Sample records for commecial practices directive

  1. Direct coercion – challenges for nursing practice

    Directory of Open Access Journals (Sweden)

    Karcz Edyta


    Full Text Available Introduction. Direct coercion is a part of medical intervention in which the patient’s autonomy as a basic human right is limited. In clinical practice, there are situations in which the use of coercion is indeed necessary to protect the patient and his/her environment against the effects of growing aggression. A very important element of action in such cases is to ensure the safety of both the patient through professional care, and of the personel executing the coercive measure.

  2. Coordinating quality practices in Direct Trade coffee

    DEFF Research Database (Denmark)

    Holland, Emil; Kjeldsen, Chris; Kerndrup, Søren


    Over the past few decades, many food niches have emerged with a specific focus on quality. In specialty coffee, micro roasters have brought about Direct Trade coffee as a way of organising an alternative around new tastes and qualities through ongoing and ‘direct’ relations to farmers...... and cooperatives. But Direct Trade also involves exporters. We ask, how do exporters and roasters work together in these new coffee relations, and what do they work on? We observe and participate in a situation where Colombian coffee exporters visit Danish roasters. They tour the roasting facilities and taste...... a number of coffees. Often, the term power is used to analyse such value chain interactions, but we argue that the term coordination better opens up these interactions for exploration and analysis. What emerges is a coordination of quality. Through touring and tasting, issues emerge and differences...

  3. Geoenvironmental practices and sustainability linkages and directions

    CERN Document Server

    Reddy, Krishna; De, Anirban; Datta, Manoj


    This volume is a compilation on issues related to sustainable practices in geo-environmental engineering, particularly as applying to developing nations such as India. While, the developed world has already developed some solutions such as landfills, developments in landfills, barriers and liners in the North America and waste-to-energy and waste incineration in Europe, developing countries like India are trying to figure out ways which suit the present condition without compromising the future needs and comforts. This volume presents case studies on the various problems and solutions adopted for different sites. Although a common approach for all the problems is not feasible or recommend, this collection aims to provide a compendium on the current efforts underway and to help achieve common ground for the practitioners and researchers involved. The works included here give insight to the possible development of resilient and sustainable structures (like offshore wind turbines) and energy geotechnics. The boo...

  4. Microsoft DirectAccess best practices and troubleshooting

    CERN Document Server

    Krause, Jordan


    This book covers best practices and acts as a complete guide to DirectAccess and automatic remote access.Microsoft DirectAccess Best Practices and Troubleshooting is an ideal guide for any existing or future DirectAccess administrator and system administrators who are working on Windows Server 2012. This book will also be beneficial for someone with a basic knowledge of networking and deployment of Microsoft operating systems and software who wants to learn the intricacies of DirectAccess and its interfaces.

  5. Oswer integrated health and safety standard operating practices. Directive

    International Nuclear Information System (INIS)


    The directive implements the OSWER (Office of Solid Waste and Emergency Response) Integrated Health and Safety Standards Operating Practices in conjunction with the OSHA (Occupational Safety and Health Act) Worker Protection Standards, replacing the OSWER Integrated Health and Safety Policy

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

    Directory of Open Access Journals (Sweden)

    Martha N. Hill


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

  7. Mentor-guided self-directed learning affects resident practice. (United States)

    Aho, Johnathon M; Ruparel, Raaj K; Graham, Elaina; Zendejas-Mummert, Benjamin; Heller, Stephanie F; Farley, David R; Bingener, Juliane


    Self-directed learning (SDL) can be as effective as instructor-led training. It employs less instructional resources and is potentially a more efficient educational approach. Although SDL is encouraged among residents in our surgical training program via 24-hour access to surgical task trainers and online modules, residents report that they seldom practice. We hypothesized that a mentor-guided SDL approach would improve practice habits among our residents. From 2011 to 2013, 12 postgraduate year (PGY)-2 general surgery residents participated in a 6-week minimally invasive surgery (MIS) rotation. At the start of the rotation, residents were asked to practice laparoscopic skills until they reached peak performance in at least 3 consecutive attempts at a task (individual proficiency). Trainees met with the staff surgeon at weeks 3 and 6 to evaluate progress and review a graph of their individual learning curve. All trainees subsequently completed a survey addressing their practice habits and suggestions for improvement of the curriculum. By the end of the rotation, 100% of participants improved in all practiced tasks (p mentor-guided SDL. Additionally, 6 (50%) residents reported that their skill level had improved relative to their peers. Some residents (n = 3) felt that the curriculum could be improved by including task-specific goals and additional practice sessions with the staff surgeon. Mentor-guided SDL stimulated surgical residents to practice with greater frequency. This repeated deliberate practice led to significantly improved MIS skills without significantly increasing the need for faculty-led instruction. Some residents preferred more discrete goal setting and increased mentor guidance. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  8. [Advance directives in clinical practice : Living will, healthcare power of attorney and care directive]. (United States)

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


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

  9. Qualitative Reasoning about Relative Directions : Computational Complexity and Practical Algorithm


    Lee, Jae Hee


    Qualitative spatial reasoning (QSR) enables cognitive agents to reason about space using abstract symbols. Among several aspects of space (e.g., topology, direction, distance) directional information is useful for agents navigating in space. Observers typically describe their environment by specifying the relative directions in which they see other objects or other people from their point of view. As such, qualitative reasoning about relative directions, i.e., determining whether a given stat...

  10. Design directions for media-supported collocated remembering practices

    NARCIS (Netherlands)

    Broekhuijsen, M.; van den Hoven, E.; Markopoulos, P.


    Since the widespread adoption of digital photography, people create many digital photos, often with the intention to use them for shared remembering. Practices around digital photography have changed along with advances in media sharing technologies such as smartphones, social media, and mobile

  11. Early Intervention Practices in China: Present Situation and Future Directions (United States)

    Hu, Xiaoyi; Yang, Xijie


    Early intervention services to young children with developmental delays in China have experienced significant growth since 1978, the beginning of the period of Reform and Opening. This article described the present situation of early intervention practices in mainland China, framed around the key components and guiding principles of Guralnick's…

  12. The Unfair Commercial Practices Directive and Vulnerable Consumers

    DEFF Research Database (Denmark)

    Trzaskowski, Jan

    the economic behaviour of consumers ‘below 1 average’ even though the practice does not meet the requirements of professional diligence. The Directive’s adoption of the European Court of Justice’s ‘average consumer’ entails that protection is generally provided only for those who are far from vulnerable......Consumer protection is deeply anchored in EU law, including the Treaty and the Charter of Fundamental Rights. This article discusses the concept of consumer vulnerability and how vulnerable consumers are protected in the context of commercial practices which is fully harmonised by the Unfair....... The Directive’s Article 5(3) concerning vulnerable consumers protects only—and to a limited extent—groups who are vulnerable due to mental or physical infirmity, age or credulity. Even though consumers make many good choices, all consumers are vulnerable in certain situations—often due to time constraints...

  13. Development of methodology and direction of practice administrative neuromarketing


    Glushchenko V.; Glushchenko I.


    Development of methodology and practical aspects of application of administrative neuromarketing acts as a subject of work, subject of article is administrative neuromarketing in the organization, in article the concept and content of administrative neuromarketing, philosophy, culture, functions, tasks and the principles of administrative neuromarketing are investigated, the technique of the logical analysis of a possibility of application of methods of administrative neuromarketing for incre...

  14. General directions and practices for management of radioactive waste

    International Nuclear Information System (INIS)

    Fioroni, M.


    The present work underlines and synthesises the essential principles, directions and methodologies developed by Industrialized Nations and by the International Organizations for management of radioactive waste of high, intermediate and low levels. It fills a gap in scientific Italian literature and represents a valid introduction to the subject. (author)

  15. The Interplay Between the Unfair Commercial Practices Directive and Codes of Conduct

    NARCIS (Netherlands)

    Charlotte Pavillon (C.M.D.S.)


    markdownabstract__Abstract__ At the heart of this paper lies the reciprocal influence between codes of conduct and the Unfair Commercial Practices Directive (UCPD). It assesses to what extent self-regulatory practice both affects and is affected by the directive. The codes' contribution to

  16. Treating Alopecia Areata: Current Practices Versus New Directions. (United States)

    Gupta, Aditya K; Carviel, Jessie; Abramovits, William


    Alopecia areata (AA) is non-scarring hair loss resulting from an autoimmune disorder. Severity varies from patchy hair loss that often spontaneously resolves to severe and chronic cases that can progress to total loss of scalp and body hair. Many treatments are available; however, the efficacy of these treatments has not been confirmed, especially in severe cases, and relapse rates are high. First-line treatment often includes corticosteroids such as intralesional or topical steroids for mild cases and systemic steroids or topical immunotherapy with diphenylcyclopropenone or squaric acid dibutylester in severe cases. Minoxidil and bimatoprost may also be recommended, usually in combination with another treatment. Ongoing research and new insights into mechanisms have led to proposals of innovative therapies. New directions include biologics targeting immune response as well as lasers and autologous platelet-rich plasma therapy. Preliminary data are encouraging, and it is hoped this research will translate into new options for the treatment of AA in the near future.

  17. Directive and non-directive food-related parenting practices: Associations between an expanded conceptualization of food-related parenting practices and child dietary intake and weight outcomes. (United States)

    Loth, K A; Friend, S; Horning, M L; Neumark-Sztainer, D; Fulkerson, J A


    This study examines associations between an expanded conceptualization of food-related parenting practices, specifically, directive and non-directive control, and child weight (BMI z-score) and dietary outcomes [Healthy Eating Index (HEI) 2010, daily servings fruits/vegetables] within a sample of parent-child dyads (8-12 years old; n = 160). Baseline data from the Healthy Home Offerings via the Mealtime Environment (HOME Plus) randomized controlled trial was used to test associations between directive and non-directive control and child dietary outcomes and weight using multiple regression analyses adjusted for parental education. Overall variance explained by directive and non-directive control constructs was also calculated. Markers of directive control included pressure-to-eat and food restriction, assessed using subscales from the Child Feeding Questionnaire; markers of non-directive control were assessed with a parental role modeling scale and a home food availability inventory in which an obesogenic home food environment score was assigned based on the types and number of unhealthful foods available within the child's home food environment. Food restriction and pressure-to-eat were positively and negatively associated with BMI z-scores, respectively, but not with dietary outcomes. An obesogenic home food environment was inversely associated with both dietary outcomes; parental role modeling of healthful eating was positively associated with both dietary outcomes. Neither non-directive behavioral construct was significantly associated with BMI z-scores. Greater total variance in BMI-z was explained by directive control; greater total variance in dietary outcomes was explained by non-directive control. Including a construct of food-related parenting practices with separate markers for directive and non-directive control should be considered for future research. These concepts address different forms of parental control and, in the present study, yielded

  18. Brachytherapy in Europe: philosophies, current practice and future directions

    International Nuclear Information System (INIS)

    Haworth, A.


    Full text: Five months sabbatical leave provided an opportunity to visit six radiotherapy centres in France, Holland and England. While brachytherapy philosophies and practices within each country were similar, there were considerable differences in attitudes between countries. The Institute Gustave Roussy, home of the Paris System and host for the French sector confirmed that the Paris System is still very much the preferred dosimetry method in this part of the world. Though their preference for low dose rate brachytherapy is still evident, high dose rate brachytherapy has found some applications but the rules of the Paris System are never far away and the words 'what about the hyperdose sleeve' are firmly implanted into this visitor's brain. The use of real time dosimetry for I-125 prostate brachytherapy at the Institute Curie (Paris) provided an interesting contrast to the standard pre and post implant dosimetry techniques commonly employed elsewhere. The two Dutch centres on the itinerary, in stark contrast to the traditional techniques seen in France, have applied the power of computers to investigate optimisation of the classic dosimetry systems and called on the analysis techniques (DVH, NTCP, TCP etc) now familiar to us all in external beam therapy. The Cookridge Hospital in England fitted somewhere between the French and Dutch centres. This centre showed how both modern and traditional techniques could be applied in an efficient way for a large variety of treatment sites. Copyright (2000) Australasian College of Physical Scientists and Engineers in Medicine

  19. Grading of direct laryngoscopy. A survey of current practice. (United States)

    Cohen, A M; Fleming, B G; Wace, J R


    One hundred and twenty anaesthetists (30 of each grade), from three separate regions, were interviewed as to how they recorded the appearance of laryngeal structures at direct laryngoscopy and about their knowledge of the commonly used numerical grading system. About two-thirds of anaesthetists surveyed (69.2%) used the numerical grading system, but of these, over half could not identify a 'grade 2' laryngoscopic appearance correctly. Of anaesthetists who did not use the numerical method, over half could not correctly state the difference between a 'grade 2' and a 'grade 3' laryngoscopic appearance. Over 40% of anaesthetists stated incorrectly that the grading should be made on the initial view, even when laryngeal pressure had been needed. Junior anaesthetists were more likely to use the numerical method of recording. The results show that there is unacceptable uncertainty and inaccuracy in the use of the numerical grading system by users as well as non-users, which makes the current routine clinical use of the numerical grading system unsatisfactory.

  20. Factors Affecting the Self-directed Learning of Students at Clinical Practice Course for Advanced Practice Nurse

    Directory of Open Access Journals (Sweden)

    Miyoung Kim, RN, PhD, MBA, GNP


    Conclusions: This study demonstrated the hierarchical relationship among belongingness, self-esteem, and self-directed learning based on the conceptual framework developed by Levett-Jones and Lathlean, thus proving the usefulness of this framework for application in the field. Therefore, this study found that there are needs of high self-esteem and belongingness in order to improve self-directed learning for APN students in clinical practice.

  1. The Use of Philosophical Practice in Lifelong and Self-Directed Learning

    DEFF Research Database (Denmark)

    Hansen, Finn Thorbjørn


    In this article I invite the reader to reconsider philosophical counselling and practice first of all as a pedagogical practice. Recent research in adult education and especially in the area of "self-directed learning" reveals a growing interest in the existential and philosophical dimensions...... of learning and guidance in the adult education setting. I suggest that we use philosophical counselling to strengthen the adult´s capacity for lifelong and self-directed learning and that philosophical practice in general could be connected to a new kind of "existential adult pedagogy"....

  2. A comparison of policy and direct practice stakeholder perceptions of factors affecting evidence-based practice implementation using concept mapping. (United States)

    Green, Amy E; Aarons, Gregory A


    The goal of this study was to assess potential differences between administrators/policymakers and those involved in direct practice regarding factors believed to be barriers or facilitating factors to evidence-based practice (EBP) implementation in a large public mental health service system in the United States. Participants included mental health system county officials, agency directors, program managers, clinical staff, administrative staff, and consumers. As part of concept mapping procedures, brainstorming groups were conducted with each target group to identify specific factors believed to be barriers or facilitating factors to EBP implementation in a large public mental health system. Statements were sorted by similarity and rated by each participant in regard to their perceived importance and changeability. Multidimensional scaling, cluster analysis, descriptive statistics and t-tests were used to analyze the data. A total of 105 statements were distilled into 14 clusters using concept-mapping procedures. Perceptions of importance of factors affecting EBP implementation varied between the two groups, with those involved in direct practice assigning significantly higher ratings to the importance of Clinical Perceptions and the impact of EBP implementation on clinical practice. Consistent with previous studies, financial concerns (costs, funding) were rated among the most important and least likely to change by both groups. EBP implementation is a complex process, and different stakeholders may hold different opinions regarding the relative importance of the impact of EBP implementation. Implementation efforts must include input from stakeholders at multiple levels to bring divergent and convergent perspectives to light.

  3. How are scientific thinking skills best developed? Direct instruction vs. inquiry practice (United States)

    Dean, David Worth, Jr.

    Despite its support and adoption by most major scientific and educational organizations, some researchers have questioned whether inquiry learning is indeed the best method for acquiring the skills of inquiry. Klahr and colleagues have investigated the development of the control of variables strategy, or controlled comparison (CC), and claim that a brief session of direct instruction, characterized by explicit training of CC, as opposed to allowing children to discover CC through inquiry learning, is sufficient for acquisition, maintenance, and transfer of this core aspect of inquiry. Kuhn and colleagues, however, argue that direct instruction may be insufficient for development of the metastrategic level of understanding necessary to adequately maintain and transfer inquiry skills. In the present study, I attempt to identify the intervention most effective in supporting acquisition, maintenance, and transfer of these skills. Three groups of students received either a direct instruction session followed by standard classroom instruction (DI-only), an introductory session (without direct instruction) followed by practice sessions only (PR-only), or a direct instruction session followed by practice sessions (DI+PR). Practice sessions involved the use of a computer-based inquiry task requiring students to investigate the effects of five potential causal variables on an outcome. The two practice groups worked with this program during 12 sessions over nine weeks. They worked with structurally identical software programs during five weekly maintenance sessions. During this time, the DI-only group received standard classroom instruction. All groups were assessed on familiar and unfamiliar computer-based inquiry tasks at the conclusion of intervention (immediate assessment) and maintenance sessions (delayed assessment). Students in the two practice groups demonstrated improvement in an integrative measure of inquiry skill (valid intent, valid strategy, valid inference, and

  4. Study of Knowledge and Practice of Patient Self directed Care among Diabetics Patients

    Directory of Open Access Journals (Sweden)

    Z. Abedini


    Full Text Available Background and ObjectivesDiabetic patients play the main role in the management of their disease. Adequate knowledge of this disease state and self directed patient care will improve the health of these patients. Some studies have indicated a high prevalence of diabetes complication are due to the lack of knowledge of self directed patient care and practice in diabetic patient group. The objective of this study is to measure the knowledge level of self directed patient care and practice in order to evaluate their effects on improvement of diabetic patients' health in the city of Qom, Iran.MethodsIn this cross sectional study 1004 patients with diabetes participated (During year 2006. Data were collected from patients of General Hospital metabolism and endocrine research center.An interviewing method was used to asses the demographics data, history of disease, and knowledge of self directed patient care in these patients. Data were analyzed using a descriptive statistic, chi-square, and Pearson correlation coefficient, and SPSS software.ResultsOut of 1004 observed case, 154 patients were with Diabetes type I and 850 patients with Diabetes type II. The knowledge of self directed patient care and practice level of with both types of diabetes were determined to be mostly at an intermediate level. In type I diabetic patients there was a significant relation between knowledge level of self directed patient care and gender of the patients (P=0.01. Also, there was a significant correlation between practice and age (P=0.03(, and economical status (P=0.06 of the patients. In type II diabetic patients there was a significant relation between knowledge level of self directed patient care and educational level (P=0.00(, and economical status (P=0.01 of the patients. The practice level of self directed patient care was significantly related to economical status (p=0.03 in this group of patients. ConclusionThese results indicate that an increase in knowledge

  5. Practical Consideration Factors to Design Array Configuration of Direction Finding System for Airborne Signal Intelligence

    Directory of Open Access Journals (Sweden)

    Jong-Hwan Lee


    Full Text Available Airborne signal intelligence (SIGINT systems must be capable of locating radio signal sources. Direction finding (DF to support this capability is an important factor. There are some practical considerations to be taken when designing the array configuration of a DF system for airborne SIGINT systems. This paper summarizes the practical factors when designing the array configuration of the DF system for airborne SIGINT. In particular, it focuses on four areas: antenna consideration factors when installing the DF system for airborne SIGINT from a practical point of view, array configuration methods for airborne communications intelligence and electronic intelligence, and a numerical analysis to select the optimum antenna position for airborne SIGINT.

  6. Online, directed journaling in community health advanced practice nursing clinical education. (United States)

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


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

  7. Practical considerations for a second-order directional hearing aid microphone system (United States)

    Thompson, Stephen C.


    First-order directional microphone systems for hearing aids have been available for several years. Such a system uses two microphones and has a theoretical maximum free-field directivity index (DI) of 6.0 dB. A second-order microphone system using three microphones could provide a theoretical increase in free-field DI to 9.5 dB. These theoretical maximum DI values assume that the microphones have exactly matched sensitivities at all frequencies of interest. In practice, the individual microphones in the hearing aid always have slightly different sensitivities. For the small microphone separation necessary to fit in a hearing aid, these sensitivity matching errors degrade the directivity from the theoretical values, especially at low frequencies. This paper shows that, for first-order systems the directivity degradation due to sensitivity errors is relatively small. However, for second-order systems with practical microphone sensitivity matching specifications, the directivity degradation below 1 kHz is not tolerable. A hybrid order directive system is proposed that uses first-order processing at low frequencies and second-order directive processing at higher frequencies. This hybrid system is suggested as an alternative that could provide improved directivity index in the frequency regions that are important to speech intelligibility.

  8. Sports Direct to appoint full-time nurse after inquiry into employment practices. (United States)


    Retailer Sports Direct is to appoint a full-time nurse at its vast warehouse in response to concerns about health and safety. The firm was the subject of a House of Commons business, innovation and skills select committee inquiry into its employment practices.

  9. E-health applications and services for patient empowerment: Directions for best practices in the Netherlands

    NARCIS (Netherlands)

    Alpay, L.L.; Henkemans, O.B.; Otten, W.; Rövekamp, T.A.J.M.; Dumay, A.C.M.


    Objective: E-health may enable the empowerment process for patients, particularly the chronically ill. However, e-health is not always designed with the requirements of patient empowerment in mind. Drawing on evidence-based e-health studies, we propose directions for best practices to develop

  10. E-health Applications and Services for Patient Empowerment : Directions for Best Practices in The Netherlands

    NARCIS (Netherlands)

    Alpay, L.L.; Blanson Henkemans, O.; Otten, W.; Rövekamp, T.A.J.M.; Dumay, A.C.M.


    Objective: E-health may enable the empowerment process for patients, particularly the chronically ill. However, e-health is not always designed with the requirements of patient empowerment in mind. Drawing on evidence-based e-health studies, we propose directions for best practices to develop

  11. The transgenosis main directions in vegetable and melon production: theory and practice

    Directory of Open Access Journals (Sweden)

    Н. В. Лещук


    Full Text Available The article deals with priority directions of vegetable and melon plants selection. The wide varieties of alien genetic information transferring methods during the transgenic plants creation of vegetable and melon species are grounded. The essence of the new hybrids identification method as genetic engineering products: kind of cabbage, tomatoes, carrots, zucchini, lettuce seed, pea Pisum sativum, common bean, eggplant and capsicum is revealed. The transgenosis main directions of botanical taxa varieties of vegetable and melon plants on condition of the international and national practice holding are proved. The international practice of the state approbation and registration of genetically engineered structures in biological objects (plant varieties and in their processed products are studied. A monitoring about food and pharmaceutical substances based on genetically modified varieties and hybrids structures of vegetable and melon plants have been held.

  12. Challenges to implementation of advance directives of will in hospital practice. (United States)

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


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

  13. Consumption in Practice: Gift-giving as Mutual Aid in Amish Direct Homes Sales

    Directory of Open Access Journals (Sweden)

    Nao Nomura


    Full Text Available The seemingly pastoral way of Amish living, manifested in their denial of modern technology, use of the horse-and-buggy, and community-sanctioned use of solid-color dress codes, does not invoke an image of the Amish as active consumers. Based on ethnographic fieldwork conducted in Lancaster County, Pennsylvania, this paper examines Amish participation in direct home sales parties, exploring how consumer culture reflects the Amish emphasis on mutual aid, a nuanced form of gift giving with its own complex, idiosyncratic set of rites and gestures. By exploring the practices of direct home sales in Amish homes, I argue that consumption-based social events such as direct home sales parties reinforce the close-knit relationship of the Amish by providing participants with opportunities to practice mutual aid in intimate social settings. Additionally, the personal nature of these parties also provides Amish women with an opportunity to socially interact with their coreligionists. In turn, this social aspect legitimizes their enthusiastic consumption activities, ultimately constituting an integral part of their religious identity.

  14. Practical colorimeter for direct measurement of microplates in enzyme immunoassay systems. (United States)

    Clem, T R; Yolken, R H


    A colorimeter capable of measuring results of enzyme-linked immunosorbent assay (ELISA) reactions directly in the wells of a microtiter plate is described. This colorimeter proved to be as accurate as a conventional spectrophotometer in assessing ELISA reactions, but had the advantage of not requiring transfer of the specimen to a separate chamber. With this colorimeter, 96 specimens can be read in approximately 5 min. A practical colorimeter such as this can make the use of ELISA tests more feasible for many laboratories.

