetenzzentrums Energie und Informationstechnik 1999-2008 - Schlussbericht

    Energy Technology Data Exchange (ETDEWEB)

    Aebischer, B

    2008-07-01

    This final report for the Swiss Federal Office of Energy (SFOE) reports on work done concerning the supervision of the competence centre for energy and information technology. The potential for increasing the rational use of electrical energy in the ICT domain and in other areas such as consumer electronics are investigated. In the past, Switzerland has played a leading role in investigating and promoting a more rational use of energy in ICT and influenced the design of energy declarations and labels on the global level. The report includes a number of annual reports for the years 1999 to 2008 which also cover not only the electricity consumption of computer centres and communication systems, but also the rational use of electricity in consumer electronics.

  7. Screening phytochimique et identification spectroscopique des ...

    African Journals Online (AJOL)

    Origin

    plante, effectuée pour la première fois, a révélé la présence des alcaloïdes, des flavonoïdes, des tanins catéchiques, des terpènes, des coumarines et des composés cyanogénétiques. Quant aux saponines et les quinones libres, ils sont présents chez les fleurs et absents chez les feuilles. La caractérisation des molécules.

  8. Designing User-Centric Patient Portals: Clinician and Patients' Uses and Gratifications

    Science.gov (United States)

    Krist, Alex H.; Aycock, Rebecca A.; Kreps, Gary L.

    2017-01-01

    Abstract Background: Legislation mandates that clinicians make patients' medical information available digitally. This has resulted in hurriedly installing patient portals that do not fully meet the needs of patients or clinicians. This study examined a specific portal, MyPreventiveCare (MPC), a patient-centered portal designed to promote preventive care to consumers, to elicit recommendations from patients and clinicians about how it could be more beneficial by uncovering their uses and gratifications (U&G). Materials and Methods: In-depth interviews with 31 patients and two clinician focus groups were conducted. Multiple methods were utilized, such as grounded theory coding to develop themes and content analysis to classify responses according to the U&G framework. Results: Four main categories emerged that users desire to be included in health portals: integration with technology (27%), coordination of care (27%), incorporation of lifestyle (26%), and increased control (20%). Additional analysis revealed that health portals are mainly utilized to fulfill cognitive and affective needs, with over 80% of recommendations related to the U&G categories of cognitive and affective needs. Cognitive (60%), affective (21%), social integrative (10%), personal integrative (9%), and tension release (0%). Conclusions: Portals will continue to evolve and become important health communication tools if they address the user's perspective and are inclusive of new technological advances. Specifically, portals must become more user centric and incorporate aspects of the patients' lifestyle and integrate health information technology. PMID:27333468

  9. Designing User-Centric Patient Portals: Clinician and Patients' Uses and Gratifications.

    Science.gov (United States)

    Alpert, Jordan M; Krist, Alex H; Aycock, Rebecca A; Kreps, Gary L

    2017-03-01

    Legislation mandates that clinicians make patients' medical information available digitally. This has resulted in hurriedly installing patient portals that do not fully meet the needs of patients or clinicians. This study examined a specific portal, MyPreventiveCare (MPC), a patient-centered portal designed to promote preventive care to consumers, to elicit recommendations from patients and clinicians about how it could be more beneficial by uncovering their uses and gratifications (U&G). In-depth interviews with 31 patients and two clinician focus groups were conducted. Multiple methods were utilized, such as grounded theory coding to develop themes and content analysis to classify responses according to the U&G framework. Four main categories emerged that users desire to be included in health portals: integration with technology (27%), coordination of care (27%), incorporation of lifestyle (26%), and increased control (20%). Additional analysis revealed that health portals are mainly utilized to fulfill cognitive and affective needs, with over 80% of recommendations related to the U&G categories of cognitive and affective needs. Cognitive (60%), affective (21%), social integrative (10%), personal integrative (9%), and tension release (0%). Portals will continue to evolve and become important health communication tools if they address the user's perspective and are inclusive of new technological advances. Specifically, portals must become more user centric and incorporate aspects of the patients' lifestyle and integrate health information technology.

  10. The meaning of co- production for clinicians: an exploratory case study of Practitioner Trainers in one Recovery College.

    Science.gov (United States)

    Dalgarno, Mark; Oates, Jennifer

    2018-05-15

    Co-production between service users and clinicians is a desirable element of recovery-oriented practice in mental health but the effect of co-production on clinicians has not been explored thoroughly. to explore the meaning of co-production for clinicians based on their experience of co-production in a Recovery College Method: Thematic analysis of eight semi-structured interviews with clinicians who have co-produced and co-delivered workshops with a Recovery College Peer Trainer. The 'meaning of co-production' had four themes: definitions, power dynamics, negotiating roles and influence on practice. Clinicians' experience of co-production meant a reassessment of their expert role and power. They said that this altered their clinical practice, particularly the language they used and the personal information they shared. Role negotiation between Practitioner and Peer Trainers is an iterative process, whereby clinicians may revise their perspectives on personal disclosure, professional identity and collegiate support. The Peer and Practitioner Trainer relationship is characterised by reciprocity and mutuality, and there is some evidence that Practitioner involvement in a co-produced activity has the potential to transform service user and provider relationships beyond the Recovery College setting. Engaging in co-produced educational workshops can alter clinicians' perspectives on roles, power and clinical expertise. Findings from this case study must be tested against research on other Recovery Colleges. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  11. Can promoting patient decision making be exclusionary? Moral expectations and cultural difference in the narratives of UK maternity clinicians.

    Science.gov (United States)

    Davies, Myfanwy; Elwyn, Glyn; Papadopoulos, Irena; Fleming, Lon; Williams, Gareth

    2009-01-01

    Patient autonomy in health care decision making is increasingly advocated as a means of promoting patients' 'responsibilities' for treatments and costs. However, little is known with regard to clinicians' understanding of patients' potential responsibilities in decision making. We explore how clinicians may view decision making as a 'moral' obligation and examine how moral virtue is discursively constructed in this context and in the face of ethnic and social difference. Data reported are derived from an interview study that examined perceptions of maternity decision making among Arab Muslim women and clinicians. Results reported here are from the clinician sample which includes obstetricians, general practitioners (GPs) and midwives. Clinicians perceived that a key element of their role involved imparting relevant information to their clients and, increasingly, involving them in making autonomous decisions about their care. However, by analysing and assessing the attribution of specific cultural differences in clinicians' discussion of decision making processes with minority group women, we demonstrate how some clinicians justified their failure to promote autonomy through shared decision making with women from these groups. We will demonstrate these attributes to be those of passivity and non-rationality which entail some negative moral judgements and which have a complex relationship to gender and power

  12. Postnatal gestational diabetes mellitus follow-up: Perspectives of Australian hospital clinicians and general practitioners.

    Science.gov (United States)

    Kilgour, Catherine; Bogossian, Fiona Elizabeth; Callaway, Leonie; Gallois, Cindy

    2018-05-04

    The reasons for low postnatal screening rates for women with gestational diabetes mellitus are not well understood. Multiple care providers, settings and changes to diagnostic criteria, may contribute to confusion over postnatal care. Quality of communication between clinicians may be an important influence for the completion of postnatal gestational diabetes mellitus follow-up. Describe and analyse communication processes between hospital clinicians (midwives, medical, allied staff) and general practitioners who provide postnatal gestational diabetes mellitus care. Purposive sampling and convergent interviews explored participants' communication experiences providing gestational diabetes mellitus postnatal follow-up. Data were analysed with Leximancer automated content analysis software; interpretation was undertaken using Communication Accommodation Theory. Clinicians who provided maternity care at a tertiary referral hospital (n=13) in Queensland, Australia, and general practitioners (n=16) who provided maternity shared care with that hospital between December 2012 and July 2013. Thematic analysis identified very different perspectives between the experiences of General Practitioners and hospital clinicians; six themes emerged. General practitioners were concerned about themes relating to discharge summaries and follow-up guidelines. In contrast, hospital clinicians were more concerned about themes relating to gestational diabetes mellitus antenatal care and specialist clinics. Two themes, gestational diabetes mellitus women and postnatal checks were shared. Gestational diabetes mellitus follow-up is characterised by communication where general practitioners appear to be information seekers whose communication needs are not met by hospital clinicians. Midwives are ideally placed to assist in improving communication and postnatal gestational diabetes mellitus follow-up. Copyright © 2018 Australian College of Midwives. Published by Elsevier Ltd. All rights

  13. Clinicians and their cameras: policy, ethics and practice in an Australian tertiary hospital.

    Science.gov (United States)

    Burns, Kara; Belton, Suzanne

    2013-09-01

    Medical photography illustrates what people would prefer to keep private, is practiced when people are vulnerable, and has the power to freeze a moment in time. Given it is a sensitive area of health, lawful and ethical practice is paramount. This paper recognises and seeks to clarify the possibility of widespread clinician-taken medical photography in a tertiary hospital in northern Australia, examining the legal and ethical implications of this practice. A framework of Northern Territory law, state Department of Health policy and human rights theory were used to argue the thesis. Clinicians from 13 purposively chosen wards were asked to participate in an anonymous survey and confidential in-depth interviews. Questions were generated from the literature and local knowledge on the topics of 'occurrence', 'image use', 'quality of consent', 'cameras and technology', 'confidentiality', 'data storage and security', 'hospital policy and law' and 'cultural issues'. One hundred and seventy surveys and eights interviews were analysed using descriptive statistics and theme and content analysis, then triangulated for similarity, difference and unique responses. Forty-eight percent of clinicians surveyed take medical photographs, with the majority using hospital-owned cameras. However, one-fifth of clinicians reported photographing with personal mobile phones. Non-compliance with written consent requirements articulated in policy was endemic, with most clinicians surveyed obtaining only verbal consent. Labeling, storage, copyright and cultural issues were generally misunderstood, with a significant number of clinicians risking the security of patient information by storing images on personal devices. If this tertiary hospital does not develop a clinical photography action plan to address staff lack of knowledge, and noncompliance with policy and mobile phone use, patients' data is at risk of being distributed into the public domain where unauthorised publication may cause

  14. Development of a wheelchair maintenance training programme and questionnaire for clinicians and wheelchair users.

    Science.gov (United States)

    Toro, Maria Luisa; Bird, Emily; Oyster, Michelle; Worobey, Lynn; Lain, Michael; Bucior, Samuel; Cooper, Rory A; Pearlman, Jonathan

    2017-11-01

    Purpose of state: The aims of this study were to develop a Wheelchair Maintenance Training Programme (WMTP) as a tool for clinicians to teach wheelchair users (and caregivers when applicable) in a group setting to perform basic maintenance at home in the USA and to develop a Wheelchair Maintenance Training Questionnaire (WMT-Q) to evaluate wheelchair maintenance knowledge in clinicians, manual and power wheelchair users. The WMTP and WMT-Q were developed through an iterative process. A convenience sample of clinicians (n = 17), manual wheelchair (n ∞ 5), power wheelchair users (n = 4) and caregivers (n = 4) provided feedback on the training programme. A convenience sample of clinicians (n = 38), manual wheelchair (n = 25), and power wheelchair users (n = 30) answered the WMT-Q throughout different phases of development. The subscores of the WMT-Q achieved a reliability that ranged between ICC(3,1) = 0.48 to ICC(3,1) = 0.89. The WMTP and WMT-Q were implemented with 15 clinicians who received in-person training in the USA using the materials developed and showed a significant increase in all except one of the WMT-Q subscores after the WMTP (p users. This training complements the World Health Organization basic wheelchair service curriculum, which only includes training of the clinicians, but does not include detailed information to train wheelchair users and caregivers. This training program offers a time efficient method for providing education to end users in a group setting that may mitigate adverse consequences resulting from wheelchair breakdown. This training program has significant potential for impact among wheelchair users in areas where access to repair services is limited.

  15. Efficacité des néonicotinoïdes et des pyréthrinoïdes utilisés contre le ...

    African Journals Online (AJOL)

    Efficacité des néonicotinoïdes et des pyréthrinoïdes utilisés contre le foreur des tiges du cacaoyer ( Eulophonotus myrmeleon Felder : Lepidoptera, Cossidae). Implications dans la stratégie de protection de la cacaoculture en Côte d'Ivoire.

  16. Allied health clinicians using translational research in action to develop a reliable stroke audit tool.

    Science.gov (United States)

    Abery, Philip; Kuys, Suzanne; Lynch, Mary; Low Choy, Nancy

    2018-05-23

    To design and establish reliability of a local stroke audit tool by engaging allied health clinicians within a privately funded hospital. Design: Two-stage study involving a modified Delphi process to inform stroke audit tool development and inter-tester reliability. Allied health clinicians. A modified Delphi process to select stroke guideline recommendations for inclusion in the audit tool. Reliability study: 1 allied health representative from each discipline audited 10 clinical records with sequential admissions to acute and rehabilitation services. Recommendations were admitted to the audit tool when 70% agreement was reached, with 50% set as the reserve agreement. Inter-tester reliability was determined using intra-class correlation coefficients (ICCs) across 10 clinical records. Twenty-two participants (92% female, 50% physiotherapists, 17% occupational therapists) completed the modified Delphi process. Across 6 voting rounds, 8 recommendations reached 70% agreement and 2 reached 50% agreement. Two recommendations (nutrition/hydration; goal setting) were added to ensure representation for all disciplines. Substantial consistency across raters was established for the audit tool applied in acute stroke (ICC .71; range .48 to .90) and rehabilitation (ICC.78; range .60 to .93) services. Allied health clinicians within a privately funded hospital generally agreed in an audit process to develop a reliable stroke audit tool. Allied health clinicians agreed on stroke guideline recommendations to inform a stroke audit tool. The stroke audit tool demonstrated substantial consistency supporting future use for service development. This process, which engages local clinicians, could be adopted by other facilities to design reliable audit tools to identify local service gaps to inform changes to clinical practice. © 2018 John Wiley & Sons, Ltd.

  17. PERCC Tools: Public Health Preparedness for Clinicians

    Centers for Disease Control (CDC) Podcasts

    2011-08-29

    CDC’s Office of Public Health Preparedness and Response funds Preparedness and Emergency Response Research Centers (PERRCs) to examine components of the public health system. This podcast is an overview of mental and behavioral health tools developed by the Johns Hopkins PERRC.  Created: 8/29/2011 by Emergency Risk Communication Branch (ERCB)/Joint Information Center (JIC); Office of Public Health Preparedness and Response (OPHPR).   Date Released: 8/30/2011.

  18. La gestion des résultats des entreprises innovantes

    OpenAIRE

    Dumas, Guillaume

    2014-01-01

    Cette thèse s’intéresse à la gestion des résultats dans le cadre des entreprises innovantes. Elle est constituée de trois articles. Dans le premier, il s’agit d’examiner si les résultats des entreprises innovantes sont gérés et si le stade de développement des innovations influence cette gestion des résultats. Il apparaît que les résultats des entreprises innovantes sont gérés à la hausse. Cette gestion ne semble intervenir qu’au cours de l’activité d’innovation (c’est-à-dire lorsque les entr...

  19. Diffusion et réception des chroniques : Chronica Naiarensis, Liber regum, Chronica regum Castellae

    OpenAIRE

    Arizaleta , Amaia

    2006-01-01

    International audience; Il est question dans ces pages des chroniques composées dans l'espace castillan au tournant du XIIe et du XIIIe siècles, afin d'avancer des informations sur le cadre pragmatique de réception des histoires royales qui devaient circuler au palais, ainsi que sur le plaisir de raconter que devaient ressentir les écrivains du roi et les auditeurs de la cour.

  20. Libéralisation du commerce des biens et services TIC : enjeux et ...

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

    Libéralisation du commerce des biens et services TIC : enjeux et implications pour la mise en oeuvre de politiques publiques en Afrique de l'Ouest. En Afrique de l'Ouest, les entreprises du secteur privé des technologies d'information et de la communication (TIC) ont démontré leur capacité à créer des emplois et à stimuler ...

  1. Assurer l'apport des pays du Sud à l'action mondiale | CRDI - Centre ...

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

    10 juin 2016 ... ... des chaînes d'approvisionnement et des systèmes d'information –, la Commission recommande 10 mesures précises en lien avec d'autres initiatives de renforcement des systèmes de santé global. Il est essentiel d'établir de tels liens, car les produits ne représentent qu'une infime partie d'un système de ...

  2. Randomised clinical trials with clinician-preferred treatment.

    Science.gov (United States)

    Korn, E L; Baumrind, S

    1991-01-19

    The standard design for randomised clinical trials may be inappropriate when the clinician believes that one of the treatments being tested is superior for the patient, or when the clinician has a preference for one of the treatments. For such instances the suggestion is that the patient is randomly allocated to treatment only when there is clinical disagreement about treatment of choice for that patient, and then the patient is assigned to a clinician who had thought that the regimen allocated is the one most appropriate for that patient.

  3. Lutte contre les cerscosporioses du bananier aux Antilles françaises : Banatrace, un système d'information géographique multi-acteurs pour la gestion et la traçabilité des épandages aériens

    OpenAIRE

    DUMAS, Marine; DUMAS, Marine

    2011-01-01

    Comment un système d’information géographique peut-il aider à améliorer la fiabilité des traitements aériens contre les maladies fongiques du bananier tout en réduisant leur impact environnemental ? Des réponses aux Antilles françaises avec l’outil informatique multi-acteurs Banatrace, conçu pour aider les gestionnaires à répondre aux différents besoins de traçabilité imposée par la réglementation récente sur les épandages aériens.

  4. Des dispositions responsables à prendre pour la protection des ...

    African Journals Online (AJOL)

    En considérant l'effet néfaste des maladies, des parasites, du changement climatique et d'autres facteurs environnementaux (les OGM par exemple) sur la survie des abeilles, la baisse de leurs populations dans certaines parties du monde ne saurait être attribuée aux seules pesticides. En plus, l'impact de ces derniers sur ...

  5. Aspects des Onychomycoses chez des patients camerounais de ...

    African Journals Online (AJOL)

    ... biologiques et évolutifs des onychomycoses chez des patients camerounais. Méthode : Il s'agit d'une étude rétrospective et descriptive menée de mars 2011 à mars 2014 dans l'unité de dermatologie de l'hôpital général de Douala (HGD), incluant des patients chez lesquels le diagnostic d'onychomycose avait été posé.

  6. Human babesiosis in Europe: what clinicians need to know.

    Science.gov (United States)

    Hildebrandt, A; Gray, J S; Hunfeld, K-P

    2013-12-01

    Although best known as an animal disease, human babesiosis is attracting increasing attention as a worldwide emerging zoonosis. Humans are commonly infected by the bite of ixodid ticks. Rare ways of transmission are transplacental, perinatal and transfusion-associated. Infection of the human host can cause a very severe host-mediated pathology including fever, and hemolysis leading to anemia, hyperbilirubinuria, hemoglobinuria and possible organ failure. In recent years, apparently owing to increased medical awareness and better diagnostic methods, the number of reported cases in humans is rising steadily worldwide. Hitherto unknown zoonotic Babesia spp. are now being reported from geographic areas where babesiosis was not previously known to occur and the growing numbers of travelers and immunocompromised individuals suggest that the frequency of cases in Europe will also continue to rise. Our review is intended to provide clinicians with practical information on the clinical management of this rare, but potentially life-threatening zoonotic disease. It covers epidemiology, phylogeny, diagnostics and treatment of human babesiosis and the potential risk of transfusion-transmitted disease with a special focus on the European situation.

  7. Integrating virtual reality video games into practice: clinicians' experiences.

    Science.gov (United States)

    Levac, Danielle E; Miller, Patricia A

    2013-10-01

    The Nintendo Wii is a popular virtual reality (VR) video gaming system in rehabilitation practice and research. As evidence emerges related to its effectiveness as a physical therapy training method, clinicians require information about the pragmatics of its use in practice. The purpose of this descriptive qualitative study is to explore observations and insights from a sample of physical therapists (PTs) working with children with acquired brain injury regarding practical implications of using the Wii as a physical therapy intervention. Six PTs employed at a children's rehabilitation center participated in semi-structured interviews, which were transcribed and analyzed using content analysis. Two themes summarize the practical implications of Wii use: 1) technology meets clinical practice; and 2) onus is on the therapist. Therapists described both beneficial and challenging implications arising from the intersection of technology and practice, and reported the personal commitment required to orient oneself to the gaming system and capably implement this intervention. Findings include issues that may be relevant to professional development in a broader rehabilitation context, including suggestions for the content of educational initiatives and the need for institutional support from managers in the form of physical resources for VR implementation.

  8. Factors influencing rural and urban emergency clinicians' participation in an online knowledge exchange intervention.

    Science.gov (United States)

    Curran, Janet A; Murphy, Andrea L; Sinclair, Douglas; McGrath, Patrick

    2013-01-01

    Rural emergency departments (EDs) generally have limited access to continuing education and are typically staffed by clinicians without pediatric emergency specialty training. Emergency care of children is complex and the majority of children receive emergency care in non-pediatric tertiary care centers. In recent decades, there has been a call to action to improve quality and safety in the emergency care of children. Of the one million ED visits by children in Ontario in 2005-2006, one in three visited more than once in a year and one in 15 returned to the ED within 72 hours of the index visit. This study explored factors influencing rural and urban ED clinicians' participation in a Web-based knowledge exchange intervention that focused on best practice knowledge about pediatric emergency care. The following questions guided the study: (i) What are the individual, context of practice or knowledge factors which impact a clinician's decision to participate in a Web-based knowledge exchange intervention?; (ii) What are clinicians' perceptions of organizational expectations regarding knowledge and information sources to be used in practice?; and (iii) What are the preferred knowledge sources of rural and urban emergency clinicians? A Web-based knowledge exchange intervention, the Pediatric Emergency Care Web Based Knowledge Exchange Project, for rural and urban ED clinicians was developed. The website contained 12 pediatric emergency practice learning modules with linked asynchronous discussion forums. The topics for the modules were determined through a needs assessment and the module content was developed by known experts in the field. A follow-up survey was sent to a convenience sample of 187 clinicians from nine rural and two urban Canadian EDs participating in the pediatric emergency Web-based knowledge exchange intervention study. The survey response rate was 56% (105/187). Participation in the knowledge exchange intervention was related to individual

  9. Effectiveness of teaching quality improvement to clinicians: a systematic review.

    Science.gov (United States)

    Boonyasai, Romsai T; Windish, Donna M; Chakraborti, Chayan; Feldman, Leonard S; Rubin, Haya R; Bass, Eric B

    2007-09-05

    Accreditation requirements mandate teaching quality improvement (QI) concepts to medical trainees, yet little is known about the effectiveness of teaching QI. To perform a systematic review of the effectiveness of published QI curricula for clinicians and to determine whether teaching methods influence the effectiveness of such curricula. The electronic literature databases of MEDLINE, EMBASE, CINAHL, and ERIC were searched for English-language articles published between January 1, 1980, and April 30, 2007. Experts in the field of QI were queried about relevant studies. Two independent reviewers selected studies for inclusion if the curriculum taught QI principles to clinicians and the evaluation used a comparative study design. Information about the features of each curriculum, its use of 9 principles of adult learning, and the type of educational and clinical outcomes were extracted. The relationship between the outcomes and the number of educational principles used was assessed. Of 39 studies that met eligibility criteria, 31 described team-based projects; 37 combined didactic instruction with experiential learning. The median number of adult learning principles used was 7 (range, 2-8). Evaluations included 22 controlled trials (8 randomized and 14 nonrandomized) and 17 pre/post or time series studies. Fourteen studies described educational outcomes (attitudes, knowledge, or skills or behaviors) and 28 studies described clinical process or patient outcomes. Nine of the 10 studies that evaluated knowledge reported only positive effects but only 2 of these described a validated assessment tool. The 6 assessments of attitudes found mixed results. Four of the 6 studies on skill or behavior outcomes reported only positive effects. Eight of the 28 studies of clinical outcomes reported only beneficial effects. Controlled studies were more likely than other studies to report mixed or null effects. Only 4 studies evaluated both educational and clinical outcomes

  10. Primary care clinicians' experiences prescribing HIV pre-exposure prophylaxis at a specialized community health centre in Boston: lessons from early adopters.

    Science.gov (United States)

    Krakower, Douglas S; Maloney, Kevin M; Grasso, Chris; Melbourne, Katherine; Mayer, Kenneth H

    2016-01-01

    An estimated 1.2 million Americans have indications for using antiretroviral pre-exposure prophylaxis (PrEP) to prevent HIV acquisition. For many of these at-risk individuals, the best opportunity to learn about and receive PrEP will be during routine visits to their generalist primary care clinicians. However, few generalist clinicians have prescribed PrEP, primarily because of practical concerns about providing PrEP in primary care settings. The experiences of specialized primary care clinicians who have prescribed PrEP can inform the feasibility of PrEP provision by generalists. During January to February 2015, 35 primary care clinicians at a community health centre in Boston that specializes in the care of sexual and gender minorities completed anonymous surveys about their experiences and practices with PrEP provision. Responses were analyzed with descriptive statistics. Thirty-two clinicians (response rate=91%) completed the surveys. Nearly all clinicians (97%) had prescribed PrEP (median 20 patients, interquartile range 11-33). Most clinicians reported testing and risk-reduction counselling practices concordant with U.S. Centers for Disease Control and Prevention guidelines for PrEP. Clinicians indicated that patients using PrEP experienced medication toxicities infrequently and generally reported high adherence. However, some clinicians' practices differed from guideline recommendations, and some clinicians observed patients with increased risk behaviours. Most clinicians (79%) rated PrEP provision as easy to accomplish, and 97% considered themselves likely to prescribe PrEP in the future. In a primary care clinic with specialized expertise in HIV prevention, clinicians perceived that PrEP provision to large numbers of patients was safe, feasible and potentially effective. Efforts to engage generalist primary care clinicians in PrEP provision could facilitate scale-up of this efficacious intervention.

  11. DES Science Portal: Computing Photometric Redshifts

    Energy Technology Data Exchange (ETDEWEB)

    Gschwend, Julia [LIneA, Rio de Janeiro

    2016-01-01

    An important challenge facing photometric surveys for cosmological purposes, such as the Dark Energy Survey (DES), is the need to produce reliable photometric redshifts (photo-z). The choice of adequate algorithms and configurations and the maintenance of an up-to-date spectroscopic database to build training sets, for example, are challenging tasks when dealing with large amounts of data that are regularly updated and constantly growing. In this paper, we present the first of a series of tools developed by DES, provided as part of the DES Science Portal, an integrated web-based data portal developed to facilitate the scientific analysis of the data, while ensuring the reproducibility of the analysis. We present the DES Science Portal photometric redshift tools, starting from the creation of a spectroscopic sample to training the neural network photo-z codes, to the final estimation of photo-zs for a large photometric catalog. We illustrate this operation by calculating well calibrated photo-zs for a galaxy sample extracted from the DES first year (Y1A1) data. The series of processes mentioned above is run entirely within the Portal environment, which automatically produces validation metrics, and maintains the provenance between the different steps. This system allows us to fine tune the many steps involved in the process of calculating photo-zs, making sure that we do not lose the information on the configurations and inputs of the previous processes. By matching the DES Y1A1 photometry to a spectroscopic sample, we define different training sets that we use to feed the photo-z algorithms already installed at the Portal. Finally, we validate the results under several conditions, including the case of a sample limited to i<22.5 with the color properties close to the full DES Y1A1 photometric data. This way we compare the performance of multiple methods and training configurations. The infrastructure presented here is an effcient way to test several methods of

  12. Clinician and cancer patient views on patient participation in treatment decision-making: a quantitative and qualitative exploration

    Science.gov (United States)

    Pieterse, A H; Baas-Thijssen, M C M; Marijnen, C A M; Stiggelbout, A M

    2008-01-01

    Patient participation in treatment decision-making is being increasingly advocated, although cancer treatments are often guideline-driven. Trade-offs between benefits and side effects underlying guidelines are made by clinicians. Evidence suggests that clinicians are inaccurate at predicting patient values. The aim was to assess what role oncologists and cancer patients prefer in deciding about treatment, and how they view patient participation in treatment decision-making. Seventy disease-free cancer patients and 60 oncologists (surgical, radiation, and medical) were interviewed about their role preferences using the Control Preferences Scale (CPS) and about their views on patient participation using closed- and open-ended questions. Almost all participants preferred treatment decisions to be the outcome of a shared process. Clinicians viewed participation more often as reaching an agreement, whereas 23% of patients defined participation exclusively as being informed. Of the participants, ⩾81% thought not all patients are able to participate and ⩾74% thought clinicians are not always able to weigh the pros and cons of treatment for patients, especially not quality as compared with length of life. Clinicians seemed reluctant to share probability information on the likely impact of adjuvant treatment. Clinicians should acknowledge the legitimacy of patients' values in treatment decisions. Guidelines should recommend elicitation of patient values at specific decision points. PMID:18781148

  13. Structurations formelle et conceptuelle des articles de dictionnaires : le deuxième modèle de codification des articles dans l’histoire des dictionnaires Larousse

    Directory of Open Access Journals (Sweden)

    Corbin Pierre

    2016-01-01

    Full Text Available La contribution soumise s’inscrit dans un ensemble d’études sur les codifications utilisées durant les cent-soixante ans d’histoire des dictionnaires Larousse pour distinguer, hiérarchiser et ordonner les informations figurant dans leurs articles, qui ont déjà donné lieu à deux publications. En prenant en compte différentes modalités de codification, que nous rappelons liminairement, nous repérons trois jalons majeurs dans ce riche catalogue. Le premier, qui trouve son origine dans le “Nouveau dictionnaire de la langue française” de 1856, ayant déjà été décrit, nous présentons ici le deuxième, ancré dans le “Grand dictionnaire universel du XIXe siècle” de 1866-1876, après l’avoir situé entre les deux autres. Par rapport au premier modèle de structuration des articles, qui reposait sur des moyens textuels (réductions des formes ou des occurrences des items traités et des éléments métalinguistiques introduisant les subdivisions, typographiques (affectant seulement les caractères : gras, italique, capitales et graphématiques (contrastes de majuscules et de minuscules, ponctuations, sans recours significatif à la mise en page, ni aux symboles, le second modèle, qui s’est diffusé, pendant plus d’un siècle, dans des dictionnaires très divers, a donné une place croissante aux symboles diacritiques (mais pas alphanumériques – ce sera la spécificité du troisième modèle, à partir du “Dictionnaire du français contemporain” de 1966 et, dans les ouvrages les plus volumineux, il a tiré parti des moyens offerts par la mise en page. Notre contribution présente en détail, en parcourant les divers groupes de dictionnaires concernés, l’ensemble de la mise en œuvre de ce deuxième modèle, qui avait vocation à permettre à leurs utilisateurs de repérer plus aisément certaines subdivisions des articles, sans cependant toujours refléter leur structuration conceptuelle profonde, sans doute

  14. Take the money and run? Redemption of a gift card incentive in a clinician survey

    Directory of Open Access Journals (Sweden)

    Jane S. Chen

    2016-02-01

    Full Text Available Abstract Background Clinician surveys provide critical information about many facets of health care, but are often challenging to implement. Our objective was to assess use by participants and non-participants of a prepaid gift card incentive that could be later reclaimed by the researchers if unused. Methods Clinicians were recruited to participate in a mailed or online survey as part of a study to characterize women’s primary health care provider attitudes towards breast and cervical cancer screening guidelines and practices (n = 177. An up-front incentive of a $50 gift card to a popular online retailer was included with the study invitation. Clinicians were informed that the gift card would expire if it went unused after 4 months. Outcome measures included use of gift cards by participants and non-participants and comparison of hypothetical costs of different incentive strategies. Results 63.5 % of clinicians who responded to the survey used the gift card, and only one provider who didn’t participate used the gift card (1.6 %. Many of those who participated did not redeem their gift cards (36.5 % of respondents. The price of the incentives actually claimed totaled $3700, which was less than half of the initial outlay. Since some of the respondents did not redeem their gift cards, the cost of incentives was less than it might have been if we had provided a conditional incentive of $50 to responders after they had completed the survey. Conclusions Redeemable online gift card codes may provide an effective way to motivate clinicians to participate in surveys.