  15. Concordance of chart and billing data with direct observation in dental practice. (United States)

    Demko, Catherine A; Victoroff, Kristin Zakariasen; Wotman, Stephen


    The commonly used methods of chart review, billing data summaries and practitioner self-reporting have not been examined for their ability to validly and reliably represent time use and service delivery in routine dental practice. A more thorough investigation of these data sources would provide insight into the appropriateness of each approach for measuring various clinical behaviors. The aim of this study was to assess the validity of commonly used methods such as dental chart review, billing data, or practitioner self-report compared with a 'gold standard' of information derived from direct observation of routine dental visits. A team of trained dental hygienists directly observed 3751 patient visits in 120 dental practices and recorded the behaviors and procedures performed by dentists and hygienists during patient contact time. Following each visit, charts and billing records were reviewed for the performed and billed procedures. Dental providers characterized their frequency of preventive service delivery through self-administered surveys. We standardized the observation and abstraction methods to obtain optimal measures from each of the multiple data sources. Multi-rater kappa coefficients were computed to monitor standardization, while sensitivity, specificity, and kappa coefficients were calculated to compare the various data sources with direct observation. Chart audits were more sensitive than billing data for all observed procedures and demonstrated higher agreement with directly observed data. Chart and billing records were not sensitive for several prevention-related tasks (oral cancer screening and oral hygiene instruction). Provider self-reports of preventive behaviors were always over-estimated compared with direct observation. Inter-method reliability kappa coefficients for 13 procedures ranged from 0.197 to 0.952. These concordance findings suggest that strengths and weaknesses of data collection sources should be considered when investigating

  16. The practical management of bleedings during treatment with direct oral anticoagulants: the emergency reversal therapy

    Directory of Open Access Journals (Sweden)

    Luca Masotti


    Full Text Available Bleeding represents the most feared complication of the new oral anticoagulants, direct oral anticoagulants (DOACs, as well as all the antithrombotic therapies. During the acute phase of bleeding in patients taking anticoagulants, restoration of an effective hemostasis represents the cornerstone of practical management. While vitamin K antagonists are effectively and promptly reversed by specific antidotes such as prothrombin complex concentrates (PCCs, fresh frozen plasma or vitamin K, it is still not clear how to manage the urgent reversal of DOACs during life-threatening or major bleedings due to the lack of specific antidotes. However, in vitro and ex vivo studies have suggested some potential strategies to reverse DOACs in clinical practice, other than general support measures that are always recommended. Activated charcoal could be used in subjects with DOAC-related bleedings presenting to the emergency department within two hours of the last oral intake. Non-activated or activated PCCs (FEIBA and recombinant activated Factor VII (raFVII seem to be the optimal strategy for urgent reversal of dabigatran, while non-activated PCCs seem to have efficacy in reversing rivaroxaban. Due to its low plasma protein binding, dabigatran could be also dialyzed in urgent cases. Clinically relevant non-major bleedings and minor bleedings should be treated with general and local measures, respectively, and, when necessary, with dose delay or drug withdrawal. In this article, the Authors describe the practical approach to bleedings occurring during DOACs treatment.

  17. On some practical implications of the recent EU-directive on radiation protection

    International Nuclear Information System (INIS)

    Tschurlovits, M


    The following practical implications of the EU 96 directive on radiation protection in Austria are discussed: Quantitative justification and optimization of the recent standards is needed. The reduction of the annual dose limit to 20 mSv will affect a very small percentage of the persons subject to monitoring. The reduction of dose limits in external exposure of the population will not be dramatic at all. The model used to set up limits for internal exposure was changed to single intake; this implies some changes in design and monitoring. The deletion of convenient figures for 'unknown' radionuclides will make environmental and release monitoring more complex without gaining a higher level of protection. (A.K.)

  18. Educating for collaborative practice: an interpretation of current achievements and thoughts for future directions. (United States)

    Hudson, Judith Nicky; Croker, Anne


    The Edinburgh Declaration, developed in 1998 as a pledge to alter the character of medical education to more effectively meet the needs of society, included a recommendation to increase the opportunity for joint learning between health and health-related professions, as part of the training for teamwork. This article acknowledges achievements since the Declaration in relation to this recommendation, using an umbrella term for the phenomenon, 'educating for collaborative practice', and presents a perspective framed as a series of questions to encourage reflection on future directions. A literature interpretation, informed by philosophical hermeneutics, was conducted using text sets comprising reports and reviews from a section of the international literature since 1988. The interpretation involved: engaging with meanings as presented in the chosen texts; making iterative returns to the texts to explore emerging understanding; and ensuring parts of our understanding from particular texts were fused with complete understanding of the texts as a whole. A lens of appreciative inquiry facilitated acknowledgement of what has been achieved, while being curious about how it could be. Interpretation of the selected literature revealed notable achievements. Areas for further consideration were identified in relation to three themes: establishing shared understanding AND purpose behind use of terminology; being a conduit AND sharing responsibility for change; exploring ways of doing things AND ensuring ongoing inclusivity. Interpreting the current literature on 'educating for collaborative practice' has generated questions for reflection on how it may be otherwise. Readers are encouraged to embrace the tensions inherent in unanswered questions, providing space for communication, initiative and diversity of thought. An ongoing dialogue with the literature is proposed, asking whether educating students for a collective identity in settings where they are learning for and with

  19. The European Working Time Directive: a practical review for surgical trainees. (United States)

    Fitzgerald, J E F; Caesar, B C


    The European Working Time Directive (EWTD) 2003/88/EC is a Union Directive laying down minimum health and safety requirements for the organisation of working time. Originally primarily intended as labour law, its progressive introduction up to full implementation for doctors-in-training in August 2009 has substantially reduced duty-hours and caused widespread concern in surgery. Detrimental effects on the continuity of patient care, reduced availability of medical staff with associated rota difficulties, and the reduction in time for training junior doctors have been widely cited. Craft-specialities such as surgery and those providing an acute service have faced particular challenges. This review offers a practical guide for surgical trainees, explaining the European regulations in the context of current terms and conditions of doctor's employment in the UK. Information is provided on protecting training, opting-out, seeking remuneration for this, and ensuring doctors and patients are protected with appropriate medical indemnity cover in place. Copyright © 2012 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  20. A framework to facilitate self-directed learning, assessment and supervision in midwifery practice: A qualitative study of supervisors' perceptions

    NARCIS (Netherlands)

    Embo, M.; Driessen, E.; Valcke, M.; Vleuten, C.P.M. van der


    BACKGROUND: Self-directed learning is an educational concept that has received increasing attention. The recent workplace literature, however, reports problems with the facilitation of self-directed learning in clinical practice. We developed the Midwifery Assessment and Feedback Instrument (MAFI)

  1. Acceleration of cardiovascular MRI using parallel imaging: basic principles, practical considerations, clinical applications and future directions

    International Nuclear Information System (INIS)

    Niendorf, T.; Sodickson, D.


    Cardiovascular Magnetic Resonance (CVMR) imaging has proven to be of clinical value for non-invasive diagnostic imaging of cardiovascular diseases. CVMR requires rapid imaging; however, the speed of conventional MRI is fundamentally limited due to its sequential approach to image acquisition, in which data points are collected one after the other in the presence of sequentially-applied magnetic field gradients and radiofrequency coils to acquire multiple data points simultaneously, and thereby to increase imaging speed and efficiency beyond the limits of purely gradient-based approaches. The resulting improvements in imaging speed can be used in various ways, including shortening long examinations, improving spatial resolution and anatomic coverage, improving temporal resolution, enhancing image quality, overcoming physiological constraints, detecting and correcting for physiologic motion, and streamlining work flow. Examples of these strategies will be provided in this review, after some of the fundamentals of parallel imaging methods now in use for cardiovascular MRI are outlined. The emphasis will rest upon basic principles and clinical state-of-the art cardiovascular MRI applications. In addition, practical aspects such as signal-to-noise ratio considerations, tailored parallel imaging protocols and potential artifacts will be discussed, and current trends and future directions will be explored. (orig.)

  2. Direct-Acting Oral Anticoagulants: Practical Considerations for Emergency Medicine Physicians

    Directory of Open Access Journals (Sweden)

    W. Frank Peacock


    Full Text Available Nonvalvular atrial fibrillation- (NVAF- related stroke and venous thromboembolism (VTE are cardiovascular diseases associated with significant morbidity and economic burden. The historical standard treatment of VTE has been the administration of parenteral heparinoid until oral warfarin therapy attains a therapeutic international normalized ratio. Warfarin has been the most common medication for stroke prevention in NVAF. Warfarin use is complicated by a narrow therapeutic window, unpredictable dose response, numerous food and drug interactions, and requirements for frequent monitoring. To overcome these disadvantages, direct-acting oral anticoagulants (DOACs—dabigatran, rivaroxaban, apixaban, and edoxaban—have been developed for the prevention of stroke or systemic embolic events (SEE in patients with NVAF and for the treatment of VTE. Advantages of DOACs include predictable pharmacokinetics, few drug-drug interactions, and low monitoring requirements. In clinical studies, DOACs are noninferior to warfarin for the prevention of NVAF-related stroke and the treatment and prevention of VTE as well as postoperative knee and hip surgery VTE prophylaxis, with decreased bleeding risks. This review addresses the practical considerations for the emergency physician in DOAC use, including dosing recommendations, laboratory monitoring, anticoagulation reversal, and cost-effectiveness. The challenges of DOACs, such as the lack of specific laboratory measurements and antidotes, are also discussed.

  3. Systematic review of dietary interventions with college students: directions for future research and practice. (United States)

    Kelly, Nichole R; Mazzeo, Suzanne E; Bean, Melanie K


    To clarify directions for research and practice, research literature evaluating nutrition and dietary interventions in college and university settings was reviewed. Systematic search of database literature. Postsecondary education. Fourteen research articles evaluating randomized controlled trials or quasi-experimental interventions targeting dietary outcomes. Diet/nutrition intake, knowledge, motivation, self-efficacy, barriers, intentions, social support, self-regulation, outcome expectations, and sales. Systematic search of 936 articles and review of 14 articles meeting search criteria. Some in-person interventions (n = 6) show promise in improving students' dietary behaviors, although changes were minimal. The inclusion of self-regulation components, including self-monitoring and goal setting, may maximize outcomes. Dietary outcomes from online interventions (n = 5) were less promising overall, although they may be more effective with a subset of college students early in their readiness to change their eating habits. Environmental approaches (n = 3) may increase the sale of healthy food by serving as visual cues-to-action. A number of intervention approaches show promise for improving college students' dietary habits. However, much of this research has methodological limitations, rendering it difficult to draw conclusions across studies and hindering dissemination efforts. Copyright © 2013 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  4. A call to improve practice concerning cultural sensitivity in advance directives: a review of the literature. (United States)

    Zager, B Sue; Yancy, Margaret


    The Patient Self Determination Act of 1990 mandates healthcare providers (HCP) to speak with patients about end-of-life preferences and advance directives (AD). HCP work with patients of varying cultures, and standard ADs do not address cultural differences. In order to understand various cultural beliefs, cultural sensitivity is important especially when discussing advance care planning (ACP). Individuals from differing ethnic backgrounds are likely to turn to their traditional norms of practice when ill or treatment choices must be made. An AD that addresses varying cultural values and beliefs was sought. A comprehensive review of the literature was conducted. Articles selected for review included qualitative and quantitative studies. The evidence was evaluated and synthesized for information related to cultural sensitivity and ADs. Three common themes emerged related to ACP discussions and culture. Healthcare provider awareness, communication, and education concerning cultural differences and ACP assisted in meeting the needs for end-of-life planning in the current era of increased globalization. Education for HCP on cultural differences and how to lead discussions promoted ACP. ADs are an essential part of health care and promote patient-centered care. (HCP) should be able to recognize differing cultural values and beliefs in order to initiate conversations about end of life. Initiating conversations about ACP can be facilitated by using open-ended questions that respect the values and beliefs of various cultures. Copyright ©2011 Sigma Theta Tau International.

  5. Highly productive mutant genotypes in barley - direct use in practice and in successive recombination

    International Nuclear Information System (INIS)

    Gustafsson, Aa.; Lundqvist, U.


    Three special cases of induced mutations in barley are discussed in this paper. They are denoted here as the Gunilla, the Pallas and the Mari cases, after the three named varieties to which the original mutants gave rise. The original mutants described represent just a small sample of the induced mutants, many of which have been tested in practice and have been further studied in basic genetics and evolutionary research. The three approved varieties have given rise to further recombination families, which also to some extent have been fused. Two of the mutant cases - Pallas and Mari - were directly useful in practice and officially approved. The third case involved a mutant of special appearance - a ''bushy type'' with an intense blue wax coating and with a supreme lodging resistance. The mutant was used in developing the Gunilla variety, which arose by recombination breeding. This variety has been highly satisfactory in further gene recombination work. A similar situation has prevailed with regard to the Pallas and Mari families arising after gene recombination, too. Up to now, the Gunilla, Pallas and Mari families include a long series of released and officially approved varieties. Several of them represent valuable agricultural contributions with wide areas of cultivation. These three mutants - with their recombination families - led to greatly increased straw stiffness and high grain production. Their phenotypic expression often corresponds to a dwarf or semidwarf description. One of the mutants - the Mari genotype - represents a group of genes and alleles which give rise to profound changes in the photoperiod (and partially also in the thermoperiod) behaviour. In fact, often even such small changes have a fundamental influence on adaptation and distribution. Data are presented analysing the property of lodging resistance with the background of plant, tiller and internode structure. A method of partial back-mutation was worked out in separating traits generally

  6. Strategic directions for developing the Australian general practice nurse role in cardiovascular disease management. (United States)

    Halcomb, Elizabeth J; Davidson, Patricia M; Yallop, Julie; Griffiths, Rhonda; Daly, John


    Practice nursing is an integral component of British and New Zealand primary care, but in Australia it remains an emerging specialty. Despite an increased focus on the Australian practice nurse role, there has been limited strategic role development, particularly relating to national health priority areas. This paper reports the third stage of a Project exploring the Australian practice nurse role in the management of cardiovascular disease (CVD). This stage involved a consensus development conference, undertaken to identify strategic, priority recommendations for practice nurse role development. 1. Practice nurses have an important role in developing systems and processes for CVD management; 2. A change in the culture of general practice is necessary to promote acceptance of nurse-led CVD management; 3. Future research needs to evaluate specific models of care, incorporating outcome measures sensitive to nursing interventions; 4. Considerable challenges exist in conducting research in general practice; and 5. Changes in funding models are necessary for widespread practice nurse role development. The shifting of funding models provides evidence to support interdisciplinary practice in Australian general practice. The time is ripe, therefore, to engage in prospective and strategic planning to inform development of the practice nurse role.

  7. Family medicine practice in Saudi Arabia: The current situation and Proposed Strategic Directions Plan 2020. (United States)

    Al-Khaldi, Yahia M; Al-Ghamdi, Essam A; Al-Mogbil, Tariq I; Al-Khashan, Hesham I


    The objectives of this study were to assess the current situation of the teaching and training of undergraduate and postgraduate programs in family medicine in KSA, assess the current practice of family medicine, and draw a roadmap to achieve Saudi vision 2020. This study was conducted with the support and collaboration of the Primary Health Care Department of the Ministry of Health, Saudi Arabia, and World Health Organization (EMRO) in November 2015. Based on the literature review of previous studies conducted for similar purposes, relevant questionnaires were developed. These consisted of four forms, each of which was directed at a different authority to achieve the above-mentioned objectives. Data of all questionnaires were coded, entered, and analyzed using SPSS version 16. There are 2282 primary health-care centers (PHCCs), 60% of which are in rural areas. More than half of the PHCCs have a laboratory and more than one-third have a Radiology Department. Out of the 6107 physicians, 636 are family physicians (10%). All medical colleges have a family medicine department with a total staff of 170 medical teachers. Thirteen departments run family medicine courses of 4-8 weeks' duration for students. Fourteen colleges have internship programs in family medicine and four colleges have postgraduate centers for family medicine (27%). There are 95 training centers for Saudi Board (Saudi Board of Family Medicine [SBFM]) and 68 centers for Saudi Diploma (Saudi Diploma of Family Medicine [SDFM]). The total number of trainers was 241, while the total trainees were 756 in SBFM and 137 in SDFM. This survey showed that there is a shortage of qualified family physicians in all health sectors in Saudi Arabia as a result of the lack of a strategic plan for the training of family physicians. A national strategic plan with specific objectives and an explicit budget are necessary to deal with this shortage and improve the quality of health-care services at PHCCs.

  8. 76 FR 39260 - Direct Investment Surveys: Alignment of Regulations With Current Practices (United States)


    ... are eliminated from the regulations are: A survey of foreign direct investment in the U.S. seafood... requirements for two surveys of new foreign direct investment in the United States. BEA suspended collection of... Enters into a Joint Venture With, a Foreign Person BE-21, Survey of Foreign Direct Investment in U.S...

  9. 76 FR 19282 - Direct Investment Surveys: Alignment of Regulations With Current Practices (United States)


    ... surveys that would be eliminated from the regulations are: a survey of foreign direct investment in the U... foreign direct investment in the United States (BE-13 and BE-14). BEA suspended collection of these... a Joint Venture With, a Foreign Person BE-21, Survey of Foreign Direct Investment in U.S. Business...

  10. Evaluating the Motivational Impact of CALL Systems: Current Practices and Future Directions (United States)

    Bodnar, Stephen; Cucchiarini, Catia; Strik, Helmer; van Hout, Roeland


    A major aim of computer-assisted language learning (CALL) is to create computer environments that facilitate students' second language (L2) acquisition. To achieve this aim, CALL employs technological innovations to create novel types of language practice. Evaluations of the new practice types serve the important role of distinguishing effective…

  11. Strength-based Supervision: Frameworks, Current Practice, and Future Directions A Wu-wei Method. (United States)

    Edwards, Jeffrey K.; Chen, Mei-Whei


    Discusses a method of counseling supervision similar to the wu-wei practice in Zen and Taoism. Suggests that this strength-based method and an understanding of isomorphy in supervisory relationships are the preferred practice for the supervision of family counselors. States that this model of supervision potentiates the person-of-the-counselor.…

  12. Direct observation of the nutrition care practices of Australian general practitioners

    Directory of Open Access Journals (Sweden)

    Ball LE


    Full Text Available INTRODUCTION: Nutrition care refers to nutrition-related advice or counselling provided by health professionals in an attempt to improve the nutrition behaviour of patients. AIM: The aim of this study was to describe the practices of a sample of Australian general practitioners (GPs when providing nutrition care to adult patients. METHODS: Eighteen GPs (13 male, 5 female were observed by fourth-year medical students during their general practice rotation. Each GP was observed for five consultations that included nutrition care, totalling 90 observed consultations. In each consultation, students completed a 31-item nutrition care checklist of nutrition care practices that could feasibly occur in a standard consultation. Each practice was marked with either a ‘yes’ (completed, ‘no’ (did not complete or ‘completed by practice nurse prior to or after the consultation’. RESULTS: Twenty-eight nutrition care practices were observed at least once. The most frequently observed practices were measuring and discussing blood pressure (76.7%; n=69, followed by general questions about current diet (74.4%; n=67. Approximately half of the consultations included a statement of a nutrition-related problem (52.2%; n=47, and the provision of nutrition advice that focused on a nutrient (45.6%; n=41 or food group (52.2%; n=47. Consultations with male GPs, as well as GPs with more than 25 years of experience, were associated with an increased number of nutrition care practices per consultation. DISCUSSION: The GPs performed nutrition care practices in varying frequencies. Further research is required to identify the most effective GP nutrition care practices to improve the nutrition behaviour of patients.

  13. Clinical Practice: Direct-to-consumer genetic testing: To test or not to ...

    African Journals Online (AJOL)

    In direct-to-consumer (DTC) genetic testing, laboratory-based genetic services are offered directly to the public without an independent healthcare professional being involved. The committee of the Southern African Society for Human Genetics (SASHG) appeals to the public and clinicians to be cautious when considering ...

  14. What institutions do: Grasping participatory practices in the water framework directive

    NARCIS (Netherlands)

    Behagel, J.H.; Arend, van der S.


    The EU Water Framework Directive (WFD) requires member states to organise public participation in the implementation of the Directive. In the Netherlands, neither the great effort put into organising such public participation in the WFD nor the numerous participatory processes that have taken place

  15. Relation of parenting styles, feeding styles and feeding practices to child overweight and obesity. Direct and moderated effects. (United States)

    Hubbs-Tait, Laura; Dickin, Katherine L; Sigman-Grant, Madeleine; Jahns, Lisa; Mobley, Amy R


    The purpose of this study was to evaluate the direct and interacting relations of parenting styles, feeding styles, and feeding practices to child overweight and obesity. Participants were 144 mothers and children under 6 years of age. Mothers completed questionnaires about parenting and feeding styles and feeding practices. Researchers weighed and measured mothers and children or obtained measurements from a recent health report. Feeding practices were not directly related to child weight status. Compared to the uninvolved feeding style, authoritative and authoritarian feeding style categories were linked to lower odds of overweight. Feeding practices interacted with authoritative and authoritarian parenting styles to predict obesity: (1) healthful modeling was associated with 61% (OR = 0.39) reduced odds of obesity in children of authoritative mothers but with 55% (OR = 1.55) increased odds in children of non-authoritative mothers and (2) covert control was linked to 156% (OR = 2.56) increased odds of obesity in children of authoritarian mothers but with 51% (OR = 0.49) decreased odds in children of non-authoritarian mothers. Healthful modeling interacted with feeding style demandingness to predict overweight and with responsiveness to predict obesity. Findings suggest the need for research and interventions on mechanisms mediating between feeding practices and obesity in families characterized by non-authoritative parenting styles. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. Agricultural practice and water quality in the Netherlands in the 1992-2002 period. Background information for the third EU Nitrate Directive Member States report

    NARCIS (Netherlands)

    Fraters B; Hotsma PH; Langenberg VT; Leeuwen TC van; Mol APA; Olsthoorn CSM; Schotten CGJ; Willems WJ; EC-LNV; RIKZ; LEI; RIZA; CBS; LDL


    This overview provides the background information for the Netherlands Member State report, 'Nitrate Directive, status and trends of aquatic environment and agricultural practice' to be submitted to the European Commission mid-2004. It documents current agricultural practice, and groundwater and

  17. Synthesis of the european national requirements and practices for recycling in HMA and WMA (DIRECT_MAT PROJECT)


    IPAVEC , Aleksander; Marsac , Paul; Mollenhauer , Konrad


    The purpose of the 2009-2011 European project DIsmantling and RECycling Techniques for road MATerials is to contribute to the waste minimization in road maintenance and construction by sharing and disseminating, at a European level, the national know-how and sustainable practices regarding the dismantling of the pavements and the recycling of the reclaimed materials. In the framework of the DIRECT_MAT subproject Asphalt materials, the present paper gives a broad overview of the European polic...

  18. Social Work Students’ Use of Knowledge in Direct Practice – Reasons, Strategies and Effects

    Directory of Open Access Journals (Sweden)


    Full Text Available This article describes a study of Swedish social work students’ use of knowledge during their field practice. Data was collected by using short written narratives, where the students reflect on situations from practice, situations they experienced as critical or problematic. The narratives were analysed with a method inspired by the interpretation theory of Paul Ricoeur. The article starts with a discussion adhering to the present trend of evidence-based social work practice. This is followed by a study of 144 narratives from social work students containing critical or problematic events. A quantitative description of the material as well as qualitative model of two type-strategies, that social work students use, is presented. The results show, among other things, that students use several forms of knowledge, where facts/evidence is one of several. The study also shows that there is a strong adaptation to varying critical situations. A conclusion is that it is difficult to a priori define the types and proportions of knowledge to use in social work practice.

  19. Integrating Theory, Research, and Practice in Vocational Psychology: Current Status and Future Directions (United States)

    Sampson, James P., Jr., Ed.; Bullock-Yowell, Emily, Ed.; Dozier, V. Casey, Ed.; Osborn, Debra S., Ed.; Lenz, Janet G., Ed.


    This publication is based on the 2016 Society for Vocational Psychology (SVP) Biennial Conference, that was held at the Florida State University on May 16-17, 2016. The conference theme was "Integrating Theory, Research, and Practice in Vocational Psychology." The conference content and the resulting edited book are based on the…

  20. Teaching Direct Practice Techniques for Work with Elders with Alzheimer's Disease: A Simulated Group Experience. (United States)

    Kane, Michael N.


    A role-play exercise about Alzheimer's disease was designed to teach group work with memory-impaired elders. Written comments from 26 social work students revealed four outcomes: demystifying practical knowledge, respect for diversity among memory-impaired individuals, increased awareness of elders' internal states, and awareness of the challenges…

  1. A Practical Teaching Course in Directed Protein Evolution Using the Green Fluorescent Protein as a Model (United States)

    Ruller, Roberto; Silva-Rocha, Rafael; Silva, Artur; Schneider, Maria Paula Cruz; Ward, Richard John


    Protein engineering is a powerful tool, which correlates protein structure with specific functions, both in applied biotechnology and in basic research. Here, we present a practical teaching course for engineering the green fluorescent protein (GFP) from "Aequorea victoria" by a random mutagenesis strategy using error-prone polymerase…

  2. Standard practice for preparation and use of direct tension stress-corrosion test specimens

    CERN Document Server

    American Society for Testing and Materials. Philadelphia


    1.1 This practice covers procedures for designing, preparing, and using ASTM standard tension test specimens for investigating susceptibility to stress-corrosion cracking. Axially loaded specimens may be stressed quantitatively with equipment for application of either a constant load, constant strain, or with a continuously increasing strain. 1.2 Tension test specimens are adaptable for testing a wide variety of product forms as well as parts joined by welding, riveting, or various other methods. 1.3 The exposure of specimens in a corrosive environment is treated only briefly because other standards are being prepared to deal with this aspect. Meanwhile, the investigator is referred to Practices G35, G36, G37, and G44, and to ASTM Special Technical Publication 425 (1).

  3. Direct access and patient/client self-referral to physiotherapy: a review of contemporary practice within the European Union. (United States)

    Bury, T J; Stokes, E K


    Direct access refers to service users being able to refer themselves to physiotherapy without a third-party referral. It represents a model of practice supported globally by the profession, growing research evidence and health policy in some health systems. To the authors' knowledge, no research has been reported to ascertain the extent to which direct access is available within the physiotherapy profession within the European Union (EU). To survey member organisations of the World Confederation for Physical Therapy (WCPT); establish the number of member states within the EU where it is possible for individuals seeking physiotherapy services to self-refer; describe the legislative/regulatory and reimbursement contexts in which physiotherapy services are delivered; examine if physiotherapy practice is different in member states where direct access is permitted compared with member states where direct access is not permitted; and to describe the barriers and facilitators to direct access perceived by member organisations of the WCPT. Cross-sectional, online survey using a purposive sample. Member organisations of the WCPT in the EU. Direct access is not available in all member states of the EU, despite the majority having legislation to regulate the profession, and entry-level education programmes that produce graduates with the requisite competencies. Key barriers perceived are those that can influence policy development, including the views of the medical profession and politicians. Support of service users and politicians, as well as professional autonomy, are seen as key facilitators. These results represent the first report of a comprehensive mapping of direct access to physiotherapy and contexts within the EU. In over half of member states, service users can self-refer to physiotherapists. These results provide insights to further individuals' understanding about the similarities and differences in working practices and service delivery factors, such as

  4. Understanding and Preventing Violence Directed against Teachers: Recommendations for a National Research, Practice, and Policy Agenda (United States)

    Espelage, Dorothy; Anderman, Eric M.; Brown, Veda Evanell; Jones, Abraham; Lane, Kathleen Lynne; McMahon, Susan D.; Reddy, Linda A.; Reynolds, Cecil R.


    Violence directed against K-12 teachers is a serious problem that demands the immediate attention of researchers, providers of teacher pre-service and in-service training, school administrators, community leaders, and policymakers. Surprisingly, little research has been conducted on this growing problem despite the broad impact teacher…

  5. Joint crisis plans and psychiatric advance directives in German psychiatric practice. (United States)

    Radenbach, Katrin; Falkai, Peter; Weber-Reich, Traudel; Simon, Alfred


    This study explores the attitude of German psychiatrists in leading positions towards joint crisis plans and psychiatric advance directives. This topic was examined by contacting 473 medical directors of German psychiatric hospitals and departments. They were asked to complete a questionnaire developed by us. That form contained questions about the incidence and acceptance of joint crisis plans and psychiatric advance directives and previous experiences with them. 108 medical directors of psychiatric hospitals and departments responded (response rate: 22.8%). Their answers demonstrate that in their hospitals these documents are rarely used. Among the respondents, joint crisis plans are more accepted than psychiatric advance directives. There is a certain uncertainty when dealing with these instruments. Our main conclusion is that German psychiatry needs an intensified discussion on the use of instruments for patients to constitute procedures for future critical psychiatric events. For this purpose it will be helpful to collect more empirical data. Furthermore, the proposal of joint crisis plans in psychiatric hospitals and departments should be discussed as well as the possibility of consulting an expert during the preparation of a psychiatric advance directive.

  6. Implementing Indigenous Education Policy Directives in Ontario Public Schools: Experiences, Challenges and Successful Practices

    Directory of Open Access Journals (Sweden)

    Emily Milne


    Full Text Available The Ontario Ministry of Education has declared a commitment to Indigenous student success and has advanced a policy framework that articulates inclusion of Indigenous content in schooling curriculum (Ontario Ministry of Education, 2007. What are the perceptions among educators and parents regarding the implementation of policy directives, and what is seen to encourage or limit meaningful implementation? To answer these questions, this article draws on interviews with 100 Indigenous (mainly Haudenosaunee, Anishinaabe, and Métis and non-Indigenous parents and educators from Ontario Canada. Policy directives are seen to benefit Indigenous and non-Indigenous students. Interviews also reveal challenges to implementing Indigenous curricular policy, such as unawareness and intimidation among non-Indigenous educators regarding how to teach material. Policy implications are considered.

  7. Newspaper advertising versus direct mail marketing in a family practice: a hands-on approach. (United States)

    Godreau, C J


    This study compares newspaper advertising and direct mail marketing to attract private patients. Newsletter advertising was distributed to 92,251 homes throughout 1991 at a cost of $20,827.13. Newspaper advertising was conducted from August 28 to October 9, 1991 at a cost of $2,261.94. The newsletter attracted 101 new patients at a cost of $206.21 per patient and a mean response rate of 0.11%. No new patients were attracted through newspaper advertising.


    Directory of Open Access Journals (Sweden)

    Cristina Aurora, Bunea-Bontaş


    Full Text Available The definition of the cost of production as applied to inventories refers to the acquisition and production cost, and its determination involves many considerations. This article emphasizes a comparative approach of the calculation of production cost under direct costing and absorption costing, and examines the impact of using these calculation systems on the financial performance of the companies presented in the income statement.

  9. Parenting Styles and Practices in Children's Obesogenic Behaviors: Scientific Gaps and Future Research Directions (United States)

    Hennessy, Erin; McSpadden, Kate; Oh, April


    Abstract Given the emerging global childhood obesity epidemic and the specter of a generation of children who will have a shorter life expectancy than that of their parents, recent research has focused on factors that influence children's weight status and obesogenic behaviors (i.e., eating, physical activity, and screen media use). Parents act as primary socializing agents for children, and thus growing evidence supports the role of parenting styles and practices in children's obesity-related behaviors and weight. Studying these processes in children and adolescents is important for several reasons. First, diet and physical activity behaviors and weight status track from childhood and adolescence into adulthood. Furthermore, diet and physical activity behaviors and weight status confer significant risk for cancer, diabetes, cardiovascular disease, and other chronic diseases. The purpose of this article is to describe the scientific gaps that need to be addressed to develop a more informed literature on parenting styles and practices in the domains of weight status and obesogenic behaviors, as identified by an expert panel assembled by the National Cancer Institute. PMID:23944926

  10. Changes in Storm Flow as a Result of Direct Seed Farming Practices on the Columbia Plateau Semiarid Croplands (United States)

    Williams, J. D.


    Mass cultivation of the prairie and shrubland-steppe on the Columbia Plateau began in the 1880's. This region is characterized by very fertile, highly erodible silt-loam soils, developed on steep slopes over Miocene basalts. Early farming practices led to excessive soil loss; lower cropland productivity, fouled in-stream habitat for andronomous and non-andronomous salmonids and eels, and deposition of sediment in first, second, and third order channels that continues to migrate down stream during storm runoff events. Sixty years of soil and water conservation efforts have slowed soil loss from fields. Presently much of the sediment moved during stormflow originates from stream bank erosion, although the annual development of rills in many fields is still observed. To quantify the continuing contribution of sediment to streams, and to evaluate the effectiveness of direct seed farming practices to soil and water conservation, four first order drainages, and one hillslope were instrumented with flumes, weirs, and storm sediment samplers. The area of instrumented drainages and hillslope were, respectfully, 25.0, 18.1, 10.0, and 6.1 ha, and a 25 percent hillslope of 1.6 ha. The 6.1 ha drainage was managed using fallow and inversion tillage practices. In October 2002, the crop stubble was fall burned and the soil was inverted using a moldboard plow; the following spring and summer the drainage was field cultivated and rod-weeded three times to control weeds and prepare the seed bed for winter wheat in October 2003. All other drainages, and the hillslope site, were farmed using direct seed technology consisting of one pass using a direct seed drill to seed and fertilize the crop, one pass to harvest the crop, one pass to break-up crop stubble, and multiple passes to spray herbicides for weed control. Total crop year precipitation for 2002-03 and 2003-04 was 10 percent lower and 15 percent higher, respectively, than the long-term average, representing typical winter

  11. ARCADO - Adding random case analysis to direct observation in workplace-based formative assessment of general practice registrars. (United States)

    Ingham, Gerard; Fry, Jennifer; Morgan, Simon; Ward, Bernadette


    Workplace-based formative assessments using consultation observation are currently conducted during the Australian general practice training program. Assessment reliability is improved by using multiple assessment methods. The aim of this study was to explore experiences of general practice medical educator assessors and registrars (trainees) when adding random case analysis to direct observation (ARCADO) during formative workplace-based assessments. A sample of general practice medical educators and matched registrars were recruited. Following the ARCADO workplace assessment, semi-structured qualitative interviews were conducted. The data was analysed thematically. Ten registrars and eight medical educators participated. Four major themes emerged - formative versus summative assessment; strengths (acceptability, flexibility, time efficiency, complementarity and authenticity); weaknesses (reduced observation and integrity risks); and contextual factors (variation in assessment content, assessment timing, registrar-medical educator relationship, medical educator's approach and registrar ability). ARCADO is a well-accepted workplace-based formative assessment perceived by registrars and assessors to be valid and flexible. The use of ARCADO enabled complementary insights that would not have been achieved with direct observation alone. Whilst there are some contextual factors to be considered in its implementation, ARCADO appears to have utility as formative assessment and, subject to further evaluation, high-stakes assessment.

  12. [Effects of Self-directed Feedback Practice using Smartphone Videos on Basic Nursing Skills, Confidence in Performance and Learning Satisfaction]. (United States)

    Lee, Seul Gi; Shin, Yun Hee


    This study was done to verify effects of a self-directed feedback practice using smartphone videos on nursing students' basic nursing skills, confidence in performance and learning satisfaction. In this study an experimental study with a post-test only control group design was used. Twenty-nine students were assigned to the experimental group and 29 to the control group. Experimental treatment was exchanging feedback on deficiencies through smartphone recorded videos of nursing practice process taken by peers during self-directed practice. Basic nursing skills scores were higher for all items in the experimental group compared to the control group, and differences were statistically significant ["Measuring vital signs" (t=-2.10, p=.039); "Wearing protective equipment when entering and exiting the quarantine room and the management of waste materials" (t=-4.74, psmartphone videos can improve basic nursing skills. The significance is that it can help nursing students gain confidence in their nursing skills for the future through improvement of basic nursing skills and performance of quality care, thus providing patients with safer care.

  13. Modeling the Longitudinal Direct and Indirect Effects of Attitudes, Self-Efficacy, and Behavioral Intentions on Practice Behavior Outcomes of Suicide Intervention Training. (United States)

    Osteen, Philip; Frey, Jodi M; Woods, MaKenna N; Ko, Jungyai; Shipe, Stacey


    The purpose of this study was to use a longitudinal path analysis to test attitudes toward suicide prevention, self-efficacy, and behavioral intentions as mediators/moderators of clinical skill development over time following suicide intervention training. Results support a direct effect of attitudes on practice behaviors and self-efficacy, but no moderating effect. Self-efficacy performed as a mediator of practice behaviors over time. Behavioral intention had a direct effect on practice behaviors and mediated the relationship between attitudes and practice behaviors. Implications for research and practice are discussed. © 2016 The American Association of Suicidology.

  14. Soil Protection in the EU According to the Directive on Industrial Emissions (IED and Croatian Practice

    Directory of Open Access Journals (Sweden)

    Ivan Pilaš


    Full Text Available Background and Purpose: Soil protection against pollution in EU is mostly covered in a new Directive on industrial emissions (IED, adopted on November 24, 2010 as a follow up of the IPPC Directive. For all industrial facilities that fall under IED, the Directive obliges the establishment of a complex system of management of contaminated soil at the national level, in order to facilitate the implementation of the principle of “polluter pays” furthermore to reduce the risk of contamination of soil and groundwater. Material and Methods: This paper presents an overview of soil management system that should be established in each EU country to fulfil IED requirements. It consists of a meta-analysis of IED requirements and current state and drawbacks of soil protection in Croatia including present state of legislation, responsibility of authorities, soil surveys and remediation activities. Results and Conclusions: IED set the obligation on the industrial operator before the start of production to prepare a report on the initial state of soil as a necessary requirement for obtaining environmental permit. It set obligations for monitoring of soil and groundwater status in the location of industrial facility for a period of ten (soil and five years (groundwater. After the cessation of production, and in the case of exceeding critical limits of pollution, the operator is obliged to perform remediation or restitution of land in the state as it was at the beginning of production. Management of contaminated soil according to IED requirements obliges the Croatian government to establish a complex multi-level system. At first it requires better definition of responsibilities between two ministries; Ministry of Environmental and Nature protection and Ministry of Agriculture. IED requires enactment of adequate legal basis (i.e. Soil protection act and the establishment of operational instruments for the implementation of soil protection, such as a register

  15. The Emotional Competitions. Theoretical Contributions for their Inclusion in the Practice of the Cuban Directives

    Directory of Open Access Journals (Sweden)

    Nureidy Betancourt-Montoya


    Full Text Available The present article has as objective to develop the concept of emotional intelligence and the competitions to her associate as an option and possible solution to achieve an effective interaction between the directive and its followers. Taking like reference the studies of about the emotional intelligence developed by Goleman established the relationship that she has with manegerial perfomance. One works resonant leader's concept so much in function of the achievement of the harmony in the personal plane as in the exchange with their subordinates.

  16. Considering "Nonlinearity" Across the Continuum in Medical Education Assessment: Supporting Theory, Practice, and Future Research Directions. (United States)

    Durning, Steven J; Lubarsky, Stuart; Torre, Dario; Dory, Valérie; Holmboe, Eric


    The purpose of this article is to propose new approaches to assessment that are grounded in educational theory and the concept of "nonlinearity." The new approaches take into account related phenomena such as "uncertainty," "ambiguity," and "chaos." To illustrate these approaches, we will use the example of assessment of clinical reasoning, although the principles we outline may apply equally well to assessment of other constructs in medical education. Theoretical perspectives include a discussion of script theory, assimilation theory, self-regulated learning theory, and situated cognition. Assessment examples to include script concordance testing, concept maps, self-regulated learning microanalytic technique, and work-based assessment, which parallel the above-stated theories, respectively, are also highlighted. We conclude with some practical suggestions for approaching nonlinearity. © 2015 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.

  17. Simulation models applied to practical learning and skill enhancement in direct and indirect ophthalmoscopy: a review

    Directory of Open Access Journals (Sweden)

    Lucas Holderegger Ricci


    Full Text Available The purpose of this review was to analyze and describe simulation methods for practical learning and training of the ophthalmoscopy exam and to organize them into specific topics relative to each principle of operation, while evaluating their preliminary results. A critical review of articles that described and evaluated simulated models for ophthalmoscopy published in the last ten years (2004-2014 was performed. One hundred articles about ophthalmology and simulation were found in national and international periodicals, but only a few discussed the examination of the posterior pole of the eye. For this study, 25 articles were considered; those articles described simulation methods, general concepts, and its actual use in ophthalmoscopy. There were many different simulation methods described, but only few articles proved their efficacy or performed a comparison between models. Review of this topic may give information for the critical analysis of the simulation devices and ideas for the development of new ones.

  18. [A new challenge in clinical practice: resistance to directly acting antivirals in hepatitis C treatment]. (United States)

    Chen, Z W; Hu, P; Ren, H


    Directly acting antivirals (DAAs) is a major treatment of hepatitis C virus (HCV) overseas. But DAAs resistance is getting more and more clinicians' attention. DAAs have not been approved in China to date, even though some of them are in clinical trials. However, a good knowledge of DAAs resistance is important on optimizing HCV treatment regimens, increasing sustained virological response (SVR) and decreasing treatment failure in clinical. In this review, DAAs resistance mechanism and virologic barrier to resistance, the prevalence of pre-existing DAAs resistance-associated variants (RAVs), the impact of RAVs on treatment outcome, the options of treatment regimens after resistance and drug resistance testing are discussed, hoping to provide some help for DAAs' standardized treatment in China in the future.

  19. Practical calibration of design data to technical capabilities of horizontal directional drilling rig (United States)

    Toropov, S. Yu; Toropov, V. S.


    In order to design more accurately trenchless pipeline passages, a technique has been developed for calculating the passage profile, based on specific parameters of the horizontal directional drilling rig, including the range of possible drilling angles and a list of compatible drill pipe sets. The algorithm for calculating the parameters of the trenchless passage profile is shown in the paper. This algorithm is based on taking into account the features of HDD technology, namely, three different stages of production. The authors take into account that the passage profile is formed at the first stage of passage construction, that is, when drilling a pilot well. The algorithm involves calculating the profile by taking into account parameters of the drill pipes used and angles of their deviation relative to each other during the pilot drilling. This approach allows us to unambiguously calibrate the designed profile for the HDD rig capabilities and the auxiliary and navigation equipment used in the construction process.

  20. Soil CO 2 fluxes from direct seeding rice fields under two tillage practices in central China (United States)

    Li, Cheng-fang; Kou, Zhi-kui; Yang, Jin-hua; Cai, Ming-li; Wang, Jin-ping; Cao, Cou-gui


    Agricultural practices affect the production and emission of carbon dioxide (CO 2) from paddy soils. It is crucial to understand the effects of tillage and N fertilization on soil CO 2 flux and its influencing factors for a better comprehension of carbon dynamics in subtropical paddy ecosystems. A 2-yr field study was conducted to assess the effects of tillage (conventional tillage [CT] and no-tillage [NT]) and N fertilization (0 and 210 kg N ha -1) on soil CO 2 fluxes during the 2008 and 2009 rice growing seasons in central China. Treatments were established following a split-plot design of a randomized complete block with tillage practices as the main plot and N fertilizer level as the split-plot treatment. The soil CO 2 fluxes were measured 24 times in 2008 and 17 times in 2009. N fertilization did not affect soil CO 2 emissions while tillage affected soil CO 2 emissions, where NT had similar soil CO 2 emissions to CT in 2008, but in 2009, NT significantly increased soil CO 2 emissions. Cumulative CO 2 emissions were 2079-2245 kg CO 2-C ha -1 from NT treatments, and 2084-2141 kg CO 2-C ha -1 from CT treatments in 2008, and were 1257-1401 kg CO 2-C ha -1 from NT treatments, and 1003-1034 kg CO 2-C ha -1 from CT treatments in 2009, respectively. Cumulative CO 2 emissions were significantly related to aboveground biomass and soil organic C. Before drainage of paddy fields, soil CO 2 fluxes were significantly related to soil temperature with correlation coefficients ( R) of 0.67-0.87 in 2008 and 0.69-0.85 in 2009; moreover, the Q 10 values ranged from 1.28 to 1.55 and from 2.10 to 5.21 in 2009, respectively. Our results suggested that NT rice production system appeared to be ineffective in decreasing carbon emission, which suggested that CO 2 emissions from integrated rice-based system should be taken into account to assess effects of tillage.

  1. Taking stock of project value creation: A structured literature review with future directions for research and practice

    DEFF Research Database (Denmark)

    Laursen, Markus; Svejvig, Per


    This paper aims to take stock of what we know about project value creation and to present future directions for research and practice. We performed an explorative and unstructured literature review, which was subsequently paired with a structured literature review. We join several research areas...... by adopting the project value creation perspective on literature relating to benefits, value, performance, and success in projects. Our review includes 111 contributions analyzed through both an inductive and deductive approach. We find that relevant literature dates back to the early 1980s, and the still...... developing value-centric view has been the subject of many publications in recent years. We contribute to research on project value creation through four directions for future research: rejuvenating value management through combining value, benefits, and costs; supplementing value creation with value capture...

  2. Medication management policy, practice and research in Australian residential aged care: Current and future directions. (United States)

    Sluggett, Janet K; Ilomäki, Jenni; Seaman, Karla L; Corlis, Megan; Bell, J Simon


    Eight percent of Australians aged 65 years and over receive residential aged care each year. Residents are increasingly older, frailer and have complex care needs on entry to residential aged care. Up to 63% of Australian residents of aged care facilities take nine or more medications regularly. Together, these factors place residents at high risk of adverse drug events. This paper reviews medication-related policies, practices and research in Australian residential aged care. Complex processes underpin prescribing, supply and administration of medications in aged care facilities. A broad range of policies and resources are available to assist health professionals, aged care facilities and residents to optimise medication management. These include national guiding principles, a standardised national medication chart, clinical medication reviews and facility accreditation standards. Recent Australian interventions have improved medication use in residential aged care facilities. Generating evidence for prescribing and deprescribing that is specific to residential aged care, health workforce reform, medication-related quality indicators and inter-professional education in aged care are important steps toward optimising medication use in this setting. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. [Advance Directives in Family Practices: Results of a Survey of GP Patients on their Care Situation]. (United States)

    Schnakenberg, Rieke; Just, Johannes; Thiessen, Vitali; Puth, Marie-Therese; Bleckwenn, Markus; Weckbecker, Klaus


    Background Advance directives (AD) are an important tool for documentation of patients' wishes and are therefore recommended to the elderly as well as patients with chronic diseases. However, there is no standardized procedure in Germany and no guideline for counseling patients who wish to write an AD with or without health care proxy. The aim of this study was to evaluate the care situation concerning the ADs and the role of the primary care physician in drafting the document Method We conducted semi-structured interviews with patients in primary care in North Rhine-Westphalia using a cross-sectional study design. Result Most of the 154 patients who were interviewed (average age: 58 years; 52% female) suffered from chronic diseases (79%), and about one-third (32%) already had an AD. Fear of "loss of autonomy" was the main reason for preparing an AD. Patients without AD were generally not opposed to the concept and named procrastination (43%) as the main reason for not having prepared one. The chance for preparing an AD increased by the factor 1.08 per life-year (Odds ratio (OR): 1.08; CI: 1.04-1.11). Patients with AD mostly got advice via the internet (22%), their primary care physicians (12%) and relatives (12%). Most patients were satisfied with their AD. Conclusion The majority of primary care patients do not make use of ADs. The primary care physicians play an important role in counseling and should motivate patients to complete ADs. Here, the establishment of quality standards would be desirable in the future. © Georg Thieme Verlag KG Stuttgart · New York.

  4. Future Directions for Dissemination and Implementation Science: Aligning Ecological Theory and Public Health to Close the Research to Practice Gap. (United States)

    Atkins, Marc S; Rusch, Dana; Mehta, Tara G; Lakind, Davielle


    Dissemination and implementation science (DI) has evolved as a major research model for children's mental health in response to a long-standing call to integrate science and practice and bridge the elusive research to practice gap. However, to address the complex and urgent needs of the most vulnerable children and families, future directions for DI require a new alignment of ecological theory and public health to provide effective, sustainable, and accessible mental health services. We present core principles of ecological theory to emphasize how contextual factors impact behavior and allow for the reciprocal impact individuals have on the settings they occupy, and an alignment of these principles with a public health model to ensure that services span the prevention to intervention continuum. We provide exemplars from our ongoing work in urban schools and a new direction for research to address the mental health needs of immigrant Latino families. Through these examples we illustrate how DI can expand its reach by embedding within natural settings to build on local capacity and indigenous resources, incorporating the local knowledge necessary to more substantively address long-standing mental health disparities. This paradigm shift for DI, away from an overemphasis on promoting program adoption, calls for fitting interventions within settings that matter most to children's healthy development and for utilizing and strengthening available community resources. In this way, we can meet the challenge of addressing our nation's mental health burden by supporting the needs and values of families and communities within their own unique social ecologies.