  15. Take the money and run? Redemption of a gift card incentive in a clinician survey.

    Science.gov (United States)

    Chen, Jane S; Sprague, Brian L; Klabunde, Carrie N; Tosteson, Anna N A; Bitton, Asaf; Onega, Tracy; MacLean, Charles D; Harris, Kimberly; Schapira, Marilyn M; Haas, Jennifer S

    2016-02-24

    Clinician surveys provide critical information about many facets of health care, but are often challenging to implement. Our objective was to assess use by participants and non-participants of a prepaid gift card incentive that could be later reclaimed by the researchers if unused. Clinicians were recruited to participate in a mailed or online survey as part of a study to characterize women's primary health care provider attitudes towards breast and cervical cancer screening guidelines and practices (n = 177). An up-front incentive of a $50 gift card to a popular online retailer was included with the study invitation. Clinicians were informed that the gift card would expire if it went unused after 4 months. Outcome measures included use of gift cards by participants and non-participants and comparison of hypothetical costs of different incentive strategies. 63.5% of clinicians who responded to the survey used the gift card, and only one provider who didn't participate used the gift card (1.6%). Many of those who participated did not redeem their gift cards (36.5% of respondents). The price of the incentives actually claimed totaled $3700, which was less than half of the initial outlay. Since some of the respondents did not redeem their gift cards, the cost of incentives was less than it might have been if we had provided a conditional incentive of $50 to responders after they had completed the survey. Redeemable online gift card codes may provide an effective way to motivate clinicians to participate in surveys.

  16. Bioethics for clinicians: 21. Islamic bioethics

    Science.gov (United States)

    Daar, Abdallah S.; Khitamy, A.

    2001-01-01

    ISLAMIC BIOETHICS DERIVES FROM A COMBINATION OF PRINCIPLES, duties and rights, and, to a certain extent, a call to virtue. In Islam, bioethical decision-making is carried out within a framework of values derived from revelation and tradition. It is intimately linked to the broad ethical teachings of the Qur'an and the tradition of the Prophet Muhammad, and thus to the interpretation of Islamic law. In this way, Islam has the flexibility to respond to new biomedical technologies. Islamic bioethics emphasizes prevention and teaches that the patient must be treated with respect and compassion and that the physical, mental and spiritual dimensions of the illness experience be taken into account. Because Islam shares many foundational values with Judaism and Christianity, the informed Canadian physician will find Islamic bioethics quite familiar. Canadian Muslims come from varied backgrounds and have varying degrees of religious observance. Physicians need to recognize this diversity and avoid a stereotypical approach to Muslim patients. PMID:11202669

  17. Media literacy for clinicians and parents.

    Science.gov (United States)

    Villani, V Susan; Olson, Cheryl K; Jellinek, Michael S

    2005-07-01

    Families and children are in the midst of a media revolution. Television, Internet access, instant messaging, cell phones, and interactive video games are delivering more information for more hours than ever in history. Exposure is occurring at younger and younger ages, often without parental oversight or interpretation. The impact on children is just beginning to be studied. Does media exposure prepare children for the world in which they live or deprive them of critical developmental opportunities? Does the steady display of violence contribute to violent behavior? This article presents a developmental context, discusses the research conducted to date, reviews the recommendations of major organizations, and tries to take a balanced perspective in the midst of a rising tide of media, technology, commercialism, and controversy.

  18. Direction des Publications

    African Journals Online (AJOL)

    Synthese

    Unité de Recherche des Matériaux et des Energies Renouvelables (U.R.M.E.R). Université Abou –Baker Belkaid B.p : 119 Tlemcen 13000 Algerie. 2. Unité de Développement de la Technologie Du Silicium. UDTS, BP 399, Alger, Algérie. Accepté le : 08/06/2011. صخلم. داوﻣﻟا نﻣ ﻲﺗﻟا ﺔﺻﺎﺧو ،ﺔﻋﺎﻧﺻ يأ رﯾوطﺗ ﻲﻓ ﺎﯾﺳﯾﺋر ﻼﻣﺎﻋ ةرﯾﺧﻷا تاوﻧﺳﻟا ...

  19. Mykotische Infektionen des Penis

    Directory of Open Access Journals (Sweden)

    Mayser P

    1999-01-01

    Full Text Available Die häufigste mykotische Infektion des Penis stellt die Balanitis/Balonoposthitis durch Candida albicans dar. Sie weist eine steigende Inzidenz auf und scheint vornehmlich durch Genitalverkehr übertragen zu werden. Penile Infektionen durch Dermatophyten sind sehr selten, obwohl die Tinea inguinalis zu den häufigeren Erkrankungen zählt. Eine Mitbeteiligung des Penis im Rahmen von Systemmykosen kennzeichnet zumeist ein schwer verlaufende Erkrankung. Ursächlich kann beim immunoinkompetenten Patienten nahezu jeder Erreger in Frage kommen. Biopsie sowie Gewebekultur aus den meist ulzerativen Veränderungen können die Diagnose sichern. Die meisten superfiziellen Infektionen sprechen zufriedenstellend auf eine topische antimykotische Behandlung an, insbesondere wenn Provokationsfaktoren und die Möglichkeit der sexuellen Transmission berücksichtigt werden. Ausgedehnte Infektionen durch Dermatophyten, Hefen und natürlich systemische Infektionen erfordern eine systemische antimykotische Therapie.

  20. Chimie des processus biologiques

    OpenAIRE

    Fontecave, Marc

    2014-01-01

    Cours : Chimie biologique radicalaire : de l’origine de l’ADN au métabolisme d’aujourd’hui Il est généralement admis que les radicaux libres, espèces chimiques très réactives, sont des poisons pour les systèmes vivants qui ont élaboré des mécanismes efficaces pour s’en protéger et s’en débarrasser lorsqu’ils viennent à se former, par accident. Par exemple ce qu’on appelle communément le stress oxydant est une situation caractérisée par une accumulation de radicaux issus de l’oxygène moléculai...

  1. La cogestion des Ressources naturelles

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

    L'eau, le sol, les nutriments, la lumière du soleil — ce sont des choses de la vie. .... habitent encore ces régions, soit de 9 % à 14 % de la population mondiale. ...... La guerre civile a fait vivre au Cambodge des années de chaos, d'anarchie et ...... et les allégeances politiques sont des facteurs qu'il est impossible d'ignorer.

  2. Child Health Disparities: What Can a Clinician Do?

    OpenAIRE

    Cheng, Tina L.; Emmanuel, Mickey; Levy, Daniel J.; Jenkins, Renee R.

    2015-01-01

    Pediatric primary and specialty practice has changed with more to do, more regulation and more family needs. Similarly, the needs of patients have changed with more demographic diversity, family stress and continued health disparities by race, ethnicity and socioeconomic status. How can clinicians continue their dedicated service to children and ensure health equity in the face of these changes? This paper outlines specific, practical, actionable and evidence-based activities for clinicians t...

  3. On the duty of the physician to inform the patient of the risk of damage to the plexus brachialis as a result of telecobalt therapy. Judgment of the Federal Supreme Court of December 12, 1989. Zur Pflicht des Arztes zur Aufklaerung des Patienten ueber das Risiko einer Schaedigung des Armplexus als Folge einer Telekobaltbestrahlung. Bundesgerichtshof Urteil vom 12. Dezember 1989

    Energy Technology Data Exchange (ETDEWEB)

    Anon,

    1990-05-20

    The BGH judgment deals with plaintiff's contractual and tortious claims relating to hospital X which carried out the operation, and hospital Y plaintiff was referred to by hospital X for the purpose of post-operative irradiation. In addition, it is examined whether there are claims against hospital Y, or its performing or vicarious personnel (contractual and tortious aspects), on account of claims resulting from breach of the duty to inform. Judgment does not deal with the question whether the charge of damage due to incorrect therapy applies (in lack of sufficient evidence in the judgment against which appeal was lodged) and with questions of the running out of the period of limitation. (BGH, judgment of December 12, 1989) (VI ZR 83/89, Zweibruecken). (RST).

  4. Grundlagen des Tissue Engineering

    Science.gov (United States)

    Mayer, Jörg; Blum, Janaki; Wintermantel, Erich

    Die Organtransplantation stellt eine verbreitete Therapie dar, um bei krankheitsoder unfallbedingter Schädigung eines Organs die Gesamtheit seiner Funktionen wieder herzustellen, indem es durch ein Spenderorgan ersetzt wird. Organtransplantationen werden für die Leber, die Niere, die Lunge, das Herz oder bei schweren grossflächigen Verbrennungen der Haut vorgenommen. Der grosse apparative, personelle und logistische Aufwand und die Risiken der Transplantationschirurgie (Abstossungsreaktionen) sowie die mangelnde Verfügbarkeit von immunologisch kompatiblen Spenderorganen führen jedoch dazu, dass der Bedarf an Organtransplantaten nur zu einem sehr geringen Teil gedeckt werden kann. Sind Spenderorgane nicht verfügbar, können in einzelnen Fällen lebenswichtige Teilfunktionen, wie beispielsweise die Filtrationsfunktion der Niere durch die Blutreinigung mittels Dialyse ersetzt oder, bei mangelnder Funktion der Bauchspeicheldrüse (Diabetes), durch die Verabreichung von Insulin ein normaler Zustand des Gesamtorganismus auch über Jahre hinweg erhalten werden. Bei der notwendigen lebenslangen Anwendung apparativer oder medikamentöser Therapie können für den Patienten jedoch häufig schwerwiegende, möglicherweise lebensverkürzende Nebenwirkungen entstehen. Daher werden in der Forschung Alternativen gesucht, um die Funktionen des ausgefallenen Organs durch die Implantation von Zellen oder in vitro gezüchteten Geweben möglichst umfassend wieder herzustellen. Dies erfordert biologisch aktive Implantate, welche die für den Stoffwechsel des Organs wichtigen Zellen enthalten und einen organtypischen Stoffwechsel entfalten.

  5. Dictionnaire des risques psychosociaux

    CERN Document Server

    Zawieja, Philippe

    2014-01-01

    Stress, suicide, harcèlement, épuisement professionnel, workaholism... Au-delà de la souffrance qu'elles désignent, ces notions souvent récentes constituent une approche inédite, et demandent à mieux être comprises, dans leur ensemble et isolément. C'est tout l'enjeu de ce dictionnaire, pionnier en son genre. Le lecteur y trouvera représentés, avec les 314 entrées (rédigées par 251 contributeurs) qui le composent, tous les champs disciplinaires s'intéressant à la souffrance au travail : psychologie du travail et des organisations, psychologie sociale et psychosociologie, psychanalyse, psychopathologie et psychiatrie, ergonomie, sociologie du travail et des organisations, médecine du travail, droit du travail et de la sécurité sociale, sciences de gestion, philosophie... Y sont détaillés les principaux concepts, notions, approches, méthodes, théories, outils, études, etc., ayant cours dans l'étude des risques psychosociaux, mais aussi certaines professions emblématiques (infirmières,...

  6. Le vernis des apparences

    Directory of Open Access Journals (Sweden)

    Grazia Nicosia

    2010-04-01

    Full Text Available Le but de cet article est de comprendre l’incidence sémiotique du nettoyage d’un tableau ainsi que la résultante cognitive induite sur l’observateur. Cette étude confronte l’analyse des phénomènes visuels engendrés par le jaunissement du vernis et son retrait, à des entretiens réalisés à dessein. Le retrait d’un vernis jauni change considérablement l’image. L’heure, le climat, la saison et l’activité même des personnages s’en trouvent ainsi modifié. La patine peut être perçue, soit comme un obstacle à l’exploration, soit pour ceux qui l’apprécient, comme le medium d’une relation plus intime entre l’œuvre et l’observateur.The purpose of this article is to understand the semiotic impact of the cleaning of a painting and the cognitive effects induced on the observer. This study analyses conjointly the visual phenomenon generated by yellowing varnish and its removal and controlled interviews of observers.The removal of yellowing varnish modifies considerably the perception of the picture. Daytime, climate, season and characters activities are modified. The patina may be perceived either as an obstacle to the painting exploration, or, for those who appreciate it, as a medium for a closer relationship between the painting and the observer.

  7. Clinician perspectives of an intensive comprehensive aphasia program.

    Science.gov (United States)

    Babbitt, Edna M; Worrall, Linda E; Cherney, Leora R

    2013-01-01

    Intensive comprehensive aphasia programs (ICAPs) have increased in number in recent years in the United States and abroad. To describe the experiences of clinicians working in an ICAP. A phenomenological approach was taken. Seven clinicians from 3 ICAPs were interviewed in person or on the phone. Their interviews were transcribed and coded for themes relating to their experiences. Clinicians described 3 major themes. The first theme related to the intensity component of the ICAP that allowed clinicians to provide in-depth treatment and gave them a different perspective with regard to providing treatment and the potential impact on the person with aphasia. The second theme of rewards for the clinicians included learning and support, seeing progress, and developing relationships with their clients and family members. Third, challenges were noted, including the time involved in learning new therapy techniques, patient characteristics such as chronicity of the aphasia, and the difficulty of returning to work in typical clinical settings after having experienced an ICAP. Although there is a potential for bias with the small sample size, this pilot study gives insight into the clinician perspective of what makes working in an ICAP both worthwhile and challenging.

  8. Equity of access to elective surgery: reflections from NZ clinicians.

    Science.gov (United States)

    McLeod, Deborah; Dew, Kevin; Morgan, Sonya; Dowell, Anthony; Cumming, Jackie; Cormack, Donna; McKinlay, Eileen; Love, Tom

    2004-10-01

    To explore factors potentially influencing equitable access to elective surgery in New Zealand by describing clinicians' perceptions of equity and the factors they consider when prioritising patients for elective surgery. A qualitative study in selected New Zealand localities. A purposive sample of 49 general practitioners, specialists and registrars were interviewed. Data were analysed thematically. General practitioners described unequal opportunities for patients to access primary and secondary care and, in particular, private sector elective surgery. They felt that socio-economically disadvantaged patients were less able to advocate for themselves and were more vulnerable to being lost to the elective surgical booking system as well as being less able to access private care. Both GPs and secondary care clinicians described situations where they would personally advocate for individual patients to improve their access. Advocacy was related to clinicians' perceptions of the 'value' that patients would receive from the surgery and patients' needs for public sector funding. The structure of the health system contributes to inequities in access to elective care in New Zealand. Subjective decision making by clinicians has the potential to advantage or disadvantage patients through the weighting clinicians place on socio-demographic factors when making rationing decisions. Review of the potential structural barriers to equitable access, further public debate and guidance for clinicians on the relative importance of socio-demographic factors in deciding access to rationed services are required for allocation of services to be fair.

  9. Clinicians' perception of the preventability of inpatient mortality.

    Science.gov (United States)

    Nash, Robert; Srinivasan, Ramya; Kenway, Bruno; Quinn, James

    2018-03-12

    Purpose The purpose of this paper is to assess whether clinicians have an accurate perception of the preventability of their patients' mortality. Case note review estimates that approximately 5 percent of inpatient deaths are preventable. Design/methodology/approach The design involved in the study is a prospective audit of inpatient mortality in a single NHS hospital trust. The case study includes 979 inpatient mortalities. A number of outcome measures were recorded, including a Likert scale of the preventability of death- and NCEPOD-based grading of care quality. Findings Clinicians assessed only 1.4 percent of deaths as likely to be preventable. This is significantly lower than previously published values ( p<0.0001). Clinicians were also more likely to rate the quality of care as "good," and less likely to identify areas of substandard clinical or organizational management. Research limitations/implications The implications of objective assessment of the preventability of mortality are essential to drive quality improvement in this area. Practical implications There is a wide disparity between independent case note review and clinicians assessing the care of their own patients. This may be due to a "knowledge gap" between reviewers and treating clinicians, or an "objectivity gap" meaning clinicians may not recognize preventability of death of patients under their care. Social implications This study gives some insight into deficiencies in clinical governance processes. Originality/value No similar study has been performed. This has significant implications for the idea of the preventability of mortality.

  10. Towards reinforcing telemedicine adoption amongst clinicians in Nigeria.

    Science.gov (United States)

    Adenuga, Kayode I; Iahad, Noorminshah A; Miskon, Suraya

    2017-08-01

    Telemedicine systems have been considered as a necessary measure to alleviate the shortfall in skilled medical specialists in developing countries. However, the obvious challenge is whether clinicians are willing to use this technological innovation, which has aided medical practice globally. One factor which has received little academic attention is the provision of suitable encouragement for clinicians to adopt telemedicine, in the form of rewards, motivation or incentives. A further consideration for telemedicine usage in developing countries, especially sub-Saharan Africa and Nigeria in particular, are to the severe shortage of available practising clinicians. The researchers therefore explore the need to positively reinforce the adoption of telemedicine amongst clinicians in Nigeria, and also offer a rationale for this using the UTAUT model. Data were collected using a structured paper-based questionnaire, with 252 physicians and nurses from six government hospitals in Ondo state, Nigeria. The study applied SmartPLS 2.0 for analysis to determine the relationship between six variables. Demographic moderating variables, age, gender and profession, were included. The results indicate that performance expectancy (ptelemedicine systems, as predicted using the extended UTAUT model. Our results showed that the use of telemedicine by clinicians in the Nigerian context is perceived as a dual responsibility which requires suitable reinforcement. In addition, performance expectancy, effort expectancy, facilitating condition and reinforcement determinants are influential factors in the use of telemedicine services for remote-patient clinical diagnosis and management by the Nigerian clinicians. Copyright © 2017. Published by Elsevier B.V.

  11. Investigating the need for clinicians to use tablet computers with a newly envisioned electronic health record.

    Science.gov (United States)

    Saleem, Jason J; Savoy, April; Etherton, Gale; Herout, Jennifer

    2018-02-01

    The Veterans Health Administration (VHA) has deployed a large number of tablet computers in the last several years. However, little is known about how clinicians may use these devices with a newly planned Web-based electronic health record (EHR), as well as other clinical tools. The objective of this study was to understand the types of use that can be expected of tablet computers versus desktops. Semi-structured interviews were conducted with 24 clinicians at a Veterans Health Administration (VHA) Medical Center. An inductive qualitative analysis resulted in findings organized around recurrent themes of: (1) Barriers, (2) Facilitators, (3) Current Use, (4) Anticipated Use, (5) Patient Interaction, and (6) Connection. Our study generated several recommendations for the use of tablet computers with new health information technology tools being developed. Continuous connectivity for the mobile device is essential to avoid interruptions and clinician frustration. Also, making a physical keyboard available as an option for the tablet was a clear desire from the clinicians. Larger tablets (e.g., regular size iPad as compared to an iPad mini) were preferred. Being able to use secure messaging tools with the tablet computer was another consistent finding. Finally, more simplicity is needed for accessing patient data on mobile devices, while balancing the important need for adequate security. Published by Elsevier B.V.

  12. Clinician-Reported Barriers to Implementing Breast Cancer Chemoprevention in the UK: A Qualitative Investigation.

    Science.gov (United States)

    Smith, Samuel G; Side, Lucy; Meisel, Susanne F; Horne, Rob; Cuzick, Jack; Wardle, Jane

    2016-01-01

    The use of tamoxifen and raloxifene as preventive therapy for women at increased risk of breast cancer was approved by the National Institute for Health and Care Excellence (NICE) in 2013. We undertook a qualitative investigation to investigate the factors affecting the implementation of preventive therapy within the UK. We recruited general practitioners (GPs) (n = 10) and clinicians working in family history or clinical genetics settings (FHCG clinicians) (n = 15) to participate in semi-structured interviews. Data were coded thematically within the Consolidated Framework for Implementation Research. FHCG clinicians focussed on the perceived lack of benefit of preventive therapy and difficulties interpreting the NICE guidelines. FHCG clinicians felt poorly informed about preventive therapy, and this discouraged patient discussions on the topic. GPs were unfamiliar with the concept of preventive therapy, and were not aware that they may be asked to prescribe it for high-risk women. GPs were reluctant to initiate therapy because it is not licensed, but were willing to continue a prescription if it had been started in secondary or tertiary care. Barriers to implementing preventive therapy within routine clinical practice are common and could be addressed by engaging all stakeholders during the development of policy documents. © 2016 The Author(s) Published by S. Karger AG, Basel.

  13. Loyalty in the trenches: practical teleology for office clinicians responding to terrorism.

    Science.gov (United States)

    Trotter, Griffin

    2004-08-01

    Were terrorists ever to effectively deploy weapons of mass destruction, medical practice would be quickly transformed. Many ordinary clinicians would be asked or required to treat unfamiliar yet serious medical conditions in a setting of overwhelming urgency and impossible odds. Clinical focus would shift from doing good things for a succession of individual patients to considering many patients at once, a change that could beget loss of trust and rapport with patients. Clinicians might also experience restrictions in personal liberties and appropriation of their property. The purpose of this essay is to develop a teleological framework for undertaking this transformation. In ordinary clinical medicine, the elusiveness of the individual telos (i.e.,the good for the individual) is acknowledged in procedures (such as social history taking,informed consent and outpatient scheduling) designed to protect patients' (and clinicians')prerogatives to interpret the telos for themselves. In mass casualty scenarios, on the other hand, the telos is standardized and regarded as an Immediate Object (usually as a state of affairs in which survival is maximized and permanent disability is minimized). Clinicians who provide mass casualty care will face a number of ethical challenges that can be negotiated by appealing to the political and ethical rationale, and limits, pertaining to the pursuit of aggregate survival as an Immediate Object.

  14. Service users' perceptions about their hospital admission elicited by service user-researchers or by clinicians.

    LENUS (Irish Health Repository)

    O'Donoghue, Brian

    2013-05-01

    OBJECTIVE Service users may express positive, ambivalent, or negative views of their hospital admission. The objective of this study was to determine whether the background of the interviewer-service user-researcher or clinician-influences the information elicited. The primary outcome was the level of perceived coercion on admission, and secondary outcomes were perceived pressures on admission, procedural justice, perceived necessity for admission, satisfaction with services, and willingness to consent to participate in the study. METHODS Participants voluntarily and involuntarily admitted to three hospitals in Ireland were randomly allocated to be interviewed at hospital discharge by either a service user-researcher or a clinician. Interviewers used the MacArthur Admission Experience Survey and the Client Satisfaction Questionnaire. RESULTS A total of 161 participants were interviewed. No differences by interviewer status or by admission status (involuntary or voluntary) were found in levels of perceived coercion, perceived pressures, procedural justice, perceived necessity, or satisfaction with services. Service users were more likely to decline to participate if their consent was sought by a service user-researcher (24% versus 8%, p=.003). CONCLUSIONS Most interviewees gave positive accounts of their admission regardless of interviewer status. The findings indicate that clinicians and researchers can be more confident that service users\\' positive accounts of admissions are not attributable to a response bias. Researchers can also feel more confident in directly comparing the results of studies undertaken by clinicians and by service user-researchers.

  15. Knowledge transfer to clinicians and consumers by the Cochrane Musculoskeletal Group.

    Science.gov (United States)

    Santesso, Nancy; Maxwell, Lara; Tugwell, Peter S; Wells, George A; O'connor, Annette M; Judd, Maria; Buchbinder, Rachelle

    2006-11-01

    The Cochrane Musculoskeletal Group (CMSG) is one of 50 groups of the Cochrane Collaboration that prepares, maintains, and disseminates systematic reviews of treatments for musculoskeletal diseases. Once systematic reviews are completed, the next challenge is presenting the results in useful formats to be integrated into the healthcare decisions of clinicians and consumers. The CMSG recommends 3 methods to aid knowledge translation and exchange between clinicians and patients: produce clinical relevance tables, create graphical displays using face figures, and write consumer summaries and patient decision aids. Accordingly, CMSG has developed specific guidelines to help researchers and authors convert the pooled estimates of metaanalyses in the systematic reviews to user-friendly numbers. First, clinical relevance tables are developed that include absolute and relative benefits or harms and the numbers needed to treat. Next, the numbers from the clinical relevance tables are presented graphically using faces. The faces represent a group of 100 people and are shaded according to how many people out of 100 benefited or were harmed by the interventions. The user-friendly numbers are also included in short summaries and decision aids written for patients. The different levels of detail in the summaries and decision aids provide patients with tools to prepare them to discuss treatment options with their clinicians. Methods to improve the effects and usability of systematic reviews by providing results in more clinically relevant formats are essential. Both clinicians and consumers can use these products to use evidence-based information in individual and shared decision-making.

  16. Harmonische Reduktion des linken Ventrikels

    OpenAIRE

    Atila, M. (Mehmet)

    2005-01-01

    In der vorliegenden Arbeit wurde die harmonische Reduktion des linken Ventrikels am Modell des ausgewachsenen Hausschweins, unter Verwendung von Saugkappen variabler Größe untersucht. In 10 Schweinen mit Herzen normaler Größe und Funktion wurde eine Saugkappe, in Größe und Form an das abzufaltende Wandsegment angepasst, auf die epikardiale Oberfläche des schlagenden Herzens gesetzt. Wir führten Messungen der linksventrik. und der pulmonalart. Drücke, des ventrikulären Durchmessers und der Her...

  17. Les pensions dans les pays de l'OCDE 2009 panorama des systèmes de retraite

    CERN Document Server

    Organisation for Economic Cooperation and Development. Paris

    2009-01-01

    Les politiques menées en matière de pensions et de retraite ont connu des évolutions considérables au cours des dernières années, les pouvoirs publics s’efforçant de concilier deux objectifs : assurer des revenus suffisants aux retraités et garantir la viabilité financière à long terme des systèmes de retraite face au vieillissement de la population. Panorama des Pensions 2009 propose un cadre de référence cohérent permettant de comparer les politiques adoptées dans ce domaine par les différents pays de l’OCDE, ainsi qu’un ensemble de données fiables. Cette troisième édition renferme des informations actualisées sur les principales caractéristiques des pensions versées au sein des pays de l’OCDE et contient des projections relatives aux revenus que percevront demain les salariés d’aujourd’hui. Elle offre également une gamme élargie d’indicateurs, parmi lesquels figurent des données chiffrées concernant les actifs, les performances des investissements, l’ampleur des ...