  5. The Impact of Therapeutic Antibodies on the Management of Digestive Diseases: History, Current Practice, and Future Directions. (United States)

    Sofia, M Anthony; Rubin, David T


    The development of therapeutic antibodies represents a revolutionary change in medical therapy for digestive diseases. Beginning with the initial studies that confirmed the pathogenicity of cytokines in inflammatory bowel disease, the development and application of therapeutic antibodies brought challenges and insights into their potential and optimal use. Infliximab was the first biological drug approved for use in Crohn's disease and ulcerative colitis. The lessons learned from infliximab include the importance of immunogenicity and the influence of pharmacokinetics on disease response and outcomes. Building on this foundation, other therapeutic antibodies achieved approval for inflammatory bowel disease and many more are in development for several digestive diseases. In this review, we reflect on the history of therapeutic antibodies and discuss current practice and future directions for the field.

  6. Resistance to changing practice from pro re nata prescriptions to patient group directions in acute mental health settings. (United States)

    Price, O; Baker, J A


    Poor practice associated with pro re nata (PRN) prescriptions in mental health is known to be common and can increase the risk of serious and potentially fatal side effects. A contributing factor to poor practice is the lack of a clear chain of accountability between the decision to prescribe and administer PRN prescriptions. To address this problem, a patient group direction (PGD) for acute behavioural disturbance (lorazepam 0.5-2 mg) and staff training materials were developed. The intention was to replace PRN prescriptions with the PGD in two mental health trusts. One of the potential benefits of this would be the removal of the contribution of PRN to high and combined dose antipsychotic prescriptions. This proposal, however, was met with significant resistance in both trusts and did not replace PRN as a result. A series of interviews and focus groups were conducted with 16 RMNs working in the two trusts, to explore the reasons why the PGD was met with resistance. Senior nurses perceived resistance to be associated with anxieties over increased responsibility for decision making. Junior nurses reported concerns regarding the medicalization of the nursing role, the paperwork associated with the PGD and the training approach used. Future efforts to implement PGDs in mental health settings must carefully consider the methods for engaging effectively with participating organizations, in terms of managing change and completing the necessary groundwork for successful implementation. © 2012 John Wiley & Sons Ltd.


    Crowell, Michael S; Dedekam, Erik A; Johnson, Michael R; Dembowski, Scott C; Westrick, Richard B; Goss, Donald L


    While advanced diagnostic imaging is a large contributor to the growth in health care costs, direct-access to physical therapy is associated with decreased rates of diagnostic imaging. No study has systematically evaluated with evidence-based criteria the appropriateness of advanced diagnostic imaging, including magnetic resonance imaging (MRI), when ordered by physical therapists. The primary purpose of this study was to describe the appropriateness of magnetic resonance imaging (MRI) or magnetic resonance arthrogram (MRA) exams ordered by physical therapists in a direct-access sports physical therapy clinic. Retrospective observational study of practice. Greater than 80% of advanced diagnostic imaging orders would have an American College of Radiology (ACR) Appropriateness Criteria rating of greater than 6, indicating an imaging order that is usually appropriate. A 2-year retrospective analysis identified 108 MRI/MRA examination orders from four physical therapists. A board-certified radiologist determined the appropriateness of each order based on ACR appropriateness criteria. The principal investigator and co-investigator radiologist assessed agreement between the clinical diagnosis and MRI/surgical findings. Knee (31%) and shoulder (25%) injuries were the most common. Overall, 55% of injuries were acute. The mean ACR rating was 7.7; scores from six to nine have been considered appropriate orders and higher ratings are better. The percentage of orders complying with ACR appropriateness criteria was 83.2%. Physical therapist's clinical diagnosis was confirmed by MRI/MRA findings in 64.8% of cases and was confirmed by surgical findings in 90% of cases. Physical therapists providing musculoskeletal primary care in a direct-access sports physical therapy clinic appropriately ordered advanced diagnostic imaging in over 80% of cases. Future research should prospectively compare physical therapist appropriateness and utilization to other groups of providers and

  8. Disability related to COPD tool (DIRECT: towards an assessment of COPD-related disability in routine practice

    Directory of Open Access Journals (Sweden)

    Aguilaniu B


    Full Text Available B Aguilaniu1, J Gonzalez-Bermejo2, A Regnault3, C Dias Barbosa3, B Arnould3, M Mueser4, G Granet5, M Bonnefoy6, T Similowski2,71HYLAB, Physiologie Clinique, Grenoble, France; 2Assistance Publique – Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Service de Pneumologie et Réanimation, Paris, France; 3Mapi Values, Lyon, France; 4Formerly Boehringer Ingelheim, Paris, France; 5General Practitioner, Sainte-Foy-lès-Lyon, Paris, France; 6Centre Hospitalier Lyon Sud, Lyon, France; 7Université Paris 6 Pierre et Marie Curie, ER10, Paris, FranceBackground: Chronic Obstructive Pulmonary Disease (COPD is a worldwide public health concern. It is also a major source of disability that is often overlooked, depriving patients of effective treatments. This study describes the development and validation of a questionnaire specifically assessing COPD-related disability.Methods: The DIsability RElated to COPD Tool (DIRECT was developed according to reference methods, including literature review, patient and clinician interviews and test in a pilot study. A 12-item questionnaire was included for finalization and validation in an observational cross-sectional study conducted by 60 French pulmonologists, who recruited 275 COPD patients of stage II, III and IV according to the GOLD classification. Rasch modeling was conducted and psychometric properties were assessed (internal consistency reliability; concurrent and clinical validity.Results: The DIRECT score was built from the 10 items retained in the Rasch model. Their internal consistency reliability was excellent (Cronbach's alpha = 0.95. The score was highly correlated with the Saint George's Respiratory Questionnaire Activity score (r = 0.83 and the London Handicap Scale (r = –0.70, a generic disability measure. It was highly statistically significantly associated to four clinical parameters (P < 0.001: GOLD classification, BODE index, FEV1 and 6-minute walk distance.Conclusion: DIRECT is a

  9. Educational outcomes associated with early immersion of second-year student pharmacists into direct patient care roles in health-system practice. (United States)

    Sanders, Kimberly A; McLaughlin, Jacqueline E; Waldron, Kayla M; Willoughby, Ian; Pinelli, Nicole R


    To assess the educational impact of engaging second professional year student pharmacists in active, direct patient care experiences in health system practice. Student pharmacists in their second professional year completed a redesigned, skill-based four-week introductory pharmacy practice experience in health system practice. The immersion consisted of experiences in both operational and clinical pharmacy environments. Students were assessed with skill development checklist assessments. Pre-post surveys were also collected. Data were analyzed using a mixed methods approach. Twenty-eight student pharmacists were included; of those, 26 completed both surveys (92.9% response rate). Survey results revealed significant increases in 81.8% of operational and 100% of clinical self-efficacy statements (psystem practice while identifying additional areas for emphasized learning. Student pharmacists engaged in early, hands-on, direct patient care experiences enhanced their skill development in operational and clinical pharmacy practice. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Social health and dementia: a European consensus on the operationalization of the concept and directions for research and practice. (United States)

    Dröes, R M; Chattat, R; Diaz, A; Gove, D; Graff, M; Murphy, K; Verbeek, H; Vernooij-Dassen, M; Clare, L; Johannessen, A; Roes, M; Verhey, F; Charras, K


    Because the pattern of illnesses changes in an aging population and many people manage to live well with chronic diseases, a group of health care professionals recently proposed reformulating the static WHO definition of health towards a dynamic one based on the ability to physically, mentally and socially adapt and self-manage. This paper is the result of a collaborative action of the INTERDEM Social Health Taskforce to operationalize this new health concept for people with dementia, more specifically the social domain, and to formulate directions for research and practice to promote social health in dementia. Based on the expertise of the Social Health Taskforce members (N = 54) three groups were formed that worked on operationalizing the three social health dimensions described by Huber et al.: (1) capacity to fulfil potential and obligations; (2) ability to manage life with some degree of independence; (3) participation in social activities. For each dimension also influencing factors, effective interventions and knowledge gaps were inventoried. After a consensus meeting, the operationalizations of the dimensions were reviewed by the European Working Group of People with Dementia (EWGPWD). The social health dimensions could be well operationalized for people with dementia and are assessed as very relevant according to the Social Health Taskforce and EWGPWD. Personal (e.g. sense of coherence, competencies), disease-related (e.g. severity of cognitive impairments, comorbidity), social (support from network, stigma) and environmental factors (e.g. enabling design, accessibility) that can influence the person with dementia's social health and many interventions promoting social health were identified. A consensus-based operationalization of social health in dementia is proposed, and factors that can influence, and interventions that improve, social health in dementia identified. Recommendations are made for research and practice.

  11. Gender Gap in Science, Technology, Engineering, and Mathematics (STEM): Current Knowledge, Implications for Practice, Policy, and Future Directions. (United States)

    Wang, Ming-Te; Degol, Jessica L


    Although the gender gap in math course-taking and performance has narrowed in recent decades, females continue to be underrepresented in math-intensive fields of Science, Technology, Engineering, and Mathematics (STEM). Career pathways encompass the ability to pursue a career as well as the motivation to employ that ability. Individual differences in cognitive capacity and motivation are also influenced by broader sociocultural factors. After reviewing research from the fields of psychology, sociology, economics, and education over the past 30 years, we summarize six explanations for US women's underrepresentation in math-intensive STEM fields: (a) cognitive ability, (b) relative cognitive strengths, (c) occupational interests or preferences, (d) lifestyle values or work-family balance preferences, (e) field-specific ability beliefs, and (f) gender-related stereotypes and biases. We then describe the potential biological and sociocultural explanations for observed gender differences on cognitive and motivational factors and demonstrate the developmental period(s) during which each factor becomes most relevant. We then propose evidence-based recommendations for policy and practice to improve STEM diversity and recommendations for future research directions.

  12. Groundwater vulnerability assessment to assist the measurement planning of the water framework directive - a practical approach with stakeholders (United States)

    Berkhoff, K.


    An evaluation scheme is presented in this paper which can be used to assess groundwater vulnerability according to the requirements of the European Water Framework Directive (WFD). The evaluation scheme results in a groundwater vulnerability map identifying areas of high, medium and low vulnerability, as necessary for the measurement planning of the WFD. The evaluation scheme is based on the definition of the vulnerability of the Intergovernmental Panel on Climate Change (IPCC). It considers exposure, sensitivity and the adaptive capacity of the region. The adaptive capacity is evaluated in an actors' platform, which was constituted for the region in the PartizipA ("Participative modelling, Actor and Ecosystem Analysis in Regions with Intensive Agriculture") project. As a result of the vulnerability assessment, 21% of the catchment area was classified as being highly vulnerable, whereas 73% has medium vulnerability and 6% has low vulnerability. Thus, a groundwater vulnerability assessment approach is presented, which can be used in practice on a catchment scale for the WFD measurement planning.

  13. Hormonal and antimicrobial therapy in theriogenology practice: currently approved drugs in the USA and possible future directions. (United States)

    Modric, T; Momcilovic, D; Gwin, W E; Peter, A T


    Hormonal and antimicrobial therapies are essential to regulate and maintain healthy reproduction in domestic animals. The appropriate and legal use of these compounds is ultimately the responsibility of the veterinarian and other users, with a primary mission to directly protect and promote the health of animals, and indirectly the health of people. The appropriate use of these products is defined by the Federal Food, Drug, and Cosmetic Act, 21 United States of America § 301 et seq and implementing regulations in the Code of Federal Regulations. In the past, use of a drug in an animal for an unapproved use violated this Act. However, passage of the Animal Medicinal Drug Use Clarification Act 1994 legalized the extra-label use of certain animal and human drugs in veterinary practice for treating diseases. This manuscript reviews currently approved hormonal and antimicrobial drugs for use in theriogenology. Considering the ever increasing knowledge in the area of veterinary reproduction, particularly in the treatment and control of reproduction using antimicrobials and hormones, it would be beneficial to widen the therapeutic options in these categories. The potential for widening the therapeutic options is also discussed in this review, by providing a non-exhaustive but essential list of potential new drugs for use in clinical animal reproduction (theriogenology). Copyright © 2011 Elsevier Inc. All rights reserved.

  14. Knowledge creation for practice in public sector management accounting by consultants and academics: Preliminary findings and directions for future research

    NARCIS (Netherlands)

    van Helden, G.J.; Aardema, H.; ter Bogt, H.J.; Groot, T.L.C.M.


    This study is about knowledge creation for practice in public sector management accounting by consultants and academics. It shows that researchers emphasize the importance of practice, but worry about the prospects of a successful cross-fertilization between practice and research, because of the

  15. Knowledge creation for practice in public sector management accounting by consultants and academics : Preliminary findings and directions for future research

    NARCIS (Netherlands)

    van Helden, G. Jan; Aardema, Harrie; ter Bogt, Henk J.; Groot, Tom L. C. M.

    This study is about knowledge creation for practice in public sector management accounting by consultants and academics. It shows that researchers emphasize the importance of practice, but worry about the prospects of a successful cross-fertilization between practice and research, because of the

  16. Child-centered versus teacher-directed teaching practices: Associations with the development of academic skills in the first grade at school


    Lerkkanen, Marja-Kristiina; Kiuru, Noona; Pakarinen, Eija; Poikkeus, Anna-Maija; Rasku-Puttonen, Helena; Siekkinen, Martti; Nurmi, Jari-Erik


    This study examined the extent to which child-centered versus teacher-directed teaching practices predicted the development of children’s reading and math skills in the first year of elementary school. In addition, we investigated whether associations between teaching practices and children’s academic skills development in Grade 1 differed among children who had low, average, or high initial academic skills at the beginning of school. The reading and math skills of 1,132 Finnish c...

  17. Investigating preventive-medicine consultations in first-opinion small-animal practice in the United Kingdom using direct observation. (United States)

    Robinson, N J; Brennan, M L; Cobb, M; Dean, R S


    Preventive-medicine consultations account for a large proportion of the veterinary caseload and previous research has suggested these consultations are fundamentally different from those in which the animal is presented for a specific health problem. There has been recent controversy around some aspects of preventive medicine for cats and dogs, and the full health benefits of the preventive-medicine consultation remain unclear. The aim of this study was to compare characteristics of the consultation and the problems discussed during the consultation between preventive-medicine consultations and other types of consultations. Data were gathered during direct observation of small-animal consultations in seven first-opinion practices in the United Kingdom. Data collected included type of clinical examination performed, patient signalment, and details of all problems discussed (including whether the problem was presenting or non-presenting, new or pre-existing, who had raised the problem, body system affected and whether an action was taken). A two-level multivariable logistic-regression model was developed, with canine and feline patients at Level 1 nested within consulting veterinary surgeons at Level 2, and a binary outcome variable of preventive-medicine consultation versus specific health-problem consultation. A total of 1807 patients were presented, of which 690 (38.2%) presented for a preventive-medicine consultation. Dogs were the most frequently presented species (n=1168; 64.6%) followed by cats (n=510; 28.2%), rabbits (n=86; 4.8%) and patients of other species (n=43; 2.4%). The five variables remaining in the multi-level model were whether multiple patients were presented, patient age, clinical examination type, weighing and number of problems discussed. Species, breed, sex, neutering status and practice did not remain in the final model. Many non-presenting problems, including both preventive-medicine problems and specific-health problems, were discussed and

  18. Integrating Public Health and Health Promotion Practice in the Medical Curriculum: A Self-Directed Team-Based Project Approach

    Directory of Open Access Journals (Sweden)

    Geraldine Kershaw


    Full Text Available Preparing health professionals in health promotion (HP and disease prevention is essential for improvement of population health, community HP, and better health care for individuals. The aim of this article is to describe an HP project in the form of a major self-directed project-based learning task integrated within the curriculum in the second year of the medical degree program at United Arab Emirates University. The project introduces students to public health and HP practice and develops students’ literature searching, writing, presentation skills, and team work. Students learn the principles underlying behavioral change, and the design of HP programs and materials, through a lecture format. Small groups of students each choose a specific health topic for their project. Over 11 weeks, students obtain information about their topic from appropriate sources (library, PubMed, Google Scholar, credible health sources such as World Health Organization. Using the principles learned in the lectures, they develop appropriate materials for their target audience: for example, posters, a pamphlet, social media content, or a video or radio message. Students seek advice from specialist faculty as needed. In week 12, each team presents their project background, rationale, and materials to their colleagues in a seminar format open to all faculty. They then submit the materials they developed for assessment. Group marks are assigned for presentations and materials. Key concepts are assessed by multiple choice questions in comprehensive course examinations. By participation in the HP project, many students develop a solid background in prevention. The information retrieval, writing, and presentation skills, as well as experience of team work, are valuable both for the remaining years of their training and their future careers.

  19. Exchange of information in the field of direct taxation in the European Union Law and in the practice of the European Court of Justice

    Directory of Open Access Journals (Sweden)

    Cvjetković Cvjetana


    Full Text Available This paper is dedicated to one form of mutual assistance in tax matters in the field of direct taxation - the exchange of information which in terms of the functioning of the single market of the European Union is gaining more importance. This paper also presents new solutions of Directive 2011/16/EU. Special attention in this paper is focused on the practice of the European Court of Justice in the area of the exchange of information.

  20. Future Directions of Evidence-Based Practice in Athletic Training: Perceived Strategies to Enhance the Use of Evidence-Based Practice (United States)

    Welch, Cailee E.; Hankemeier, Dorice A.; Wyant, Aimee L.; Hays, Danica G.; Pitney, William A.; Van Lunen, Bonnie L.


    Context: The shift to a culture of evidence-based practice (EBP) in athletic training is a necessary step in both the optimization of patient care and the advancement of athletic trainers (ATs) as health care professionals. Whereas individuals have gained knowledge in this area, most ATs still are not practicing in an evidence-based manner. Exploring perceived strategies to enhance the use of EBP will help to determine the best approaches to assist ATs in applying EBP concepts to practice to improve patient care. Objective: To explore beneficial strategies and techniques ATs perceived would promote successful implementation of EBP within athletic training education and clinical practice. Design: Qualitative study. Setting: Individual telephone interviews. Patients or Other Participants: Twenty-five ATs (12 educators, 13 clinicians; athletic training experience = 16.00 ± 9.41 years) were interviewed. Data Collection and Analysis: One phone interview was conducted with each participant. After the interview was transcribed, the data were analyzed and coded into common themes and categories. Triangulation of the data occurred via the use of multiple researchers and member checking to confirm the accuracy of the data. Results: Participants identified several components they perceived as essential for enhancing the use of EBP within the athletic training profession. These components included the need for more EBP resources, more processed information, focused workshops, peer discussion and mentorship, and continual repetition and exposure. Participants also indicated that ATs need to accept their professional responsibilities to foster EBP in their daily practices. Conclusions: The proper shift to a culture of EBP in athletic training will take both time and a persistent commitment by ATs to create strategies that will enhance the implementation of EBP across the profession. Researchers should focus on continuing to identify effective educational interventions for ATs

  1. An Assessment of Direct on-Farm Energy Use for High Value Grain Crops Grown under Different Farming Practices in Australia

    Directory of Open Access Journals (Sweden)

    Tek Maraseni


    Full Text Available Several studies have quantified the energy consumption associated with crop production in various countries. However, these studies have not compared the energy consumption from a broad range of farming practices currently in practice, such as zero tillage, conventional tillage and irrigated farming systems. This study examines direct on-farm energy use for high value grain crops grown under different farming practices in Australia. Grain farming processes are identified and “typical” farming operation data are collected from several sources, including published and unpublished literature, as well as expert interviews. The direct on-farm energy uses are assessed for 27 scenarios, including three high value grain crops―wheat, barley and sorghum―for three regions (Northern, Southern and Western Australia under three farming conditions with both dryland (both for conventional and zero-tillage and irrigated conditions. It is found that energy requirement for farming operations is directly related to the intensity and frequency of farming operations, which in turn is related to tillage practices, soil types, irrigation systems, local climate, and crop types. Among the three studied regions, Western Australia requires less direct on-farm energy for each crop, mainly due to the easily workable sandy soils and adoption of zero tillage systems. In irrigated crops, irrigation energy remains a major contributor to the total on-farm energy demand, accounting for up to 85% of total energy use.

  2. Practical and Ethical Aspects of Advance Research Directives for Research on Healthy Aging: German and Israeli Professionals' Perspectives. (United States)

    Werner, Perla; Schicktanz, Silke


    Healthy aging is the development and maintenance of optimal cognitive, social and physical well-being, and function in older adults. Preventing or minimizing disease is one of the main ways of achieving healthy aging. Dementia is one of the most prevalent and life-changing diseases of old age. Thus, dementia prevention research is defined as one of the main priorities worldwide. However, conducting research with persons who lack the capacity to give consent is a major ethical issue. Our study attempts to explore if and how advance research directives (ARDs) may be used as a future tool to deal with the ethical and practical issues in dementia research. We conducted focus groups and in-depth interviews with German and Israeli professional stakeholders from the fields of gerontology, ethics, medical law, psychiatry, neurology and policy advice ( n  = 16), and analyzed the main topics discussed regarding cross-national similarities and controversies within the groups, as well as across the two national contexts. While both countries are in the midst of a developmental process and have recognized the importance and need for ARD as a tool for expanding healthy aging, Germany is in a more advanced stage than Israel because of the EU regulation process, which indicates the influence of international harmonization on these research-related ethical issues. Consensual themes within the qualitative material were identified: the need for a broader debate on ARD, the ethical importance of autonomy and risk-benefit assessment for ARD implementation, the role of the proxy and the need for the differentiation of types of dementia research. Controversies and dilemmas aroused around themes such as the current role of IRBs in each country, the need for limits, and how to guaranty safeguarding and control. Implementing a new tool is a step-by-step procedure requiring a thorough understanding of the current state of knowledge as well as of the challenges and hurdles ahead. As long

  3. Practical and Ethical Aspects of Advance Research Directives for Research on Healthy Aging: German and Israeli Professionals’ Perspectives

    Directory of Open Access Journals (Sweden)

    Perla Werner


    Full Text Available BackgroundHealthy aging is the development and maintenance of optimal cognitive, social and physical well-being, and function in older adults. Preventing or minimizing disease is one of the main ways of achieving healthy aging. Dementia is one of the most prevalent and life-changing diseases of old age. Thus, dementia prevention research is defined as one of the main priorities worldwide. However, conducting research with persons who lack the capacity to give consent is a major ethical issue.ObjectiveOur study attempts to explore if and how advance research directives (ARDs may be used as a future tool to deal with the ethical and practical issues in dementia research.MethodWe conducted focus groups and in-depth interviews with German and Israeli professional stakeholders from the fields of gerontology, ethics, medical law, psychiatry, neurology and policy advice (n = 16, and analyzed the main topics discussed regarding cross-national similarities and controversies within the groups, as well as across the two national contexts.ResultsWhile both countries are in the midst of a developmental process and have recognized the importance and need for ARD as a tool for expanding healthy aging, Germany is in a more advanced stage than Israel because of the EU regulation process, which indicates the influence of international harmonization on these research-related ethical issues. Consensual themes within the qualitative material were identified: the need for a broader debate on ARD, the ethical importance of autonomy and risk–benefit assessment for ARD implementation, the role of the proxy and the need for the differentiation of types of dementia research. Controversies and dilemmas aroused around themes such as the current role of IRBs in each country, the need for limits, and how to guaranty safeguarding and control.DiscussionImplementing a new tool is a step-by-step procedure requiring a thorough understanding of the current state of knowledge

  4. Test Directions as a Critical Component of Test Design: Best Practices and the Impact of Examinee Characteristics (United States)

    Lakin, Joni M.