  18. Process of smoking cessation. Implications for clinicians.

    Science.gov (United States)

    Prochaska, J O; Goldstein, M G

    1991-12-01

    The process of smoking cessation involves progression through five stages of change: precontemplation, contemplation, preparation, action, and maintenance. Most patients are not prepared to take action on their smoking, yet most smoking cessation programs are designed for smokers who are so prepared. Small percentages of smokers register for action-oriented cessation programs. How much progress patients make after an intervention is directly related to what stage they are in prior to intervention. The stages of change can be quickly assessed with four questions. Physicians can then be more effective with a broader range of patients by matching their interventions to the patients' stage of change. Helping patients progress just one stage can double their chances of not smoking 6 months later. Providing personalized information about the cons of smoking, asking affect-arousing questions, and encouraging patients to re-evaluate themselves as smokers are interventions physicians can use to help patients who are not prepared to quit smoking. Behavioral interventions, such as providing substitutes like nicotine gum and removing or altering cues for smoking, are most helpful for patients who are ready to take action. The use of a stage-matched, patient-centered counseling intervention can help physicians to feel less frustrated and more effective in their efforts to help a broad range of their patients.

  19. Medication errors: an overview for clinicians.

    Science.gov (United States)

    Wittich, Christopher M; Burkle, Christopher M; Lanier, William L

    2014-08-01

    Medication error is an important cause of patient morbidity and mortality, yet it can be a confusing and underappreciated concept. This article provides a review for practicing physicians that focuses on medication error (1) terminology and definitions, (2) incidence, (3) risk factors, (4) avoidance strategies, and (5) disclosure and legal consequences. A medication error is any error that occurs at any point in the medication use process. It has been estimated by the Institute of Medicine that medication errors cause 1 of 131 outpatient and 1 of 854 inpatient deaths. Medication factors (eg, similar sounding names, low therapeutic index), patient factors (eg, poor renal or hepatic function, impaired cognition, polypharmacy), and health care professional factors (eg, use of abbreviations in prescriptions and other communications, cognitive biases) can precipitate medication errors. Consequences faced by physicians after medication errors can include loss of patient trust, civil actions, criminal charges, and medical board discipline. Methods to prevent medication errors from occurring (eg, use of information technology, better drug labeling, and medication reconciliation) have been used with varying success. When an error is discovered, patients expect disclosure that is timely, given in person, and accompanied with an apology and communication of efforts to prevent future errors. Learning more about medication errors may enhance health care professionals' ability to provide safe care to their patients. Copyright © 2014 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  20. Register of Education and Training Activities in Librarianship, Information Science and Archives = Inventaire des activites de formation dans le domaine de la bibliotheconomie, des sciences de l'information et de l'archivistique = Inventario de las actividades de formacion en la esfera de la bibliotecologia, las ciencias de la informacion y la archivologia.

    Science.gov (United States)

    de Grolier, Eric, Comp.

    This register provides information on information science, librarianship, documentation, and archival science training activities conducted outside regular university courses organized by specialized schools. Based on a December 1980 UNESCO questionnaire survey, the register includes seminars, refresher courses, continuing education courses, and…

  1. Adolescent autonomy revisited: clinicians need clearer guidance.

    Science.gov (United States)

    Brierley, Joe; Larcher, Victor

    2016-08-01

    In 1996, Brazier and Bridge raised the question 'is adolescent autonomy truly dead and buried' following judicial decisions which had seemed to reverse the Gillick-inspired trend for greater child autonomy in healthcare. Subsequent decisions by the courts have reinforced the view that those below 18 years in England and Wales remain children with limited rights to refuse treatment compared with adults. This is at variance with the daily experience of those working with young people who increasingly seek to actively involve them in making freely informed decisions about their healthcare, in accordance with the principles enunciated in the UN Convention of the Rights of the Child and the UK Children Acts. We review the derivation of the law in England and Wales in this area, in the light of another recent family court judgement enforcing treatment on a 'competent' child without his or her consent and ask: 'How can the Common Law and the ethical practice of those caring for young people have diverged so far?' Either young people can decide whether to have a recommended treatment, or they cannot. Given Ian McEwan's book, the Children Act, has stimulated wider social debate in this area might this be an opportune moment to seek public policy resolution with regards to healthcare decision making by young people? We argue that events since the Gillick case have underlined the need for a comprehensive review of legal policy and practice in this area. While absolute autonomy and freedom of choice are arguably inconsistent with the protection rights that society has agreed are owed to children, healthcare practitioners need clarity over the circumstances in which society expects that autonomous choices of adolescents can be overridden. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  2. Herpes: a dilemma for client and clinician.

    Science.gov (United States)

    Edlund, B J; Poteet, G W

    1987-01-01

    In the last 10 years genital herpes simplex has reached epidemic proportions, affecting 5 million Americans, with 500,000 new cases yearly. The incidence is highest among middle and upper socioeconomic groups and among whites. There are 2 antigenically distinct strains of the herpes simplex virus, and type II is the cause of 85% of the genital infections. The virus has an affinity for tissues derived from the embryonic ectoderm -- skin, mucous membranes, eye, and central nervous system. Transmission is by personal contact with an infected area. The clinical course of the disease involves 4 stages. In the primary stage the typical lesions are vesicles, which rupture, leaving painful shallow ulcerations. The primary stage lasts from 2 to 4 weeks with approximately 10 days of viral shedding. In the latent stage the virus lies dormant in the sacral ganglion and is noninfectious. In the shedding stage the virus replicates and sheds in genital secretions. The recurrent stage is characterized by prodromal itching or tingling sensations prior to the eruption of the vesicles and by neuralgia. Recurrence occurs as often as 4 to 7 times a year and lasts from 7 to 10 days, with viral shedding for 4 or 5 days. Definitive diagnosis can be made from viral tissue culture or the Tzanck and Papanicolaou smears. There is no cure for herpes although acyclovir has been found to shorten the duration of the episodes. Except for pregnancy complications, the most serious complications of recurrent genital herpes are psychological. The disease is socially stigmatizing and inhibits sexual activity. The nurse should provide supportive care, information about the transmission and symptoms of the disease, and counseling as to precautions to take, such as condom and spermicide use, avoidance of oral sex, abstention when lesions are present, and limiting sex to one partner.

  3. L’OCDE évalue les compétences des adultes

    OpenAIRE

    Bardi, Anne-Marie

    2014-01-01

    Une dizaine d’années après les premiers résultats du Programme international de suivi des acquis des élèves (PISA), l’Organisation de coopération et de développement économiques (OCDE) livre une étude sur les compétences des adultes de 16 à 65 ans. Ce nouveau Programme pour l’évaluation internationale des compétences des adultes (PIIAC) est conçu en cycles, dont le premier s’achève en 2013. Il vise à informer sur la maîtrise des compétences jugées indispensables pour évoluer dans un monde hyp...

  4. Information and Announcements

    Indian Academy of Sciences (India)

    Information and Announcements. lfijRefresher Course in ... Classical encrypton techniques, block ciphers and DES, AES, confidentiality using symmetric encryption, message ... network security', W Stallings, PHI, III Ed. (2004). Recent trends in ...

  5. Development and adaptation of the ELBIS Elbe river information system into a water quality information system of the ARGE-ELBE working group. Final report; Entwicklung und Anpassung des Elbeinformationssystems ELBIS fuer ein Gewaessergueteinformationssystem der ARGE-ELBE. Abschlussbericht

    Energy Technology Data Exchange (ETDEWEB)

    Frank, B.; Prange, A.

    2001-07-01

    The geo-information system ELBIS was installed in mid-November 2000 to provide information on the web on Elbe water quality and other information. It presents the current results of the national Elbe monitoring programme of the ARGE Elbe working group, as well as the results of the 'Elbe 2000' programme of the nineties. [German] Das Geo-Informationssystem ELBIS informiert seit November 2000 im Internet ueber die Wasserqualitaet und verwandte Elbe-Themen. Mittels einer geografischen Oberflaeche stellt es die fortlaufenden, aktuellen Ergebnisse der nationalen Elbe-Messprogramme der ARGE Elbe (Arbeitsgemeinschaft fuer die Reinhaltung der Elbe) dar sowie Forschungsdaten aus der 'Elbe 2000'-Schadstoffforschung der neunziger Jahre. Auf einfache und zeitgemaesse Weise macht ELBIS diese Ergebnisse der interessierten Oeffentlichkeit zugaenglich und bietet Fachleuten einen umfassenden Ueberblick ueber die Datenlage. (orig.)

  6. Information

    International Nuclear Information System (INIS)

    Boyard, Pierre.

    1981-01-01

    The fear for nuclear energy and more particularly for radioactive wastes is analyzed in the sociological context. Everybody agree on the information need, information is available but there is a problem for their diffusion. Reactions of the public are analyzed and journalists, scientists and teachers have a role to play [fr

  7. La recherche en action : des solutions locales, des effets durables ...

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

    15 déc. 2010 ... Le Centre de recherches pour le développement international (CRDI) appuie la production et l'application de connaissances qui améliorent de façon notable la situation des habitants des pays en développement.

  8. Analyse des caractéristiques structurelles et des performances ...

    African Journals Online (AJOL)

    SARAH

    28 févr. 2014 ... performances technico-économiques de la riziculture irriguée en Côte d' .... en nous basant sur les prix des intrants et des produits en vigueur au cours ..... la recherche et de la vulgarisation et le transfert de technologies ; (2) ...

  9. Evaluation des pratiques de gestion des adventices en riziculture

    African Journals Online (AJOL)

    Les résultats ont montré que les méthodes de gestion de l'enherbement ont .... Le contrôle des adventices en riziculture irriguée a principalement .... mesurer la hauteur des plantes et la longueur ..... Performance agronomique du Sys- tème de ...

  10. Diversification des moyens de subsistance des petits producteurs de ...

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

    L'économie du Malawi repose essentiellement sur la culture du tabac, qui représente plus de 70 % des revenus d'exportation. Pour 60 % des 100 000 membres de la National Smallholder Farmers' Association of Malawi (NASFAM), le tabac est la seule et unique source de revenus. Les cultivateurs de tabac, au Malawi ...

  11. Culture du bambou : diversification des moyens de subsistance des ...

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

    Culture du bambou : diversification des moyens de subsistance des petits producteurs de tabac du sud de la province de Nyanza, au Kenya - phase II. Au cours de la première phase du projet (projet no 103765), les chercheurs ont effectué une analyse de marché pour le bambou et les produits du bambou, comparé les ...

  12. Roles et taches des accompagnateurs des patients hospitalises ...

    African Journals Online (AJOL)

    Roles et taches des accompagnateurs des patients hospitalises dans le service de pneumo-phtysiologie au Centre Hospitalier Universitaire Yalgado Ouedraogo de ... Logistical support represented by material support, drug supply, cleaning of premises, and littering occupied respectively 100%, 91%, 42% and 73%.

  13. INIS: international nuclear information system. World first international database on pacific uses of nuclear sciences and technologies; INIS: International Nuclear Information System. Premiere base de donnees internationale sur les applications pacifiques des sciences et technologies nucleaires

    Energy Technology Data Exchange (ETDEWEB)

    Surmont, J.; Constant, A.; Guille, N.; Le Blanc, A.; Mouffron, O.; Anguise, P.; Jouve, J.J

    2007-07-01

    This poster, prepared for the 2007 CEA meetings on scientific and technical information, presents the INIS information system, the document-types content and subject coverage of the database, the French contribution to this system thanks to the INIS team of the CEA-Saclay, the input preparation process, and an example of valorization of a scientific and historical patrimony with the CEA/IAEA joint project of digitization of about 2760 CEA reports published between 1948 and 1969. All these reports have been digitized by the IAEA and analyzed by CEA, and entered in the INIS database with a link to the full text. (J.S.)

  14. Moore's Law, disruptive technologies, and the clinician.

    Science.gov (United States)

    Vosburgh, Kirby G; Newbower, Ronald S

    2002-01-01

    The advancement of technical power described by Moore's Law offers great potential for enabling more cost-effective medical devices and systems. However, progress has been slow. Many factors for this failure have been cited, including the anti-rational economic structure of healthcare and the complexity and long time scale of medical development. Christensen et al. suggest that "disruptive technologies" may circumvent some of these difficulties. "Disruptive Technologies" are defined as those that are established in one market, but then penetrate and overwhelm another market. These incursions are accelerated by economic factors, and capitalize on functionality, reliability, and advancements supported by the original market. Christensen has cited many examples from industrial and service businesses, but few examples can be found yet in healthcare. We argue that positive technology impacts in medicine occur most readily when innovators augment the skills of and collaborate with caregivers, rather than seeking to displace them. In the short term, a new approach may improve efficiency or quality. In the longer term, such approaches may obviate human tasks at lower-skill levels, and even permit task automation. One successful example has been the introduction of flexible monitoring for physiologic information. Systems for computer-aided diagnosis, which have failed to impact complex decision making, have succeeded in simpler specialty areas such as the interpretation of EKG's and mammograms, and may do the same with analysis of some pathology images. The next frontier may the operating room, and the adoption of such systemic technologies by caregivers in emergency medicine and general care may then have an even wider "disruptive" effect. Responding to time and cost pressures, and the desire to move care to the patient, other workers, such as radiologists, will drive the trend away from isolated, complex, large-scale devices, and toward integrated, modular, and simpler

  15. 'So you want to be a clinician-educator...': designing a clinician-educator curriculum for internal medicine residents.

    Science.gov (United States)

    Heflin, Mitchell T; Pinheiro, Sandro; Kaminetzky, Catherine P; McNeill, Diana

    2009-06-01

    Despite a growing demand for skilled teachers and administrators in graduate medical education, clinician-educator tracks for residents are rare and though some institutions offer 'resident-as-teacher' programs to assist residents in developing teaching skills, the need exists to expand training opportunities in this area. The authors conducted a workshop at a national meeting to develop a description of essential components of a training pathway for internal medicine residents. Through open discussion and small group work, participants defined the various roles of clinician-educators and described goals, training opportunities, assessment and resource needs for such a program. Workshop participants posited that the clinician-educator has several roles to fulfill beyond that of clinician, including those of teacher, curriculum developer, administrator and scholar. A pathway for residents aspiring to become clinician educators must offer structured training in each of these four areas to empower residents to effectively practice clinical education. In addition, the creation of such a track requires securing time and resources to support resident learning experiences and formal faculty development programs to support institutional mentors and leaders. This article provides a framework by which leaders in medical education can begin to prepare current trainees interested in careers as clinician-educators.

  16. USER FRUSTRATION IN HIT INTERFACES: EXPLORING PAST HCI RESEARCH FOR A BETTER UNDERSTANDING OF CLINICIANS' EXPERIENCES.

    Science.gov (United States)

    Opoku-Boateng, Gloria A

    2015-01-01

    User frustration research has been one way of looking into clinicians' experience with health information technology use and interaction. In order to understand how clinician frustration with Health Information Technology (HIT) use occurs, there is the need to explore Human-Computer Interaction (HCI) literature that addresses both frustration and HIT use. In the past three decades, HCI frustration research has increased and expanded. Researchers have done a lot of work to understand emotions, end-user frustration and affect. This paper uses a historical literature review approach to review the origins of emotion and frustration research and explore the research question; Does HCI research on frustration provide insights on clinicians' frustration with HIT interfaces? From the literature review HCI research on emotion and frustration provides additional insights that can indeed help explain user frustration in HIT. Different approaches and HCI perspectives also help frame HIT user frustration research as well as inform HIT system design. The paper concludes with a suggested directions on how future design and research may take.

  17. Investigating suspected acute pulmonary embolism - what are hospital clinicians thinking?

    International Nuclear Information System (INIS)

    McQueen, A.S.; Worthy, S.; Keir, M.J.

    2008-01-01

    Aims: To assess local clinical knowledge of the appropriate investigation of suspected acute pulmonary embolism (PE) and this compare with the 2003 British Thoracic Society (BTS) guidelines as a national reference standard. Methods: A clinical questionnaire was produced based on the BTS guidelines. One hundred and eight-six participants completed the questionnaires at educational sessions for clinicians of all grades, within a single NHS Trust. The level of experience amongst participants ranged from final year medical students to consultant physicians. Results: The clinicians were divided into four groups based on seniority: Pre-registration, Junior, Middle, and Senior. Forty-six point eight percent of all the clinicians correctly identified three major risk factors for PE and 25.8% recognized the definition of the recommended clinical probability score from two alternatives. Statements regarding the sensitivity of isotope lung imaging and computed tomography pulmonary angiography (CTPA) received correct responses from 41.4 and 43% of participants, respectively, whilst 81.2% recognized that an indeterminate ventilation-perfusion scintigraphy (V/Q) study requires further imaging. The majority of clinicians correctly answered three clinical scenario questions regarding use of D-dimers and imaging (78, 85, and 57.5%). There was no statistically significant difference between the four groups for any of the eight questions. Conclusions: The recommended clinical probability score was unfamiliar to all four groups of clinicians in the present study, and the majority of doctors did not agree that a negative CTPA or isotope lung scintigraphy reliably excluded PE. However, questions based on clinical scenarios received considerably higher rates of correct responses. The results indicate that various aspects of the national guidelines on suspected acute pulmonary embolism are unfamiliar to many UK hospital clinicians. Further research is needed to identify methods to improve

  18. Gouvernance des systèmes alimentaires urbains pour la prévention ...

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

    ... contre ces systèmes alimentaires en évolution et l'augmentation connexe des maladies ... les systèmes d'information et d'enregistrement des faits d'état civil dans les pays en ... GrowInclusive : la plateforme tant attendue est en construction.

  19. Renforcement des capacités de recherche sur les TIC-D au Moyen ...

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

    La recherche sur les incidences et les impacts des technologies de l'information et de la communication (TIC) sur le développement social et humain est embryonnaire au Moyen-Orient et en Afrique du Nord (région MOAN). Ce projet vise à encourager les chercheurs de la région MOAN à entreprendre des recherches ...

  20. effet des ados en courbes de niveau sur la distribution et la diversite ...

    African Journals Online (AJOL)

    Administrateur

    d'arachide a permis d'évaluer les performances des ados en courbes de niveau. ... However, in a context of global environmental degradation, only some information on their effects on ..... gestion de l'eau du sol et le rendement des cultures ...

  1. Intégration de l'évaluation évolutive à des initiatives de ...

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

    ... développement se déroulent dans des environnements caractérisés par la complexité du contexte social et l'incertitude. ... Les subtilités des interactions entre les technologies de l'information et de la communication (TIC) et les sociétés en ...

  2. The decision to extract: part II. Analysis of clinicians' stated reasons for extraction.

    Science.gov (United States)

    Baumrind, S; Korn, E L; Boyd, R L; Maxwell, R

    1996-04-01

    In a recently reported study, the pretreatment records of each subject in a randomized clinical trial of 148 patients with Class I and Class II malocclusions presenting for orthodontic treatment were evaluated independently by five experienced clinicians (drawn from a panel of 14). The clinicians displayed a higher incidence of agreement with each other than had been expected with respect to the decision as to whether extraction was indicated in each specific case. To improve our understanding of how clinicians made their decisions on whether to extract or not, the records of a subset of 72 subjects randomly selected from the full sample of 148, have now been examined in greater detail. In 21 of these cases, all five clinicians decided to treat without extraction. Among the remaining 51 cases, there were 202 decisions to extract (31 unanimous decision cases and 20 split decision cases). The clinicians cited a total of 469 reasons to support these decisions. Crowding was cited as the first reason in 49% of decisions to extract, followed by incisor protrusion (14%), need for profile correction (8%), Class II severity (5%), and achievement of a stable result (5%). When all the reasons for extraction in each clinician's decision were considered as a group, crowding was cited in 73% of decisions, incisor protrusion in 35%, need for profile correction in 27%, Class II severity in 15% and posttreatment stability in 9%. Tooth size anomalies, midline deviations, reduced growth potential, severity of overjet, maintenance of existing profile, desire to close the bite, periodontal problems, and anticipation of poor cooperation accounted collectively for 12% of the first reasons and were mentioned in 54% of the decisions, implying that these considerations play a consequential, if secondary, role in the decision-making process. All other reasons taken together were mentioned in fewer than 20% of cases. In this sample at least, clinicians focused heavily on appearance

  3. Competing priorities in treatment decision-making: a US national survey of individuals with depression and clinicians who treat depression.

    Science.gov (United States)

    Barr, Paul J; Forcino, Rachel C; Mishra, Manish; Blitzer, Rachel; Elwyn, Glyn

    2016-01-08

    To identify information priorities for consumers and clinicians making depression treatment decisions and assess shared decision-making (SDM) in routine depression care. 20 questions related to common features of depression treatments were provided. Participants were initially asked to select which features were important, and in a second stage they were asked to rank their top 5 'important features' in order of importance. Clinicians were asked to provide rankings according to both consumer and clinician perspectives. Consumers completed CollaboRATE, a measure of SDM. Multiple logistic regression analysis identified consumer characteristics associated with CollaboRATE scores. Online cross-sectional surveys fielded in September to December 2014. We administered surveys to convenience samples of US adults with depression and clinicians who treat depression. Consumer sampling was targeted to reflect age, gender and educational attainment of adults with depression in the USA. Information priority rankings; CollaboRATE, a 3-item consumer-reported measure of SDM. 972 consumers and 244 clinicians completed the surveys. The highest ranked question for both consumers and clinicians was 'Will the treatment work?' Clinicians were aware of consumers' priorities, yet did not always prioritise that information themselves, particularly insurance coverage and cost of treatment. Only 18% of consumers reported high levels of SDM. Working with a psychiatrist (OR 1.87; 95% CI 1.07 to 3.26) and female gender (OR 2.04; 95% CI 1.25 to 3.34) were associated with top CollaboRATE scores. While clinicians know what information is important to consumers making depression treatment decisions, they do not always address these concerns. This mismatch, coupled with low SDM, adversely affects the quality of depression care. Development of a decision support intervention based on our findings can improve levels of SDM and provide clinicians and consumers with a tool to address the existing

  4. Intégration des données de l'atlas des marais atlantiques alimentés en eau de mer dans un système d'information à référence spatiale

    OpenAIRE

    Loubersac, Lionel; Manaud, Francois; Loarer, Ronan; Kerdreux, Michel; Durand, Christophe

    1998-01-01

    Ce papier décrit une méthodologie d’intégration des données analogiques d’un Atlas des marais salés atlantiques dans un SIG. On développe les différentes étapes de la méthode après avoir décrit les données originales sources sous forme de cartographie analogique thématique et de textes associés. Ces étapes incluent la digitalisation, les corrections géométriques, la définition d’une typologie et d’attributs, la mise en place de liens entre les graphiques, textes et images, le croisement de co...

  5. Information report from the Economic Affairs commission on photovoltaic energy; Rapport d'information depose en application de l'article 145 du reglement par la commission des affaires economiques sur l'energie photovoltaique

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-07-01

    Today and for several years to come, photovoltaic energy represents only a minimal part of the world's electric power production. Photovoltaic energy is only at its beginnings, however several countries have already taken opportunities in the business. This report gives a comprehensive information about photovoltaic energy (basic principles, conversion systems, photovoltaic power plants, incentive programs in other developed countries, regulations ...) and arguments for the development of a structured photovoltaic energy policy in France.

  6. Clinicians' recognition and management of emotions during difficult healthcare conversations.

    Science.gov (United States)

    Martin, Elliott B; Mazzola, Natalia M; Brandano, Jessica; Luff, Donna; Zurakowski, David; Meyer, Elaine C

    2015-10-01

    To examine the most commonly reported emotions encountered among healthcare practitioners when holding difficult conversations, including frequency and impact on care delivery. Interprofessional learners from a range of experience levels and specialties completed self-report questionnaires prior to simulation-based communication workshops. Clinicians were asked to describe up to three emotions they experienced when having difficult healthcare conversations; subsequent questions used Likert-scales to measure frequency of each emotion, and whether care was affected. 152 participants completed questionnaires, including physicians, nurses, and psychosocial professionals. Most commonly reported emotions were anxiety, sadness, empathy, frustration, and insecurity. There were significant differences in how clinicians perceived these different emotions affecting care. Empathy and anxiety were emotions perceived to influence care more than sadness, frustration, and insecurity. Most clinicians, regardless of clinical experience and discipline, find their emotional state influences the quality of their care delivery. Most clinicians rate themselves as somewhat to quite capable of recognizing and managing their emotions, acknowledging significant room to grow. Further education designed to increase clinicians' recognition of, reflection on, and management of emotion would likely prove helpful in improving their ability to navigate difficult healthcare conversations. Interventions aimed at anxiety management are particularly needed. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  7. From leader to leadership: clinician managers and where to next?

    Science.gov (United States)

    Fulop, Liz; Day, Gary E

    2010-08-01

    Individual clinician leadership is at the forefront of health reforms in Australia as well as overseas with many programs run by health departments (and hospitals) generally focus on the development of individual leaders. This paper argues, along with others, that leadership in the clinician management context cannot be understood from an individualistic approach alone. Clinician managers, especially in the ranks of doctors, are usually described as 'hybrid-professional managers' as well as reluctant leaders for whom most leadership theories do not easily apply. Their experiences of leadership development programs run by health departments both in Australia and internationally are likely to be based on an individual leader-focussed approach that is driving health care reforms. These approaches work from three key assumptions: (1) study and fix the person; (2) give them a position or title; and (3) make them responsible for results. Some would argue that the combination of these three approaches equates to heroic and transformational leadership. Several alternative approaches to leadership development are presented to illustrate how reforms in healthcare, and notably in hospitals, must incorporate alternative approaches, such as those based on collective and relational forms of leadership. This does not mean eschewing individual approaches to leadership but rather, thinking of them differently and making them more relevant to the daily experiences of clinician managers. We conclude by highlighting several significant challenges facing leadership development for clinician managers that arise from these considerations.

  8. Utilisation sans risque des eaux usées, des excréta et des eaux ...

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

    Les responsables de ce projet piloteront l'application et l'adaptation des principes directeurs relatifs à l'utilisation sans risque des eaux usées, des excreta et des eaux grises en agriculture et en aquaculture (Guidelines for the Safe Use of Wastewater, Excreta and Greywater in Agriculture and Aquaculture), que ...

  9. Information for Librarians and Trainers

    Science.gov (United States)

    ... Internet Health Information: A Tutorial from the National Library of Medicine ( download ) Évaluation des sources (NLM): Évaluer les informations sur la santé trouvées sur Internet, in French ( ...

  10. Direction des Publications

    African Journals Online (AJOL)

    Synthese

    mélange pulvérulent de coke et de calcaire. La réduction est assurée par le gaz CO à 1250°C [2]. Le procédé Kawazaki iron powder utilise la calamine comme matière première et aussi CO comme gaz réducteur pour élaborer des poudres de fer. [3]. Un autre procédé plus connu qui fabrique les poudres de fer à partir de la.

  11. Glossaire des sigles

    OpenAIRE

    2015-01-01

    ABM Anti-ballistic missile = Missile antimissile balistique AGM Air-to-ground missile = Missile air-sol AIEA Agence Internationale de l’Energie Atomique ALCM Air-launched cruise missile = Missile de croisière air-sol ANSEA Association des Nations du Sud-Est asiatique ANT* Arme nucléaire tactique ASAT Anti-satellite = Arme antisatellite ASW Anti-submarine warfare = Guerre anti-sous-marine AWACS Airborne warning and control system = Système aérien de contrôle et d’alerte BMD Ballistic missile d...

  12. Les reseaux de politique publique comme facteur d'influence du choix des instruments de politique energetique canadienne a des fins environnementales de 1993 a nos jours

    Science.gov (United States)

    Fathy El Dessouky, Naglaa

    Au cours de la derniere decennie, les modes de la gouvernance ont pris place dans un contexte totalement different de celui qu'ils avaient auparavant. Les gouvernements modernes se rendent compte qu'ils perdent de plus en plus leur capacite a elaborer et a gerer les changements d'une maniere autonome. Ainsi, les fonctions et les activites traditionnellement accomplies exclusivement par le gouvernement engagent de nos jours une gamme d'acteurs etatiques et non etatiques. A l'encontre du concept traditionnel de l'Etat controleur, la gouvernance contemporaine est ainsi devenue moins une question d'offre de service et davantage une gestion indirecte des reseaux de politique publique. Dans cette entreprise, les gouvernements contemporains, cherchant plus d'information, de soutien et de legitimite en matiere de formulation des decisions, ont besoin d'etablir des relations avec les divers groupes d'interet qui, a leur tour, voulaient plus de promotion et de protection en faveur de leurs interets a travers leur implication au processus de l'elaboration et de la mise en oeuvre des politiques publiques. Ainsi, l'approche des reseaux de politique publique represente aujourd'hui un courant considerable au sein du champ d'analyse des politiques publiques. Toutefois, les preoccupations des chercheurs pour cette approche, dans le domaine des politiques energetiques a des fins environnementales, semblent recentes, et les etudes realisees sont encore trop peu nombreuses. Au Canada, au debut des annees 1990, le gouvernement ainsi que plusieurs groupes d'interets, des differents secteurs energetique, industriel et environnemental, ont commence a intensifier leurs efforts pour s'attaquer au probleme du changement climatique d'origine energetique, genere surtout par le secteur de l'industrie. Au cours de la derniere decennie, la question touchant plutot le sujet du developpement energetique durable represente le plus important domaine des politiques publiques ayant surgi recemment dans

  13. Identification et prise en charge des femmes ayant des antécédents familiaux de cancer du sein

    Science.gov (United States)

    Heisey, Ruth; Carroll, June C.