    The purpose of test directions is to familiarize examinees with a test so that they respond to items in the manner intended. However, changes in educational measurement as well as the U.S. student population present new challenges to test directions and increase the impact that differential familiarity could have on the validity of test score…

  5. Effects of variability of practice in music: A pilot study on fast goal-directed movements in pianists

    Directory of Open Access Journals (Sweden)

    Marc eBangert


    Full Text Available Variability of Practice (VOP refers to the acquisition of a particular target movement by practicing a range of varying targets rather than by focusing on fixed repetitions of the target only. VOP has been demonstrated to have beneficial effects on transfer to a novel task and on skill consolidation. This study extends the line of research to musical practice. In a task resembling a barrier-knockdown paradigm, 36 music students trained to perform a wide left-hand interval leap on the piano. Performance at the target distance was tested before and after a 30-minute standardized training session. The high-variability group (VAR practiced 4 different intervals including the target. Another group (FIX practiced the target interval only. A third group (SPA performed spaced practice on the target only, interweaving with periods of not playing. Transfer was tested by introducing an interval novel to either group. After a 24-hour period with no further exposure to the instrument, performance was retested. All groups performed at comparable error levels before training, after training, and after the retention interval. At transfer, however, the FIX group, unlike the other groups, committed significantly more errors than in the target task. After the retention period, the effect was washed out for the FIX group but then was present for VAR. Thus, the results provide only partial support for the VOP hypothesis for the given setting. Additional exploratory observations suggest tentative benefits of VOP regarding execution speed, loudness, and performance confidence.We derive specific hypotheses and specific recommendations regarding sample selection and intervention duration for future investigations. Furthermore, the proposed leap task measurement is shown to be (a robust enough to serve as a standard framework for studies in the music domain, yet (b versatile enough to allow for a wide range of designs not previously investigated for music on a

  6. Effects of variability of practice in music: a pilot study on fast goal-directed movements in pianists. (United States)

    Bangert, Marc; Wiedemann, Anna; Jabusch, Hans-Christian


    Variability of Practice (VOP) refers to the acquisition of a particular target movement by practicing a range of varying targets rather than by focusing on fixed repetitions of the target only. VOP has been demonstrated to have beneficial effects on transfer to a novel task and on skill consolidation. This study extends the line of research to musical practice. In a task resembling a barrier-knockdown paradigm, 36 music students trained to perform a wide left-hand interval leap on the piano. Performance at the target distance was tested before and after a 30-min standardized training session. The high-variability group (VAR) practiced four different intervals including the target. Another group (FIX) practiced the target interval only. A third group (SPA) performed spaced practice on the target only, interweaving with periods of not playing. Transfer was tested by introducing an interval novel to either group. After a 24-h period with no further exposure to the instrument, performance was retested. All groups performed at comparable error levels before training, after training, and after the retention (RET) interval. At transfer, however, the FIX group, unlike the other groups, committed significantly more errors than in the target task. After the RET period, the effect was washed out for the FIX group but then was present for VAR. Thus, the results provide only partial support for the VOP hypothesis for the given setting. Additional exploratory observations suggest tentative benefits of VOP regarding execution speed, loudness, and performance confidence. We derive specific hypotheses and specific recommendations regarding sample selection and intervention duration for future investigations. Furthermore, the proposed leap task measurement is shown to be (a) robust enough to serve as a standard framework for studies in the music domain, yet (b) versatile enough to allow for a wide range of designs not previously investigated for music on a standardized basis.

  7. 'Before reaching the last mile'- Knowledge, attitude, practice and perceived barriers related to tuberculosis directly observed therapy among ASHA workers in Central India: A mixed method study. (United States)

    Singh, Akash Ranjan; Pakhare, Abhijit; Kokane, Arun M; Shewade, Hemant Deepak; Chauhan, Ashish; Singh, Abhishek; Gangwar, Arti; Thakur, Prahlad Singh


    Community-based direct observed treatment (DOT) providers are an important bridge for the national tuberculosis programme in India to reach the unreached. The present study has explored the knowledge, attitude, practice and barriers perceived by the community-based DOT providers. Mixed-methods study design was used among 41 community-based DOT providers (Accredited Social Health Activist (ASHAs)) working in 67 villages from a primary health center in Raisen district of Madhya Pradesh, India. The cross-sectional quantitative component assessed the knowledge and practices and three focus-group discussions explored the attitude and perceived barriers related to DOT provision. 'Adequate knowledge' and 'satisfactory practice' related to DOT provision was seen in 14 (34%) and 13 (32%) ASHAs respectively. Only two (5%) received any amount of honorarium for completion of DOT in last 3years. The focus-group discussions revealed unfavourable attitude; inadequate training and supervision, non-payment of honorarium, issues related to assured services after referral and patient related factors as the barriers to satisfactory practice of DOT. Study revealed inadequate knowledge and unsatisfactory practice related to DOT provision among ASHAs. Innovations addressing the perceived barriers to improve practice of DOT provision by ASHAs are urgently required. Copyright © 2017 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

  8. Training the Next Generation of School Psychologists to Deliver Evidence Based Mental Health Practices: Current Challenges and Future Directions (United States)

    Shernoff, Elisa S.; Bearman, Sarah Kate; Kratochwill, Thomas R.


    School psychologists are uniquely positioned to support the delivery of evidence-based mental health practices (EBMHPs) to address the overwhelming mental health needs of children and youth. Graduate training programs can promote EBMHPs in schools by ensuring school psychologists enter the workplace prepared to deliver and support high-quality,…

  9. School Psychology Research and Practice in East Asia: Perspectives on the Past, Present, and Future Directions of the Field (United States)

    Brown, Jacqueline A.; Watanabe, Yayoi; Lee, Dong Hun; McIntosh, Kent


    To engage in a comparison of school psychology research and practice in eastern and western countries, the current study sought to identify key themes that have influenced the field of school psychology in East Asian countries. Forty-six leading school psychology professionals in Japan, Hong Kong, South Korea, Thailand, and Taiwan provided their…

  10. [Ethical issues in the practice of advance directives, living wills, and self-determination in end of life care]. (United States)

    Fang, Hui-Feng; Jhing, Huei-Yu; Lin, Chia-Chin


    The Hospice-Palliative Care Act, enacted in Taiwan in 2000, was designed to respect the end of life medical wishes of patients with incurable illnesses, safeguard the rights of these patients, and provide clinical guidelines for healthcare workers responsible to provide end of life care. Self-determination is a core element of human dignity. Advance directive documents include a living will, and durable power of attorney for healthcare. This article reviews current issues and ethical dilemmas with regard to advance directives. Patients, family members, and clinicians may require better education on the Hospice-Palliative Care Act in order to respect more appropriately patient end of life medical care wishes.

  11. The direct-Mat Project: Dismantling and Recycling Techniques for road Materials. Sharing Knowledge and Practices; El proyecto DIRECT-MAT: Tecnicas de demolicion y reciclado de materiales para la carretera-Compartiendo conocimientos y practicas

    Energy Technology Data Exchange (ETDEWEB)

    Sinis Fernandez, F.; Rubio guzman, B.; Gonzalez Abadias, A. I.


    This article describes the content of the DIRECT-MAT (Dismantling and Recycling for road Materials) project. the DIRECT MAT project objectives consist of sharing and disseminating, at the European scale, national knowledge and field practices regarding the dismantling and recycling of road and road related materials, for the benefit of all European countries. Road material recycling processes have previously been studied in national research projects in the last years; unfortunately, the results of those projects almost never benefit other European countries. This is especially true for the newer Member States. The DIRECT-MAT project, within 7{sup t}h Framework Programme, is a three year project starting in 2009, and is comparised of 20 partners from 15 participating countries. to reach the aims of the project, a WEB database will be created to compile and display the extensive and already validated research and job site data and a set of Best Practices Guides on dismantling and recycling of different types of materials will be issued. Finally, guidelines will be proposed to ensure database updating, including the results of future researches. (Author) 6 refs.

  12. General directions and practices for management of radioactive waste; Indirizzi generali e pratiche di gestione dei rifiuti radioattivi

    Energy Technology Data Exchange (ETDEWEB)

    Fioroni, M [ENEA - Area Energia, Ambiente e Salute, Centro Ricerche Energia, Casaccia, Rome (Italy)


    The present work underlines and synthesises the essential principles, directions and methodologies developed by Industrialized Nations and by the International Organizations for management of radioactive waste of high, intermediate and low levels. It fills a gap in scientific Italian literature and represents a valid introduction to the subject. (author)

  13. Self-Directed Support: Impact of Hiring Practices on Adults with Intellectual and Developmental Disabilities and Families (United States)

    Heller, Tamar; Arnold, Catherine K.; van Heumen, Lieke; McBride, Elizabeth L.; Factor, Alan


    The study examined the differential experiences and outcomes for people with intellectual and developmental disabilities and their families receiving self-directed services based on the type of personal support worker hired (parents, siblings, other relatives, friends, and agency staff). The sample consisted of 372 participants in a self-directed…

  14. Globalisation as we enter the 21st century: reflections and directions for nursing education, science, research and clinical practice. (United States)

    Davidson, Patricia M; Meleis, Afaf; Daly, John; Douglas, Marilyn Marty


    The events of September 11th, 2001 in the United States and the Bali bombings of October 2002 are chastening examples of the entangled web of the religious, political, health, cultural and economic forces we experience living in a global community. To view these forces as independent, singular, linearly deterministic entities of globalisation is irrational and illogical. Understanding the concept of globalisation has significant implications not only for world health and international politics, but also the health of individuals. Depending on an individual's political stance and world-view, globalisation may be perceived as an emancipatory force, having the potential to bridge the chasm between rich and poor or, in stark contrast, the very essence of the divide. It is important that nurses appreciate that globalisation does not pertain solely to the realms of economic theory and world politics, but also that it impacts on our daily nursing practice and the welfare of our patients. Globalisation and the closer interactions of human activity that result, have implications for international governance, policy and theory development as well as nursing education, research and clinical practice. Nurses, individually and collectively, have the political power and social consciousness to influence the forces of globalisation to improve health for all. This paper defines and discusses globalisation in today's world and its implications for contemporary nursing education, science, research and clinical practice.

  15. Workshop Euratom Directive 97/43. New trends in radiation protection in clinical practice, in research and in regulation

    International Nuclear Information System (INIS)

    Mazzei, F.


    The Euratom Directive 97/43 on health protection of individuals against the dangers of ionizing radiation in relation to medical exposure is presented. In particular the following topics are focused, with a multidisciplinary approach, on: diagnostic reference levels in radiodiagnostics and nuclear medicine; radiation protection in paediatrics, in interventional radiology and in computer tomography; radiation protection radiotherapy, radiation protection in medical research; radiation protection in prenatal and neonatal exposure; radiation protection in medical-legal exposures [it

  16. Matching fundus photographs of classmates. An informal competition to promote learning and practice of direct ophthalmoscopy among medical students. (United States)

    Krohn, Jørgen; Kjersem, Bård; Høvding, Gunnar


    To present a new approach for teaching direct ophthalmoscopy to medical students. At the University of Bergen, four consecutive classes of fourth-year medical students complete a required 9-week ophthalmology course every year. In the present project, one fundus photograph was taken of each student. The photographs were randomly numbered, printed on A4 glossy photo paper, and displayed on the classroom wall. Each student was given a form to fill in the fellow students' names matching the number of the fundus photographs. They were encouraged to practise direct ophthalmoscopy on their classmates outside formal teaching hours. At the end of the course, they returned the filled-in forms, and those with the highest number of correct matches between the fundus photographs and fellow students received a reward. Between 2011 and 2013, 239 students completed their ophthalmology course. Of these, 220 students (92%) voluntarily participated in the project. The mean score was 70% correct matches between fundus photographs and fellow students (range 7 - 100%). The students' course evaluations were overall positive. We recommend the use of peer fundus photographs in the context of a learning competition as a simple, inexpensive, and effective way to improve teaching of direct ophthalmoscopy.

  17. [Modern directions of scientific and practical research of the policy of active and healthy longevity: experience and perspectives]. (United States)

    Golubeva, E Yu

    Modern terminology on active and healthy aging used in scientific and project activities is discussed. There have been analyzed the WHO conception on active aging, which has no precise universally agreed definition, its main determinants. The directions of scientific expertise in the major European projects INNOVAGE - assessment of potentially profitable social innovations relating to the welfare and quality of life and health in old age; MOPACT - the interference between the demographic development and the main dimensions of economic and social contribution of older persons is defined. The approach to implement the policy of active and healthy longevity as a valuable asset of the modern society is underlined.

  18. [Promoting directives of the Quality Law of the Spanish National Health System: Computer-interpretable clinical practice guidelines]. (United States)

    González-Ferrer, Arturo; Valcárcel, María Ángel


    The Cohesion and Quality Act of the National Health System promotes the use of new technologies to make it possible for health professionals put the scientific evidence into practice. In order to do this, there are technological tools, known as of computer-interpretable guidelines, which can help achieve this goal from an innovation perspective. They can be adopted using an iterative process, having a great initial potential as an educational tool, of quality and safety of the patient, in the decision making and, optionally, can be integrated with the electronic medical history, once they are rigorously validated. This article presents updates on these tools, reviews international projects, and personal experiences in which they have demonstrated their value, and highlights the advantages, risks, and limitations they present from a clinical point of view. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  19. Ethical and clinical practice considerations for genetic counselors related to direct-to-consumer marketing of genetic tests. (United States)

    Wade, Christopher H; Wilfond, Benjamin S


    Several companies utilize direct-to-consumer (DTC) advertising for genetic tests and some, but not all, bypass clinician involvement by offering DTC purchase of the tests. This article examines how DTC marketing strategies may affect genetic counselors, using available cardiovascular disease susceptibility tests as an illustration. The interpretation of these tests is complex and includes consideration of clinical validity and utility, and the further complications of gene-environment interactions and pleiotropy. Although it is unclear to what extent genetic counselors will encounter clients who have been exposed to DTC marketing strategies, these strategies may influence genetic counseling interactions if they produce directed interest in specific tests and unrealistic expectations for the tests' capacity to predict disease. Often, a client's concern about risk for cardiovascular diseases is best addressed by established clinical tests and a family history assessment. Ethical dilemmas may arise for genetic counselors who consider whether to accept clients who request test interpretation or to order DTC-advertised tests that require a clinician's authorization. Genetic counselors' obligations to care for clients extend to interpreting DTC tests, although this obligation may be fulfilled by referral or consultation with specialists. Genetic counselors do not have an obligation to order DTC-advertised tests that have minimal clinical validity and utility at a client's request. This can be a justified restriction on autonomy based on consideration of risks to the client, the costs, and the implications for society. Published 2006 Wiley-Liss, Inc.

  20. Student-Directed Video Validation of Psychomotor Skills Performance: A Strategy to Facilitate Deliberate Practice, Peer Review, and Team Skill Sets. (United States)

    DeBourgh, Gregory A; Prion, Susan K


    Background Essential nursing skills for safe practice are not limited to technical skills, but include abilities for determining salience among clinical data within dynamic practice environments, demonstrating clinical judgment and reasoning, problem-solving abilities, and teamwork competence. Effective instructional methods are needed to prepare new nurses for entry-to-practice in contemporary healthcare settings. Method This mixed-methods descriptive study explored self-reported perceptions of a process to self-record videos for psychomotor skill performance evaluation in a convenience sample of 102 pre-licensure students. Results Students reported gains in confidence and skill acquisition using team skills to record individual videos of skill performance, and described the importance of teamwork, peer support, and deliberate practice. Conclusion Although time consuming, the production of student-directed video validations of psychomotor skill performance is an authentic task with meaningful accountabilities that is well-received by students as an effective, satisfying learner experience to increase confidence and competence in performing psychomotor skills.

  1. The effect of direct referral for fast CT scan in early lung cancer detection in general practice. A clinical, cluster-randomised trial. (United States)

    Guldbrandt, Louise Mahncke


    This PhD thesis is based on the project "The effect of direct referral for fast CT scan in early lung cancer detection in general practice. A clinical, cluster-randomised trial", performed in Denmark in 2010-2013. The thesis includes four papers and focuses on early lung cancer diagnostics in general practice. A total of 4200 new cases of lung cancer are diagnosed in Denmark annually. The stage of the disease is an important prognostic factor; thus, the opportunity for curative treatment declines with more advanced tumour stage. Lung cancer patients in Denmark (like in the UK) have a poorer prognosis than lung cancer patients in other European countries. One explanation could be delayed diagnosis. A fast-track pathway was therefore introduced in an attempt to expedite the diagnosis of cancer. However, it seems that not all patients can be diagnosed through this pathway. In order to ensure fast and early lung cancer diagnosis, it is crucial to examine the initial diagnostic process in general and the role general practice plays in lung cancer diagnostics in particular. The specific areas of investigation include the pathways to diagnosis, the characteristics of patients who are at special risk of delayed diagnosis and the level of prediagnostic activity in general practice. A chest radiograph is often the first choice in the investigation of lung cancer. Unfortunately, radiographs are less suitable for central and small tumours. Low-dose computer tomography (LDCT), however, has a high sensitivity for lung cancer which implies that it can be used to detect patients with localised, potentially curable disease. The aim of this thesis was to increase our knowledge of the initial stages of lung cancer diagnostics in general practice. The thesis also examined the effect of a direct referral from general practice to an additional diagnostic test, the LDCT. The aims of this thesis were: 1) To describe Danish patients' pathways to the diagnosis of lung cancer in general and

  2. Social Media Technology and Public Health in Ontario: Findings from a Planning Meeting Exploring Current Practices and Future Research Directions. (United States)

    Booth, Richard; McMurray, Josephine; Regan, Sandra; Kothari, Anita; Donelle, Lorie; McBride, Susan; Sobel, Annette; Hall, Jodi; Fraser, Robert; Foisey, Lyndsay


    In the province of Ontario, many of the public health units (PHUs) now possess and use social media as part of their daily health promotion and communication operations. To explore this topic, a planning meeting was held to generate deeper insights toward the use of these forms of technology for preventative services delivery. The planning meeting was held with 50 participants, comprising representatives from 20 of the 36 PHUs in Ontario, interested academics, students and government representatives. A nominal group technique (NGT) was used to build consensus related to future research needs, as related to public health and social media. Participants generated a range of insights around the use of social media, including the need for: leadership buy-in and resource allocation; social media policy and governance structure; performance measurement and evaluation; practices related to engagement with program recipients and addressing the lack of resources faced by many health units. Future research priorities were also generated, related to evaluating the cost-benefit of social media activities and understanding behaviour change implications. Further research is needed to evaluate the functionality, leadership and competency requirements and impact(s) of these new forms of health communication technology within public health service delivery. Copyright © 2017 Longwoods Publishing.

  3. A practical theoretical formalism for atomic multielectron processes: direct multiple ionization by a single auger decay or by impact of a single electron or photon (United States)

    Liu, Pengfei; Zeng, Jiaolong; Yuan, Jianmin


    Multiple electron processes occur widely in atoms, molecules, clusters, and condensed matters when they are interacting with energetic particles or intense laser fields. Direct multielectron processes (DMEP) are the most complicated among the general multiple electron processes and are the most difficult to describe theoretically. In this work, a unified and accurate theoretical formalism is proposed on the DMEP of atoms including the multiple auger decay and multiple ionization by an impact of a single electron or a single photon based on the atomic collision theory described by a correlated many-body Green's function. Such a practical treatment is made possible by taking consideration of the different coherence features of the atoms (matter waves) in the initial and final states. We first explain how the coherence characteristics of the ejected continuum electrons is largely destructed, by taking the electron impact direct double ionization process as an example. The direct double ionization process is completely different from the single ionization where the complete interference can be maintained. The detailed expressions are obtained for the energy correlations among the continuum electrons and energy resolved differential and integral cross sections according to the separation of knock-out (KO) and shake-off (SO) mechanisms for the electron impact direct double ionization, direct double and triple auger decay, and double and triple photoionization (TPI) processes. Extension to higher order DMEP than triple ionization is straight forward by adding contributions of the following KO and SO processes. The approach is applied to investigate the electron impact double ionization processes of C+, N+, and O+, the direct double and triple auger decay of the K-shell excited states of C+ 1s2{s}22{p}2{}2D and {}2P, and the double and TPI of lithium. Comparisons with the experimental and other theoretical investigations wherever available in the literature show that our

  4. UK doctors’ views on the implementation of the European Working Time Directive as applied to medical practice: a qualitative analysis (United States)

    Clarke, Rachel T; Pitcher, Alex; Lambert, Trevor W; Goldacre, Michael J


    Objectives To report on what doctors at very different levels of seniority wrote, in their own words, about their concerns about the European Working Time Directive (EWTD) and its implementation in the National Health Service (NHS). Design All medical school graduates from 1993, 2005 and 2009 were surveyed by post and email in 2010. Setting The UK. Methods Using qualitative methods, we analysed free-text responses made in 2010, towards the end of the first year of full EWTD implementation, of three cohorts of the UK medical graduates (graduates of 1993, 2005 and 2009), surveyed as part of the UK Medical Careers Research Group's schedule of multipurpose longitudinal surveys of doctors. Results Of 2459 respondents who gave free-text comments, 279 (11%) made unprompted reference to the EWTD; 270 of the 279 comments were broadly critical. Key themes to emerge included frequent dissociation between rotas and actual hours worked, adverse effects on training opportunities and quality, concerns about patient safety, lowering of morale and job satisfaction, and attempts reportedly made in some hospitals to persuade junior doctors to collude in the inaccurate reporting of compliance. Conclusions Further work is needed to determine whether problems perceived with the EWTD, when they occur, are attributable to the EWTD itself, and shortened working hours, or to the way that it has been implemented in some hospitals. PMID:24503304

  5. UK doctors' views on the implementation of the European Working Time Directive as applied to medical practice: a qualitative analysis. (United States)

    Clarke, Rachel T; Pitcher, Alex; Lambert, Trevor W; Goldacre, Michael J


    To report on what doctors at very different levels of seniority wrote, in their own words, about their concerns about the European Working Time Directive (EWTD) and its implementation in the National Health Service (NHS). All medical school graduates from 1993, 2005 and 2009 were surveyed by post and email in 2010. The UK. Using qualitative methods, we analysed free-text responses made in 2010, towards the end of the first year of full EWTD implementation, of three cohorts of the UK medical graduates (graduates of 1993, 2005 and 2009), surveyed as part of the UK Medical Careers Research Group's schedule of multipurpose longitudinal surveys of doctors. Of 2459 respondents who gave free-text comments, 279 (11%) made unprompted reference to the EWTD; 270 of the 279 comments were broadly critical. Key themes to emerge included frequent dissociation between rotas and actual hours worked, adverse effects on training opportunities and quality, concerns about patient safety, lowering of morale and job satisfaction, and attempts reportedly made in some hospitals to persuade junior doctors to collude in the inaccurate reporting of compliance. Further work is needed to determine whether problems perceived with the EWTD, when they occur, are attributable to the EWTD itself, and shortened working hours, or to the way that it has been implemented in some hospitals.

  6. Key directions of the Russian economy innovative development with the innovative activity practice of the integrated corporate structures

    Directory of Open Access Journals (Sweden)

    F. I. Shamhalov


    Full Text Available The article deals with the problems and the key directions of The article deals with the problems and key directions of innovative development of the Russian industry in connection with the need to reduce the dependence of the national economy on the situation on world commodity markets, as well as to create the conditions and incentives for the introduction and modern technologies development, improving energy and environmental efficiency of the economy and productivity for the development of economic sectors and industries, producing goods with high added value for the implementation of innovative projects and in general - to upgrade the socio-economic system of the country.The following statement is given: the development of innovative high-tech and knowledge-intensive industries must ensure import substitution products at the first stage, primarily in the militaryindustrial complex, and in the future - export-oriented competitive product.The article analyzes the experience of innovative activity of the integrated corporate structures with the participation of the state in the following areas: the integration of the industrial and financial capital; the concentration of capital (through the merger and acquisition of enterprises, strategic alliances; diversification of forms and fields of activity; globalization of activities (creation of subsidiaries in the most attractive countries and working on promising markets; capital internationalization (through the creation of transnational companies.On the basis of generalization of global corporate management experience in the state corporations the article analyzes key conditions and factors that determine the efficiency of the state-owned companies as a whole: a clear statement of goals and objectives of the state as the owner, whose interests go beyond the usual business purposes; fixing of these goals and objectives in the regulations, in the concepts and programs of long-term socioeconomic

  7. UK doctors' views on the implementation of the European Working Time Directive as applied to medical practice: a quantitative analysis. (United States)

    Maisonneuve, Jenny J; Lambert, Trevor W; Goldacre, Michael J


    To report on doctors' views, from all specialty backgrounds, about the European Working Time Directive (EWTD) and its impact on the National Health Service (NHS), senior doctors and junior doctors. All medical school graduates from 1999 to 2000 were surveyed by post and email in 2012. The UK. Among other questions, in a multipurpose survey on medical careers and career intentions, doctors were asked to respond to three statements about the EWTD on a five-point scale (from strongly agree to strongly disagree): 'The implementation of the EWTD has benefited the NHS', 'The implementation of the EWTD has benefited senior doctors' and 'The implementation of the EWTD has benefited junior doctors'. The response rate was 54.4% overall (4486/8252), 55.8% (2256/4042) of the 1999 cohort and 53% (2230/4210) of the 2000 cohort. 54.1% (2427) of all respondents were women. Only 12% (498/4136 doctors) agreed that the EWTD has benefited the NHS, 9% (377) that it has benefited senior doctors and 31% (1289) that it has benefited junior doctors. Doctors' views on EWTD differed significantly by specialty groups: 'craft' specialties such as surgery, requiring extensive experience in performing operations, were particularly critical. These cohorts have experience of working in the NHS before and after the implementation of EWTD. Their lack of support for the EWTD 4 years after its implementation should be a concern. However, it is unclear whether problems rest with the current ceiling on hours worked or with the ways in which EWTD has been implemented.

  8. Improving Speaking Skill Of The Tenth Grade Students Of SMK 17 Agustus 1945 Muncar Through Direct Practice With The Native Speaker

    Directory of Open Access Journals (Sweden)

    Mohamad Nor Shodiq


    Full Text Available The Classroom Action Research (CAR aims to invent teaching and learning strategy which fits the learners’ style and to solve the teachers’ problem in finding the appropriate technique in teaching. The researcher took SMK 17 Agustus 1945 Muncar Banyuwangi on 35 students of the tenth grade of AK 1 and was conducted in one cycle with the phases of planning, implementing, observing, and reflecting. The researcher found that the implementation of Direct Practice with the Native Speaker could improve the students’ speaking skill. It was proved by the result of the students’ speaking score. The average classical score in preliminary study was 50. 00. They had improvement from the third meeting but did not all of students meet the criteria of success and were still below the KKM. In the fourth meeting was found that all of the students could reach criteria of success and KKM score as 70. 00. Direct Practice with the Native Speaker creates the teaching and learning process fun, and good atmosphere of competition among the students.

  9. Spatially explicit groundwater vulnerability assessment to support the implementation of the Water Framework Directive – a practical approach with stakeholders

    Directory of Open Access Journals (Sweden)

    K. Berkhoff


    Full Text Available The main objective of the study presented in this paper was to develop an evaluation scheme which is suitable for spatially explicit groundwater vulnerability assessment according to the Water Framework Directive (WFD. Study area was the Hase river catchment, an area of about 3 000 km2 in north-west Germany which is dominated by livestock farming, in particular pig and poultry production. For the Hase river catchment, the first inventory of the WFD led to the conclusion that 98% of the catchment area is "unclear/unlikely" to reach a good groundwater status due to diffuse nitrogen emissions from agriculture. The groundwater vulnerability assessment was embedded in the PartizipA project ("Participative modelling, Actor and Ecosystem Analysis in Regions with Intensive Agriculture",, within which a so-called actors' platform was established in the study area. The objective of the participatory process was to investigate the effects of the WFD on agriculture as well as to discuss groundwater protection measures which are suitable for an integration in the programme of measures. The study was conducted according to the vulnerability assessment concept of the Intergovernmental Panel on Climate Change, considering sensitivity, exposure and adaptive capacity. Sensitivity was computed using the DRASTIC index of natural groundwater pollution potential. Exposure (for a reference scenario was computed using the STOFFBILANZ nutrient model. Several regional studies were analysed to evaluate the adaptive capacity. From these studies it was concluded that the adaptive capacity in the Hase river catchment is very low due to the economic importance of the agricultural sector which will be significantly affected by groundwater protection measures. As a consequence, the adaptive capacity was not considered any more in the vulnerability assessment. A groundwater vulnerability evaluation scheme is presented which enjoys the advantage that both

  10. Implementation of a Goal-Directed Mechanical Ventilation Order Set Driven by Respiratory Therapists Improves Compliance With Best Practices for Mechanical Ventilation. (United States)

    Radosevich, Misty A; Wanta, Brendan T; Meyer, Todd J; Weber, Verlin W; Brown, Daniel R; Smischney, Nathan J; Diedrich, Daniel A


    Data regarding best practices for ventilator management strategies that improve outcomes in acute respiratory distress syndrome (ARDS) are readily available. However, little is known regarding processes to ensure compliance with these strategies. We developed a goal-directed mechanical ventilation order set that included physician-specified lung-protective ventilation and oxygenation goals to be implemented by respiratory therapists (RTs). We sought as a primary outcome to determine whether an RT-driven order set with predefined oxygenation and ventilation goals could be implemented and associated with improved adherence with best practice. We evaluated 1302 patients undergoing invasive mechanical ventilation (1693 separate episodes of invasive mechanical ventilation) prior to and after institution of a standardized, goal-directed mechanical ventilation order set using a controlled before-and-after study design. Patient-specific goals for oxygenation partial pressure of oxygen in arterial blood (Pao 2 ), ARDS Network [Net] positive end-expiratory pressure [PEEP]/fraction of inspired oxygen [Fio 2 ] table use) and ventilation (pH, partial pressure of carbon dioxide) were selected by prescribers and implemented by RTs. Compliance with the new mechanical ventilation order set was high: 88.2% compliance versus 3.8% before implementation of the order set ( P mechanical ventilation, intensive care unit (ICU) length of stay, and in-hospital or ICU mortality. A standardized best practice mechanical ventilation order set can be implemented by a multidisciplinary team and is associated with improved compliance to written orders and adherence to the ARDSNet PEEP/Fio 2 table.

  11. Determinants of completion of advance directives: a cross-sectional comparison of 649 outpatients from private practices versus 2158 outpatients from a university clinic. (United States)

    Pfirstinger, Jochen; Bleyer, Bernhard; Blum, Christian; Rechenmacher, Michael; Wiese, Christoph H; Gruber, Hans


    To compare outpatients from private practices and outpatients from a university clinic regarding the determinants of completion of advance directives (AD) in order to generalise results of studies from one setting to the other. Five determinants of completion of AD were studied: familiarity with AD, source of information about AD, prior experiences with own life-threatening diseases or family members in need of care and motives in favour and against completion of AD. Observational cross-sectional study. Private practices and a university clinic in Germany in 2012. 649 outpatients from private practices and 2158 outpatients from 10 departments of a university clinic. Completion of AD, familiarity with AD, sources of information about AD (consultation), prior experiences (with own life-threatening disease and family members in need of care), motives in favour of or against completion of AD, sociodemographic data. Determinants of completion of AD did not differ between outpatients from private practices versus university clinic outpatients. Prior experience with severe disease led to a significantly higher rate of completion of AD (33%/36% with vs 24%/24% without prior experience). Participants with completion of AD had more often received legal than medical consultation before completion, but participants without completion of AD are rather aiming for medical consultation. The motives in favour of or against completion of AD indicated inconsistent patterns. Determinants of completion of AD are comparable in outpatients from private practices and outpatients from a university clinic. Generalisations from university clinic samples towards a broader context thus seem to be legitimate. Only one-third of patients with prior experience with own life-threatening diseases or family members in need of care had completed an AD as expression of their autonomous volition. The participants' motives for or against completion of AD indicate that ADs are considered a kind of

  12. Genetic testing for susceptibility to breast and ovarian cancer: evaluating the impact of a direct-to-consumer marketing campaign on physicians' knowledge and practices. (United States)

    Myers, Melanie F; Chang, Man-Huei; Jorgensen, Cynthia; Whitworth, William; Kassim, Sidibe; Litch, James A; Armstrong, Lori; Bernhardt, Barbara; Faucett, W Andrew; Irwin, Debra; Mouchawar, Judy; Bradley, Linda A


    To assess the impact of direct-to-consumer marketing of genetic testing for risk of breast and ovarian cancer by a biotechnology company on: 1) physicians' knowledge; 2) reasons given when asking questions about the test; and 3) physicians' practice patterns in two pilot cities where the campaign took place and two control cities. Survey of randomly selected family physicians, internists, obstetrician-gynecologists, and oncologists from May 1-May 21, 2003. Physicians' knowledge did not differ between pilot and control cities. Significant differences (pilot versus control cities) were seen in the reasons patients gave for asking questions about testing. More physicians in pilot cities (14%) than control cities (7%) reported an increase in the number of times they ordered genetic testing for breast and ovarian cancer risk in the previous 6 months (adjusted odds ratio 1.9, 95% confidence interval, 1.2-3.1). Awareness of professional guidelines and being in a practice with a policy on genetic testing for risk of breast and ovarian cancer were associated with physicians' behaviors and interest among patients in testing. Given the complexity and limitations of genetic testing for risk of breast and ovarian cancer, the development and broad dissemination of clinical guidelines and education of physicians are needed.

  13. Health-related direct-to-consumer genetic tests: a public health assessment and analysis of practices related to Internet-based tests for risk of thrombosis. (United States)

    Goddard, K A B; Robitaille, J; Dowling, N F; Parrado, A R; Fishman, J; Bradley, L A; Moore, C A; Khoury, M J


    Recent years have seen increased concern about direct-to-consumer (DTC) genetic testing (i.e., the sale and use of genetic tests without involving a health care provider). Numerous professional organizations have developed policies in this area. However, little systematic evidence exists to inform public policy about these tests. We conducted a systematic search to identify genetic tests that are sold DTC without involving a health care provider. We evaluated the practices of companies offering DTC genetic tests for risk of thrombosis using criteria from multiple sources and a minimal set of key practices. We identified 84 instances of currently available health-related DTC genetic tests sold on 27 Web sites; the most common were for pharmacogenomics (12), risk of thrombosis (10), and nutrigenomics (10). For the DTC genetic tests for risk of thrombosis, we found low adherence to recommendations. Online information was frequently incomplete and had low agreement with professional recommendations. Our findings document the rapid growth in the availability of health-related DTC genetic tests and highlight the need to improve the delivery of DTC genetic tests. A major implication of this study is the need for the scientific and medical community to develop consistent recommendations to increase their impact. Copyright 2008 S. Karger AG, Basel.

  14. Demographics of cleft care providers in Africa and reported experience in training and practice: direct analysis of continent-based practitioners. (United States)

    Adetayo, Oluwaseun A; Martin, Mark C


    To elucidate the impact of several geographic, cultural, and socioeconomic variables on cleft care delivery in Africa, and to investigate the current status of cleft care delivery in Africa. Survey of practitioners attending the second Pan-African Congress on Cleft Lip and Palate (PACCLIP). The annual PACCLIP conference in Ibadan, Nigeria, West Africa, February 2007. To provide an analysis of the demographics and training experience of cleft care providers in Africa by collating information directly from the continent-based practitioners. Plastic surgeons and oral and maxillofacial surgeons provide the majority of cleft care. Most of the participants reported availability of formal training programs in their respective countries. The predominant practice settings were university and government-based. During training, half of the providers had encountered up to 30 cleft cases, and a quarter had managed more than 100 cases. Representation of visiting surgeons were equally distributed between African and non-African countries. This study provides initial and detailed analysis crucial to understanding the underlying framework of cleft care composition teams, demographics of providers, and training and practice experience. This awareness will further enable North American and other non-African plastic surgeons to effectively partner with African cleft care providers to have a further reaching impact in the region.


    Directory of Open Access Journals (Sweden)

    L. E. Kuvshinova


    Full Text Available Aim. To compare direct medical costs of dabigatran and warfarin therapy in patients with non-valvular atrial fibrillation (NVAF during preparation for elective cardioversion. Material and methods. An open non-randomized study was conducted to evaluate direct medical costs (cost of drug, cost of the international normalized ratio (INR adjust- ment in outpatient clinic, cost of visits to cardiologist. Patients (n=62 with persistent NVAF (AF paroxysm duration > 48 hours were enrolled. All of them requested medical as- sistance and were decided to perform an elective cardioversion. The patients received warfarin (n=32 or dabigatran (n=30. The patients of the both groups were similar in the main clinical characteristics and thromboembolic risk levels according to CHA2DS2-VASc scale.Results. Treatment duration before elective cardioversion was 21±2 and 30.5±4.5 days for dabigatran and warfarin groups, respectively (p<0.05. Average costs of visits to cardiologists were 3,720 and 744 RUB in warfarin and dabigatran groups, respectively (p<0.05, and drug costs were 53.63 and 1,172.01 RUB, respectively (p<0.05. The costs of laboratory INR monitoring were 3,058 RUB in warfarin group. Total costs per patient were 6,831.63 and 1,916.01 RUB in warfarin and dabigatran groups, respectively (p<0.05. Conclusion. In the real clinical practice in patients with NVAF dabigatran antithromboembolic therapy substantially reduces direct medical costs in comparison with warfarin ther- apy during preparation for elective cardioversion. Dabigatran therapy reduces time from the decision of elective cardioversion and antithromboembolic therapy start to car- dioversion performance.


    Directory of Open Access Journals (Sweden)

    L. E. Kuvshinova


    Full Text Available Aim. To compare direct medical costs of dabigatran and warfarin therapy in patients with non-valvular atrial fibrillation (NVAF during preparation for elective cardioversion. Material and methods. An open non-randomized study was conducted to evaluate direct medical costs (cost of drug, cost of the international normalized ratio (INR adjust- ment in outpatient clinic, cost of visits to cardiologist. Patients (n=62 with persistent NVAF (AF paroxysm duration > 48 hours were enrolled. All of them requested medical as- sistance and were decided to perform an elective cardioversion. The patients received warfarin (n=32 or dabigatran (n=30. The patients of the both groups were similar in the main clinical characteristics and thromboembolic risk levels according to CHA2DS2-VASc scale.Results. Treatment duration before elective cardioversion was 21±2 and 30.5±4.5 days for dabigatran and warfarin groups, respectively (p<0.05. Average costs of visits to cardiologists were 3,720 and 744 RUB in warfarin and dabigatran groups, respectively (p<0.05, and drug costs were 53.63 and 1,172.01 RUB, respectively (p<0.05. The costs of laboratory INR monitoring were 3,058 RUB in warfarin group. Total costs per patient were 6,831.63 and 1,916.01 RUB in warfarin and dabigatran groups, respectively (p<0.05. Conclusion. In the real clinical practice in patients with NVAF dabigatran antithromboembolic therapy substantially reduces direct medical costs in comparison with warfarin ther- apy during preparation for elective cardioversion. Dabigatran therapy reduces time from the decision of elective cardioversion and antithromboembolic therapy start to car- dioversion performance.

  17. Comparison of prescriber evaluations and patient-directed self-reports in office-based practice for buprenorphine treatment of opiate-dependent individuals in France, 2002

    Directory of Open Access Journals (Sweden)

    Estelle Lavie


    Full Text Available Estelle Lavie1, Mélina Fatséas1, Jean-Pierre Daulouède1,2, Cécile Denis1, Jacques Dubernet1, Laurent Cattan3, Marc Auriacombe11Laboratoire de psychiatrie/EA4139, INSERM IFR-99 and Faculté de médecine Victor Pachon, University Victor Segalen Bordeaux 2, Bordeaux, France; 2Bizia, Centre de soins d’addictologie, Centre Hospitalier de la Côte Basque, Bayonne, France; 3Centre médical, Noisy-le-sec, FranceAbstract: The objective of this cross-sectional evaluation study was to compare data generated through prescriber assessments, and data generated from independent direct contact with opiate-dependent patients in office-based practice to evaluate buprenorphine treatment for modality of buprenorphine absorption, benzodiazepine use, and depressive symptoms. A group of buprenorphine office-based practice prescribers was selected to participate in this study. They were asked to screen for inclusion all their patients coming for a visit from February to August 2002. Once included by their prescribing physician, patients were given a series of self-administered questionnaires to be returned directly to the research staff, independently of their prescriber. Each prescriber was given a questionnaire to complete based on their knowledge and interview of the patient. Items assessed were history of current treatment, current substance use, buprenorphine treatment related behavior (daily frequency of intake, route of administration, benzodiazepine use and existence of a major depressive episode. Prescribers and patients’ questionnaires were compared. Concordance of both assessments was assessed by kappa statistics. The sensitivity and specificity as well as the positive and negative predictive values of prescriber collected information were compared to that of their patients’. There was an overall good correlation between both data sources on the procedures for buprenorphine use especially for intravenous use of buprenorphine. There were important

  18. Nuclear supervision - Administration by the federal states on behalf of the Federal Government or direct federal administration? Evaluation from a practical point of view

    International Nuclear Information System (INIS)

    Cloosters, W.


    The organization of supervisory authorities under the Atomic Energy Act is not a new issue. In fact, it was discussed vehemently in the Federal Republic of Germany as far back as in the early fifties. Federal legislation in late 1959 decided to have the Atomic Energy Act executed in part under direct federal responsibility and, as far as the important supervision of the nuclear power plants operated in the Federal Republic of Germany was concerned, by the federal states on behalf of the federal government. Federal Minister for the Environment Trittin reopened the debate about the organization of nuclear administration by announcing his intention to transfer the supervision of nuclear power plants to direct federal administration. This announcement not only raises the question of legal permissibility of transferring nuclear power plant oversight to federal administration, but also requires a critical review, as presented in this article, of practical regulatory supervision to ensure safe operation of nuclear facilities. In this connection, both the actual content of supervisory activities and the way in which they are carried out must be examined in an effort to find an answer based on solid premises to the question raised above. For reasons explained in the contribution, oversight of nuclear power plants cannot be carried out as a centralized function. Instead, the legislative decision of 1959 in favor of the federal states exercising supervision on behalf of the federal government continues to be correct at the present stage also in the light of the steps initiated to opt out of the peaceful uses of nuclear power. (orig.)

  19. Evaluating whether direct-to-consumer marketing can increase demand for evidence-based practice among parents of adolescents with substance use disorders: rationale and protocol. (United States)

    Becker, Sara J


    Fewer than one in 10 adolescents with substance use disorders (ASUDs) will receive specialty treatment, and even fewer will receive treatment designated as evidence-based practice (EBP). Traditional efforts to increase the utilization of EBP by ASUDs typically focus on practitioners-either in substance use clinics or allied health settings. Direct-to-consumer (DTC) marketing that directly targets parents of ASUDs represents a potentially complementary paradigm that has yet to be evaluated. The current study is the first to evaluate the relevance of a well-established marketing framework (the Marketing Mix) and measurement approach (measurement of perceived service quality [PSQ]) with parents of ASUDs in need of treatment. A mixed-methods design is employed across three study phases, consistent with well-established methods used in the field of marketing science. Phase 1 consists of formative qualitative research with parents (and a supplementary sample of adolescents) in order to evaluate and potentially adapt a conceptual framework (Marketing Mix) and measure of PSQ. Phase 2 is a targeted survey of ASUD parents to elucidate their marketing preferences, using the adapted Marketing Mix framework, and to establish the psychometric properties of the PSQ measure. The survey will also gather data on parents' preferences for different targeted marketing messages. Phase 3 is a two-group randomized controlled trial comparing the effectiveness of targeted marketing messages versus standard clinical information. Key outcomes will include parents' ratings of PSQ (using the new measure), behavioral intentions to seek out information about EBP, and actual information-seeking behavior. The current study will inform the field whether a well-established marketing framework and measurement approach can be used to increase demand for EBP among parents of ASUDs. Results of this study will have the potential to immediately inform DTC marketing efforts by professional organizations

  20. Safety and risk factors for difficult endoscopist-directed ERCP sedation in daily practice: a hospital-based case-control study

    Directory of Open Access Journals (Sweden)

    Enrique Pérez-Cuadrado-Robles

    Full Text Available Background: There are limited data concerning endoscopist-directed endoscopic retrograde cholangiopancreatography deep sedation. The aim of this study was to establish the safety and risk factors for difficult sedation in daily practice. Patients and methods: Hospital-based, frequency matched case-control study. All patients were identified from a database of 1,008 patients between 2014 and 2015. The cases were those with difficult sedations. This concept was defined based on the combination of the receipt of high-doses of midazolam or propofol, poor tolerance, use of reversal agents or sedation-related adverse events. The presence of different factors was evaluated to determine whether they predicted difficult sedation. Results: One-hundred and eighty-nine patients (63 cases, 126 controls were included. Cases were classified in terms of high-dose requirements (n = 35, 55.56%, sedation-related adverse events (n = 14, 22.22%, the use of reversal agents (n = 13, 20.63% and agitation/discomfort (n = 8, 12.7%. Concerning adverse events, the total rate was 1.39%, including clinically relevant hypoxemia (n = 11, severe hypotension (n = 2 and paradoxical reactions to midazolam (n = 1. The rate of hypoxemia was higher in patients under propofol combined with midazolam than in patients with propofol alone (2.56% vs. 0.8%, p < 0.001. Alcohol consumption (OR: 2.674 [CI 95%: 1.098-6.515], p = 0.030, opioid consumption (OR: 2.713 [CI 95%: 1.096-6.716], p = 0.031 and the consumption of other psychoactive drugs (OR: 2.015 [CI 95%: 1.017-3.991], p = 0.045 were confirmed to be independent risk factors for difficult sedation. Conclusions: Endoscopist-directed deep sedation during endoscopic retrograde cholangiopancreatography is safe. The presence of certain factors should be assessed before the procedure to identify patients who are high-risk for difficult sedation.

  1. Nordic working group on x-ray diagnostics - Practical implementation of the directive on medical exposures in the Nordic EU countries

    Energy Technology Data Exchange (ETDEWEB)

    Waltenburg, H.N.; Groen, P. [National Institute of Radiation Hygiene, Herlev (Denmark); Leitz, W. [Swedish Radiation Protection Authority, Stockholm (Sweden); Servomaa, A. [Finnish Centre for Radiation and Nuclear Safety, Helsinki (Finland); Einarsson, G. [Icelandic Radiation Protection Institute, Reykjavik (Iceland); Olerud, H. [Norwegian Radiation Protection Authority, Oslo (Norway)


    The EU directive on medical exposure, 97/43/EURATOM (referred to in the following as MED) imposes new requirements on hospital departments using ionising radiation for either diagnostics or treatment of illnesses. The directive was approved on 30 June 1997, and the member states were obliged to implement the requirements into national legislation before 13 May 2000. The implementation of a directive of this kind is a complicated process requiring time as well as other resources. The Nordic EU countries (Sweden, Finland and Denmark) must comply with the rules in MED, while this is not the case for Norway and Iceland as EFTA (European Free Trade Association) members, since the agreements between EFTA and EU does not cover the EURATOM treaty. The issues that have to be addressed in the national legislation are justification, optimisation, responsibilities, procedures, training, equipment, special protection during pregnancy and breast-feeding, and potential exposure. A central aspect in MED is the requirement for quality assurance programmes to be established in radiological departments (and in other departments employing ionising radiation). A change of this magnitude in legislation requires adjustments in the routines of the individual departments. The staff in each department needs to prepare and follow procedures and instructions for daily work and also participate in day-to-day quality assurance. A considerable burden has also been laid on the radiation protection authorities in the member states, first in the process of transposing MED into national law or regulations, and secondly in guiding the process of practical implementation. Here we will describe how the individual Nordic EU countries have chosen to implement MED in national legislation and how far the process of complying with the requirements has come so far. Although Norway and Iceland are not required to follow MED, it is still interesting for comparison to include the situation in these countries

  2. Nordic working group on x-ray diagnostics - Practical implementation of the directive on medical exposures in the Nordic EU countries

    International Nuclear Information System (INIS)

    Waltenburg, H.N.; Groen, P.; Leitz, W.; Servomaa, A.; Einarsson, G.; Olerud, H.


    The EU directive on medical exposure, 97/43/EURATOM (referred to in the following as MED) imposes new requirements on hospital departments using ionising radiation for either diagnostics or treatment of illnesses. The directive was approved on 30 June 1997, and the member states were obliged to implement the requirements into national legislation before 13 May 2000. The implementation of a directive of this kind is a complicated process requiring time as well as other resources. The Nordic EU countries (Sweden, Finland and Denmark) must comply with the rules in MED, while this is not the case for Norway and Iceland as EFTA (European Free Trade Association) members, since the agreements between EFTA and EU does not cover the EURATOM treaty. The issues that have to be addressed in the national legislation are justification, optimisation, responsibilities, procedures, training, equipment, special protection during pregnancy and breast-feeding, and potential exposure. A central aspect in MED is the requirement for quality assurance programmes to be established in radiological departments (and in other departments employing ionising radiation). A change of this magnitude in legislation requires adjustments in the routines of the individual departments. The staff in each department needs to prepare and follow procedures and instructions for daily work and also participate in day-to-day quality assurance. A considerable burden has also been laid on the radiation protection authorities in the member states, first in the process of transposing MED into national law or regulations, and secondly in guiding the process of practical implementation. Here we will describe how the individual Nordic EU countries have chosen to implement MED in national legislation and how far the process of complying with the requirements has come so far. Although Norway and Iceland are not required to follow MED, it is still interesting for comparison to include the situation in these countries

  3. Experiences of nursing students of Evidence-Based Practice Education according to Rogers' Diffusion of Innovation Model: A Directed Content Analysis. (United States)

    Pashaeypoor, Shahzad; Ashktorab, Tahereh; Rassouli, Maryam; Alavi Majd, Hamid


    Evidence based practice (EBP) education is essential in promoting of clinical care, but an effective educational strategy for teaching EBP in nursing faculties is not available. The aim of this study was to explore the experiences of nursing students of EBP Education according to Rogers' Diffusion of Innovation Model. This qualitative study was carried out using a directed content analysis method and purposeful sampling. Data were collected until saturation by fourteen semi-structured face-to-face individual interviews and two focus group discussions with nursing students from two nursing faculties in Tehran, Iran. Rogers' Model was used in this study. Data were classified into five themes and 11 categories according to the Rogers's Model. Themes and main categories were knowledge (educational enrichment, new strategy for education), persuasion (internalization of education, improvement of motivation), decision (acceptance, use in the future), implementation (objectivity, consolidation of learning) and confirmation (learning and teaching, achieving a goal, self-confidence). EBP Education, based on the teaching strategy of Rogers's Model, leads to an improved EBP learning. All the necessary steps for a better education of it are included in this educational approach which can be used to teach any new subject like EBP.