    2016-01-01

    Résumé Objectif Résumer les meilleures données portant sur les stratégies d’identification et de prise en charge des femmes qui présentent des antécédents familiaux de cancer du sein. Sources d’information Une recherche a été effectuée sur PubMed à l’aide des mots-clés anglais suivants : breast cancer, guidelines, risk, family history, management et magnetic resonance imaging screening, entre 2000 et 2016. La plupart des données sont de niveau II. Message principal Une bonne anamnèse familiale est essentielle lors de l’évaluation du risque de cancer du sein afin d’identifier les femmes qui sont candidates à une recommandation en counseling génétique pour un éventuel test génétique. On peut sauver des vies en offrant aux femmes porteuses d’une mutation au gène BRCA des interventions chirurgicales de réduction des risques (mastectomie bilatérale prophylactique, salpingo-ovariectomie bilatérale). Il faut encourager toutes les femmes qui présentent des antécédents familiaux de cancer du sein à demeurer actives et à limiter leur consommation d’alcool à moins de 1 verre par jour; certaines femmes sont admissibles à la chimioprévention. Il faut offrir aux femmes dont le risque à vie de cancer du sein est de 20 à 25 % ou plus un dépistage poussé par imagerie par résonance magnétique en plus d’une mammographie. Conclusion Une vie saine et la chimioprévention (chez les candidates) pourraient réduire l’incidence du cancer du sein; le dépistage poussé pourrait entraîner une détection plus précoce. Le fait d’aiguiller des femmes porteuses d’une mutation au BRCA vers la chirurgie de réduction des risques sauve des vies. PMID:27737991

  14. The use of traditional Chinese medicine among breast cancer patients: implications for the clinician.

    Science.gov (United States)

    Wong, Kar Yong; Tan, Ern Yu; Chen, Juliana J C; Teo, Christine; Chan, Patrick M Y

    2014-02-01

    Traditional Chinese Medicine or Traditional Complementary Medicine (TCM) is commonly used in our culture. There are several concerns regarding its use in patients undergoing conventional treatments for breast cancer. In this study, we aimed to evaluate the prevalence and pattern of TCM use among our breast cancer patients, and to identify patients who were most likely to choose TCM. A total of 300 patients on active follow-up with Breast Service at Tan Tock Seng Hospital were interviewed using a structured questionnaire. A total of 35% (104 of 296) of patients reported using TCM. The majority of the patients were introduced to TCM by family and friends following the diagnosis of breast cancer. All except 3 patients continued with recommended conventional therapy although most did not inform their clinicians of TCM use. None of the patients reported any serious adverse events and 75% of them perceived a benefit from TCM use. Younger patients and those of Chinese ethnicity were more likely to use TCM (P 0.05). TCM use is common among our breast cancer patients, particularly the younger women. However, most patients do not inform their clinicians of TCM use while on recommended conventional therapies. It is therefore important for clinicians to initiate discussions regarding TCM use in order to be aware of potential unwanted drug interactions.

  15. Exploring dialectical behaviour therapy clinicians' experiences of team consultation meetings.

    Science.gov (United States)

    Walsh, Cian; Ryan, Patrick; Flynn, Daniel

    2018-01-01

    This article presents a detailed idiographic analysis of Dialectical Behaviour Therapy (DBT) clinicians' experiences of team consultation meetings. DBT is an evidence-based psychological intervention with a demonstrated efficacy in the treatment of borderline personality disorder (BPD). Team consultation meetings encompass one of the primary components involved in this treatment model; where DBT clinicians regularly meet to discuss client work and enhance further learning. The present study's aim was to assess what are DBT clinicians' experiences of the consultation meeting component and whether it is useful or not. Semi-structured interviews were completed with 11 DBT clinicians (nine females, two males) from three different consultation teams. The research project utilised an interpretative phenomenological analysis (IPA) framework. Audio-recorded interview data was analysed using this framework. Four superordinate themes emerged from the interview data, which included ten subordinate themes. The superordinate themes focused on: (1) the acquisition of DBT technical knowledge and other MDT related expertise (2) participants' emotional experiences of DBT and consultation meetings, and how this can evolve over time (3) the underlying processes that occur in the consultation team including the development of a team bond and the impact of membership changes and (4) the largely consistent and reliable nature of consultation meetings and how they help maintain clinician motivation. Team consultation meetings were found to be supportive; playing an important role in maintaining clinician motivation through the availability of team support, opportunities to reflect and learn, and assistance in regulating emotions. Challenges arose in relation to team membership changes and acclimatisation to the type of feedback utilised in team consultation. The study's implications for practise are considered.

  16. Review of Fusion Systems and Contributing Technologies for SIHS-TD (Examen des Systemes de Fusion et des Technologies d’Appui pour la DT SIHS)

    Science.gov (United States)

    2007-03-31

    objective evaluation were identified: methods based on statistical characteristics, methods based on definition, methods based on information theory ...des auteurs et des documents connus, puis à suivre les références qu’ils fournissaient à d’autres ouvrages. À la fin de la recherche, environ 150...Information Theory .....................................54 4.3.3.2.4 Objective Evaluation Based on Important Features

  17. Isolement et identification des levures.

    Directory of Open Access Journals (Sweden)

    S. DOMERCQ

    1967-06-01

    Full Text Available La fermentation du moût de raisin est assurée par les levures qui se trouvent sur la pellicule du raisin, sur les rafles, et aussi, par celles qui envahissent le matériel de vendange et de vinification dès que la récolte est commencée. L'apparition deLa fermentation du moût de raisin est assurée par les levures qui se trouvent sur la pellicule du raisin, sur les rafles, et aussi, par celles qui envahissent le matériel de vendange et de vinification dès que la récolte est commencée. L'apparition des signes de la fermentation est spontanée. La fermentation est rapide dans la majorité des cas, si elle devient trop violente et que la température s'élève dangeureusement, il faut la « canaliser », la calmer. Des accidents peuvent se produire; des arrêts de fermentation laissant des sucres non fermentés pouvant être attaqués par d'autres microorganismes, des développements de levures formant des substances nuisibles à la qualité; par la suite, il s'agit d'obtenir la stabilité du vin, en particulier, éviter les refermentations des vins doux. L'étude de ces problèmes nécessite une étude préliminaire, celle des levures responsables de la fermentation alcoolique du jus de raisin, qui ne peut être faite que sur des cultures pures, isolées au préalable à l'aide de prélèvements soigneusement réalisés.s signes de la fermentation est spontanée. La fermentation est rapide dans la majorité des cas, si elle devient trop violente et que la température s'élève dangeureusement, il faut la « canaliser », la calmer. Des accidents peuvent se produire; des arrêts de fermentation laissant des sucres non fermentés pouvant être attaqués par d'autres microorganismes, des développements de levures formant des substances nuisibles à la qualité; par la suite, il s'agit d'obtenir la stabilité du vin, en particulier, éviter les refermentations des vins doux. L'étude de ces problèmes nécessite une étude pr

  18. Le Débat des semences

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

    Solutions pour les lois nationales régissant le contrôle des ressources génétiques et des ...... des pouvoirs) qui reconnaissent, dans une certaine mesure, les droits de gestion collectifs des ...... documentés, les performances physiques, etc.

  19. Mécanique des sols et des roches

    CERN Document Server

    Vullier, Laurent; Zhao, Jian

    2016-01-01

    La mécanique des sols et la mécanique des roches sont des disciplines généralement traitées séparément dans la littérature. Pour la première fois, un traité réunit ces deux spécialités, en intégrant également les connaissances en lien avec les écoulements souterrains et les transferts thermiques. A la fois théorique et pratique, cet ouvrage propose tout d'abord une description détaillée de la nature et de la composition des sols et des roches, puis s'attache à la modélisation de problèmes aux conditions limites et présente les essais permettant de caractériser les sols et les roches, tant d'un point de vue mécanique qu'hydraulique et thermique. La problématique des sols non saturés et des écoulements multiphasiques est également abordée. Une attention particulière est portée aux lois de comportement mécanique et à la détermination de leurs paramètres par des essais in situ et en laboratoire, et l'ouvrage offre également une présentation détaillée des systèmes de classi...

  20. Do clinicians assess patients' religiousness? An audit of an aged psychiatry community team.

    Science.gov (United States)

    Payman, Vahid; Lim, Zheng Jie

    2018-03-01

    To determine the frequency and quality of religious history taking of patients by clinicians working in an old age psychiatry service. A retrospective audit of 80 randomised patient files from the Koropiko Mental Health Services for Older People (MHSOP) in Middlemore Hospital, Auckland, New Zealand. A total of 66 clinical records were available for analysis. A religious history was taken in 33/66 (50%) patients. However, when such histories were evaluated using the FICA assessment tool, only 10/33 (30.3%) histories contained detailed information regarding the patient's religiousness. The infrequency and low quality of religious histories discovered in this audit suggest that clinicians need more training in taking a religious history from patients.

  1. Big-Data Based Decision-Support Systems to Improve Clinicians' Cognition.

    Science.gov (United States)

    Roosan, Don; Samore, Matthew; Jones, Makoto; Livnat, Yarden; Clutter, Justin

    2016-01-01

    Complex clinical decision-making could be facilitated by using population health data to inform clinicians. In two previous studies, we interviewed 16 infectious disease experts to understand complex clinical reasoning. For this study, we focused on answers from the experts on how clinical reasoning can be supported by population-based Big-Data. We found cognitive strategies such as trajectory tracking, perspective taking, and metacognition has the potential to improve clinicians' cognition to deal with complex problems. These cognitive strategies could be supported by population health data, and all have important implications for the design of Big-Data based decision-support tools that could be embedded in electronic health records. Our findings provide directions for task allocation and design of decision-support applications for health care industry development of Big data based decision-support systems.

  2. An organizational assessment of disruptive clinician behavior: findings and implications.

    Science.gov (United States)

    Walrath, Jo M; Dang, Deborah; Nyberg, Dorothy

    2013-01-01

    This study investigated registered nurses' (RNs) and physicians' (MD) experiences with disruptive behavior, triggers, responses, and impacts on clinicians, patients, and the organization. Using the Disruptive Clinician Behavior Survey for Hospital Settings, it was found that RNs experienced a significantly higher frequency of disruptive behaviors and triggers than MDs; MDs (45% of 295) and RNs (37% of 689) reported that their peer's disruptive behavior affected them most negatively. The most frequently occurring trigger was pressure from high census, volume, and patient flow; 189 incidences of harm to patients as a result of disruptive behavior were reported. Findings provide organizational leaders with evidence to customize interventions to strengthen the culture of safety.

  3. Informe

    Directory of Open Access Journals (Sweden)

    Egon Lichetenberger

    1950-10-01

    Full Text Available Informe del doctor Egon Lichetenberger ante el Consejo Directivo de la Facultad, sobre el  curso de especialización en Anatomía Patológica patrocinado por la Kellogg Foundation (Departamento de Patología

  4. Santé des mères et des enfants | CRDI - Centre de recherches pour ...

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

    Il faut aussi souligner que la plus importante cohorte de jeunes de l'histoire arrive à l'âge de procréer. Ces adolescents n'ont pas toujours l'information nécessaire ni la possibilité d'exercer leurs droits et d'accéder aux services dont ils ont besoin pour se protéger contre des situations dommageables et leurs conséquences.

  5. Chirurgie des grassmanniennes

    CERN Document Server

    Lafforgue, Laurent

    2003-01-01

    Les compactifications diverses de variétés de modules sont un thème important et récurrent des mathématiques modernes, et elles connaissent un grand nombre d'applications. Ce livre traite le cas de cellules de Schubert minces, qui sont de sous-variétés naturelles de grassmanniennes. L'auteur a été amené à traiter ces questions par un cas particulier lié à ses travaux sur le programme de Langlands. Dans cette monographie, il en développe une théorie plus systématique, présentant le fortes similarités avec celle des modules du courbes stables. The various compactifications of moduli spaces are an important recurrent theme of modern mathematics, and they have a large number of applications. This book treats the case of thin Schubert varieties, which are natural subvarieties of Grassmannians. The author was led to these questions by a particular case linked to his work on the Langlands program. In this monograph, he develops the theory in a more systematic way, which exhibits strong similarities...

  6. Formation des formateurs en ligne : obstacles, rôles et compétences

    Directory of Open Access Journals (Sweden)

    Louise Sauvé

    2004-01-01

    Full Text Available L’adoption d’une technologie de l’information et de la communication (TIC pour la formation ne peut se faire sans changement dans l’organisation. Ces changements touchent les formateurs, hommes et femmes, qui ont une histoire professionnelle, une mentalité, des pratiques qui se sont construites au cours des années et dans un contexte précis de travail. Or les changements technologiques peuvent déstabiliser la vie professionnelle des formateurs. Il est donc essentiel de gérer ce changement, car le succès des projets d’introduction des TIC dans la formation n’est plus fonction de la puissance des technologies, mais plutôt de la capacité des formateurs à exploiter leur potentiel afin de changer et d’améliorer l’efficience du processus d’apprentissage. C’est dans un contexte d’implantation d’une formation des formateurs en ligne que se situe cet article qui aborde les questions suivantes : quels sont les obstacles au changement par rapport à l’adoption des TIC dans le milieu de la formation? Quels sont les principaux rôles d’un formateur en ligne (ou e-formateur? Quelles sont les compétences générales que les formateurs doivent développer pour soutenir les apprenants dans un contexte de formation en ligne (synchrone et asynchrone?

  7. 2004 annual report. Defense, safety, energy, information, health. CEA in the center of big European challenges; Rapport annuel 2004. Defense, securite, energie, information, sante. Le CEA au coeur des grands defis europeens

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-07-01

    This document is the 2004 annual report of the French atomic energy commission (CEA). It presents the R and D activities of the CEA in three main domains: 1 - defense and safety, maintaining perenniality of nuclear dissuasion and nuclear safety: supplying nuclear weapons to armies, maintaining dissuasion capability with the simulation program, sharing R and D means with the scientific community and the industrial world, designing and maintaining naval nuclear propulsion reactors, cleansing Marcoule and Pierrelatte facilities, monitoring treaties and fighting against proliferation and terrorism; 2 - energy, developing more competitive and cleaner energy sources: nuclear waste management, optimization of industrial nuclear activities, future nuclear systems and new energy technologies, basic research on energy, radiobiology and toxicology; 3 - information and health, valorizing industry thanks to technological research and supplying new tools for health and medical research: micro- and nano-technologies, software technologies, basic research for industrial innovation, nuclear technologies for health and bio-technologies. (J.S.)

  8. Energy consumptions and information and communication technologies (ICT) in the tertiary sector in France; Consommations d'energie et technologies de l'information et des communications (TIC) dans le secteur tertiaire en France

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-01-01

    In France, investment expenses in information and communication technologies (ICT) reached 162 billions of French francs in 1999 with an average annual growth of 13.3% during the 1989-1999 era. In parallel, the end-use energy consumption reached 212 Mtep in 1999 with an average annual growth of 1.55% during the same period. The introduction and spreading of computer equipments and softwares in offices is one possible explanation to this evolution. This study uses the data available for the tertiary sector to model and quantify the impact of ICTs development on the electricity consumption in this sector and draws out some consumption forecasts according to different hypotheses. (J.S.)

  9. Information note about the protection of nuclear facilities against aircraft crashes; Note d'information sur la protection des installations nucleaires contre les chutes d'avions

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-07-01

    The protection of nuclear facilities against external risks (earthquakes, floods, fires etc..) is an aspect of safety taken into consideration by the French authority of nuclear safety (ASN). Concerning the aircraft crashes, the fundamental safety rules make three categories of aircraft: the small civil aircraft (weight < 5.7 t), the military aircraft, and the commercial aircraft (w > 5.7 t). Nuclear facilities are designed to resist against crashes of aircraft from the first category only, because the probability of the accidental crash of a big aircraft are extremely low. This document comprises an information note about the protection of nuclear facilities against aircraft crashes, a dossier about the safety of nuclear facilities with respect to external risks in general (natural disasters and aircraft crashes), and an article about the protection of nuclear power plants against aircraft crashes (design, safety measures, regulation, surveillance, experience feedback). (J.S.)

  10. Comportement des polluants des eaux pluviales urbaines en ...

    African Journals Online (AJOL)

    développement et la croissance des organismes vivant dans l'eau et particulièrement les micro- organismes. Le suivi des températures enregistrées oscille entre 9 et 16°C dans les trois sites d'observation durant la période ... de la lumière du soleil. Le site C est bien aéré et .... Effets de différents modes de gestion des eaux ...

  11. Coordination des installations et survey dans les zones experimentales impératifs de collaboration et de flexibilité

    CERN Document Server

    Gayde, JC; CERN. Geneva. TS Department

    2005-01-01

    La section TS/SU-EM fournit les informations géométriques de formes, dimensions et positions des infrastructures des cavernes et des détecteurs des expériences LHC. Elle intervient à toutes les étapes de construction et ses opérations sont dépendantes des autres chantiers, des entreprises en particulier, et de la configuration changeante des lieux. Les travaux de TS/SU-EM dans les cavernes LHC font donc partie des multiples tâches que TS/LEA a pour mandat de coordonner et gérer. Bien que défini et planifié, le moment exact des interventions est souvent connu sous des délais courts, la méthodologie et les ressources devant alors être adaptées et prêtes au moment décidé. De plus, la section intervient souvent pour des opérations de contrôle de dernière minute par définition non programmées. Une communication permanente et directe entre SU et LEA a été établie pour assurer les échanges indispensables au bon déroulement du projet. Ses formes et moyens seront présentés ici.

  12. Feedback mechanisms of change: How problem alerts reported by youth clients and their caregivers impact clinician-reported session content

    Science.gov (United States)

    Douglas, Susan R.; Jonghyuk, Bae; de Andrade, Ana Regina Vides; Tomlinson, M. Michele; Hargraves, Ryan Pamela; Bickman, Leonard

    2015-01-01

    Objective This study explored how clinician-reported content addressed in treatment sessions was predicted by clinician feedback group and multi-informant cumulative problem alerts that appeared in computerized feedback reports for 299 clients aged 11 to 18 years receiving home-based community mental health treatment. Method Measures included a clinician-report of content addressed in sessions and additional measures of treatment progress and process (e.g., therapeutic alliance) completed by clinicians, clients, and their caregivers. Item responses in the top 25th percentile in severity from these measures appeared as ‘problem alerts’ on corresponding computerized feedback reports. Clinicians randomized to the feedback group received feedback weekly while the control group did not. Analyses were conducted using the Cox proportional hazards regression for recurrent events. Results For all content domains, the results of the survival analyses indicated a robust effect of the feedback group on addressing specific content in sessions, with feedback associated with shorter duration to first occurrence and increased likelihood of addressing or focusing on a topic compared to the non-feedback group. Conclusion There appears to be an important relationship between feedback and cumulative problem alerts reported by multiple informants as they influence session content. PMID:26337327

  13. Processing of data issued from {gamma} spectrometer. Application to the study of decay schemes; Traitement des informations issues d'un spectrometre {gamma}. Application a l'etude de schemas de desintegration

    Energy Technology Data Exchange (ETDEWEB)

    Boulanger, J P; Legrand, J [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

    1967-07-01

    The main purpose of the following report is the study of a generation method of {gamma} spectra corresponding to any energy, from a library of some basic spectra. Then we point out how to establish the decay scheme of a radio-nuclide, in using an accurate analysis of full-energy peaks which appear in its complex spectrum, followed by a generation of plain spectra corresponding to the energies of the different transitions, and ending with a least-squares fitting procedure of the complex spectrum. The accuracy of the process is examined comparing the calculated spectra to the ones issued from two kinds of spectrometers (Na I(Tl) and Ge(Li)). The method is then applied to the study of {sup 134}Cs and {sup 95}Zr - {sup 95}Nb. (authors) [French] Le present rapport a pour principal objet l'etude d'une methode de generation de spectres {gamma} correspondant a n'importe quelle energie, a partir d'une bibliotheque de quelques spectres de reference. On montre ensuite comment on peut etablir le schema de desintegration d'un radionucleide, a l'aide d'une analyse precise des pics d'absorption totale apparaissant dans son spectre complexe, suivie d'une generation des spectres simples correspondant aux energies des diverses transitions, et en terminant par une decomposition du spectre complexe par la methode des moindres carres. On examine la validite du procede en comparant les spectres calcules a ceux obtenus avec deux types de detecteurs (scintillateurs et semi-conducteurs). On applique alors la methode a l'etude du {sup 134}Cs et du {sup 95}Zr - {sup 95}Nb. (auteurs)

  14. Attitudes toward antipsychotic treatment among patients with bipolar disorders and their clinicians: a systematic review

    Directory of Open Access Journals (Sweden)

    Sajatovic M

    2017-08-01

    Full Text Available Martha Sajatovic,1 Faith DiBiasi,2 Susan N Legacy3 1Departments of Psychiatry and Neurology, Case Western Reserve University School of Medicine, Cleveland, OH, USA; 2US Medical Affairs, Neuroscience, Otsuka Pharmaceutical Development & Commercialization, Inc., Rockville, MD, USA; 3US Medical Affairs, Neuroscience, Otsuka Pharmaceutical Development & Commercialization, Inc., Princeton, NJ, USA Introduction: Antipsychotics are recommended as first-line therapy for acute mania and maintenance treatment of bipolar disorder; however, published literature suggests their real-world use remains limited. Understanding attitudes toward these medications may help identify barriers and inform personalized therapy. This literature review evaluated patient and clinician attitudes toward the use of antipsychotics for treating bipolar disorder. Materials and methods: A systematic search of the Cochrane Library, Ovid MEDLINE, Embase, and BIOSIS Previews identified English language articles published between January 1, 2000, and June 15, 2016, that reported attitudinal data from patients, health care professionals, or caregivers; treatment decision-making; or patient characteristics that predicted antipsychotic use for bipolar disorder. Results were analyzed descriptively. Results: Of the 209 references identified, 11 met the inclusion criteria and were evaluated. These articles provided attitudinal information from 1,418 patients with bipolar disorder and 1,282 treating clinicians. Patients’ attitudes toward antipsychotics were generally positive. Longer duration of clinical stability was associated with positive attitudes. Implementation of psychoeducational and adherence enhancement strategies could improve patient attitudes. Limited data suggest clinicians’ perceptions of antipsychotic efficacy and tolerability may have the greatest impact on their prescribing patterns. Because the current real-world evidence base is inadequate, clinician attitudes

  15. When to use discrete event simulation (DES) for the economic evaluation of health technologies? A review and critique of the costs and benefits of DES.

    Science.gov (United States)

    Karnon, Jonathan; Haji Ali Afzali, Hossein

    2014-06-01

    Modelling in economic evaluation is an unavoidable fact of life. Cohort-based state transition models are most common, though discrete event simulation (DES) is increasingly being used to implement more complex model structures. The benefits of DES relate to the greater flexibility around the implementation and population of complex models, which may provide more accurate or valid estimates of the incremental costs and benefits of alternative health technologies. The costs of DES relate to the time and expertise required to implement and review complex models, when perhaps a simpler model would suffice. The costs are not borne solely by the analyst, but also by reviewers. In particular, modelled economic evaluations are often submitted to support reimbursement decisions for new technologies, for which detailed model reviews are generally undertaken on behalf of the funding body. This paper reports the results from a review of published DES-based economic evaluations. Factors underlying the use of DES were defined, and the characteristics of applied models were considered, to inform options for assessing the potential benefits of DES in relation to each factor. Four broad factors underlying the use of DES were identified: baseline heterogeneity, continuous disease markers, time varying event rates, and the influence of prior events on subsequent event rates. If relevant, individual-level data are available, representation of the four factors is likely to improve model validity, and it is possible to assess the importance of their representation in individual cases. A thorough model performance evaluation is required to overcome the costs of DES from the users' perspective, but few of the reviewed DES models reported such a process. More generally, further direct, empirical comparisons of complex models with simpler models would better inform the benefits of DES to implement more complex models, and the circumstances in which such benefits are most likely.

  16. Approche historique des classifications en psychiatrie

    OpenAIRE

    Garrabé , J.

    2011-01-01

    Resume Des le milieu du xixe siecle s?est posee la question des criteres de classification des maladies. Pour les maladies mentales, diverses classifications ont alors ete proposees par des auteurs francais (Morel) et allemands (Kahlbaum, Kraepelin). A partir de la fin du xixe siecle, le Bureau International de Statistique (Paris) a publie a une Classification Internationale des Maladies, a revision decennale (J. Bertillon). Cette tache a ete poursuivie dans l?entre-deux-guerres pa...

  17. Complications du traitement traditionnel des fractures : aspects ...

    African Journals Online (AJOL)

    Tous les patients reçus avec des complications du traitement traditionnel des fractures ont été inclus dans ce travail. Le diagnostic des lésions était clinique et radiologique. Nous avions reçu 51 patients porteurs de complications suite à des traitements de médecine traditionnelle, soit 13,7% du total des patients hospitalisés ...

  18. Aspects structurels et fonctionnels de la biodiversité des peuplements de poissons

    Directory of Open Access Journals (Sweden)

    WINEMILLER K. O.

    1995-04-01

    -spécifique, mais également souvent au niveau intra-spécifique, particulièrement durant l'ontogenèse. La structuration en guildes trophiques est plus complexe dans les peuplements comprenant beaucoup d'espèces. Le partage des ressources alimentaires est généralement perceptible quand les régimes sont examinés sur une période de temps suffisamment longue pour gommer les variations de disponibilité des ressources. La structure et le fonctionnement des réseaux trophiques est variable dans l'espace et dans le temps, et des maillons biotiques et abiotiques peuvent être fortement affectés par les poissons. La gestion des peuplements de poissons au sein d'une biosphère en modification nécessite des informations accrues sur les liens existant entre la diversité biologique et l'habitat, une meilleure connaissance des facteurs qui sont à l'origine des tendances observées, et le développement de modèles qui prédisent les relations entre structure et fonctionnement écologique.

  19. Des cartes dans la classe…

    Directory of Open Access Journals (Sweden)

    R. Gimeno

    1990-09-01

    Full Text Available La majorité des enseignants qui veulent faire des cartes — et les faire réaliser aux élèves — pour répondre aux exigences des instructions officielles, doivent surmonter leur manque de compétences en cartographie et en didactique ainsi que les difficultés propres aux logiciels de cartographie encore peu performants. Ces compétences et la réflexion qui les accompagne sont pourtant accessibles aux enfants de l’école élémentaire…

  20. Knowledge of cardiopulmonary resuscitation of clinicians at a South ...

    African Journals Online (AJOL)

    2011-11-28

    Nov 28, 2011 ... patients and recognising cardiac arrest, to assess clinicians' ... programmes that are accessible, innovative and inexpensive. .... well as, and sometimes better than, traditional CPR.16 In ... resuscitation training programme resulted in a noticeable ... 31 physicians in Canada whose resuscitation skills were.

  1. Magnesium 1993 Maternal-Fetal Toxicology. A Clinician's Guide ...

    African Journals Online (AJOL)

    I S I G I 0 I M I. Maternal-Fetal Toxicology. A Clinician's. Guide. 2nd edition. Ed. by Gideon Koren. Pp. 824 ... analysis is presented, and survival curve ideas for effects over time. Final chapters ... SPSS-PC+, SAS and Nanostat. Several important.

  2. Attitude and Perceptions of Clinicians in Lagos to Autopsy Practice ...

    African Journals Online (AJOL)

    Using pretested questionnaire instrument, a cross sectional survey of clinicians working in the Lagos University Teaching Hospital to obtain their attitudes and perception towards autopsy practice. 230 questionnaires were administered and the response rate was 80.7% . 41.5% of respondents often requested for autopsy.

  3. Dysarthria of Motor Neuron Disease: Clinician Judgments of Severity.

    Science.gov (United States)

    Seikel, J. Anthony; And Others

    1990-01-01

    This study investigated the relationship between the temporal-acoustic parameters of the speech of 15 adults with motor neuron disease. Differences in predictions of the progression of the disease and clinician judgments of dysarthria severity were found to relate to the linguistic systems of both speaker and judge. (Author/JDD)

  4. Antiretroviral drug resistance: A guide for the southern African clinician

    African Journals Online (AJOL)

    Both private and public sector see a bewildering clinical array of patients taking failing antiretroviral (ARV) regimens. We intend this article to provide a practical guide to help clinicians understand and manage ARV drug resistance in an African context. ARV resistance is a rapidly evolving field, requiring expertise in dealing ...

  5. Clinician or Witness? The Intervener's Relationship with Traumatized Children

    Science.gov (United States)

    Steele, William

    2008-01-01

    To heal the hurt child, one begins not as a clinician but as a person trying to witness how the child experiences trauma. This requires more than just talking since the child's terrifying memories are stored in the brain's senses and visual imagery, not in rational thoughts and words. The goal is to change these frightening sensory experiences…

  6. Feminist Family Therapy: Ethical Considerations for the Clinician.

    Science.gov (United States)

    Costa, Luann; Sorenson, Jody

    1993-01-01

    Notes the traditional minimization of gender and power issues in the cultural context by systemic family therapists. Presents five questions that can serve as guidelines in examining ethical and personal issues and provides ethical considerations for the clinician. (Author/NB)

  7. Capitalising on leadership fellowships for clinicians in the NHS.

    Science.gov (United States)

    Nicol, Edward D

    2011-04-01

    Clinical leadership has become a primary focus of the NHS with many leadership programmes, particularly those aimed at junior clinicians, being developed. This article illustrates the potential of these programmes but also urges caution when assessing the success of these schemes both from an individual and organisational perspective.

  8. Remote clinical decision-making: a clinician's definition.

    Science.gov (United States)

    Brady, Mike; Northstone, Kate

    2017-05-12

    Aims Remote clinical decision-making (RCDM), commonly known as 'telephone triage' or 'hear and treat', describes clinicians' non-face-to-face involvement with patient care, and is an established strategy in UK ambulance services for managing increasing demand. However, there is no suitable definition of RCDM that fully explains the roles undertaken by clinicians in 999 hubs, or for its use as an ambulance quality indicator (AQI). The aim of this study, which is part of a larger evaluation of a new RCDM module in higher education, is to determine how clinicians define RCDM. Methods Three participants were asked, during semi-structured interviews, to define RCDM. The interviews were recorded, transcribed and thematically analysed. Results Clinicians do not focus on outcomes when defining RCDM, but on the efficacy of the process and the appropriateness of the determined outcome. Conclusion There is no precise description of the role of healthcare professionals in 999 clinical hubs, but there is a need for role clarity, for employees and organisations. The study questions the suitability of the definition of hear and treat as an AQI, as it does not appear to represent fully the various duties undertaken by 999 clinical hub healthcare professionals. More research is needed to consider the definition of RCDM in all its forms.

  9. A framework for understanding moral distress among palliative care clinicians.

    Science.gov (United States)

    Rushton, Cynda H; Kaszniak, Alfred W; Halifax, Joan S

    2013-09-01

    Palliative care clinicians confront suffering as they care for people living with life-limiting conditions. When the degree of suffering becomes unjustified, moral distress can ensue. Promising work from neuroscience and social psychology has yet to be applied to clinical practice. Our objective was to expand a social psychology model focusing on empathy and compassion in response to suffering to include an ethical dimension and to examine how the interrelationships of its proposed components can assist clinicians in understanding their responses to morally distressing situations. In the clinical context, responses to distressing events are thought to include four dimensions: empathy (emotional attunement), perspective taking (cognitive attunement), memory (personal experience), and moral sensitivity (ethical attunement). These dynamically intertwined dimensions create the preconditions for how clinicians respond to a triggering event instigated by an ethical conflict or dilemma. We postulate that if the four dimensions are highly aligned, the intensity and valence of emotional arousal will influence ethical appraisal and discernment by engaging a robust view of the ethical issues, conflicts, and possible solutions and cultivating compassionate action and resilience. In contrast, if they are not, ethical appraisal and discernment will be deficient, creating emotional disregulation and potentially leading to personal and moral distress, self-focused behaviors, unregulated moral outrage, burnout, and secondary stress. The adaptation and expansion of a conceptual framework offers a promising approach to designing interventions that help clinicians mitigate the detrimental consequences of unregulated moral distress and to build the resilience necessary to sustain themselves in clinical service.

  10. Diversification des moyens de subsistance des petits producteurs de ...

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

    Cette subvention permettra à l'Institut international de recherche sur les cultures des zones tropicales ... In ROSSA's latest bulletin issue: A farewell message from Simon Carter, the Regional Director of the ... Cigarette Taxation in Tanzania.

  11. How Do Clinicians Learn About Knowledge Translation? An Investigation of Current Web-Based Learning Opportunities.

    Science.gov (United States)

    Damarell, Raechel A; Tieman, Jennifer J

    2017-07-13

    Clinicians are important stakeholders in the translation of well-designed research evidence into clinical practice for optimal patient care. However, the application of knowledge translation (KT) theories and processes may present conceptual and practical challenges for clinicians. Online learning platforms are an effective means of delivering KT education, providing an interactive, time-efficient, and affordable alternative to face-to-face education programs. This study investigates the availability and accessibility of online KT learning opportunities for health professionals. It also provides an analysis of the types of resources and associated disciplines retrieved by a range of KT synonyms. We searched a range of bibliographic databases and the Internet (Google advanced option) using 9 KT terms to identify online KT learning resources. To be eligible, resources had to be free, aimed at clinicians, educational in intent, and interactive in design. Each term was searched using two different search engines. The details of the first 100 websites captured per browser (ie, n=200 results per term) were entered into EndNote. Each site was subsequently visited to determine its status as a learning resource. Eligible websites were appraised for quality using the AACODS (Authority, Accuracy, Coverage, Objectivity, Date, Significance) tool. We identified 971 unique websites via our multiple search strategies. Of these, 43 were health-related and educational in intent. Once these sites were evaluated for interactivity, a single website matched our inclusion criteria (Dementia Knowledge Translation Learning Centre). KT is an important but complex system of processes. These processes overlap with knowledge, practice, and improvement processes that go by a range of different names. For clinicians to be informed and competent in KT, they require better access to free learning opportunities. These resources should be designed from the viewpoint of the clinician, presenting KT

  12. L'exode des cerveaux et le renforcement des capacités en Afrique ...

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

    1 févr. 2011 ... Ce phénomène ébranle les assises économiques et politiques de bien des pays africains. ... le défi consiste à recruter ces cerveaux. ... des missions africaines, des organisations non gouvernementales et des groupes de la diaspora réunis pour parler de l'exode des cerveaux en Afrique et des stratégies à ...

  13. Online Health Searches and their Perceived Effects on Patients and Patient-Clinician Relationships: A Systematic Review,,✯✯✯.

    Science.gov (United States)

    Wang, Jane; Ashvetiya, Tamara; Quaye, Emmanuel; Parakh, Kapil; Martin, Seth S

    2018-05-03

    Online health searches are common and may be impacting patients and their relationships with their clinicians in ways that are not fully understood. We searched PubMed, Embase, Cochrane Reviews, Cochrane Trials, Scopus, and CINAHL from 1 January 1990 to 29 January 2016 for studies in which patients searched online for any aspect of healthcare and then visited their clinician. We extracted data pertaining to either patients' or clinicians' perceptions of the effects of these online searches on patients and the patient-clinician relationship. Searches seemed to induce patient anxiety but more often led to patient reassurance, clinical understanding, and empowerment. Patients tended to perceive that online health searches had a positive effect on the patient-clinician relationship, though the nature of the effect could depend on the clinician's response to patient queries regarding the information. Clinicians generally perceived neutral effects on patients and the patient-clinician relationship, and commonly raised concerns about accuracy of online content. Significant methodological heterogeneity prevented quantitative synthesis. Accuracy of online health search content was not assessed, and randomized controlled trials were notably lacking. Copyright © 2018. Published by Elsevier Inc.

  14. Evaluation des pratiques de gestion des adventices en riziculture ...

    African Journals Online (AJOL)

    Le riz est l'aliment principal pour la quasi-totalité des populations vivant en Côte d'Ivoire. Cependant, les adventices sont considérées comme la contrainte biologique la plus importante faisant obstacle à la production rizicole. L'objectif de cette étude menée en 2015 était d'évaluer différentes techniques de gestion des ...

  15. Cartographie des zones d'intervention des partenaires techniques et ...

    African Journals Online (AJOL)

    cartographier les zones d'intervention des partenaires techniques et financiers au Bénin. L'approche méthodologique utilisée a consisté à la recherche documentaire, à la collecte de données auprès des partenaires techniques et financiers et à l'analyse de ces données. Les résultats ont permis de constater que cent dix ...

  16. Modernisation des marchés agroalimentaires - inclusion des petits ...

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

    Les marchés agroalimentaires connaissent de rapides changements dans les pays en développement et les pays en transition. Sous l'influence de la libéralisation du commerce et des nouvelles technologies de transformation des aliments et de commerce de détail, les marchés agroalimentaires évoluent vers une plus ...

  17. A Qualitative Case Study of Smartphone-Connected Hearing Aids: Influences on Patients, Clinicians, and Patient-Clinician Interactions.

    Science.gov (United States)

    Ng, Stella L; Phelan, Shanon; Leonard, MaryAnn; Galster, Jason

    2017-06-01

    Innovations in hearing aid technology influence clinicians and individuals who use hearing aids. Little research, to date, explains the innovation adoption experiences and perspectives of clinicians and patients, which matter to a field like audiology, wherein technology innovation is constant. By understanding clinician and patient experiences with such innovations, the field of audiology may develop technologies and ways of practicing in a manner more responsive to patients' needs, and attentive to society's influence. The authors aimed to understand how new innovations influence clinician and patient experiences, through a study focusing on connected hearing aids. "Connected" refers to the wireless functional connection of hearing aids with everyday technologies like mobile phones and tablets. The authors used a qualitative collective case study methodology, borrowing from constructivist grounded theory for data collection and analysis methods. Specifically, the authors designed a collective case study of a connected hearing aid and smartphone application, composed of two cases of experience with the innovation: the case of clinician experiences, and the case of patient experiences. The qualitative sampling methods employed were case sampling, purposive within-case sampling, and theoretical sampling, and culminated in a total collective case n = 19 (clinician case n = 8; patient case n = 11). These data were triangulated with a supplementary sample of ten documents: relevant news and popular media collected during the study time frame. The authors conducted interviews with the patients and clinicians, and analyzed the interview and document data using the constant comparative method. The authors compared their two cases by looking at trends within, between, and across cases. The clinician case highlighted clinicians' heuristic-based candidacy judgments in response to the adoption of the connected hearing aids into their practice. The patient case revealed

  18. What motivates senior clinicians to teach medical students?

    Directory of Open Access Journals (Sweden)

    Owen Cathy

    2005-07-01

    Full Text Available Abstract Background This study was designed to assess the motivations of senior medical clinicians to teach medical students. This understanding could improve the recruitment and retention of important clinical teachers. Methods The study group was 101 senior medical clinicians registered on a teaching list for a medical school teaching hospital (The Canberra Hospital, ACT, Australia. Their motivations to teach medical students were assessed applying Q methodology. Results Of the 75 participants, 18 (24% were female and 57 (76% were male. The age distribution was as follows: 30–40 years = 16 participants (21.3%, 41–55 years = 46 participants (61.3% and >55 years = 13 participants (17.3%. Most participants (n = 48, 64% were staff specialists and 27 (36% were visiting medical officers. Half of the participants were internists (n = 39, 52%, 12 (16% were surgeons, and 24 (32% were other sub-specialists. Of the 26 senior clinicians that did not participate, two were women; 15 were visiting medical officers and 11 were staff specialists; 16 were internists, 9 were surgeons and there was one other sub-specialist. The majority of these non-participating clinicians fell in the 41–55 year age group. The participating clinicians were moderately homogenous in their responses. Factor analysis produced 4 factors: one summarising positive motivations for teaching and three capturing impediments for teaching. The main factors influencing motivation to teach medical students were intrinsic issues such as altruism, intellectual satisfaction, personal skills and truth seeking. The reasons for not teaching included no strong involvement in course design, a heavy clinical load or feeling it was a waste of time. Conclusion This study provides some insights into factors that may be utilised in the design of teaching programs that meet teacher motivations and ultimately enhance the effectiveness of the medical teaching workforce.

  19. Leadership, clinician managers and a thing called "hybridity".

    Science.gov (United States)

    Fulop, Liz

    2012-01-01

    In many countries leadership theories and leadership development programs in healthcare have been dominated by individualistic and heroic approaches that focus on developing the skills and competencies of health professionals. Alternative approaches have been proffered but mainly in the form of post-heroic and distributed forms of leadership. The notion of "hybridity" has emerged to challenge the assumptions of distributed leadership. The paper seeks to explore how the concept of hybridity can be used to re-theorize leadership in healthcare as it relates to clinician managers (or hybrid-professional managers). The theoretical developments are explored and empirical material is presented from research in Australian public hospitals to support the case for the existence of hybridized forms of leadership in healthcare. The paper discusses whether hybridity needs re-theorizing to adequately account for clinician leadership. It contributes to debates surrounding the role of clinician leadership in healthcare reform particularly in relation to those doctors who occupy management positions at the division or unit levels as distinct to CEOs. The study uses qualitative research, i.e. interactive interviews to present accounts of how healthcare professionals describe leadership. It undertakes both deductive and inductive theme analysis of the interview material. There is support for hybridized configurations of leadership in interview materials of healthcare professionals but other aspects were also noted that cannot be explained by this approach alone. The paper is the first to examine the concept of hybridity in the context of clinician leadership. Many approaches to leadership in healthcare fail to address the complexity of leadership within the ranks of clinician managers and thus are unable to deal adequately with the role of leadership in healthcare reform and change.

  20. Smallpox vaccination and adverse reactions. Guidance for clinicians.

    Science.gov (United States)

    Cono, Joanne; Casey, Christine G; Bell, David M

    2003-02-21

    , vaccination during pregnancy should not ordinarily be a reason to consider termination of pregnancy. No known indication exists for routine, prophylactic use of VIG in an unintentionally vaccinated pregnant woman; however, VIG should not be withheld if a pregnant woman develops a condition where VIG is needed. Other less-common adverse events after smallpox vaccination have been reported to occur in temporal association with smallpox vaccination, but causality has not been established. Prophylactic treatment with VIG is not recommended for persons or close contacts with contraindications to smallpox vaccination who are inadvertently inoculated or exposed. These persons should be followed closely for early recognition of adverse reactions that might develop, and clinicians are encouraged to enroll these persons in the CDC registry by calling the Clinician Information Line at 877-554-4625. To request clinical consultation and IND therapies for vaccinia-related adverse reactions for civilians, contact your state health department or CDC's Clinician Information Line (877-554-4625). Clinical evaluation tools are available at http.//www.bt.cdc.gov/agent/smallpox/vaccination/clineval. Clinical specimen-collection guidance is available at http://www.bt.cdc.gov/agent/smallpox/vaccination/vaccinia-specimen-collection.asp. Physicians at military medical facilities can request VIG or cidofovir by calling the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID) at 301-619-2257 or 888-USA-RIID.

  1. On-line ethics education for occupational therapy clinician-educators: a single-group pre-/post-test study.

    Science.gov (United States)

    VanderKaay, Sandra; Letts, Lori; Jung, Bonny; Moll, Sandra E

    2018-05-20

    Ethics education is a critical component of training rehabilitation practitioners. There is a need for capacity-building among ethics educators regarding facilitating ethical decision-making among students. The purpose of this study was to evaluate the utility of an on-line ethics education module for occupational therapy clinician-educators (problem-based learning tutors/clinical placement preceptors/evidence-based practice facilitators). The Knowledge-to-Action Process informed development and evaluation of the module. Clinician-educators (n = 33) viewed the module and reported on its impact on knowledge and facilitation practices via pre, post, and follow-up questionnaires. Pre- and post-test data indicated improvement in self-reported ethics knowledge (t = 8.275, p ethics education module for clinician-educators. Future recommendations include broader consideration of context, adding supplemental knowledge translation components, and further research exploring outcomes with larger samples, longer follow-up and randomized trial methodology. Implications for Rehabilitation The on-line ethics module has potential to improve rehabilitation practice by addressing the noted gap in knowledge among clinician-educators. Viewing an on-line module regarding approaches to ethics education may not be sufficient to change clinician-educators' teaching practices. More time and opportunities to discuss ethics with student occupational therapists may be required to effect practice change among clinician-educators. Developing ethics education tools for clinician-educators requires ongoing and iterative input from knowledge users to optimize translation of ideas to practice.

  2. Die Versprachlichung des Sakralen

    DEFF Research Database (Denmark)

    Larsen, Øjvind

    2011-01-01

    transformation of the sacred as a harmonious theory of secularization. However, if we follow Weber in his religious-sociological considerations of modernity, we reach a tragic theory of secularization that poses the real problem that modernity’s connection to the sacred has been dissolved.......Habermas claims in connection with his development of the theory of communicative action that the sacred is transformed in a positive way and can take the form of free deliberation in society, the so-called Versprachlichung des Sakralen. The thesis is that the authority which could be found...... in religion and which is of fundamental significance for the integration of pre-modern societies is taken over by modern societies in forms of deliberation. Habermas develops his thesis in a discussion of Durkheim’s religious-sociological considerations. Habermas presents his thesis about the linguistic...

  3. Code des baux 2018

    CERN Document Server

    Vial-Pedroletti, Béatrice; Kendérian, Fabien; Chavance, Emmanuelle; Coutan-Lapalus, Christelle

    2017-01-01

    Le code des baux 2018 vous offre un contenu extrêmement pratique, fiable et à jour au 1er août 2017. Cette 16e édition intègre notamment : le décret du 27 juillet 2017 relatif à l’évolution de certains loyers dans le cadre d’une nouvelle location ou d’un renouvellement de bail, pris en application de l’article 18 de la loi n° 89-462 du 6 juillet 1989 ; la loi du 27 janvier 2017 relative à l’égalité et à la citoyenneté ; la loi du 9 décembre 2016 relative à la transparence, à la lutte contre la corruption et à la modernisation de la vie économique ; la loi du 18 novembre 2016 de modernisation de la justice du xxie siècle

  4. Ethics of fertility preservation for prepubertal children: should clinicians offer procedures where efficacy is largely unproven?

    Science.gov (United States)

    McDougall, Rosalind J; Gillam, Lynn; Delany, Clare; Jayasinghe, Yasmin

    2018-01-01

    Young children with cancer are treated with interventions that can have a high risk of compromising their reproductive potential. ‘Fertility preservation’ for children who have not yet reached puberty involves surgically removing and cryopreserving reproductive tissue prior to treatment in the expectation that strategies for the use of this tissue will be developed in the future. Fertility preservation for prepubertal children is ethically complex because the techniques largely lack proven efficacy for this age group. There is professional difference of opinion about whether it is ethical to offer such ‘experimental’ procedures. The question addressed in this paper is: when, if ever, is it ethically justifiable to offer fertility preservation surgery to prepubertal children? We present the ethical concerns about prepubertal fertility preservation, drawing both on existing literature and our experience discussing this issue with clinicians in clinical ethics case consultations. We argue that offering the procedure is ethically justifiable in certain circumstances. For many children, the balance of benefits and burdens is such that the procedure is ethically permissible but not ethically required; when the procedure is medically safe, it is the parents’ decision to make, with appropriate information and guidance from the treating clinicians. We suggest that clinical ethics support processes are necessary to assist clinicians to engage with the ethical complexity of prepubertal fertility preservation and describe the framework that has been integrated into the pathway of care for patients and families attending the Royal Children’s Hospital in Melbourne, Australia. PMID:29084865

  5. Extended regimen combined oral contraception: A review of evolving concepts and acceptance by women and clinicians.

    Science.gov (United States)

    Nappi, Rossella E; Kaunitz, Andrew M; Bitzer, Johannes

    2016-01-01

    The clinical utility of extended regimen combined oral contraceptives (COCs) is increasingly being recognised. Our objective was to understand the attitudes of women and clinicians about the use of these regimens. We present the rationale for extended regimen COCs from a historical perspective, and trace their evolution and growing popularity in light of their clinical benefits. We conclude by offering potential strategies for counselling women about extended regimen COC options. We conducted a MEDLINE search to identify and summarise studies of extended regimen COCs, focusing on attitudes of women and clinicians regarding efficacy, safety/tolerability and fewer scheduled bleeding episodes and other potential benefits. The body of contemporary literature on extended regimen COCs suggests that their contraceptive efficacy is comparable to that of conventional 28-day (i.e., 21/7) regimens. For women seeking contraception that allows infrequent scheduled bleeding episodes, particularly those who suffer from hormone withdrawal symptoms and cyclical symptoms (e.g., headache, mood changes, dysmenorrhoea, heavy menstrual bleeding), extended regimen COCs are an effective and safe option. Although satisfaction with extended regimen COCs in clinical trials is high, misperceptions about continuous hormone use may still limit the widespread acceptance of this approach. Despite the widespread acceptance among clinicians of extended regimen COCs as an effective and safe contraceptive option, these regimens are underused, likely due to a lack of awareness about their availability and utility among women. Improved patient education and counselling regarding the safety and benefits of extended regimen COCs may help women make more informed contraceptive choices.

  6. Clinician and Parent Perspectives on Educational Needs for Increasing Adolescent HPV Vaccination.

    Science.gov (United States)

    Widman, Christy A; Rodriguez, Elisa M; Saad-Harfouche, Frances; Twarozek, Annamaria Masucci; Erwin, Deborah O; Mahoney, Martin C

    2018-04-01

    Human papillomavirus (HPV)-related morbidity and mortality remain a significant public health burden despite the availability of HPV vaccines for cancer prevention. We engaged clinicians and parents to identify barriers and opportunities related to adolescent HPV vaccination within a focused geographic region. This mixed-method study design used an interviewer-administered semi-structured interview with clinicians (n = 52) and a written self-administered survey with similar items completed by parents (n = 54). Items focused on experiences, opinions, and ideas about HPV vaccine utilization in the clinical setting, family, and patient perceptions about HPV vaccination and potential future efforts to increase vaccine utilization. Quantitative items were analyzed using descriptive statistics, while qualitative content was analyzed thematically. Suggested solutions for achieving higher rates of HPV vaccination noted by clinicians included public health education, the removal of stigma associated with vaccines, media endorsements, and targeting parents as the primary focus of educational messages. Parents expressed the need for more information about HPV-related disease, HPV vaccines, vaccine safety, sexual concerns, and countering misinformation on social media. Results from this mixed-method study affirm that educational campaigns targeting both health care professionals and parents represent a key facilitator for promoting HPV vaccination; disease burden and cancer prevention emerged as key themes for this messaging.

  7. Le réseau de politiques fondées sur des données probantes ...

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

    Les résultats de recherche n'ont aucune valeur s'ils ne sont pas mis à la disposition des praticiens et des responsables des politiques. Les articles scientifiques ne suffisent pas. Il est nécessaire d'organiser les résultats de recherche en fonction d'un plus vaste public et de faire en sorte que l'information circule dans les ...

  8. Digitalisierung des Kulturellen Erbes (Europas)

    NARCIS (Netherlands)

    Gruber, Marion

    2011-01-01

    Gruber, M. R. (2011, 13 December). Digitalisierung des Kulturellen Erbes (Europas). Guest lecture at the IPMZ - Institute of Mass Communication and Media Research, Devision Media Change & Innovation, University of Zurich, Switzerland.

  9. Vecteurs Singuliers des Theories des Champs Conformes Minimales

    Science.gov (United States)

    Benoit, Louis

    En 1984 Belavin, Polyakov et Zamolodchikov revolutionnent la theorie des champs en explicitant une nouvelle gamme de theories, les theories quantiques des champs bidimensionnelles invariantes sous les transformations conformes. L'algebre des transformations conformes de l'espace-temps presente une caracteristique remarquable: en deux dimensions elle possede un nombre infini de generateurs. Cette propriete impose de telles conditions aux fonctions de correlations qu'il est possible de les evaluer sans aucune approximation. Les champs des theories conformes appartiennent a des representations de plus haut poids de l'algebre de Virasoro, une extension centrale de l'algebre conforme du plan. Ces representations sont etiquetees par h, le poids conforme de leur vecteur de plus haut poids, et par la charge centrale c, le facteur de l'extension centrale, commune a toutes les representations d'une meme theorie. Les theories conformes minimales sont constituees d'un nombre fini de representations. Parmi celles-ci se trouvent des theories unitaires dont les representation forment la serie discrete de l'algebre de Virasoro; leur poids h a la forme h_{p,q}(m)=[ (p(m+1) -qm)^2-1] (4m(m+1)), ou p,q et m sont des entiers positifs et p+q= 2. Ces representations possedent un sous-espace invariant engendre par deux sous-representations avec h_1=h_{p,q} + pq et h_2=h_{p,q} + (m-p)(m+1-q) dont chacun des vecteurs de plus haut poids portent le nom de vecteur singulier et sont notes respectivement |Psi _{p,q}> et |Psi_{m-p,m+1-q}>. . Les theories super-conformes sont une version super-symetrique des theories conformes. Leurs champs appartiennent a des representation de plus haut poids de l'algebre de Neveu-Schwarz, une des deux extensions super -symetriques de l'algebre de Virasoro. Les theories super -conformes minimales possedent la meme structure que les theories conformes minimales. Les representations sont elements de la serie h_{p,q}= [ (p(m+2)-qm)^2-4] /(8m(m+2)) ou p,q et m sont

  10. UK medical students' perceptions, attitudes, and interest toward medical leadership and clinician managers.

    Science.gov (United States)

    Rouhani, Maral J; Burleigh, Eleanor J; Hobbis, Chloe; Dunford, Charlotte; Osman, Nadir I; Gan, Christine; Gibbons, Norma B; Ahmed, Hashim U; Miah, Saiful

    2018-01-01

    We aimed to determine UK medical students' perceptions and attitudes and interest toward medical leadership and clinician managers. A cross-sectional study was conducted during the academic year 2015-2016. An online questionnaire was distributed to 2,349 final-year students from 10 UK medical schools. Participants were asked to complete a 5-point Likert scale on their current perceptions, attitudes, and interest toward medical leadership and clinician managers. They were also asked to self-rate their leadership competences set by the Medical Leadership Competency Framework and to rate the quality of management and leadership training they received from their medical school. In total, we received 114 complete responses. Only 7.9% of respondents were in agreement (strongly agree or agree) when asked whether they felt they were well informed about what a managerial position in medicine entails. When asked whether clinicians should influence managerial decisions within a clinical setting, 94.7% of respondents were in agreement with the statement. About 85% of respondents were in agreement that it is important for clinicians to have managerial or leadership responsibilities, with 63.2% of students in agreement that they would have liked more management or leadership training during medical school. Over half the respondents rated their management and leadership training they received during medical school as "very poor" or "poor" (54.4%). Our study suggests that UK medical students have an appetite for management and leadership training and appreciate its importance but feel that the training they are receiving is poor. This suggests that there is a gap between the demand for management and leadership training and the quality of training supplied by UK medical schools.

  11. Nouvelles approches ergonomiques de la cartographie des risques industriels

    Directory of Open Access Journals (Sweden)

    Éliane Propeck-Zimmermann

    2009-12-01

    Full Text Available Les cartes actuelles présentent des insuffisances pour une gestion territoriale des risques industriels. En redéfinissant le concept de «situation à risques» et en l'implémentant dans un SIG, on peut disposer à la demande d'informations riches et variées: cartes analytiques, de synthèse, typologies, requêtes spatiales diverses. Les recherches en cours visent à développer une interface ergonomique pour faciliter la concertation entre différents acteurs.

  12. Professional practice assessment. Pertinence of positron emission tomography clinical indications in oncology; Evaluation des pratiques professionnelles. Pertinence des indications de la tomographie a emission de positons en cancerologie

    Energy Technology Data Exchange (ETDEWEB)

    Le Stanc, E.; Tainturier, C. [Hopital Foch, Service de Medecine Nucleaire, 92 - Suresnes (France); Swaenepoel, J. [Hopital Foch, Cellule Qualite, 92 - Suresnes (France)

    2009-09-15

    Introduction As part of the health care quality and safety policy in France, Professional Practice Assessment (P.P.A.) are mandatory in the health services 'certification' process. We present our study regarding the pertinence of Positron Emission Tomography (PET) indications in oncology. Materials and methods A multidisciplinary task group used the Quick Audit method with two rounds of 100 request forms each. The assessment list of criteria comprised four items of decreasing relevance grading the PET scans clinical indications, which were derived from the three French published guidelines (S.O.R. [F.N.C.L.C.C]., 'Guide du bon usage des examens d'imagerie medicale' [S.F.R.-S.F.M.N.], 'Guide pour la redaction de protocoles pour la TEP au F.D.G. en cancerologie' [S.F.M.N.]) and five additional items: clinical information, patient's body weight, previous treatments dates, diabetes, claustrophobia. Results The first round showed that 68% of the requested scans corresponded to the two most relevant groups of indications (S.O.R. Standards and Options). The request forms were correctly filled in regarding the clinical information, but this was not the case for the other items we tested. Several actions were conducted: dedicated PET request form, availability of the S.O.R. on the hospital intranet, boost of the referring physicians awareness during the multidisciplinary oncology meetings (Reunions de Concertation Pluridisciplinaires RCP). The second round showed a better pertinence of the PET scans indications (75% versus 68%); the patient's body weight was more frequently mentioned on the request form. Discussion This study is an example of P.P.A. in our discipline. It led to an improvement of the oncologic PET scans clinical indications in our hospital. This work is pursued in everyday discussion with the referring clinicians, especially during the RCP. (authors)

  13. Perspective: Entering uncharted waters: navigating the transition from trainee to career for the nonphysician clinician-scientist.

    Science.gov (United States)

    MacDonald, Shannon E; Sharpe, Heather M; Shikako-Thomas, Keiko; Larsen, Bodil; MacKay, Lyndsay

    2013-01-01

    The transition from trainee to career clinician-scientist can be a stressful and challenging time, particularly for those entering the less established role of nonphysician clinician-scientist. These individuals are typically PhD-prepared clinicians in the allied health professions, who have either a formal or informal joint appointment between a clinical institution and an academic or research institution. The often poorly defined boundaries and expectations of these developing roles can pose additional challenges for the trainee-to-career transition.It is important for these trainees to consider what they want and need in a position in order to be successful, productive, and fulfilled in both their professional and personal lives. It is also critical for potential employers, whether academic or clinical (or a combination of both), to be fully aware of the supports and tools necessary to recruit and retain new nonphysician clinician-scientists. Issues of relevance to the trainee and the employer include finding and negotiating a position; the importance of mentorship; the value of effective time management, particularly managing clinical and academic time commitments; and achieving work-life balance. Attention to these issues, by both the trainee and those in a position to hire them, will facilitate a smooth transition to the nonphysician clinician-scientist role and ultimately contribute to individual and organizational success.