  4. Knowledge translation of the HELPinKIDS clinical practice guideline for managing childhood vaccination pain: usability and knowledge uptake of educational materials directed to new parents. (United States)

    Taddio, Anna; Shah, Vibhuti; Leung, Eman; Wang, Jane; Parikh, Chaitya; Smart, Sarah; Hetherington, Ross; Ipp, Moshe; Riddell, Rebecca Pillai; Sgro, Michael; Jovicic, Aleksandra; Franck, Linda


    Although numerous evidence-based and feasible interventions are available to treat pain from childhood vaccine injections, evidence indicates that children are not benefitting from this knowledge. Unrelieved vaccination pain puts children at risk for significant long-term harms including the development of needle fears and subsequent health care avoidance behaviours. Parents report that while they want to mitigate vaccination pain in their children, they lack knowledge about how to do so. An evidence-based clinical practice guideline for managing vaccination pain was recently developed in order to address this knowledge-to-care gap. Educational tools (pamphlet and video) for parents were included to facilitate knowledge transfer at the point of care. The objectives of this study were to evaluate usability and effectiveness in terms of knowledge acquisition from the pamphlet and video in parents of newly born infants. Mixed methods design. Following heuristic usability evaluation of the pamphlet and video, parents of newborn infants reviewed revised versions of both tools and participated in individual and group interviews and individual knowledge testing. The knowledge test comprised of 10 true/false questions about the effectiveness of various pain management interventions, and was administered at three time points: at baseline, after review of the pamphlet, and after review of the video. Three overarching themes were identified from the interviews regarding usability of these educational tools: receptivity to learning, accessibility to information, and validity of information. Parents' performance on the knowledge test improved (p≤0.001) from the baseline phase to after review of the pamphlet, and again from the pamphlet review phase to after review of the video. Using a robust testing process, we demonstrated usability and conceptual knowledge acquisition from a parent-directed educational pamphlet and video about management of vaccination pain. Future studies

  5. Comparison of non-directive counselling and cognitive behaviour therapy for patients presenting in general practice with an ICD-10 depressive episode: a randomized control trial. (United States)

    King, M; Marston, L; Bower, P


    Most evidence in the UK on the effectiveness of brief therapy for depression concerns cognitive behaviour therapy (CBT). In a trial published in 2000, we showed that non-directive counselling and CBT were equally effective in general practice for patients with depression and mixed anxiety and depression. Our results were criticized for including patients not meeting diagnostic criteria for a depressive disorder. In this reanalysis we aimed to compare the effectiveness of the two therapies for patients with an ICD-10 depressive episode. Patients with an ICD-10 depressive episode or mixed anxiety and depression were randomized to counselling, CBT or usual general practitioner (GP) care. Counsellors provided nondirective, interpersonal counselling following a manual that we developed based on the work of Carl Rogers. Cognitive behaviour therapists provided CBT also guided by a manual. Modelling was carried out using generalized estimating equations with the multiply imputed datasets. Outcomes were mean scores on the Beck Depression Inventory, Brief Symptom Inventory, and Social Adjustment Scale at 4 and 12 months. A total of 134 participants were randomized to CBT, 126 to counselling and 67 to usual GP care. We undertook (1) an interaction analysis using all 316 patients who were assigned a diagnosis and (2) a head-to-head comparison using only those 130 (41%) participants who had an ICD-10 depressive episode at baseline. CBT and counselling were both superior to GP care at 4 months but not at 12 months. There was no difference in the effectiveness of the two psychological therapies. We recommend that national clinical guidelines take our findings into consideration in recommending effective alternatives to CBT.

  6. Transcranial direct current stimulation (tDCS) Paired with massed practice training to promote adaptive plasticity and motor recovery in chronic incomplete tetraplegia: a pilot study. (United States)

    Potter-Baker, Kelsey A; Janini, Daniel P; Lin, Yin-Liang; Sankarasubramanian, Vishwanath; Cunningham, David A; Varnerin, Nicole M; Chabra, Patrick; Kilgore, Kevin L; Richmond, Mary Ann; Frost, Frederick S; Plow, Ela B


    Objective Our goal was to determine if pairing transcranial direct current stimulation (tDCS) with rehabilitation for two weeks could augment adaptive plasticity offered by these residual pathways to elicit longer-lasting improvements in motor function in incomplete spinal cord injury (iSCI). Design Longitudinal, randomized, controlled, double-blinded cohort study. Setting Cleveland Clinic Foundation, Cleveland, Ohio, USA. Participants Eight male subjects with chronic incomplete motor tetraplegia. Interventions Massed practice (MP) training with or without tDCS for 2 hrs, 5 times a week. Outcome Measures We assessed neurophysiologic and functional outcomes before, after and three months following intervention. Neurophysiologic measures were collected with transcranial magnetic stimulation (TMS). TMS measures included excitability, representational volume, area and distribution of a weaker and stronger muscle motor map. Functional assessments included a manual muscle test (MMT), upper extremity motor score (UEMS), action research arm test (ARAT) and nine hole peg test (NHPT). Results We observed that subjects receiving training paired with tDCS had more increased strength of weak proximal (15% vs 10%), wrist (22% vs 10%) and hand (39% vs. 16%) muscles immediately and three months after intervention compared to the sham group. Our observed changes in muscle strength were related to decreases in strong muscle map volume (r=0.851), reduced weak muscle excitability (r=0.808), a more focused weak muscle motor map (r=0.675) and movement of weak muscle motor map (r=0.935). Conclusion Overall, our results encourage the establishment of larger clinical trials to confirm the potential benefit of pairing tDCS with training to improve the effectiveness of rehabilitation interventions for individuals with SCI. Trial Registration NCT01539109.

  7. Knowledge translation of the HELPinKIDS clinical practice guideline for managing childhood vaccination pain: usability and knowledge uptake of educational materials directed to new parents

    Directory of Open Access Journals (Sweden)

    Taddio Anna


    Full Text Available Abstract Background Although numerous evidence-based and feasible interventions are available to treat pain from childhood vaccine injections, evidence indicates that children are not benefitting from this knowledge. Unrelieved vaccination pain puts children at risk for significant long-term harms including the development of needle fears and subsequent health care avoidance behaviours. Parents report that while they want to mitigate vaccination pain in their children, they lack knowledge about how to do so. An evidence-based clinical practice guideline for managing vaccination pain was recently developed in order to address this knowledge-to-care gap. Educational tools (pamphlet and video for parents were included to facilitate knowledge transfer at the point of care. The objectives of this study were to evaluate usability and effectiveness in terms of knowledge acquisition from the pamphlet and video in parents of newly born infants. Methods Mixed methods design. Following heuristic usability evaluation of the pamphlet and video, parents of newborn infants reviewed revised versions of both tools and participated in individual and group interviews and individual knowledge testing. The knowledge test comprised of 10 true/false questions about the effectiveness of various pain management interventions, and was administered at three time points: at baseline, after review of the pamphlet, and after review of the video. Results Three overarching themes were identified from the interviews regarding usability of these educational tools: receptivity to learning, accessibility to information, and validity of information. Parents’ performance on the knowledge test improved (p≤0.001 from the baseline phase to after review of the pamphlet, and again from the pamphlet review phase to after review of the video. Conclusions Using a robust testing process, we demonstrated usability and conceptual knowledge acquisition from a parent-directed educational

  8. Realistic assessment of doses to members of the public according to council directive 96/29/Euratom and common practice in Germany

    International Nuclear Information System (INIS)

    Hornung-Lauxmann, L.; Steiner, M.


    According to Article 45 of the Council Directive 96/29/Euratom competent authorities of member states are obliged to assess radiation doses to the population as a whole and to reference groups of the population as realistic as possible. In EU member states different approaches are in use, both to identify reference groups and to assess doses. In addition realistic dose assessments are in general not systematically performed. Hence, the European Commission commissioned a study on the realistic assessment of radiation doses due to radioactive discharges from nuclear installations under normal operation. Based on this study a guide including recommendations for dose assessment has been established by an Article 31 expert group, which is applicable to retrospective and prospective dose assessment as well. The most important recommendation is to use as much site-specific information as possible. Concerning the dose assessment of reference groups it is recommended to use critical groups. Critical groups comprise of persons who receive the highest effective doses because of their living habits. In the opinion of EU experts it is sufficient to take into account only the age groups of one-year-olds, ten-years-olds and adults. Exposure pathways have been sub-divided into three groups: Those, which have to be considered in any case, those, which contribute significantly to dose depending on local conditions, and those, which only insignificantly contribute to dose. It is recommended to use only models for dose assessment which are robust, appropriate, and validated against measurements. In Germany, (hypothetical) reference persons are used for the assessment of radiation exposure to the population due to radioactive discharges from nuclear installations under normal operation. They are assumed to live at the most disadvantageous location around the site and to eat foodstuff produced at the most disadvantageous locations. For this purpose models, generalized assumptions and

  9. Do organizational practices matter in role stress processes? A study of direct and moderating effects for marketing-oriented boundary spanners

    NARCIS (Netherlands)

    J. Singh (Jagdip); W.J.M.I. Verbeke (Willem); G.K. Rhoads (Gary)


    textabstractPrevious research and meta-analyses suggest that the influence of organizational variables on boundary role stress processes is weak and marginal. Using the emerging work in organizational practices and configurations, the authors reexamine this relationship by addressing three critical

  10. The Potential of the Bi-Directional Gaze: A Call for Neuroscientific Research on the Simultaneous Activation of the Sympathetic and Parasympathetic Nervous Systems through Tantric Practice

    Directory of Open Access Journals (Sweden)

    Jeffrey S. Lidke


    Full Text Available This paper is a call for the development of a neuroscientific research protocol for the study of the impact of Tantric practice on the autonomic nervous system. Tantric texts like Abhinavagupta’s Tantrāloka map out a complex meditative ritual system in which inward-gazing, apophatic, sense-denying contemplative practices are combined with outward-gazing, kataphatic sense-activating ritual practices. Abhinavagupta announces a culminating “bi-directional” state (pratimīlana-samādhi as the highest natural state (sahaja-samādhi in which the practitioner becomes a perfected yogi (siddhayogi. This state of maximized cognitive capacities, in which one’s inward gaze and outward world-engagement are held in balance, appears to be one in which the anabolic metabolic processes of the parasympathetic nervous system and the catabolic metabolic processes of the sympathetic nervous systems are simultaneously activated and integrated. Akin to secularized mindfulness and compassion training protocols like Emory’s CBCT, I propose the development of secularized “Tantric protocols” for the development of secular and tradition-specific methods for further exploring the potential of the human neurological system.

  11. Direct Reactions

    Energy Technology Data Exchange (ETDEWEB)

    Austern, N. [University of Pittsburgh, Pittsburgh, PA (United States)


    In order to give a unified presentation of one point of view, these lectures are devoted only to a detailed development of the standard theories of direct reactions, starting from basic principles. Discussion is given of the present status of the theories, of the techniques used for practical calculation, and of possible future developments. The direct interaction (DI) aspects of a reaction are those which involve only a few of the many degrees of freedom of a nucleus. In fact the minimum number of degrees of freedom which must be involved in a reaction are those required to describe the initial and final channels, and DI studies typically consider these degrees of freedom and no others. Because of this simplicity DI theories may be worked out in painstaking detail. DI processes concern only part of the wave function for a problem. The other part involves complicated excitations of many degrees of freedom, and gives the compound nucleus (CN) effects. While it is extremely interesting to learn how to separate DI and CN effects in an orderly manner, if they are both present in a reaction, no suitable method has yet been found. Instead, current work stresses the kinds of reactions and the kinds of final states in which DI effects dominate and in which CN effects may almost be forgotten. The DI cross-sections which are studied are often extremely large, comparable to elastic scattering cross-sections. (author)

  12. Coding of DNA samples and data in the pharmaceutical industry: current practices and future directions--perspective of the I-PWG. (United States)

    Franc, M A; Cohen, N; Warner, A W; Shaw, P M; Groenen, P; Snapir, A


    DNA samples collected in clinical trials and stored for future research are valuable to pharmaceutical drug development. Given the perceived higher risk associated with genetic research, industry has implemented complex coding methods for DNA. Following years of experience with these methods and with addressing questions from institutional review boards (IRBs), ethics committees (ECs) and health authorities, the industry has started reexamining the extent of the added value offered by these methods. With the goal of harmonization, the Industry Pharmacogenomics Working Group (I-PWG) conducted a survey to gain an understanding of company practices for DNA coding and to solicit opinions on their effectiveness at protecting privacy. The results of the survey and the limitations of the coding methods are described. The I-PWG recommends dialogue with key stakeholders regarding coding practices such that equal standards are applied to DNA and non-DNA samples. The I-PWG believes that industry standards for privacy protection should provide adequate safeguards for DNA and non-DNA samples/data and suggests a need for more universal standards for samples stored for future research.


    Directory of Open Access Journals (Sweden)

    D. V. Lisitsky


    Full Text Available Creation of animated cartographic products – a growing trend in modern domestic and foreign computer mapping. In [Lissitzky, Khoroshilov Kolesnikov, 2014], the authors explained this by saying that «... the abundance and availability of software tools, a wide practice of animation effects in the representation of space in a variety of computer games led to spontaneous activation of the general users to create a variety of map images combination with various animation elements». The estimation of the development of animation cartography based on materials of international cartographic conferences of the International Cartographic Association and the International Congress «Interexpo GEO-Siberia» for the period from 2006 to 2015. The results of calculation of the distribution of papers in international conferences and congresses are presented in the tables illustrated figures and conclusions. The article formulated definitions «animation mapping» and «two-dimensional animation map». Animation in a two-dimensional mapping provide an opportunity to take a fresh look at the general theory of cartographic representation and allows new interpretation of the three main components of semiotic principles.

  14. Site Practice

    DEFF Research Database (Denmark)

    Wahedi, Haseebullah


    different practices in the construction phase. The research is based on an ethnographic study of a case in Denmark. The empirical data were collected through direct observations and semi-structured interviews with site managers, contract managers, foremen and craftsmen. Findings revealed...... that the construction phase comprises several communities and practices, leading to various uses of the drawings. The results indicated that the craftsmen used drawings to position themselves in the correct location, and that the site managers and contract managers used them as management tools and legal documents...

  15. The theoretical and practical principles of determining doses and carrying out dosimetric audit programmes in radiotherapy units in Poland (adjustment to the European Union Council Directive 97/43 EURATOM)

    International Nuclear Information System (INIS)

    Bulski, W.


    This project was aimed at developing research and organizational programmes to implement in Poland the Council Directive 97143 EURATOM in the field of dosimetric audits. The project included two types of research in detail: (1) the preparation of precise and reproducible standards of radiation doses, or, in other words, the investigation, development and determination of exact and effective principles of the standardization of ionization chambers used in carrying out dosimetric audit programmes, (2) the investigation of TL detectors used in audits, with the aim of obtaining the best possible measurement accuracy as well as analysis of available results of audits under reference conditions, and the development and implementation of audits for non-reference conditions, including computer-assisted treatment planning systems (TPS) indispensable in present-day radiotherapy practices. (author)

  16. Telehealth: current practices and future directions (United States)

    David, Yadin B.


    When we review the positive impact that the integration of ostensibly independent patient-care services have on the efficient management of quality care, education, and collaborative research, it is not surprising that telehealth deployment is on the rise. The forces that drive this phenomenon include: the need to manage the entire disease episode; the desire for wider geographically-distributed quality health care; the escalation of customer expectations; globalization of healthcare and its support services; an increase in patient and provider convenience; and the acceptance of the present technological community. At the Telehealth Center at the Texas Children's Hospital, current classifications of clinical applications are listed: (1) initial urgent evaluation of patients, (2) triage decisions and pretransfer arrangements, (3) medical and surgical follow-up and medication review, (4) consultation for primary care encounters, (5) real-time subspecialty care consultation and planning, (6) management of chronic diseases and conditions, (7) extended diagnostic work-ups, (8) review of diagnostic images, and (9) preventive medicine and patient education. The delivery of such services is associated with challenges and opportunities. As we move forward from limited data processing to an integrated communication system, from centralized main frame functions to personalized and location-independent workstations, and from hospitals to clinics and homecare, an increase in the minimum features provided by the equipment and the communication systems must accompany the widening variety of clinical applications. Future expansion of telehealth systems stands to revolutionize the delivery of services to the benefits of providers' networks, our economy, and patients through integration.

  17. Direct Democracy

    DEFF Research Database (Denmark)

    Beramendi, Virginia; Ellis, Andrew; Kaufman, Bruno

    While many books on direct democracy have a regional or national approach, or simply focus on one of the many mechanisms associated with direct democracy, this Handbook delves into a global comparison of direct democracy mechanisms, including referendums, citizens' initiatives, agenda initiatives...... learned. In addition, the uniquely comprehensive world survey outlines direct democracy provisions in 214 countries and territories and indicates which, if any, of these provisions are used by each country or territory at both the national and sub-national levels. Furthermore, the world survey includes...

  18. Directing 101. (United States)

    Pintoff, Ernest

    Providing an introduction to anyone considering directing as a field of study or career, this book takes a broad look at the process of directing and encourages students and professionals alike to look outside of the movie industry for inspiration. Chapters in the book discuss selecting and acquiring material; budgeting and financing; casting and…

  19. Nuclear supervision - Administration by the federal states on behalf of the Federal Government or direct federal administration? Evaluation from a practical point of view; Atomaufsicht - Bundesauftragsverwaltung oder Bundeseigenverwaltung? Bewertung aus der Sicht der Praxis

    Energy Technology Data Exchange (ETDEWEB)

    Cloosters, W. [Ministerium fuer Soziales, Gesundheit und Verbraucherschutz des Landes Schleswig-Holstein, Kiel (Germany). Abt. Reaktorsicherheit


    The organization of supervisory authorities under the Atomic Energy Act is not a new issue. In fact, it was discussed vehemently in the Federal Republic of Germany as far back as in the early fifties. Federal legislation in late 1959 decided to have the Atomic Energy Act executed in part under direct federal responsibility and, as far as the important supervision of the nuclear power plants operated in the Federal Republic of Germany was concerned, by the federal states on behalf of the federal government. Federal Minister for the Environment Trittin reopened the debate about the organization of nuclear administration by announcing his intention to transfer the supervision of nuclear power plants to direct federal administration. This announcement not only raises the question of legal permissibility of transferring nuclear power plant oversight to federal administration, but also requires a critical review, as presented in this article, of practical regulatory supervision to ensure safe operation of nuclear facilities. In this connection, both the actual content of supervisory activities and the way in which they are carried out must be examined in an effort to find an answer based on solid premises to the question raised above. For reasons explained in the contribution, oversight of nuclear power plants cannot be carried out as a centralized function. Instead, the legislative decision of 1959 in favor of the federal states exercising supervision on behalf of the federal government continues to be correct at the present stage also in the light of the steps initiated to opt out of the peaceful uses of nuclear power. (orig.)

  20. Directing Creativity

    DEFF Research Database (Denmark)

    Darsø, Lotte; Ibbotson, Piers


    In this article we argue that leaders facing complex challenges can learn from the arts, specifically that leaders can learn by examining how theatre directors direct creativity through creative constraints. We suggest that perceiving creativity as a boundary phenomenon is helpful for directing it....... Like leaders, who are caught in paradoxical situations where they have to manage production and logistics simultaneously with making space for creativity and innovation, theatre directors need to find the delicate balance between on one hand renewal of perceptions, acting and interaction...... and on the other hand getting ready for the opening night. We conclude that the art of directing creativity is linked to developing competencies of conscious presence, attention and vigilance, whereas the craft of directing creativity concerns communication, framing and choice....

  1. Direct Heat

    Energy Technology Data Exchange (ETDEWEB)

    Lienau, P J


    Potential resources and applications of earth heat in the form of geothermal energy are large. United States direct uses amount to 2,100 MWt thermal and worldwide 8,850 MWt above a reference temperature of 35 degrees Celsius. Space and district heating are the major direct uses of geothermal energy. Equipment employed in direct use projects is of standard manufacture and includes downhole and circulation pumps, transmission and distribution pipelines, heat exchangers and convectors, heat pumps and chillers. Direct uses of earth heat discussed are space and district heating, greenhouse heating and fish farming, process and industrial applications. The economic feasibility of direct use projects is governed by site specific factors such as location of user and resource, resource quality, system load factor and load density, as well as financing. Examples are presented of district heating in Klamath Falls, and Elko. Further developments of direct uses of geothermal energy will depend on matching user needs to the resource, and improving load factors and load density.

  2. Directed polymers versus directed percolation (United States)

    Halpin-Healy, Timothy


    Universality plays a central role within the rubric of modern statistical mechanics, wherein an insightful continuum formulation rises above irrelevant microscopic details, capturing essential scaling behaviors. Nevertheless, occasions do arise where the lattice or another discrete aspect can constitute a formidable legacy. Directed polymers in random media, along with its close sibling, directed percolation, provide an intriguing case in point. Indeed, the deep blood relation between these two models may have sabotaged past efforts to fully characterize the Kardar-Parisi-Zhang universality class, to which the directed polymer belongs.

  3. Direct marketing

    Directory of Open Access Journals (Sweden)

    Čičić Muris


    Full Text Available Direct Marketing (DM is usually treated as unworthy activity, with actions at the edge of legality and activities minded cheating. Despite obvious problems regarding ethics and privacy threat, DM with its size, importance and role in a concept of integrated marketing communication deserves respect and sufficient analysis and review

  4. Type-Directed Partial Evaluation

    DEFF Research Database (Denmark)

    Danvy, Olivier


    Type-directed partial evaluation uses a normalization function to achieve partial evaluation. These lecture notes review its background, foundations, practice, and applications. Of specific interest is the modular technique of offline and online type-directed partial evaluation in Standard ML...

  5. Type-Directed Partial Evaluation

    DEFF Research Database (Denmark)

    Danvy, Olivier


    Type-directed partial evaluation uses a normalization function to achieve partial evaluation. These lecture notes review its background, foundations, practice, and applications. Of specific interest is the modular technique of offline and online type-directed partial evaluation in Standard ML of ...

  6. New directions in information organization

    CERN Document Server

    Park, Jung-ran; Spink, Amanda


    New Directions in Information Organization, co-edited by Dr. Jung-ran Park and Dr. Lynne Howarth seeks to provide an overview and understanding of the future directions, leading edge theories and models for research and practice in information organization.

  7. Marketing a Radiology Practice. (United States)

    Levin, David C; Rao, Vijay M; Flanders, Adam E; Sundaram, Baskaran; Colarossi, Margaret


    In addition to being a profession, the practice of radiology is a business, and marketing is an important part of that business. There are many facets to marketing a radiology practice. The authors present a number of ideas on how to go about doing this. Some marketing methods can be directed to both patients and referring physicians. Others should be directed just to patients, while still others should be directed just to referring physicians. Aside from marketing, many of them provide value to both target audiences. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  8. Port practices


    Grigorut Cornel; Anechitoae Constantin; Grigorut Lavinia-Maria


    Commercial practices are practices or rules applicable to contractual relations between the participants to international trade activities. Commercial practices require a determined objective element of a particular practice, attitude or behavior. They are characterized by: continuity, consistency and uniformity and require duration, repeatability and stability. Depending on how many partners apply them, practices differ from the habits established between certain contracting parties

  9. Future direction of direct writing (United States)

    Kim, Nam-Soo; Han, Kenneth N.