  14. Importance ratings on patient-reported outcome items for survivorship care: comparison between pediatric cancer survivors, parents, and clinicians.

    Science.gov (United States)

    Jones, Conor M; Baker, Justin N; Keesey, Rachel M; Eliason, Ruth J; Lanctot, Jennifer Q; Clegg, Jennifer L; Mandrell, Belinda N; Ness, Kirsten K; Krull, Kevin R; Srivastava, Deokumar; Forrest, Christopher B; Hudson, Melissa M; Robison, Leslie L; Huang, I-Chan

    2018-04-18

    To compare importance ratings of patient-reported outcomes (PROs) items from the viewpoints of childhood cancer survivors, parents, and clinicians for further developing short-forms to use in survivorship care. 101 cancer survivors, 101 their parents, and 36 clinicians were recruited from St. Jude Children's Research Hospital. Participants were asked to select eight items that they deemed useful for clinical decision making from each of the four Patient-Reported Outcomes Measurement Information System Pediatric item banks. These item banks were pain interference (20 items), fatigue (23 items), psychological stress (19 items), and positive affect (37 items). Compared to survivors, clinicians rated more items across four domains that were statistically different than did parents (23 vs. 13 items). Clinicians rated five items in pain interference domain (ORs 2.33-6.01; p's important but rated three items in psychological stress domain (ORs 0.14-0.42; p's important than did survivors. In contrast, parents rated seven items in positive affect domain (ORs 0.25-0.47; p's important than did survivors. Survivors, parents, and clinicians viewed importance of PRO items for survivorship care differently. These perspectives should be used to assist the development of PROs tools.

  15. The patient perspective: arthritis care provided by Advanced Clinician Practitioner in Arthritis Care program-trained clinicians

    Directory of Open Access Journals (Sweden)

    Warmington K

    2015-08-01

    Full Text Available Kelly Warmington,1 Carol A Kennedy,2 Katie Lundon,3 Leslie J Soever,4 Sydney C Brooks,5 Laura A Passalent,6 Rachel Shupak,7 Rayfel Schneider,8 1Learning Institute, Hospital for Sick Children, 2Musculoskeletal Health and Outcomes Research, St Michael’s Hospital, 3Continuing Professional Development, Faculty of Medicine, University of Toronto, 4University Health Network, 5Ontario Division, Arthritis Society, 6Toronto Western Hospital, 7Division of Rheumatology, St Michael's Hospital, 8Division of Rheumatology, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada Objective: To assess patient satisfaction with the arthritis care services provided by graduates of the Advanced Clinician Practitioner in Arthritis Care (ACPAC program. Materials and methods: This was a cross-sectional evaluation using a self-report questionnaire for data collection. Participants completed the Patient–Doctor Interaction Scale, modified to capture patient–practitioner interactions. Participants completed selected items from the Group Health Association of America's Consumer Satisfaction Survey, and items capturing quality of care, appropriateness of wait times, and a comparison of extended-role practitioner (ERP services with previously received arthritis care. Results: A total of 325 patients seen by 27 ERPs from 15 institutions completed the questionnaire. Respondents were primarily adults (85%, female (72%, and living in urban areas (79%. The mean age of participants was 54 years (range 3–92 years, and 51% were not working. Patients with inflammatory (51% and noninflammatory conditions (31% were represented. Mean (standard deviation Patient–Practitioner Interaction Scale subscale scores ranged from 4.50 (0.60 to 4.63 (0.48 (1 to 5 [greater satisfaction]. Overall satisfaction with the quality of care was high (4.39 [0.77], as was satisfaction with wait times (referral to appointment, 4.27 [0.86]; in clinic, 4.24 [0.91]. Ninety-eight percent of

  16. Controle optique de qubits lies a des centres isoelectroniques d'azote dans le GaAs

    Science.gov (United States)

    Ethier-Majcher, Gabriel

    Le traitement de l'information quantique est un domaine de recherche actuellement en pleine effervescence car il laisse entrevoir une revolution dans notre facon de traiter et d'echanger de l'information. D'une part, l'ordinateur quantique promet de resoudre des problemes comme la factorisation d'un polynome de facon beaucoup plus efficace qu'un ordinateur classique. D'autre part, les communications quantiques promettent l'echange d'information de facon fondamentalement inviolable. Afin de tirer pleinement profit de ces nouvelles technologies, il sera avantageux de construire des reseaux quantiques. Dans un tel reseau, des processeurs quantiques, les noeuds, seront connectes par des photons voyageant dans des fibres optiques. Les reseaux quantiques permettront de deployer les communications quantiques a grande echelle et de creer des super-ordinateurs quantiques. La realisation de reseaux quantiques necessitera des interfaces optiques pouvant echanger l'information de facon coherente entre un qubit (bit d'information quantique) et un photon. L'implementation de telles interfaces dans un systeme physique s'avere un important defi scientifique et technologique. Or, les systemes actuellement envisages a cette fin souffrent d'un faible couplage avec la lumiere ou encore de grandes inhomogeneites, constituant des obstacles a la realisation de reseaux a grande echelle. Dans cette these, le potentiel des centres isoelectroniques pour realiser des interfaces optiques est evalue. Deux types de qubits lies a des paires d'azote dans le GaAs sont consideres : les qubits excitoniques et les qubits de spin electronique, controlables par l'intermediaire d'excitons charges. Le controle optique complet des qubits excitoniques est demontre, ce qui constitue la premiere realisation du genre dans les centres isoelectroniques. L'observation d'excitons charges dans ce systeme, liant a la fois des trous lourds et des trous legers, laisse entrevoir de nouvelles possibilites afin de

  17. Caracterisation environnementale des emissions atmospheriques d'une source fixe et creation d'un outil de gestion dynamique =

    Science.gov (United States)

    Fournier, Marie-Claude

    Une caracterisation des emissions atmospheriques provenant des sources fixes en operation, alimentees au gaz et a l'huile legere, a ete conduite aux installations visees des sites no.1 et no.2. La caracterisation et les calculs theoriques des emissions atmospheriques aux installations des sites no.1 et no.2 presentent des resultats qui sont en dessous des valeurs reglementaires pour des conditions d'operation normales en periode hivernale et par consequent, a de plus fortes demandes energetiques. Ainsi, pour une demande energetique plus basse, le taux de contaminants dans les emissions atmospheriques pourrait egalement etre en dessous des reglementations municipales et provinciales en vigueur. Dans la perspective d'une nouvelle reglementation provinciale, dont les termes sont discutes depuis 2005, il serait souhaitable que le proprietaire des infrastructures visees participe aux echanges avec le Ministere du Developpement Durable, de l'Environnement et des Parcs (MDDEP) du Quebec. En effet, meme si le principe de droit acquis permettrait d'eviter d'etre assujetti a la nouvelle reglementation, l'application de ce type de principe ne s'inscrit pas dans ceux d'un developpement durable. L'âge avance des installations etudiees implique la planification d'un entretien rigoureux afin d'assurer les conditions optimales de combustion en fonction du type de combustible. Des tests de combustion sur une base reguliere sont donc recommandes. Afin de supporter le processus de suivi et d'evaluation de la performance environnementale des sources fixes, un outil d'aide a la gestion de l'information environnementale a ete developpe. Dans ce contexte, la poursuite du developpement d'un outil d'aide a la gestion de l'information environnementale faciliterait non seulement le travail des personnes affectees aux inventaires annuels mais egalement le processus de communication entre les differents acteurs concernes tant intra- qu'inter-etablissement. Cet outil serait egalement un bon

  18. Hyperspective, un outil d'aide à la définition des problématiques d'Intelligence Economique

    OpenAIRE

    Goria, Stéphane; Geffroy, Philippe

    2004-01-01

    International audience; Tout dialogue entre deux personnes peut donner suite à de malheureux quiproquos après une interprétation erronée d'un ou plusieurs des termes (et des concepts sous-jacents à ces derniers) employés par l'un ou l'autre des intervenants. Aussi, suite à certaines observations effectuées sur le terrain de l'Intelligence Territoriale, nous avons décidé de développer un outil d'aide à la définition des sujets des demandes de recherche d'information et de veilles, combinant le...

  19. Financial capacity in older adults: a growing concern for clinicians.

    Science.gov (United States)

    Gardiner, Paul A; Byrne, Gerard J; Mitchell, Leander K; Pachana, Nancy A

    2015-02-02

    Older people with cognitive impairment and/or dementia may be particularly vulnerable to diminished financial decision-making capacity. Financial capacity refers to the ability to satisfactorily manage one's financial affairs in a manner consistent with personal self-interest and values. Impairment of financial capacity makes the older individual vulnerable to financial exploitation, may negatively affect their family's financial situation and places strain on relationships within the family. Clinicians are often on the front line of responding to queries regarding decision-making capacity, and clinical evaluation options are often not well understood. Assessment of financial capacity should include formal objective assessment in addition to a clinical interview and gathering contextual data. Development of a flexible, empirically supported and clinically relevant assessment approach that spans all dimensions of financial capacity yet is simple enough to be used by non-specialist clinicians is needed.

  20. The cultural divide: exploring communication barriers between scientists and clinicians.

    Science.gov (United States)

    Restifo, Linda L; Phelan, Gerald R

    2011-07-01

    Despite remarkable advances in basic biomedical science that have led to improved patient care, there is a wide and persistent gap in the abilities of researchers and clinicians to understand and appreciate each other. In this Editorial, the authors, a scientist and a clinician, discuss the rift between practitioners of laboratory research and clinical medicine. Using their first-hand experience and numerous interviews throughout the United States, they explore the causes of this 'cultural divide'. Members of both professions use advanced problem-solving skills and typically embark on their career paths with a deeply felt sense of purpose. Nonetheless, differences in classroom education, professional training environments, reward mechanisms and sources of drive contribute to obstacles that inhibit communication, mutual respect and productive collaboration. More than a sociological curiosity, the cultural divide is a significant barrier to the bench-to-bedside goals of translational medicine. Understanding its roots is the first step towards bridging the gap.

  1. The cultural divide: exploring communication barriers between scientists and clinicians

    Directory of Open Access Journals (Sweden)

    Linda L. Restifo

    2011-07-01

    Despite remarkable advances in basic biomedical science that have led to improved patient care, there is a wide and persistent gap in the abilities of researchers and clinicians to understand and appreciate each other. In this Editorial, the authors, a scientist and a clinician, discuss the rift between practitioners of laboratory research and clinical medicine. Using their first-hand experience and numerous interviews throughout the United States, they explore the causes of this ‘cultural divide’. Members of both professions use advanced problem-solving skills and typically embark on their career paths with a deeply felt sense of purpose. Nonetheless, differences in classroom education, professional training environments, reward mechanisms and sources of drive contribute to obstacles that inhibit communication, mutual respect and productive collaboration. More than a sociological curiosity, the cultural divide is a significant barrier to the bench-to-bedside goals of translational medicine. Understanding its roots is the first step towards bridging the gap.

  2. L'accumulation des métaux lourds au niveau des cultures : Cas des ...

    African Journals Online (AJOL)

    Le Bassin de Sebou présente une importance socio-économique pour le Maroc. En effet, il est sujet de diverses utilisations ; eau potable, eau d'irrigation et eau industrielle. Toutefois, ce bassin subit des pressions multiples, notamment par la pollution métallique. Considérant le risque de bioaccumulation des métaux par ...

  3. Communication skills in healthcare: academic, clinician and patient perspectives

    OpenAIRE

    CHARLOTTE ABYNA INDERMAUR DENNISTON

    2018-01-01

    This PhD explores healthcare communication skills from the perspectives of academics, clinicians and patients. We know that communication is key to effective healthcare and this research has revealed new approaches for teaching and learning these skills. Findings indicate that we need to consider multiple stakeholders in the design of communication education, we need to develop healthcare professionals’ skills at assessing their own communication and asking for feedback, and workplace teachin...

  4. Child Health Disparities: What Can a Clinician Do?

    Science.gov (United States)

    Cheng, Tina L; Emmanuel, Mickey A; Levy, Daniel J; Jenkins, Renee R

    2015-11-01

    Pediatric primary and specialty practice has changed, with more to do, more regulation, and more family needs than in the past. Similarly, the needs of patients have changed, with more demographic diversity, family stress, and continued health disparities by race, ethnicity, and socioeconomic status. How can clinicians continue their dedicated service to children and ensure health equity in the face of these changes? This article outlines specific, practical, actionable, and evidence-based activities to help clinicians assess and address health disparities in practice. These tools may also support patient-centered medical home recognition, national and state cultural and linguistic competency standards, and quality benchmarks that are increasingly tied to payment. Clinicians can play a critical role in (1) diagnosing disparities in one's community and practice, (2) innovating new models to address social determinants of health, (3) addressing health literacy of families, (4) ensuring cultural competence and a culture of workplace equity, and (5) advocating for issues that address the root causes of health disparities. Culturally competent care that is sensitive to the needs, health literacy, and health beliefs of families can increase satisfaction, improve quality of care, and increase patient safety. Clinical care approaches to address social determinants of health and interrupting the intergenerational cycle of disadvantage include (1) screening for new health "vital signs" and connecting families to resources, (2) enhancing the comprehensiveness of services, (3) addressing family health in pediatric encounters, and (4) moving care outside the office into the community. Health system investment is required to support clinicians and practice innovation to ensure equity. Copyright © 2015 by the American Academy of Pediatrics.

  5. Digitizing the Facebow: A Clinician/Technician Communication Tool.

    Science.gov (United States)

    Kalman, Les; Chrapka, Julia; Joseph, Yasmin

    2016-01-01

    Communication between the clinician and the technician has been an ongoing problem in dentistry. To improve the issue, a dental software application has been developed--the Virtual Facebow App. It is an alternative to the traditional analog facebow, used to orient the maxillary cast in mounting. Comparison data of the two methods indicated that the digitized virtual facebow provided increased efficiency in mounting, increased accuracy in occlusion, and lower cost. Occlusal accuracy, lab time, and total time were statistically significant (Ptechnician communication.

  6. Relationships between radiologists and clinicians: Results from three surveys

    International Nuclear Information System (INIS)

    Dalla Palma, L.; Stacul, F.; Meduri, S.; Geitung, J. Te.

    2000-01-01

    AIM: To analyse reasons for and the nature of clinico-radiological contacts and their clinical impact. MATERIALS AND METHODS: Three different surveys were performed. (1) Data concerning contacts between staff radiologists (n = 20) and clinicians during 10 consecutive working days were collected; (2) staff clinicians (n = 174) filled in a questionnaire asking for their opinions about relationships with radiologists; (3) staff radiologists collected data about contacts with clinicians related to more urgent/complicated cases. Radiologists assessed the clinical impact of the radiological procedure and of the consultation. RESULTS: (1) During 220 working days 20 radiologists had a mean of 3.95 contacts per day (48.2% personal contacts, 51.8% telephone contacts), amounting to a personal total of 21.65 min per day. These contacts amounted to a total of 7.08 h per day, roughly one whole-time equivalent radiologist. (2) These consultations helped to refine the diagnostic strategy often (12.6%) or sometimes (71.4%) and to alter therapeutic decisions often (10.4%) or sometimes (56.6%). (3) The initial clinical diagnosis was changed in 50% of cases and the therapy was substantially changed on the basis of further radiological investigations and clinical-radiological discussion in 60% of cases. CONCLUSION: Clinical-radiological consultations are time consuming but have a beneficial diagnostic and therapeutic impact. Dalla Palma, L. (2000)

  7. Reiki Reduces Burnout Among Community Mental Health Clinicians.

    Science.gov (United States)

    Rosada, Renee M; Rubik, Beverly; Mainguy, Barbara; Plummer, Julie; Mehl-Madrona, Lewis

    2015-08-01

    Clinicians working in community mental health clinics are at high risk for burnout. Burnout is a problem involving emotional exhaustion, depersonalization, and reduced personal accomplishment. Reiki is a holistic biofield energy therapy beneficial for reducing stress. The purpose of this study was to determine if 30 minutes of healing touch could reduce burnout in community mental health clinicians. We utilized a crossover design to explore the efficacy of Reiki versus sham Reiki, a pseudo treatment designed to mimic true Reiki, as a means to reduce symptoms of burnout. Subjects were randomized to whether they started with Reiki or sham. The Maslach Burnout Inventory-Human Services Survey (MBI-HSS) and the Measure Your Medical Outcome Profile Version 2 (MYMOP-2) were used as outcome measures. Multilevel modeling was used to represent the relations among variables. Reiki was statistically significantly better than sham Reiki in reducing burnout among community mental health clinicians (p=0.011). Reiki was significant in reducing depersonalization (pReiki reduced the primary symptom on the MYMOP also only among single people (p=0.03). The effects of Reiki were differentiated from sham Reiki. Reiki could be helpful in community mental health settings for the mental health of the practitioners.

  8. Understanding academic clinicians' intent to treat pediatric obesity.

    Science.gov (United States)

    Frankfurter, Claudia; Cunningham, Charles; Morrison, Katherine M; Rimas, Heather; Bailey, Karen

    2017-02-08

    To examine the extent to which the theory of planned behavior (TPB) predicts academic clinicians' intent to treat pediatric obesity. A multi-disciplinary panel iteratively devised a Likert scale survey based on the constructs of the TPB applied to a set of pediatric obesity themes. A cross-sectional electronic survey was then administered to academic clinicians at tertiary care centers across Canada from January to April 2012. Descriptive statistics were used to summarize demographic and item agreement data. A hierarchical linear regression analysis controlling for demographic variables was conducted to examine the extent to which the TPB subscales predicted intent to treat pediatric obesity. A total of 198 physicians, surgeons, and allied health professionals across Canada (British Columbia, Alberta, Manitoba, Saskatchewan, Nova Scotia, Ontario and Quebec) completed the survey. On step 1, demographic factors accounted for 7.4% of the variance in intent scores. Together in step 2, demographic variables and TPB subscales predicted 56.9% of the variance in a measure of the intent to treat pediatric obesity. Perceived behavioral control, that is, confidence in one's ability to manage pediatric obesity, and subjective norms, congruent with one's context of practice, were the most significant predictors of the intent to treat pediatric obesity. Attitudes and barriers did not predict the intent to treat pediatric obesity in this context. Enhancing self-confidence in the ability to treat pediatric obesity and the existence of supportive treatment environments are important to increase clinician's intent to treat pediatric obesity.

  9. Factors that influence clinicians' assessment and management of family violence.

    Science.gov (United States)

    Tilden, V P; Schmidt, T A; Limandri, B J; Chiodo, G T; Garland, M J; Loveless, P A

    1994-01-01

    OBJECTIVES. High rates of family violence and low rates of detection, report, and therapeutic intervention by health professionals are well documented. This study was undertaken to determine what factors influence clinicians' decision making about identifying abuse and intervening with victims. METHODS. Survey data about clinicians' experiences with and attitudes toward family violence were gathered by mailed questionnaire from a random sample of practicing clinicians in six disciplines (n = 1521). RESULTS. Data showed similarities within and wide differences among three groups of subjects: dentists/dental hygienists, nurses/physicians, and psychologists/social workers. Overall, a third of subjects reported having received no educational content on child, spouse, or elder abuse in their professional training programs. Subjects with education on the topic more commonly suspected abuse in their patients than those without; among all subjects, spouse abuse was suspected more often than child abuse while elder abuse was suspected infrequently. Significant numbers of subjects did not view themselves as responsible for dealing with problems of family violence. Subjects indicated low confidence in and low compliance with mandatory reporting laws. CONCLUSIONS. There is a need for educators to expand curricula on family violence and for legislators to reexamine mandatory reporting laws. PMID:8154568

  10. Nature & prevalence of stalking among New Zealand mental health clinicians.

    Science.gov (United States)

    Hughes, Frances A; Thom, Katey; Dixon, Robyn

    2007-04-01

    Stalking involves recurrent and persistent unwanted communication or contact that generates fear for safety in the victims. This pilot study evaluated the nature and prevalence of stalking among New Zealand nurses and physicians working in mental health services. An anonymous questionnaire asking respondents to describe their experiences with 12 stalking behaviors was distributed to 895 clinicians. Results indicated that regardless of discipline, women were more likely than men to have experienced one or more stalking behaviors, including receiving unwanted telephone calls, letters, and approaches; receiving personal threats: and being followed, spied on, or subject to surveillance. Women also reported higher levels of fearfulness as a consequence of stalking behaviors. Nearly half of the stalkers were clients; the remaining were former partners, colleagues, or acquaintances. In client-related cases, the majority of respondents told their colleagues and supervisors first, and the majority found them to be the most helpful resource. The results of this pilot study indicate a need for further research focused on the stalking of mental health clinicians in New Zealand and for development of workplace policies for adequate response to the stalking of mental health clinicians.

  11. Effect of Physical Therapy Students' Clinical Experiences on Clinician Productivity.

    Science.gov (United States)

    Pivko, Susan E; Abbruzzese, Laurel D; Duttaroy, Pragati; Hansen, Ruth L; Ryans, Kathryn

    2016-01-01

    Physical therapy clinical education experiences (CEEs) are difficult to secure, particularly first-level CEEs. Our purpose was to determine 1) what impact student full-time CEEs have on PT clinician productivity and 2) whether there is a productivity difference between first vs final CEEs. Productivity logs, including possible factors impacting productivity, were distributed to clinician-student pairings on first and final CEEs. Two-week baseline data (without a student) were compared to weeks 1 and 6 (with a student) for 31 logs using a 2x4 repeated-measures ANOVA. In a subset of 17 logs for CEEs 8 weeks or longer, a 2x5 repeated-measures ANOVA was performed. There was a significant increase in the number of patients seen and CPT units billed by both levels of CEEs comparing weeks 1 and 6. In the subset of CEEs, 8 weeks or longer, there was a significant increase in the number of patients treated per hour at week 6 and a trend toward a change at week 8 when compared to baseline week A. The factors selected as impacting productivity were census (59%) and staffing (32%). Physical therapy clinician-student pairings showed an overall increase in productivity during both full-time first and final level CEEs.

  12. Conflicts in the ICU: perspectives of administrators and clinicians.

    Science.gov (United States)

    Danjoux Meth, Nathalie; Lawless, Bernard; Hawryluck, Laura

    2009-12-01

    The purpose of this study is to understand conflicts in the ICU setting as experienced by clinicians and administrators and explore methods currently used to resolve such conflicts when there may be discordance between clinicians and families, caregivers or administration. Qualitative case study methodology using semi-structured interviews was used. The sample included community and academic health science centres in 16 hospitals from across the province of Ontario, Canada. A total of 42 participants including hospital administrators and ICU clinicians were interviewed. Participants were sampled purposively to ensure representation. The most common source of conflict in the ICU is a result of disagreement about the goals of treatment. Such conflicts arise between the ICU and referring teams (inter-team), among members of the ICU team (intra-team), and between the ICU team and patients' family/substitute decision-maker (SDM). Inter- and intra-team conflicts often contribute to conflicts between the ICU team and families. Various themes were identified as contributing factors that may influence conflict resolution practices as well as the various consequences and challenges of conflict situations. Limitations of current conflict resolution policies were revealed as well as suggested strategies to improve practice. There is considerable variability in dealing with conflicts in the ICU. Greater attention is needed at a systems level to support a culture aimed at prevention and resolution of conflicts to avoid increased sources of anxiety, stress and burnout.

  13. DES-TOMATO: A Knowledge Exploration System Focused On Tomato Species

    KAUST Repository

    Salhi, Adil; Negrã o, Só nia; Essack, Magbubah; Morton, Mitchell J. L.; Bougouffa, Salim; Mohamad Razali, Rozaimi; Radovanovic, Aleksandar; Marchand, Benoit; Kulmanov, Maxat; Hoehndorf, Robert; Tester, Mark A.; Bajic, Vladimir B.

    2017-01-01

    Tomato is the most economically important horticultural crop used as a model to study plant biology and particularly fruit development. Knowledge obtained from tomato research initiated improvements in tomato and, being transferrable to other such economically important crops, has led to a surge of tomato-related research and published literature. We developed DES-TOMATO knowledgebase (KB) for exploration of information related to tomato. Information exploration is enabled through terms from 26 dictionaries and combination of these terms. To illustrate the utility of DES-TOMATO, we provide several examples how one can efficiently use this KB to retrieve known or potentially novel information. DES-TOMATO is free for academic and nonprofit users and can be accessed at http://cbrc.kaust.edu.sa/des_tomato/, using any of the mainstream web browsers, including Firefox, Safari and Chrome.

  14. DES-TOMATO: A Knowledge Exploration System Focused On Tomato Species

    KAUST Repository

    Salhi, Adil

    2017-07-14

    Tomato is the most economically important horticultural crop used as a model to study plant biology and particularly fruit development. Knowledge obtained from tomato research initiated improvements in tomato and, being transferrable to other such economically important crops, has led to a surge of tomato-related research and published literature. We developed DES-TOMATO knowledgebase (KB) for exploration of information related to tomato. Information exploration is enabled through terms from 26 dictionaries and combination of these terms. To illustrate the utility of DES-TOMATO, we provide several examples how one can efficiently use this KB to retrieve known or potentially novel information. DES-TOMATO is free for academic and nonprofit users and can be accessed at http://cbrc.kaust.edu.sa/des_tomato/, using any of the mainstream web browsers, including Firefox, Safari and Chrome.

  15. UK medical students’ perceptions, attitudes, and interest toward medical leadership and clinician managers

    Directory of Open Access Journals (Sweden)

    Rouhani MJ

    2018-02-01

    Full Text Available Maral J Rouhani,1 Eleanor J Burleigh,2 Chloe Hobbis,2 Charlotte Dunford,1 Nadir I Osman,3 Christine Gan,1 Norma B Gibbons,1 Hashim U Ahmed,1,4 Saiful Miah1,5 1Department of Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK; 2Medical School, University of Sheffield, Sheffield, UK; 3Department of Urology, Royal Hallamshire Hospital, Sheffield, UK; 4Division of Surgery, Department of Surgery and Cancer, Imperial College London, London, UK; 5Division of Surgery and Interventional Science, University College London, London, UK Background: We aimed to determine UK medical students’ perceptions and attitudes and interest toward medical leadership and clinician managers. Methods: A cross-sectional study was conducted during the academic year 2015–2016. An online questionnaire was distributed to 2,349 final-year students from 10 UK medical schools. Participants were asked to complete a 5-point Likert scale on their current perceptions, attitudes, and interest toward medical leadership and clinician managers. They were also asked to self-rate their leadership competences set by the Medical Leadership Competency Framework and to rate the quality of management and leadership training they received from their medical school. Results: In total, we received 114 complete responses. Only 7.9% of respondents were in agreement (strongly agree or agree when asked whether they felt they were well informed about what a managerial position in medicine entails. When asked whether clinicians should influence managerial decisions within a clinical setting, 94.7% of respondents were in agreement with the statement. About 85% of respondents were in agreement that it is important for clinicians to have managerial or leadership responsibilities, with 63.2% of students in agreement that they would have liked more management or leadership training during medical school. Over half the respondents rated their management and leadership

  16. Terre des hommes

    CERN Multimedia

    Staff Association

    2012-01-01

    Transformez votre téléphone portable en geste de solidarité ! Collecte du 12 au 23 novembre 2012   Faites un geste simple et utile en déposant vos téléphones portables inutilisés dans les urnes installées dans les trois restaurants du CERN. En Suisse, une personne change tous les 12 à 18 mois de téléphone portable. La plupart de nos vieux appareils sont simplement laissés à l’abandon avec comme seule fonction de parer une éventuelle panne à venir. On  estime ainsi que 8 millions de portables sont inutilisés, alors qu'entre 30 et 50% peuvent être réutilisés. L'action Solidarcomm leur offre une deuxième vie ! Terre des Hommes Suisse, dans le cadre de la campagne Solidarcomm, collecte et valorise vos téléphones inutilis&...

  17. Onlinespieler abseits des Mainstreams

    Directory of Open Access Journals (Sweden)

    Harald Baumgartlinger

    2012-12-01

    Full Text Available MMO(RPGs „Massively Multiplayer Online (Role-Playing Games“ nehmen einen Sonderstatus unter den Onlinespielen ein, welcher durch den wachsenden wirtschaftlichen Erfolg, insbesondere durch den „breakthrough hit“ (Duchenaut et al. 2006: 407 World of Warcraft (WoW, auch an Bedeutung für die Medien- und Kommunikationswissenschaft gewinnt (vgl. Inderst 2009: 15; vgl. Seifert/Jöckel 2008: 297. Der Primus des Genres, WoW, repräsentiert gemeinsam mit einigen nahezu identen Titeln insgesamt 85 Prozent der gespielten MMOGs (vgl. Williams et al. 2008: 999. Daher befasst sich auch die Mehrheit der vorliegenden Studien mit eben diesen Spielen. Neue Formen von MMO(Gs können jedoch zu ebenso neuartigen Spielerfahrungen führen und damit unterschiedliche Nutzungsmotive befriedigen (vgl. Seifert/Jöckel 2008: 309 und folglich zu einem gänzlich anderen Spielerleben führen. Während im Mainstream die kooperativen Spielerbeziehungen überwiegen, dominiert in Darkfall Online der soziale Wettbewerb. Der von Williams et al. 2008 verwendete Fragebogen diente als Rohling für die Kreation eines für die speziellen Anforderungen adaptierten Erhebungstools zur Erforschung der Spielertypologie und der Motive der Darkfall-Online-SpielerInnen. Die in der Onlinebefragung (N = 506 gesammelten Daten belegen, dass sich sowohl die Spielerdemographie, als auch die Motive der Spieler von den Mainstream MMOs unterscheiden. Zudem konnten realweltliche Eigenschaften der Spieler als signifikante Einflussfaktoren für die Spielzuwendung identifiziert werden.

  18. Gyrodactylidae et Gyrodactylose des Salmonidae

    Directory of Open Access Journals (Sweden)

    MALMBERG G.

    1993-01-01

    Full Text Available Vingt et une espèces de Gyrodactylus de Salmonidae arrangées en six groupes sont présentées. Les observations concernant ces espèces dans les milieux naturels et en pisciculture sont résumées. Sur la base de données générales relatives aux espèces de Gyrodactylus en milieu naturel en Scandinavie et Baltique, les observations biologiques, écologiques et comportementales de G. salaris Malmberg, 1957 et G. derjavini MALMBERG et MALMBERG (1987 des salmonidae sauvages des rivières norvégiennes et suédoises sont présentées. La viviparité unique, la reproduction asexuée et sexuée et le pouvoir de reproduction chez les Gyrodactylus sont développés. La Gyrodactylose à G. salaris est abordée en milieu naturel, dans les rivières norvégiennes et en pisciculture, en Suède et au Danemark. L'étude ultrastructurale des blessures causées par G. salaris ainsi que les résultats expérimentaux sur les espèces norvégiennes et canadiennes sont présentés. La distribution géographique naturelle des Salmonidae, les modifications liées à l'homme et à l'activité économique ainsi que les Salmonidae élevés sont revus. La présence de six groupes d'espèces de Gyrodactylus en Amérique du Nord et Eurasie est discutée en fonction de la distribution géographique des espèces hôtes. Il est souligné qu'une propagation intercontinentale des espèces de Gyrodactylus de Salmonidae a dû être impossible à cause de leur origine limnique d'une part et de la salinité élevée des océans atlantique et pacifique d'autre part. Les exigences micro et macro environnementales des espèces sont discutées dans les conditions naturelles et les variations saisonnières, préférendums et tolérances du parasitisme sont signalés. L'effet des conditions de pisciculture sur les espèces de Gyrocactylus sont discutées : la capacité reproductrice et de propagation ainsi que la spécificité — stricte dans la nature — peuvent être influenc

  19. Current algebra; Algebre des courants

    Energy Technology Data Exchange (ETDEWEB)

    Jacob, M [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

    1967-07-01

    The first three chapters of these lecture notes are devoted to generalities concerning current algebra. The weak currents are defined, and their main properties given (V-A hypothesis, conserved vector current, selection rules, partially conserved axial current,...). The SU (3) x SU (3) algebra of Gell-Mann is introduced, and the general properties of the non-leptonic weak Hamiltonian are discussed. Chapters 4 to 9 are devoted to some important applications of the algebra. First one proves the Adler- Weisberger formula, in two different ways, by either the infinite momentum frame, or the near-by singularities method. In the others chapters, the latter method is the only one used. The following topics are successively dealt with: semi leptonic decays of K mesons and hyperons, Kroll- Ruderman theorem, non leptonic decays of K mesons and hyperons ( {delta}I = 1/2 rule), low energy theorems concerning processes with emission (or absorption) of a pion or a photon, super-convergence sum rules, and finally, neutrino reactions. (author) [French] La premiere partie de ce cours (trois premiers chapitres), traite des generalites concernant l'algebre de courants. Apres une definition rapide des courants faibles et un rappel de leurs proprietes (hypothese V-A, conservation du courant vecteur, regles de selection, courant axial partiellement conserve,...), l'on introduit l'algebre de Gell-Mann SU (3) x SU (3), et discute les proprietes generales de l'Hamiltonien faible non leptonique. Les chapitres IV a IX sont consacres a des applications importantes de l'algebre des courants. En premier lieu l'on demontre la formule de Adler et Weisberger, par deux methodes differentes, celle dite du repere de moment infini et celle des singularites proches. Cette derniere est seule utilisee dans la suite. Puis, l'on traite successivement les problemes suivants: desintegrations semi-leptoniques des mesons K et des hyperons, theoreme de Kroll-Ruderman, desintegrations non leptoniques des mesons

  20. L’entretien des corps / Body care

    Directory of Open Access Journals (Sweden)

    Pascal Gaberel

    2008-10-01

    Full Text Available Nous analysons ici le rapport à l’alimentation d’une cohorte de 387 personnes en situation de pauvreté reconnue. Ces usagers genevois de l’aide sociale ont été interrogés par questionnaires et entretiens durant une étude à long terme. Après un examen des lois et règlements cadrant la nécessité alimentaire et d’autres sources d’information, nous explorerons la conception du bien manger des usagers. Nous la comparerons ensuite à leurs consommations hebdomadaires et aux activités alimentaires régulières : courses, préparation, consommation, invitations et sorties. Deux tiers disent, comme les mangeurs ordinaires, que bien manger c’est « manger sainement » et suivre les recommandations diététiques actuelles. Une moitié affirme suivre un régime pour raisons médicales. Un tiers des usagers de l’aide sociale définit le Bien manger comme un art de vivre ou une gastronomie qui nécessite des moyens financiers indisponibles et contrarient les régimes médicaux. Un cinquième dit respecter des prescriptions éthiques, dont l’interdit du porc ou de l’alcool, qui recoupent une tendance végétarienne et une orientation musulmane. Une personne sur vingt adopte une définition minimaliste et ascétique : bien manger c’est nourrir son corps. Comme les régimes médicaux et l’ascétisme, prescriptions et interdits vont de pair avec la loi d’Engels favorisant économie et privations, comme cela apparaît en comparant les consommations des usagers de l’aide sociale et de la population générale.This article looks at how people who live on welfare relate to nutrition, food and meals. A total of 387 French-speaking Genevan welfare recipients took part in a long term study based on questionnaires and personal interviews. After considering the place of nutrition in Welfare legislation and other sources of information available to welfare recipients, we compare their conception of "good eating" with their weekly

  1. 76 FR 78161 - Safety Zone, Brandon Road Lock and Dam to Lake Michigan Including Des Plaines River, Chicago...

    Science.gov (United States)

    2011-12-16

    ... Zone, Brandon Road Lock and Dam to Lake Michigan Including Des Plaines River, Chicago Sanitary and Ship...; Brandon Road Lock and Dam to Lake Michigan including Des Plaines River, Chicago Sanitary and Ship Canal... INFORMATION: The Coast Guard will enforce a segment of the Safety Zone; Brandon Road Lock and Dam to Lake...

  2. 75 FR 64147 - Safety Zone, Brandon Road Lock and Dam to Lake Michigan Including Des Plaines River, Chicago...

    Science.gov (United States)

    2010-10-19

    ... Zone, Brandon Road Lock and Dam to Lake Michigan Including Des Plaines River, Chicago Sanitary and Ship...; Brandon Road Lock and Dam to Lake Michigan including Des Plaines River, Chicago Ship and Sanitary Canal... . SUPPLEMENTARY INFORMATION: The Coast Guard will enforce Safety Zone, Brandon Road Lock and Dam to Lake Michigan...

  3. 76 FR 65609 - Safety Zone, Brandon Road Lock and Dam to Lake Michigan Including Des Plaines River, Chicago...

    Science.gov (United States)

    2011-10-24

    ... Road Lock and Dam to Lake Michigan Including Des Plaines River, Chicago Sanitary and Ship Canal... Lock and Dam to Lake Michigan including Des Plaines River, Chicago Sanitary and Ship Canal, Chicago... INFORMATION: The Coast Guard will enforce a segment of the Safety Zone; Brandon Road Lock and Dam to Lake...

  4. Barriers to Translation of Physical Activity into the Lung Cancer Model of Care. A Qualitative Study of Clinicians' Perspectives.

    Science.gov (United States)

    Granger, Catherine L; Denehy, Linda; Remedios, Louisa; Retica, Sarah; Phongpagdi, Pimsiri; Hart, Nicholas; Parry, Selina M

    2016-12-01

    both clinician- and healthcare system-related factors. A combined approach to target a number of these factors should be used to inform research, improve clinical services, and develop policies aiming to increase physical activity and improve survivorship outcomes for patients with lung cancer.

  5. Real-time feedback on nonverbal clinical communication. Theoretical framework and clinician acceptance of ambient visual design.

    Science.gov (United States)

    Hartzler, A L; Patel, R A; Czerwinski, M; Pratt, W; Roseway, A; Chandrasekaran, N; Back, A

    2014-01-01

    This article is part of the focus theme of Methods of Information in Medicine on "Pervasive Intelligent Technologies for Health". Effective nonverbal communication between patients and clinicians fosters both the delivery of empathic patient-centered care and positive patient outcomes. Although nonverbal skill training is a recognized need, few efforts to enhance patient-clinician communication provide visual feedback on nonverbal aspects of the clinical encounter. We describe a novel approach that uses social signal processing technology (SSP) to capture nonverbal cues in real time and to display ambient visual feedback on control and affiliation--two primary, yet distinct dimensions of interpersonal nonverbal communication. To examine the design and clinician acceptance of ambient visual feedback on nonverbal communication, we 1) formulated a model of relational communication to ground SSP and 2) conducted a formative user study using mixed methods to explore the design of visual feedback. Based on a model of relational communication, we reviewed interpersonal communication research to map nonverbal cues to signals of affiliation and control evidenced in patient-clinician interaction. Corresponding with our formulation of this theoretical framework, we designed ambient real-time visualizations that reflect variations of affiliation and control. To explore clinicians' acceptance of this visual feedback, we conducted a lab study using the Wizard-of-Oz technique to simulate system use with 16 healthcare professionals. We followed up with seven of those participants through interviews to iterate on the design with a revised visualization that addressed emergent design considerations. Ambient visual feedback on non- verbal communication provides a theoretically grounded and acceptable way to provide clinicians with awareness of their nonverbal communication style. We provide implications for the design of such visual feedback that encourages empathic patient

  6. ETUDE DE LA DISTRIBUTION DES CATIONS ECHANGEABLES

    African Journals Online (AJOL)

    SEI Joseph

    pollution. L'objectif du présent travail est l'étude de la qualité des eaux superficielles et souterraines pour évaluer le degré de pollution provenant des lixiviats de la décharge et des cours d'eaux dans lesquels les ..... Les métaux lourds dosés ont montré une pollution métallique des eaux souterraine par rapport à la norme.

  7. ETUDE DE LA DISTRIBUTION DES CATIONS ECHANGEABLES

    African Journals Online (AJOL)

    SEI Joseph

    D'autre part, à cause de la corrélation directe entre l'étendue des inondations et les quantités de poissons et de pâturages fournies par la plaine, il y a eu dégradation des ... aux changements climatiques en zone sahélienne du Cameroun. Un des objectifs de notre étude était de préciser le comportement des agriculteurs ...

  8. Prise en charge des urgences au service d'accueil des urgences ...

    African Journals Online (AJOL)

    Introduction: La prise en charge des patients dans les services d'accueil des urgences est une des meilleures vitrines d'un système de santé. En Afrique subsaharienne, la gestion des urgences se heurte à des difficultés humaines et matérielles. Le but de ce travail était d'évaluer les difficultés de prise en charge au Service ...

  9. Evaluer des études de gestion des entreprises : combiner des éléments principales avec des éléments pratiques

    NARCIS (Netherlands)

    Pennink, B.J.W.

    2002-01-01

    Evaluer la recherche de gestion demande une combinaison des critères classiques et des critères pratiques. Par cette combinaison il est possible de trouver une réponse cerrecte concernant la validité et l'effet de la recherche. Dans cet article nous allons décrire comment une combinaison des

  10. Perceptions locales de la manifestation des changements ...

    African Journals Online (AJOL)

    SARAH

    . PRPR. ERMA. DC. UD cluster 1 cluster 2. Pauvres. Riches et moyens. Figure 4. Positionnement des classes d'impacts socio-économiques des changements climatiques dans un système d'axes de l'analyse factorielle des ...

  11. Migration transnationale des Vietnamiennes en Asie | IDRC ...

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

    Souvent, cependant, les pays d'origine ne disposent pas des politiques ni des lois ayant force exécutoire qui permettraient d'assurer des pratiques d'embauche ... Women's movements in India are struggling to address problems arising from rapidly changing social relations and vulnerabilities associated with, among other ...

  12. La politique qualité de la certification des comptes publics. Le cas de la Cour des comptes

    OpenAIRE

    Portal , Marine

    2009-01-01

    This research concerns the quality of the public accounts financial audit and more specifically the quality policy of this financial audit carries out by the Cour des comptes. The context is characterized by an increase of demands concerning the quality of financial and accounting information. The accounting and budgetary reform in France, generated by the LOLF 2001, is changing deeply performance of public management and accountancy by emphasizing transparence and quality for information, tw...

  13. The clinician factor: Personality characteristics of clinicians and their impact upon clinical outcomes in the management of children and adolescents with type 1 diabetes.

    Science.gov (United States)

    Cameron, Fergus J; Russell, Ellyn; McCombe, Julia; O'Connell, Michele A; Skinner, Timothy

    2018-06-01

    The purpose of this study was to estimate clinician qualities that influence metabolic outcomes in youth with type 1 diabetes. Data were gathered over two 3 month periods in a large tertiary diabetes center (1500 patients, 8 clinicians) from patients with type 1 diabetes who received continuous care from each clinician. Data included sex, age, diabetes duration, insulin regimen, body mass index (BMI), insulin dose and episodes of severe hypoglycemia. Clinician data included target blood glucose levels, target glycated hemoglobin (HbA1c), Diabetes Attitude Scale and Big 5 Personality Inventory Scale. Mean HbA1c per clinician was the primary outcome variable. The 8 clinicians saw a total of 464 patients during the first time period, and 603 in the second time period. Lowest to highest mean HbA1c per clinician varied by 0.7%. There were small but statistically significant differences between clinicians with their patients' age at diagnosis, duration of diabetes, age, gender, treatment type and BMI SD score. After controlling for these differences, the clinician characteristics that were associated with lower mean HbA1c were having no lower limit in target HbA1c and being self-reportedly "less agreeable." The impact of these clinician attitudinal traits was equivalent to the combined effects of patient characteristics and treatment type. There was a significant variation in metabolic outcomes between treating clinicians. After controlling for patient clinical differences, clinician mean HbA1c was associated with lower limit in target HbA1c and being "less agreeable." Clinicians who were more demanding and dogmatic appeared to have better outcomes. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Aux origines des Jeux olympiques.

    Directory of Open Access Journals (Sweden)

    Isabelle Debilly

    2005-11-01

    Full Text Available Si les Jo modernes sont régulièrement sous les feux de l’actualité, soit par la répétition temporelle des Olympiades elle-même, soit par les enjeux économiques féroces qui découlent du choix des lieux, ceux de l’Antiquité sont en général cantonnés au domaine scolaire ou universitaire. Néanmoins, ils bénéficient tous les quatre ans d`un éclairage médiatique. L’ouvrage Olympie. La victoire pour les dieux est au croisement des deux domaines. En effet, écrit par un ...

  15. Romagnat – Bois des Goules

    OpenAIRE

    Leguet, Daniel

    2014-01-01

    Lien Atlas (MCC) : http://atlas.patrimoines.culture.fr/atlas/trunk/index.php?ap_theme=DOM_2.01.02&ap_bbox=3.027;45.698;3.133;45.745 La parcelle prospectée se situe sur le flanc nord du col des Goules, passage traditionnel vers l’oppidum de Gergovie, dans un profond thalweg emprunté jadis par un chemin descendant sur Romagnat. Sur la pente actuelle entièrement boisée, on trouve des sentiers récents et des pistes de motocross. C’est sur l’une de ces dernières que nous avions recueilli un poids ...

  16. Radioisotopes in sedimentology; Emploi des radioelements en sedimentologie

    Energy Technology Data Exchange (ETDEWEB)

    Courtois, G [CEA, Centre d' etudes Nucleaires de Saclay (France)

    1967-05-15

    , surface and mass labelling (with particular reference to the problem of silting), immersion and detection equipment, and problems of navigation and topographical reference points. In the section dealing with the application of the results, the problem of obtaining quantitative results is discussed and the proposed methods described. The author also refers to the current, highly commendable attempts to relate the numerous sediment transport theories to measurements carried out in situ with radioactive tracers. The author also goes into some aspects of the safety question. The methods described may also be applied to related problems of considerable importance (soil erosion, soil stabilization and the movement of sand dunes) and brief references are made to these problems. Finally, the author reviews the current possibilities of using radioisotopes in sedimentology, their limitations and the improvement which should be made in their application. Continuous turbidity measurements. Since the transport of suspended solids is generally much more significant than bed-load movement, continuous measurements are of great importance. A number of examples are given of the value of information obtained by such measurements. Measurements of this kind can be carried out by means of gauges described in the literature. The author describes the principles and operation of such gauges, giving bibliographical references. The author also shows what information concerning turbidity can be obtained by measuring the natural radioactivity of suspended sediment and compares the two methods. Other measurements. Other radioisotope techniques which may also be used in sedimentology are touched on: dating, analytical studies (either continuous analysis of core samples by means of X-ray fluorescence or the detection of trace elements by activation analysis), use of tracers, for example for the study of particle movements when affected by freezing of the soil or for the study of the formation and

  17. Clinicians' views and experiences of offering two alternative consent pathways for participation in a preterm intrapartum trial: a qualitative study.

    Science.gov (United States)

    Chhoa, Celine Y; Sawyer, Alexandra; Ayers, Susan; Pushpa-Rajah, Angela; Duley, Lelia

    2017-04-26

    The Cord Pilot Trial compared alternative policies for timing of cord clamping at very preterm birth at eight UK hospitals. Preterm birth can be rapid and unexpected, allowing little time for the usual consent process. Therefore, in addition to the usual procedure for written consent, a two-stage pathway for consent for use when birth was imminent was developed. The aims of this study were to explore clinicians' views and experiences of offering two consent pathways for recruitment to a randomised trial of timing of cord clamping at very preterm birth. This was a qualitative study using semi-structured interviews. Clinicians from eight hospitals in the UK who had been involved in offering consent to the Cord Pilot Trial were invited to take part in an interview. Clinicians were interviewed in person or by telephone. Interviews were analysed using inductive systematic thematic analysis. Seventeen clinicians who had either offered usual written consent only (n = 6) or both the two-stage pathway (with oral assent before the birth and written consent after the birth) and usual written consent (n = 11) were interviewed. Six themes were identified: (1) team approach to offering participation; (2) consent form as a record; (3) consent and participation as a continual process; (4) different consent pathways for different trials; (5) balance between time, information, and understanding; and (6) validity of consent. Overall, clinicians were supportive of the two-stage consent pathway. Some clinicians felt that in time-critical situations oral assent presented an advantage over the usual written consent as they provided information on a "need to know" basis. However, there was some concern about how much information should be given for oral assent, and how this is understood by women when birth is imminent. The two-stage pathway for consent developed for use in the Cord Pilot Trial when birth was imminent was acceptable to clinicians for comparable low-risk studies

  18. Collaboration in a competitive healthcare system: negotiation 101 for clinicians.

    Science.gov (United States)

    Clay-Williams, Robyn; Johnson, Andrew; Lane, Paul; Li, Zhicheng; Camilleri, Lauren; Winata, Teresa; Klug, Michael

    2018-04-09

    Purpose The purpose of this paper is to evaluate the effectiveness of negotiation training delivered to senior clinicians, managers and executives, by exploring whether staff members implemented negotiation skills in their workplace following the training, and if so, how and when. Design/methodology/approach This is a qualitative study involving face-to-face interviews with 18 senior clinicians, managers and executives who completed a two-day intensive negotiation skills training course. Interviews were transcribed verbatim, and inductive interpretive analysis techniques were used to identify common themes. Research setting was a large tertiary care hospital and health service in regional Australia. Findings Participants generally reported positive affective and utility reactions to the training, and attempted to implement at least some of the skills in the workplace. The main enabler was provision of a Negotiation Toolkit to assist in preparing and conducting negotiations. The main barrier was lack of time to reflect on the principles and prepare for upcoming negotiations. Participants reported that ongoing skill development and retention were not adequately addressed; suggestions for improving sustainability included provision of refresher training and mentoring. Research limitations/implications Limitations include self-reported data, and interview questions positively elicited examples of training translation. Practical implications The training was well matched to participant needs, with negotiation a common and daily activity for most healthcare professionals. Implementation of the skills showed potential for improving collaboration and problem solving in the workplace. Practical examples of how the skills were used in the workplace are provided. Originality/value To the authors' knowledge, this is the first international study aimed at evaluating the effectiveness of an integrative bargaining negotiation training program targeting executives, senior

  19. Francis Jauréguiberry & Serge Proulx, Usages et enjeux des technologies de communication

    Directory of Open Access Journals (Sweden)

    Jean-Pierre Durand

    2013-03-01

    Full Text Available Ce petit ouvrage propose une très large revue de littérature sur les usages des technologies de l’information et de la communication. On peut dire que cet ouvrage est complet, en particulier parce qu’il couvre aussi la production intellectuelle du monde anglo-saxon. Il est très agréable à lire parce que les thèses y sont exposées clairement. C’est aussi un ouvrage qui reprend l’historique des usages des TIC et leurs analyses dans les sciences humaines. Le premier chapitre propose un cadrage t...

  20. Comparison of methods of alert acknowledgement by critical care clinicians in the ICU setting

    Directory of Open Access Journals (Sweden)

    Andrew M. Harrison

    2017-03-01

    Full Text Available Background Electronic Health Record (EHR-based sepsis alert systems have failed to demonstrate improvements in clinically meaningful endpoints. However, the effect of implementation barriers on the success of new sepsis alert systems is rarely explored. Objective To test the hypothesis time to severe sepsis alert acknowledgement by critical care clinicians in the ICU setting would be reduced using an EHR-based alert acknowledgement system compared to a text paging-based system. Study Design In one arm of this simulation study, real alerts for patients in the medical ICU were delivered to critical care clinicians through the EHR. In the other arm, simulated alerts were delivered through text paging. The primary outcome was time to alert acknowledgement. The secondary outcomes were a structured, mixed quantitative/qualitative survey and informal group interview. Results The alert acknowledgement rate from the severe sepsis alert system was 3% (N = 148 and 51% (N = 156 from simulated severe sepsis alerts through traditional text paging. Time to alert acknowledgement from the severe sepsis alert system was median 274 min (N = 5 and median 2 min (N = 80 from text paging. The response rate from the EHR-based alert system was insufficient to compare primary measures. However, secondary measures revealed important barriers. Conclusion Alert fatigue, interruption, human error, and information overload are barriers to alert and simulation studies in the ICU setting.

  1. Inter-rater Agreement of Clinicians' Treatment Recommendations Based on Modified Barium Swallow Study Reports.

    Science.gov (United States)

    Slovarp, Laurie; Danielson, Jennifer; Liss, Julie

    2018-06-07

    The modified barium swallow study (MBSS) is a commonly used radiographic procedure for diagnosis and treatment of swallowing disorders. Despite attempts by dysphagia specialists to standardize the MBSS, most institutions have not adopted such standardized procedures. High variability of assessment patterns arguably contribute to variability of treatment recommendations made from diagnostic information derived from the MBSS report. An online survey was distributed to speech-language pathologists (SLPs) participating in American Speech Language Hearing Association (ASHA) listservs. Sixty-three SLPs who treat swallowing disorders participated. Participating SLPs reviewed two MBSS reports and chose physiologic treatment targets (e.g., tongue base retraction) based on each report. One report primarily contained symptomatology (e.g., aspiration, pharyngeal residue) with minimal information on impaired physiology (e.g., laryngeal incompetence, reduced hyolaryngeal elevation/excursion). In contrast, the second report contained a clear description of impaired physiology to explain the dysphagia symptoms. Fleiss kappa coefficients were used to analyze inter-rater agreement across the high and low physiology report types. Results revealed significantly higher inter-rater agreement across clinicians when reviewing reports with clear explanation(s) of physiologic impairment relative to reports that primarily focused on symptomatology. Clinicians also reported significantly greater satisfaction and treatment confidence following review of reports with clear description(s) of impaired physiology.

  2. Are Clinicians Better Than Lay Judges at Recalling Case Details? An Evaluation of Expert Memory.

    Science.gov (United States)

    Webb, Christopher A; Keeley, Jared W; Eakin, Deborah K

    2016-04-01

    This study examined the role of expertise in clinicians' memory for case details. Clinicians' diagnostic formulations may afford mechanisms for retaining and retrieving information. Experts (N = 41; 47.6% males, 23.8% females; 28.6% did not report gender; age: mean [M] = 54.69) were members of the American Board of Professional Psychologists. Lay judges (N = 156; 25.4% males, 74.1% females; age: M = 18.85) were undergraduates enrolled in general psychology. Three vignettes were presented to each group, creating a 2 (group: expert, lay judge) x 3 (vignettes: simple, complex-coherent, complex-incoherent) mixed factorial design. Recall accuracy for vignette details was the dependent variable. Data analyses used multivariate analyses of variance to detect group differences among multiple continuous variables. Experts recalled more information than lay judges, overall. However, experts also exhibited more false memories for the complex-incoherent case because of their schema-based knowledge. This study supported clinical expertise as beneficial. Nonetheless, negative influences from experts' schema-based knowledge, as exhibited, could adversely affect clinical practices. © 2016 Wiley Periodicals, Inc.

  3. The clinician's guide to composing effective business plans.

    Science.gov (United States)

    Ettinger, Alan B; Blondell, Catherine

    2011-01-01

    In today's challenging healthcare environment, clinicians need to understand the fundamentals of financial analysis, which are the underpinnings of their clinical programs, especially when seeking administrative support for new initiatives. The business plan for new clinical program initiatives is composed of diverse elements such as the mission statement, market and competitive analyses, operations plan, and financial analysis. Armed with a basic knowledge of financial analysis of clinical programs, as well as forward-looking analysis of an initiative's added value, the healthcare provider can work much more effectively with administration in developing or creating new healthcare program initiatives.

  4. Supporting clinician educators to achieve “work-work balance”

    Directory of Open Access Journals (Sweden)

    Jerry M Maniate

    2016-10-01

    Full Text Available Clinician Educators (CE have numerous responsibilities in different professional domains, including clinical, education, research, and administration. Many CEs face tensions trying to manage these often competing professional responsibilities and achieve “work-work balance.” Rich discussions of techniques for work-work balance amongst CEs at a medical education conference inspired the authors to gather, analyze, and summarize these techniques to share with others. In this paper we present the CE’s “Four Ps”; these are practice points that support both the aspiring and established CE to help improve their performance and productivity as CEs, and allow them to approach work-work balance.

  5. Clinician-patient E-mail communication: challenges for reimbursement.

    Science.gov (United States)

    Komives, Eugenie M

    2005-01-01

    Clinicians are rapidly gaining experience with online clinician-patient consultation, and more tools are becoming available to support these efforts. In addition, we now have evidence that using electronic communication is cost-effective to payers and appealing to patients and providers. At present, there appear to be few barriers to the adoption of these solutions for practices that use other online services. Security concerns can easily be overcome by using programs described in this commentary. Larger and longer studies that evaluate the benefits and cost savings in more detail may help convince other payers and providers of the utility of the Web-based programs. More studies are needed to understand the effect of dinician-patient electronic communication on the costs of caring for chronic illness. When these solutions also include support tools, such as electronic prescribing, which could improve patient safety and quality of care, they should be encouraged. In their article entitled, "Electrons in Flight-Email between Doctors and Patients," Delbanco and Sands postulate that the future of e-communication in medicine will be integrated with a patient-controlled health record and will include secure synchronous and asynchronous communication, video conferencing and messaging, instant transcription into the written record, full-patient access to the record, translation into different languages, connectivity to multiple data sources, incorporation of multi-media educational materials. It-will also allow data from home-based diagnostic technology to be sent to clinicians. "Electronic communication will move medicine inexorably toward such transparency, enabling doctors and patients to share knowledge, responsibility, and decision-making more equally. We need to explore rapidly how this change will affect the quality of care for patients and the quality of life for doctors." The widespread dependence on Internet-based electronic communication to support a variety of

  6. November 8, 2016: The day I became a White clinician.

    Science.gov (United States)

    Bodnar, Susan

    2018-05-01

    When Donald Trump became president of the United States, I discovered that my clients who identified as Black saw me as a White clinician. With that came a host of nefarious attributions. To preserve therapeutic efficacy, and the genuine relationships with people about whom I cared, I had to distinguish myself from the president; thus, I learned not only how it feels to be seen through the bias of skin color but what I needed to do to identify as a person rather than a White person. "Welcome to my world," said one African American client. © 2018 Wiley Periodicals, Inc.

  7. Provisional materials: advances lead to extensive options for clinicians.

    Science.gov (United States)

    Comisi, John C

    2015-01-01

    The progression of provisional materials to bis-acrylics has lead to such improvements as easier handling, improved compressive and tensile strength, less water sorption, and less shrinkage. The end-result is more options for clinicians for high-quality chairside provisional restorations. Newer provisional materials are easy to manipulate and bring increased comfort to the patient. This review of current products affirms that the choices of provisional materials available for the dental professional today are quite extensive and have advanced the quality of interim restorations.

  8. Determination of the separation factor of uranium isotopes by gaseous diffusion; Determination des facteurs de separation des isotopes de l'uranium par diffusion gazeuse

    Energy Technology Data Exchange (ETDEWEB)

    Bilous, O; Counas, G [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

    1958-07-01

    A 12-stage pilot separation cascade with a low output has been constructed to measure the separation factor of uranium isotopes by gaseous diffusion. The report describes some of the separation results obtained, and also provides information on the time necessary for equilibrium to be established and on the influence of various perturbations on the pressure profile in the cascade. (author) [French] Une cascade pilote de 12 etages de separation a faible debit a ete construite pour mesurer le facteur de separation des isotopes de l'uranium par diffusion gazeuse. Le rapport decrit certains des resultats de separation obtenus et fournit egalement des donnees sur les temps de mise en equilibre et l'influence de diverses perturbations sur le profil des pressions dans la cascade. (auteur)

  9. Cardiotoxicité des psychotropes

    OpenAIRE

    TAHIRI, Abdallah

    2013-01-01

    Même à dose thérapeutique, les médicaments psychotropes sont susceptibles d'engendrer des troubles du rythme cardiaque graves avec risque létal concourant à expliquer la pré valence de la mort subite dans la population psychiatrique. Les situations cliniques à risque telles que poly médication (des psychotropes entre eux ou d'un psychotrope avec un non psychotrope allongeur de QTc), interactions médicamenteuses aussi bien pharmacodynamiques que pharmacocinétiques, traitement pa...

  10. Tombes et cimetières éthiopiens : des rois, des saints, des anonymes1

    OpenAIRE

    Derat, Marie-Laure

    2009-01-01

    L’histoire des tombes et cimetières éthiopiens, dans la longue durée, en est encore à ses balbutiements. Si les tombes des saints et des rois nous sont un peu mieux connus grâce à des textes témoignant à la fois des enjeux entourant les sépultures de ces personnages hors du commun et des soins apportés à leur inhumation, en revanche, les cimetières ordinaires échappent encore largement à l’enquête, en grande partie parce que le commun des mortels est inhumé dans l’anonymat et dans un grand dé...

  11. Application of the Moessbauer effect to the study of the structure of transition metal complexes; Applications de l'effet Mossbauer a l'etude de la structure des complexes des metaux de transition

    Energy Technology Data Exchange (ETDEWEB)

    Tsymbal, C [Commissariat a l' Energie Atomique, Grenoble (France). Centre d' Etudes Nucleaires

    1968-07-01

    In this survey, the structural investigations of transition metal complexes by the hyperfine interactions in the Moessbauer effect are described. The isomer shift provides a unique tool for estimating s electrons covalency in high spin complexes and one of the best pieces of evidence for the importance of bacle donation in low spin complexes. The electric field gradient deriving from quadrupole coupling measurements is correlated with the energy levels distribution of d orbitals in high spin complexes, whereas in low spin complexes it originates from the unbalanced d electrons. (authors) [French] Dans cette etude, nous decrivons les applications des interactions hyperfines dans l' effet Mossbauer a l'etude de la structure des complexes des metaux de transition. Le deplacement isomerique donne des informations tres utiles sur la covalence des electrons s dans les complexes a spin eleve et met en evidence d'une maniere nette l'importance du phenomene de 'bacle donation' dans les complexes a spin faible. Le gradient de champ electrique qui provient des mesures d'interaction quadripolaire est lie a la distribution des niveaux d'energie des orbitales d dans les complexes a spin eleve alors que dans les complexes a spin faible, il est provoque par des electrons d non apparies. (auteurs)

  12. Traits morphologiques des graines et vigueur des jeunes plants de ...

    African Journals Online (AJOL)

    écologique du Sénégal afin de pouvoir sélectionner une meilleure semence qui sera destinée aux programmes de développement des énergies renouvelables. Morphological traits of seeds and seedling vigor of two sources of Jatropha curcas L. in ...

  13. Traits morphologiques des graines et vigueur des jeunes plants de ...

    African Journals Online (AJOL)

    SARAH

    écologique du Sénégal afin de pouvoir sélectionner une meilleure semence qui sera destinée aux programmes de développement des énergies renouvelables. Journal of Applied Biosciences 88:8249– 8255. ISSN 1997–5902 ...

  14. Original Paper Dynamique des peuplements des Parcelles d'Essais ...

    African Journals Online (AJOL)

    permanentes (PFTP) à Bensékou visait à évaluer la dynamique de la population de ... est alors important de mettre en œuvre une sensibilisation de la population locale sur les mérites de la gestion ..... contrôle des PES se sont encore montré.

  15. Evaluation des conditions de germination des noyaux de Grewia ...

    African Journals Online (AJOL)

    personnel

    31 janv. 2014 ... 1Laboratoire de Physiologie et Production Végétales, Université Marien NGOUABI,. Faculté des Sciences et Techniques, BP.69. Brazzaville, Republique du Congo. 2Ecole Nationale Supérieure d'Agronomie et Forestérie, Université Marien NGOUABI,. BP. 69. Brazzaville, Republique du Congo.

  16. Evidence summaries (decision boxes) to prepare clinicians for shared decision-making with patients: a mixed methods implementation study.

    Science.gov (United States)

    Giguere, Anik M C; Labrecque, Michel; Haynes, R Brian; Grad, Roland; Pluye, Pierre; Légaré, France; Cauchon, Michel; Greenway, Matthew; Carmichael, Pierre-Hugues

    2014-10-05

    Decision boxes (Dboxes) provide clinicians with research evidence about management options for medical questions that have no single best answer. Dboxes fulfil a need for rapid clinical training tools to prepare clinicians for clinician-patient communication and shared decision-making. We studied the barriers and facilitators to using the Dbox information in clinical practice. We used a mixed methods study with sequential explanatory design. We recruited family physicians, residents, and nurses from six primary health-care clinics. Participants received eight Dboxes covering various questions by email (one per week). For each Dbox, they completed a web questionnaire to rate clinical relevance and cognitive impact and to assess the determinants of their intention to use what they learned from the Dbox to explain to their patients the advantages and disadvantages of the options, based on the theory of planned behaviour (TPB). Following the 8-week delivery period, we conducted focus groups with clinicians and interviews with clinic administrators to explore contextual factors influencing the use of the Dbox information. One hundred clinicians completed the web surveys. In 54% of the 496 questionnaires completed, they reported that their practice would be improved after having read the Dboxes, and in 40%, they stated that they would use this information for their patients. Of those who would use the information for their patients, 89% expected it would benefit their patients, especially in that it would allow the patient to make a decision more in keeping with his/her personal circumstances, values, and preferences. They intended to use the Dboxes in practice (mean 5.6±1.2, scale 1-7, with 7 being "high"), and their intention was significantly related to social norm, perceived behavioural control, and attitude according to the TPB (Pdecision aids and training in shared decision-making would facilitate the use of the Dbox information. Some participants would have liked

  17. The Texts of the Agency's Agreements with the United Nations; Texte Des Accords Conclus Entre L'Agence Et L'Organisation Des Nations Unies

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1959-10-30

    The texts of the following agreements and supplementary agreements between the Agency and the United Nations are reproduced in this document for the information of all Members of the Agency: I. A. Agreement Governing the Relationship Between the United Nations and the International Atomic Energy Agency; B. Protocol Concerning the Entry into Force of the Agreement between the United Nations and the International Atomic Energy Agency; II. Administrative Arrangement Concerning the Use of the United Nations Laissez-Passer by Officials of the International Atomic Energy Agency; and III. Agreement for the Admission of the International Atomic Energy Agency into the United Nations Joint Staff Pension Fund [French] Le texte des accords et des accords additionnels ci-apres, conclus entre l'Agence et l'Organisation des Nations Unies, est reproduit dans le present document pour l'information de tous les Membres de l'Agence. A.Accord regissant les relations entre l'Organisation des Nations Unies et l'Agence internationale de l'energie atomique; B.Protocole relatif a l'entree en vigueur de l'accord conclu entre l'Organisation des Nations Unies et l'Agence internationale de l'energie atomique; II.Dispositions administratives concernant l'utilisation du laissez-passer de l'Organisation des Nations Unies par les fonctionnaires de l'Agence internationale de l'energie atomique; III.Accord en vue de l'admission de l'Agence internationale de l'energie atomique a la Caisse commune des pensions du personnel des Nations Unies.

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

    Science.gov (United States)

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

    2014-12-01

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

  19. Premenstrual dysphoric disorder. A guide for the treating clinician.

    Science.gov (United States)

    Elliott, Hal

    2002-01-01

    Up to 75% of women report some premenstrual symptoms, but less than 10% have symptoms severe enough to qualify for a diagnosis of PMDD. A key to diagnosis is establishing a pattern of typical PMDD symptoms that recur during the late luteal phase of the menstrual cycle and remit after menses. Underlying psychiatric and medical disorders that might mimic PMDD should be ruled out or addressed. The clinician should recognize that severe PMS and PMDD are most likely caused by sensitivity to hormonal cycling rather than an abnormality of hormone levels. Current treatment is based on the hypothesis that serotonin depletion is responsible for the premenstrual irritability, dysphoria, and poor impulse control in PMDD. There is some evidence that GABA, endogenous opiates, allopregenolone, and various vitamins and minerals might play roles in severe PMS and PMDD. Treatment with oral contraceptives or supplementary progesterone or estrogen has not been effective. For the treating clinician, a reasonable approach to the patient with severe PMS or PMDD is shown in Table 2.

  20. Patient satisfaction with clinicians in colorectal 2-week wait clinics.

    Science.gov (United States)

    Cock, Karen; Kent, Bridie

    2017-03-23

    To determine if patient satisfaction is affected by the clinician (nurse or doctor), conducting the colorectal 2-week wait (2ww) clinics. A prospective non-randomised comparative cohort study of 339 consecutive patients (divided by blind allocation into nurse-led (n=216) and doctor-led (n=123) cohorts) conducted over a 3-month period. Patient satisfaction in both cohorts was assessed by an adapted version of the Grogan et al validated patient satisfaction questionnaire. The questionnaire was piloted first and was found to have high internal reliability (Cronbach's alpha=0.91). The study had a response rate of 78% (n=258/331) and overall satisfaction scores showed 85% (n=149/175) of patients in the nurse-led cohort and 65% (n=54/83) of patients in the doctor-led cohort strongly agreed that they were satisfied with the care they received. Mean overall satisfaction scores in the two cohorts revealed that the nurse-led cohort achieved significantly more 'strongly agree' responses than the doctor-led cohort (ppatient satisfaction was affected by the clinician conducting the 2ww clinic, in that the nurse-led cohort displayed significantly higher patient satisfaction. However, there are areas that merit further research.

  1. Eye dosimetry and protective eye wear for interventional clinicians

    International Nuclear Information System (INIS)

    Martin, C.J.; Magee, J.S.; Sandblom; Almen, A.; Lundh, C.

    2015-01-01

    Doses to the eyes of interventional clinicians can exceed 20 mSv. Various protective devices can afford protection to the eyes with the final barrier being protective eye wear. The protection provided by lead glasses is difficult to quantify, and the majority of dosimeters are not designed to be worn under lead glasses. This study has measured dose reduction factors (DRFs) equal to the ratio of the dose with no protection, divided by that when lead glasses are worn. Glasses have been tested in X-ray fields using anthropomorphic phantoms to simulate the patient and clinician. DRFs for X-rays incident from the front vary from 5.2 to 7.6, while values for orientations reminiscent of clinical practice are between 1.4 and 5.2. Results suggest that a DRF of two is a conservative factor that could be applied to personal dosimeter measurements to account for the dose reduction provided by most types of lead glasses. (authors)

  2. Strategies for research engagement of clinicians in allied health (STRETCH): a mixed methods research protocol.

    Science.gov (United States)

    Mickan, Sharon; Wenke, Rachel; Weir, Kelly; Bialocerkowski, Andrea; Noble, Christy

    2017-09-11

    Allied health professionals (AHPs) report positive attitudes to using research evidence in clinical practice, yet often lack time, confidence and skills to use, participate in and conduct research. A range of multifaceted strategies including education, mentoring and guidance have been implemented to increase AHPs' use of and participation in research. Emerging evidence suggests that knowledge brokering activities have the potential to support research engagement, but it is not clear which knowledge brokering strategies are most effective and in what contexts they work best to support and maintain clinicians' research engagement. This protocol describes an exploratory concurrent mixed methods study that is designed to understand how allied health research fellows use knowledge brokering strategies within tailored evidence-based interventions, to facilitate research engagement by allied health clinicians. Simultaneously, a realist approach will guide a systematic process evaluation of the research fellows' pattern of use of knowledge brokering strategies within each case study to build a programme theory explaining which knowledge brokering strategies work best, in what contexts and why. Learning and behavioural theories will inform this critical explanation. An explanation of how locally tailored evidence-based interventions improve AHPs use of, participation in and leadership of research projects will be summarised and shared with all participating clinicians and within each case study. It is expected that local recommendations will be developed and shared with medical and nursing professionals in and beyond the health service, to facilitate building research capacity in a systematic and effective way. © 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.

  3. Evidence gaps in advanced cancer care: community-based clinicians' perspectives and priorities for CER.

    Science.gov (United States)

    Lowry, Sarah J; Loggers, Elizabeth T; Bowles, Erin J A; Wagner, Edward H

    2012-05-01

    Although much effort has focused on identifying national comparative effectiveness research (CER) priorities, little is known about the CER priorities of community-based practitioners treating patients with advanced cancer. CER priorities of managed care-based clinicians may be valuable as reflections of both payer and provider research interests. We conducted mixed methods interviews with 10 clinicians (5 oncologists and 5 pharmacists) at 5 health plans within the Health Maintenance Organization Cancer Research Network. We asked, "What evidence do you most wish you had when treating patients with advanced cancer" and questioned participants on their impressions and knowledge of CER and pragmatic clinical trials (PCTs). We conducted qualitative analyses to identify themes across interviews. Ninety percent of participants had heard of CER, 20% had heard of PCTs, and all rated CER/PCTs as highly relevant to patient and health plan decision making. Each participant offered between 3 and 10 research priorities. Half (49%) involved head-to-head treatment comparisons; another 20% involved comparing different schedules or dosing regimens of the same treatment. The majority included alternative outcomes to survival (eg, toxicity, quality of life, noninferiority). Participants cited several limitations to existing evidence, including lack of generalizability, funding biases, and rapid development of new treatments. Head-to-head treatment comparisons remain a major evidence need among community- based oncology clinicians, and CER/PCTs are highly valued methods to address the limitations of traditional randomized trials, answer questions of cost-effectiveness or noninferiority, and inform data-driven dialogue and decision making by all stakeholders.

  4. Managing diabetic foot infections: a survey of Australasian infectious diseases clinicians.

    Science.gov (United States)

    Commons, Robert J; Raby, Edward; Athan, Eugene; Bhally, Hasan; Chen, Sharon; Guy, Stephen; Ingram, Paul R; Lai, Katy; Lemoh, Chris; Lim, Lyn-Li; Manning, Laurens; Miyakis, Spiros; O'Reilly, Mary; Roberts, Adam; Sehu, Marjoree; Torda, Adrienne; Vicaretti, Mauro; Lazzarini, Peter A

    2018-01-01

    Diabetic foot infections (DFI) present a major morbidity, mortality and economic challenge for the tertiary health sector. However, lack of high quality evidence for specific treatment regimens for patients with DFIs may result in inconsistent management. This study aimed to identify DFI caseload proportion and patterns of clinical practice of Infectious Diseases (ID) Physicians and Trainees within Australia and New Zealand. A cross-sectional online survey of Australian and New Zealand ID Physicians and Trainees was undertaken, to estimate the overall ID caseload devoted to patients with DFIs and assess clinicians' management practices of patients with DFIs. Approximately 28% (142/499) of ID Physicians and Trainees from Australia and New Zealand responded to the survey. DFI made up 19.2% of all ID consultations. Involvement in multidisciplinary teams (MDT) was common as 77.5% (93/120) of those responding indicated their patients had access to an inpatient or outpatient MDT. Significant heterogeneity of antimicrobial treatments was reported, with 82 unique treatment regimens used by 102 respondents in one scenario and 76 unique treatment regimens used by 101 respondents in the second scenario. The duration of therapy and the choice of antibiotics for microorganisms isolated from superficial swabs also varied widely. Patients with DFIs represent a significant proportion of an ID clinician's caseload. This should be reflected in the ID training program. Large heterogeneity in practice between clinicians reflects a lack of evidence from well-designed clinical trials for patients with DFI and highlights the need for management guidelines informed by future trials.

  5. Ethics of fertility preservation for prepubertal children: should clinicians offer procedures where efficacy is largely unproven?

    Science.gov (United States)

    McDougall, Rosalind J; Gillam, Lynn; Delany, Clare; Jayasinghe, Yasmin

    2018-01-01

    Young children with cancer are treated with interventions that can have a high risk of compromising their reproductive potential. 'Fertility preservation' for children who have not yet reached puberty involves surgically removing and cryopreserving reproductive tissue prior to treatment in the expectation that strategies for the use of this tissue will be developed in the future. Fertility preservation for prepubertal children is ethically complex because the techniques largely lack proven efficacy for this age group. There is professional difference of opinion about whether it is ethical to offer such 'experimental' procedures. The question addressed in this paper is: when, if ever, is it ethically justifiable to offer fertility preservation surgery to prepubertal children? We present the ethical concerns about prepubertal fertility preservation, drawing both on existing literature and our experience discussing this issue with clinicians in clinical ethics case consultations. We argue that offering the procedure is ethically justifiable in certain circumstances. For many children, the balance of benefits and burdens is such that the procedure is ethically permissible but not ethically required; when the procedure is medically safe, it is the parents' decision to make, with appropriate information and guidance from the treating clinicians. We suggest that clinical ethics support processes are necessary to assist clinicians to engage with the ethical complexity of prepubertal fertility preservation and describe the framework that has been integrated into the pathway of care for patients and families attending the Royal Children's Hospital in Melbourne, Australia. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  6. To act or not to act: responses to electronic health record prompts by family medicine clinicians.

    Science.gov (United States)

    Zazove, Philip; McKee, Michael; Schleicher, Lauren; Green, Lee; Kileny, Paul; Rapai, Mary; Mulhem, Elie

    2017-03-01

    A major focus of health care today is a strong emphasis on improving the health and quality of care for entire patient populations. One common approach utilizes electronic clinical alerts to prompt clinicians when certain interventions are due for individual patients being seen. However, these alerts have not been consistently effective, particularly for less visible (though important) conditions such as hearing loss (HL) screening. We conducted hour-long cognitive task analysis interviews to explore how family medicine clinicians view, perceive, and use electronic clinical alerts, and to utilize this information to design a more effective alert using HL identification and referral as a model diagnosis. Four key direct barriers were identified that impeded alert use: poor standardization and formatting, time pressures in primary care, clinic workflow variations, and mental models of the condition being prompted (in this case, HL). One indirect barrier was identified: electronic health record and institution/government regulations. We identified that clinicians' mental model of the condition being prompted was probably the major barrier, though this was often expressed as time pressure. We discuss solutions to each of the 5 identified barriers, such as addressing physicians' mental models, by focusing on physicians' expertise rather than knowledge to improve their comfort when caring for patients with the conditions being prompted. To unleash the potential of electronic clinical alerts, electronic health record and health care institutions need to address some key barriers. We outline these barriers and propose solutions. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  7. Clinical Decision-Making in Community Children's Mental Health: Using Innovative Methods to Compare Clinicians With and Without Training in Evidence-Based Treatment.

    Science.gov (United States)

    Baker-Ericzén, Mary J; Jenkins, Melissa M; Park, Soojin; Garland, Ann F

    2015-02-01

    Mental health professionals' decision-making practice is an area of increasing interest and importance, especially in the pediatric research and clinical communities. The present study explored the role of prior training in evidence-based treatments on clinicians' assessment and treatment formulations using case vignettes. Specifically, study aims included using the Naturalistic Decision Making (NDM) cognitive theory to 1) examine potential associations between EBT training and decision-making processes (novice versus expert type), and 2) explore how client and family contextual information affects clinical decision-making. Forty-eight clinicians across two groups (EBT trained=14, Not EBT trained=34) participated. Clinicians were comparable on professional experience, demographics, and discipline. The quasi-experimental design used an analog "think aloud" method where clinicians read case vignettes about a child with disruptive behavior problems and verbalized case conceptualization and treatment planning out-loud. Responses were coded according to NDM theory. MANOVA results were significant for EBT training status such that EBT trained clinicians' displayed cognitive processes more closely aligned with "expert" decision-makers and non-EBT trained clinicians' decision processes were more similar to "novice" decision-makers, following NDM theory. Non-EBT trained clinicians assigned significantly more diagnoses, provided less detailed treatment plans and discussed fewer EBTs. Parent/family contextual information also appeared to influence decision-making. This study offers a preliminary investigation of the possible broader impacts of EBT training and potential associations with development of expert decision-making skills. Targeting clinicians' decision-making may be an important avenue to pursue within dissemination-implementation efforts in mental health practice.

  8. La maison des mathématiques

    CERN Document Server

    Villani, Cédric; Moncorgé, Vincent

    2014-01-01

    Comment travaillent les mathématiciens ? C'est peut-être en se promenant dans les couloirs de la première des " maisons des mathématiques " de France, l'institut Henri Poincaré, que l'on trouvera quelques réponses. Le mathématicien Cédric Villani et le physicien Jean-Philippe Uzan nous invitent à découvrir cette discipline et ses acteurs. Au fil des pages on suit, à travers de superbes images signées du photographe Vincent Moncorgé, la façon dont se fabrique cette science qui reste souvent mystérieuse. Toutes les dimensions, scientifique, esthétique et poétique, des mathématiques sont convoquées grâce à des regards croisés : la diversité des inspirations des chercheurs, la source de leur créativité, l'imaginaire littéraire et artistique des mathématiques, la drôle de tribu des mathématiciens. Un voyage au cœur de cette " auberge espagnole " des mathématiques, campus " à la française " accueillant des centaines de chercheurs du monde entier, devenu un lieu d'émulation et d'éc...

  9. Discharge planning for a patient with a new ostomy: best practice for clinicians.

    Science.gov (United States)

    Prinz, Anita; Colwell, Janice C; Cross, Heidi H; Mantel, Janet; Perkins, Jacqueline; Walker, Cynthia A

    2015-01-01

    A comprehensive discharge plan for a patient with a new stoma is needed to ensure the individual receives the necessary ostomy education prior to discharge. The plan should include teaching basic skills and providing information about how to manage the ostomy (ie, emptying and changing the pouch, how to order supplies, available manufacturers, dietary/fluid guidelines, potential complications, medications, and managing gas and odor), assisting with transitions in care, and providing information about resources for support and assistance. The purpose of this best practice guideline is to provide clinicians with a brief overview of the essential elements that should be included in the discharge plan to facilitate patient education and the transition of care from hospital to home.

  10. Efficacité des politiques publiques brésiliennes visant à s'attaquer à ...

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

    Ces plats font l'objet d'une vive promotion au sein des groupes à faible revenu les plus touchés par le taux d'obésité élevé. L'emballage des aliments et le marketing alimentaire ne sont encadrés par aucune règle et sont souvent considérés comme trompeurs et inadéquats sur le plan de l'information nutritionnelle.

  11. Harmonisation des méthodologies de planification et d'évaluation ...

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

    Le nouveau site Web facilitera l'enregistrement des événements démographiques afin d'améliorer l'accès aux services pour tous. Le nouveau site Web et la nouvelle bibliothèque de ressources aideront à améliorer les systèmes d'information et d'enregistrement des faits d'état civil dans les pays en développement.

  12. Capacité de recherche accrue pour améliorer la gestion des ...

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

    Le nouveau site Web facilitera l'enregistrement des événements démographiques afin d'améliorer l'accès aux services pour tous. Le nouveau site Web et la nouvelle bibliothèque de ressources aideront à améliorer les systèmes d'information et d'enregistrement des faits d'état civil dans les pays en développement.

  13. Analyse du financement de la santé et des avantages en Ouganda ...

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

    Le nouveau site Web facilitera l'enregistrement des événements démographiques afin d'améliorer l'accès aux services pour tous. Le nouveau site Web et la nouvelle bibliothèque de ressources aideront à améliorer les systèmes d'information et d'enregistrement des faits d'état civil dans les pays en développement.

  14. Un mur contre la malaria : Du nouveau dans la prévention des ...

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

    Le nouveau site Web facilitera l'enregistrement des événements démographiques afin d'améliorer l'accès aux services pour tous. Le nouveau site Web et la nouvelle bibliothèque de ressources aideront à améliorer les systèmes d'information et d'enregistrement des faits d'état civil dans les pays en développement.

  15. Kontrolle des Verwaltungsrates : eine Untersuchung der internen und externen Kontrollinstitutionen, -instrumente und -mechanismen

    OpenAIRE

    Reust, Dominik

    2014-01-01

    Eine wichtige Erkenntnis dieser Arbeit ist, dass eine effiziente und effektive Kontrolle des Verwaltungsrates nur über das Zusammenspiel der internen körperschaftlichen Kontrollinstitutionen und -instrumente mit den externen Kontrollinstitutionen und Kontrollmechanismen des Marktes erreicht wird. Die Vorschriften der VegüV betreffend transparente Entschädigungspolitik und unabhängige Stimmrechtsvertreter sowie die in der Aktienrechtsrevision angestrebte Stärkung der Informations-, Mitwirk...

  16. analyse de la variabilite des rendements du riz selon les varietes et ...

    African Journals Online (AJOL)

    ACSS

    15 févr. 2018 ... objectif, l'étude s'est basée sur une phase d'enquête basée sur un questionnaire intégré dans un Smartphone, et une autre phase d'observation, basée sur la mise en place des placettes et sous-placettes dans les champs des producteurs afin de recueillir les informations sur les pratiques culturales du riz ...

  17. Etude des erreurs d'estimation des populations par la méthode des captures successives (DeLURY, 2 captures et des captures-recaptures (PETERSEN

    Directory of Open Access Journals (Sweden)

    LAURENT M.

    1978-01-01

    Full Text Available L'estimation des populations naturelles par capture-recapture et par captures successives est souvent entachée d'erreur car, dans de nombreux cas, l'hypothèse fondamentale d'égalité des probabilités de captures pour tous les individus dans le temps et dans l'espace n'est pas respectée. Dans le cas des populations de poissons envisagés ici, les captures ont lieu par la pêche électrique. On a pu chiffrer l'ordre de grandeur des erreurs systématiques faites sur l'estimation des peuplements, en fonction des conditions particulières, biotiques et abiotiques, des différents milieux inventoriés.

  18. Reduction des effectifs ou licenciements

    CERN Multimedia

    Maiani, Luciano

    2002-01-01

    "Vous faites un amalgame entre la reduction en cours des effectifs du CERN (organisation europeenne pour la recherche nucleaire) et les economies que le laboratoire doit realiser dans les cinq ans a venir pour financer le projet de grand collisionneur de hadrons (Le Monde du 4 septembre)" (1/2 page).

  19. Les parcs des porcelainiers Haviland

    Directory of Open Access Journals (Sweden)

    Colette Chabrely

    2012-04-01

    Full Text Available Les parcs du Reynou et de Mont-Méry en Limousin, anciennes propriétés des porcelainiers Haviland, présentent l’un et l’autre un grand intérêt paysager et botanique. Dans les deux cas, l’attribution de la création est incertaine. Cet article propose pour le Reynou une analyse de documents figurés anciens permettant de préciser la chronologie des travaux du château et du parc. Pour Mont-Méry il s’agit de poser de nouveaux jalons pour une étude plus approfondie des sources et de la composition des jardins afin d’envisager de nouvelles pistes pour leur attribution.The Reynou and Mont-Méry parks near Limoges originally belonged to the city’s porcelain manufacturers, the Havilands. Both parks are of considerable interest in terms of their landscaping and their botany. In both cases, there is some uncertainty as to the identity of their designers. This article offers an analysis of the graphic representations of the Reynou park, clarifying the chronology of the creation of the château and its park. For the Mont-Méry park, the aim is to offer some guidelines for further research in the source material and on the design of the park itself, perhaps allowing for the designer to be identified.

  20. Bangalore, ville des nouvelles technologies

    Directory of Open Access Journals (Sweden)

    Clarisse Didelon

    2003-06-01

    Full Text Available Bangalore est devenue la Silicon Valley de l’Inde. Une partie de ses habitants y vit à l’occidentale mais le reste de la population souffre de la croissance spectaculaire de la ville. Face à l’insuffisance des infrastructures, Bangalore devient de moins en moins attractive pour les entreprises internationales.