    Direct write technology using special inks consisting of finely dispersed metal nanoparticles in liquid is receiving an undivided attention in recent years for its wide range of applicability in modern electronic industry. The application of this technology covers radio frequency identification-tag (RFID-tag), flexible-electronics, organic light emitting diodes (OLED) display, e-paper, antenna, bumpers used in flip-chip, underfilling, frit, miniresistance applications and biological uses, artificial dental applications and many more. In this paper, the authors have reviewed various direct write technologies on the market and discussed their advantages and shortfalls. Emphasis has given on microdispensing deposition write (MDDW), maskless mesoscale materials deposition (M3D), and ink-jet technologies. All of these technologies allow printing various patterns without employing a mask or a resist with an enhanced speed with the aid of computer. MDDW and M3D are capable of drawing patterns in three-dimension and MDDW, in particular, is capable of writing nanoinks with high viscosity. However, it is still far away for direct write to be fully implemented in the commercial arena. One of the hurdles to overcome is in manufacturing conductive inks which are chemically and physically stable, capable of drawing patterns with acceptable conductivity, and also capable of drawing patterns with acceptable adhesiveness with the substrates. The authors have briefly discussed problems involved in manufacturing nanometal inks to be used in various writing devices. There are numerous factors to be considered in manufacturing such inks. They are reducing agents, concentrations, oxidation, compact ability allowing good conductivity, and stability in suspension.

  10. The assessment of practical skills


    Reiss, M. J.; Abrahams, I.


    Major changes are currently afoot as to how practical work will be assessed in high status examinations (GCSEs for 16 year-olds and ‘A’ levels for 18 year-olds) in England. We explore here how practical skills might best be assessed in school science and introduce two terms: direct assessment of practical skills (DAPS) and indirect assessment of practical skills (IAPS). We conclude that both the direct and indirect assessment of practical skills have their place in effective assessment of sch...

  11. AngularJS directives

    CERN Document Server

    Vanston, Alex


    This book uses a practical, step-by-step approach, starting with how to build directives from the ground up before moving on to creating web applications comprised of multiple modules all working together to provide the best user experience possible.This book is intended for intermediate JavaScript developers who are looking to enhance their understanding of single-page web application development with a focus on AngularJS and the JavaScript MVC frameworks.It is expected that readers will understand basic JavaScript patterns and idioms and can recognize JSON formatted data.

  12. Advanced directives: open issues

    Directory of Open Access Journals (Sweden)

    Gabriella Negrini


    Full Text Available BACKGROUND In Italy Advanced directives have not been regulated by law yet. Moreover, there is a confusion of concepts: advanced directives, refusal of treatment, medical futility and euthanasia are not synonymous.DISCUSSION The following aspects are then discussed: object of directives; elapse of time between their expression and their application; knowledge of the directives and their obligatory nature. The refusal of a treatment that can save a person’s life is a critical subject. There are different ethical points of view: according to lay ethics, the patient’s self-determination prevails; the religious viewpoint, instead, says that life is a gift which we cannot dispose of. In any case, the patient will be confronted with the professional autonomy of the doctor. Should the doctor save a patient’s life in any case or should he achieve best clinical practice, in respect of his will? The doctor should interpret the patient’s will but with caution and judgment. An exemption from responsibility should be provided by law for doctors who respect patient’s living will.

  13. AAGL Practice Report

    DEFF Research Database (Denmark)

    Munro, Malcolm G; Storz, Karl; Abbott, Jason A


    The objective of this guideline is to provide clinicians with evidence-based information about commonly used and available hysteroscopic distending media to guide them in their performance of both diagnostic and operative hysteroscopy. While necessary for the performance of hysteroscopy and hyste...... is critical for the safe performance of hysteroscopic procedures. This report was developed under the direction of the Practice Committee of the AAGL as a service to their members and other practicing clinicians....

  14. Third European Company Survey – Direct and indirect employee participation

    NARCIS (Netherlands)

    Akkerman, Agnes; Sluiter, Roderick; Jansen, Giedo


    This report studies practices in EU establishments for direct and indirect employee participation in decision-making. Indirect employee participation is the involvement of employee representatives in decision-making processes, while direct employee participation describes direct interaction between

  15. Practice management. (United States)

    Althausen, Peter L; Mead, Lisa


    The practicing orthopaedic traumatologist must have a sound knowledge of business fundamentals to be successful in the changing healthcare environment. Practice management encompasses multiple topics including governance, the financial aspects of billing and coding, physician extender management, ancillary service development, information technology, transcription utilization, and marketing. Some of these are universal, but several of these areas may be most applicable to the private practice of medicine. Attention to each component is vital to develop an understanding of the intricacies of practice management.

  16. EIA practice


    Wärnbäck, Antoienette


    This thesis is about Environmental Impact Assessment (EIA) practice in Sweden. Impact Assessment (IA) is expected to play a crucial role in enabling democratic and enlightened decision making. EIA practice seems however not to be in accordance with best IA practice norms and legislation in many countries. We therefore need a more thorough understanding of IA practice and its outcomes and about what is gained through EIA and thus also be able to suggest, on a more profound basis...

  17. Conventional radiotherapy treatments (direct planning) of head and neck with photon X10 planning system (cms) and Siemens Primus accelerator: proposed protocol planning, difficulties encountered, tricks practical and possible amendments to the class solution

    International Nuclear Information System (INIS)

    Saez, F.; Benito, M. A.; Saez, M.


    In this paper we propose a protocol for the systematic planning process for a planner and an Accelerator XiO Primus. This protocol includes the creation of ancillary volumes for better dosimetric evaluation and design fields. Are some practical tips and cases arise in which you can change the Class Solution home. We compare this treatment with 10 turns without turning table with other tables. Finally, we show the advantages of this method from the radiobiological point of view to the bone, the main body of this type of risk treatments.

  18. European power station market. Impact of later CE Directives on the practice of awarding orders in the field of power stations; Kraftwerksmarkt Europa. Auswirkungen neuer EG-Richtlinien auf die Vergabepraxis im Kraftwerksbereich

    Energy Technology Data Exchange (ETDEWEB)

    Bechthold, H.; Bennert, J.


    When implementing the Public Procurement Directive during the past years a series of standards EN 45510 has been established defining new guidelines for the procurement of power station equipment. Purchasers as well as tenderers are concerned respectively. This publication gives guidance on the application of this standards series. (orig.) [Deutsch] In den vergangenen Jahren entstand bei der Umsetzung der Sektorenrichtlinie die Normenreihe EN 45510, die neue Festlegungen fuer die Auftragsvergabe von Kraftwerksausruestungen trifft. Davon sind Auftraggeber und Bieter gleichermassen betroffen. Der Beitrag hilft bei der Interpretation dieser Normenreihe. (orig.)

  19. Ophthalmic practice

    Directory of Open Access Journals (Sweden)

    Sue Stevens


    Full Text Available Eye health workers carry out many basic routine procedures. Sometimes bad practice develops and this, in turn, may lead to new members of staff learning unsafe methods. Community Eye Health Journal plans to run a series on practical procedures, when applicable, relating to the theme.

  20. Practicing Humanities

    DEFF Research Database (Denmark)

    Gimmler, Antje


    and self-reflective democracy. Contemporary humanities have adopted a new orientation towards practices, and it is not clear how this fits with the ideals of ‘Bildung’ and ‘pure science’. A possible theoretical framework for this orientation towards practices could be found in John Dewey’s pragmatic...

  1. Changing Practice. (United States)

    Benson, Chris, Ed.


    This serial issue contains nine articles all on the subject of "changing practice," i.e., innovative practices of rural English teachers in the Bread Loaf Rural Teacher Network. "Byte-ing into Medieval Literature" (John Fyler) describes an online conference on medieval literature for rural high school students. "Literacy…

  2. Practical concerns (United States)

    Steve; Harmsworth, Andrew; Knight, Jenny; Bhulai, Alfred; g-moore


    In reply to the blog post “Why axing physics practicals from exams is a bad idea” (10 April,, which criticized the decision to remove marks for practical lab exercises from the final grades of A-level science students in England.

  3. Practical consequences of the Water Framework Directive implementation for combustion plants. New water cleaning technologies and methods for improvement of effluent discharges; Praktiska konsekvenser foer foerbraenningsanlaeggningar vid infoerandet av Vattendirektivet. Nya reningstekniker och foerbaettringsaatgaerder vid utslaepp till vatten

    Energy Technology Data Exchange (ETDEWEB)

    Axby, Fredrik; Hansson, Christina [Carl Bro Energikonsult AB, Malmoe (Sweden)


    As a consequence of the growing impact on water resources the Water Framework Directive was legislated in 2000. The directive should ensure that a 'good water status' and entail a coordinated legislation striving for a long-term protection of all water resources. Stakeholders should be able to participate in the preparations of river basin management plans and programs of measures. District based water authorities will administrate the implementation and are mandated to decide upon regional environmental quality standards and promulgate fees for water use and discharges. The Directive contains a list of 33 prioritized substances that should be reduced or phased out. Discharges from combustion plants contain twelve, polyaromatic hydrocarbons (PAH) and heavy metals. PAH and heavy metals impacts growth and vital functions as respiration and photosynthesis of water living organisms and induces cancer in humans. NOEC-values (NO Effect Concentration) state manageable substance concentrations for an organism. Flue gas condensate contains concentrations of some of the substances which impact exceeds the critical state level. Extended sewage treatment could thus be needed. Sludge, wash and soot water contains elevated levels of heavy metals. This water is normally treated by municipal sewage treatment. Further treatment at plant site could be relevant. Presence of PAH and heavy metals in leach water depends on the precipitation. Additional flowing-independent water treatment could be relevant. It is very uncertain how plant owners will be affected. Licenses could be reviewed and standards could be raised for sensitive recipients; new limits for prioritized substances and standards for other types of discharges and water fees could be added. Respites could be given if costs exceed the benefits. Location, ecotoxicological risk assessments and precautionary measures could become more relevant in an EIA. Pricing of water could take place by using a system of emissions

  4. Comprehensive in-hospital monitoring in acute heart failure: applications for clinical practice and future directions for research. A statement from the Acute Heart Failure Committee of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC). (United States)

    Harjola, Veli-Pekka; Parissis, John; Brunner-La Rocca, Hans-Peter; Čelutkienė, Jelena; Chioncel, Ovidiu; Collins, Sean P; De Backer, Daniel; Filippatos, Gerasimos S; Gayat, Etienne; Hill, Loreena; Lainscak, Mitja; Lassus, Johan; Masip, Josep; Mebazaa, Alexandre; Miró, Òscar; Mortara, Andrea; Mueller, Christian; Mullens, Wilfried; Nieminen, Markku S; Rudiger, Alain; Ruschitzka, Frank; Seferovic, Petar M; Sionis, Alessandro; Vieillard-Baron, Antoine; Weinstein, Jean Marc; de Boer, Rudolf A; Crespo Leiro, Maria G; Piepoli, Massimo; Riley, Jillian P


    This paper provides a practical clinical application of guideline recommendations relating to the inpatient monitoring of patients with acute heart failure, through the evaluation of various clinical, biomarker, imaging, invasive and non-invasive approaches. Comprehensive inpatient monitoring is crucial to the optimal management of acute heart failure patients. The European Society of Cardiology heart failure guidelines provide recommendations for the inpatient monitoring of acute heart failure, but the level of evidence underpinning most recommendations is limited. Many tools are available for the in-hospital monitoring of patients with acute heart failure, and each plays a role at various points throughout the patient's treatment course, including the emergency department, intensive care or coronary care unit, and the general ward. Clinical judgment is the preeminent factor guiding application of inpatient monitoring tools, as the various techniques have different patient population targets. When applied appropriately, these techniques enable decision making. However, there is limited evidence demonstrating that implementation of these tools improves patient outcome. Research priorities are identified to address these gaps in evidence. Future research initiatives should aim to identify the optimal in-hospital monitoring strategies that decrease morbidity and prolong survival in patients with acute heart failure. © 2018 The Authors. European Journal of Heart Failure © 2018 European Society of Cardiology.

  5. CORPEX{reg_sign} NORM decontamination process

    Energy Technology Data Exchange (ETDEWEB)

    Azrak, R.G.


    This paper describes a commecial process which has been developed for application to the remediation of NORM deposits on metal parts or embedded in scales on such parts. The process employs a registered chemical process, involving non-RCRA regulated chemicals, which can remove fixed {sup 226,228}Radium, {sup 210}Lead, and {sup 210}Polonium. The author describes the capabilities of the chemical process which has been developed, the way it is offered to potential customers as a practical process, and numerous examples of its application in the field.

  6. Industrial practices

    International Nuclear Information System (INIS)

    Velasquez Torrez, Patricia Irma


    This document reports the industrial practices carried out by the author viewing the requirements fulfilled for obtention the academic degree in chemical engineering of the San Andres University - Bolivia

  7. Practical theories

    DEFF Research Database (Denmark)

    Jensen, Klaus Bruhn


    This article revisits the place of normative and other practical issues in the wider conceptual architecture of communication theory, building on the tradition of philosophical pragmatism. The article first characterizes everyday concepts of communication as the accumulated outcome of natural...... evolution and history: practical resources for human existence and social coexistence. Such practical concepts have served as the point of departure for diverse theoretical conceptions of what communication is. The second part of the article highlights the past neglect and current potential of normative...... communication theories that ask, in addition, what communication ought to be, and what it could be, taking the relationship between communication and justice as a case in point. The final section returns to empirical conceptualizations of different institutions, practices and discourses of communication...

  8. Practicing induction:

    DEFF Research Database (Denmark)

    Sprogøe, Jonas; Rohde, Nicolas


    We claim that induction potentially triggers both individual and organizational learning and by drawing on practice-based theory we discuss how the interplay between individual and organization, what we call a generative dance, ignites both kinds of learning.......We claim that induction potentially triggers both individual and organizational learning and by drawing on practice-based theory we discuss how the interplay between individual and organization, what we call a generative dance, ignites both kinds of learning....

  9. Modelling Practice

    DEFF Research Database (Denmark)

    Cameron, Ian; Gani, Rafiqul


    This chapter deals with the practicalities of building, testing, deploying and maintaining models. It gives specific advice for each phase of the modelling cycle. To do this, a modelling framework is introduced which covers: problem and model definition; model conceptualization; model data...... requirements; model construction; model solution; model verification; model validation and finally model deployment and maintenance. Within the adopted methodology, each step is discussedthrough the consideration of key issues and questions relevant to the modelling activity. Practical advice, based on many...

  10. Future directions for nursing administration. (United States)

    Poulin, M A


    As the age of centralization wanes, nurse executives must look ahead. The author, noting a terrain obscured by the increasing complexity of nursing practice, points out the advantages of decentralizing decision making and of providing a distinctive nursing stamp to research and administration theory. Nurse executives, trained in management from early in their professional formation, can provide enlightened direction and flexible support for tomorrow's opportunities.

  11. Direct olive oil analysis

    Directory of Open Access Journals (Sweden)

    Peña, F.


    Full Text Available The practical impact of “direct analysis” is undeniable as it strong contributes to enhance the so-called productive analytical features such as expeditiousness, reduction of costs and minimisation of risks for the analysts and environment. The main objective is to establish a reliable bypass to the conventional preliminary operations of the analytical process. This paper offers a systematic approach in this context and emphasises the great field of action of direct methodologies in the routine analysis of olive oil. Two main types of methodologies are considered. On the one hand, the direct determination of volatile components is systematically considered. On the other hand, simple procedures to automatically implement the preliminary operations of the oil analysis using simple devices in which the sample is directly introduced with/without a simple dilution are present and discussed.El impacto práctico del análisis directo es tan innegable como que el contribuye decisivamente a mejorar las denominadas características analíticas relacionadas con la productividad como la rapidez, la reducción de costes y la minimización de riesgos para los analistas y el ambiente. El principal objetivo es establecer un adecuado "bypass" a las operaciones convencionales preliminares del proceso analítico. Este artículo ofrece una propuesta sistemática en este contexto y resalta el gran campo de acción de las metodologías directas en los análisis de rutina del aceite de oliva. Se analizan los dos tipos principales de metodologías. Por una lado, se analiza la determinación directa de los compuestos volátiles. Por el otro, se presentan y discuten los procedimientos simples para implementar automáticamente las operaciones preliminares del análisis del aceite usando sistemas simples en los que la muestra se introduce directamente con/sin un dilución simple.

  12. Social Practices

    DEFF Research Database (Denmark)

    Schmidt, Kirsten


    The present understanding of LCM as a product management system supported by a number of tools and methods does not pay attention to the importance of social practices that the employees develop in relation to the systematic approach. A new conceptual model of LCM including the social practices i...... company serves as case for the empirical analyses of the formalized structures and their interaction with the social practices developed by the employees over time.......The present understanding of LCM as a product management system supported by a number of tools and methods does not pay attention to the importance of social practices that the employees develop in relation to the systematic approach. A new conceptual model of LCM including the social practices...... is presented and discussed from theoretical and empirical perspectives. Theoretically, the analyses cover the formalized structures related to the division of labor and the coordination of the tasks on the one hand, and the social practices as meanings, values and priorities on the other hand. A larger Danish...

  13. Stigma and Schizophrenia: Directions in Student Training (United States)

    Mason, Susan E.; Miller, Rachel


    The persistence of stigma related to schizophrenia is addressed as a continuing challenge for social work students working in mental health. Student education is best grounded in direct clinical work with clients in conjunction with field supervision and classroom education. Through direct practice in individual and group sessions, students learn…

  14. A condensed review of the intelligent user modeling of information retrieval system

    International Nuclear Information System (INIS)

    Choi, Kwang


    This study discussed theoretical aspects of user modeling, modeling cases of commecial systems and elements that need consideration when constructing user models. The results of this study are 1) Comprehensive and previous analysis of system users is required to bulid user model. 2) User information is collected from users directly and inference. 3) Frame structure is compatible to build user model. 4) Prototype user model is essential to bulid a user model and based on previous user analysis. 5) User model builder has interactive information collection, inference, flexibility, model updating functions. 6) User model builder has to reflect user's feedback

  15. A condensed review of the intelligent user modeling of information retrieval system

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Kwang


    This study discussed theoretical aspects of user modeling, modeling cases of commecial systems and elements that need consideration when constructing user models. The results of this study are 1) Comprehensive and previous analysis of system users is required to bulid user model. 2) User information is collected from users directly and inference. 3) Frame structure is compatible to build user model. 4) Prototype user model is essential to bulid a user model and based on previous user analysis. 5) User model builder has interactive information collection, inference, flexibility, model updating functions. 6) User model builder has to reflect user's feedback.

  16. Biomechanics principles and practices

    CERN Document Server

    Peterson, Donald R


    Presents Current Principles and ApplicationsBiomedical engineering is considered to be the most expansive of all the engineering sciences. Its function involves the direct combination of core engineering sciences as well as knowledge of nonengineering disciplines such as biology and medicine. Drawing on material from the biomechanics section of The Biomedical Engineering Handbook, Fourth Edition and utilizing the expert knowledge of respected published scientists in the application and research of biomechanics, Biomechanics: Principles and Practices discusses the latest principles and applicat

  17. Aural Image in Practice: A Multicase Analysis of Instrumental Practice in Middle School Learners (United States)

    Oare, Steve


    This multiple case study examined six adolescent band students engaged in self-directed practice. The students' practice sessions were videotaped. Students provided verbal reports during their practice and again retrospectively while reviewing their video immediately after practice. Students were asked to discuss their choice of practice…

  18. Positive criminology in practice. (United States)

    Ronel, Natti; Segev, Dana


    The discourse regarding offender rehabilitation has been criticized by various scholars who have claimed that reducing negative causes and managing risk will not automatically prompt positive human development and elements that are associated with desistance. Positive criminology is an innovative concept that challenges the common preoccupation with negative elements, by placing emphasis on human encounters and forces of inclusion that are experienced positively by target individuals and that can promote crime desistance. However, as the concept is relatively new, there are still no guiding principles for the practice of positive criminology that could direct research and the criminal justice system. This article attempts to fill that gap by providing principles that could be practiced by criminal justice personnel and examples of different interventions that reflect positive criminology. The article also provides ideological explanations for adopting the concept of positive criminology in practice. © The Author(s) 2013.


    Directory of Open Access Journals (Sweden)

    Božo Obradović


    Full Text Available The issue of linking educational theory to educational practice (educational work with young people is highly topical and important issue for the science of pedagogy. One way of achieving this task is a pedagogical practice (PP students. In paper we deal with identifying, comparing, and analyzing the curricula of vocational (Curriculum for Preschool Teacher (2007 and academic (Curriculum for Educators (2007. Studies Teacher Training in Serbia, as well as educational disciplines and areas of pedagogical science derived from them. The results showed many similarities, but also differences when it comes to educational disciplines that are taught, the name of pedagogical practice, the number of classes to implement, ECTS (European Credit Transfer System, which affect the quality and coherence of educational theory and educational practice. In order to identify similarities and overcome weaknesses that accompany the pedagogical practice analysis, we came to know about the specifics of each of the six pedagogical practice. For each pedagogical practice defined specific goals and tasks arising from the curriculum, and in particular pedagogical disciplines taught at university. Each of these pedagogical practices is the ability to connect educational theory and educational practice and direct way to increase the quality of training and competence of future teachers for direct work with children.

  20. Shielding practice

    International Nuclear Information System (INIS)

    Sauermann, P.F.


    The basis of shielding practice against external irradiation is shown in a simple way. For most sources of radiation (point sources) occurring in shielding practice, the basic data are given, mainly in the form of tables, which are required to solve the shielding problems. The application of these data is explained and discussed using practical examples. Thickness of shielding panes of glove boxes for α and β radiation; shielding of sealed γ-radiography sources; shielding of a Co-60 radiation source, and of the manipulator panels for hot cells; damping factors for γ radiation and neutrons; shielding of fast and thermal neutrons, and of bremsstrahlung (X-ray tubes, Kr-85 pressure gas cylinders, 42 MeV betatrons, 20 MeV linacs); two-fold shielding (lead glass windows for hot cells, 14 MeV neutron generators); shielding against scattered radiation. (orig./HP) [de

  1. Teaching Practices, School Support and Bullying (United States)

    Rodríguez, Ana Carolina Reyes; Noriega, José Angel Vera; Cuervo, Angel Alberto Valdés


    Research in recent years indicates that schools, and in particular teaching practices, play an essential role in preventing bullying. This study's aim is to investigate the direct and indirect relationships between permissive and direct intervention teacher practices, school support and bullying. In a non-probabilistic way, 386 (58.1%) boys and…

  2. Nearshoring Practices

    DEFF Research Database (Denmark)

    Slepniov, Dmitrij; Brazinskas, Sigitas; Wæhrens, Brian Vejrum


    Purpose: The principal objective of this paper is to unravel and assess current nearshoring practices and their outlook in the Baltic region. Design/methodology/approach: We draw on the offshoring and outsourcing literature and use mixed methods of enquiry, including case studies, survey techniques...... and secondary statistical data. Part of the empirical base of the study is an examination of three Scandinavian firms that offshore their operations to vendors in the Baltics. To provide a more complete view of the practices and processes of offshoring in the region, we complement the case studies of Swedish...

  3. Prototyping Practice

    DEFF Research Database (Denmark)

    Ramsgaard Thomsen, Mette; Tamke, Martin


    This paper examines the role of the prototyping in digital architecture. During the past decade, a new research field has emerged exploring the digital technology’s impact on the way we think, design and build our environment. In this practice the prototype, the pavilion, installation or demonstr......This paper examines the role of the prototyping in digital architecture. During the past decade, a new research field has emerged exploring the digital technology’s impact on the way we think, design and build our environment. In this practice the prototype, the pavilion, installation...

  4. 48 CFR 9904.407 - Use of standard costs for direct material and direct labor. (United States)



  5. Practical Metallurgy

    DEFF Research Database (Denmark)

    Bissacco, Giuliano; Deganello, Davide


    This is the report regards the activities carried out during the practical metatllurgy course concerning material properties and structures and their testing & analysis methods. During the course several aspects of the materials have been considered and different techniques have been analyzed....

  6. Induction practice -

    DEFF Research Database (Denmark)

    Rohde, Nicolas; Sprogøe, Jonas


    that induction potentially triggers both individual and organizational learning and by drawing on practice-based theory we discuss how the interplay between individual and the organization, what we call agenerative dance, ignites both kinds of learning. We focus on and describe the interplay , ignites both kinds...

  7. Practical Latex

    CERN Document Server

    Grätzer, George


    Accessible at 200+ pages to all who want to learn the practical usages of LaTeX Avoids technical subjects like font usage Friendly and easy to read, with many examples included Extra source materials include sample LaTeX files and suggestions for further reading

  8. Practical Statistics

    CERN Document Server

    Lyons, L.


    Accelerators and detectors are expensive, both in terms of money and human effort. It is thus important to invest effort in performing a good statistical anal- ysis of the data, in order to extract the best information from it. This series of five lectures deals with practical aspects of statistical issues that arise in typical High Energy Physics analyses.

  9. Quality in Human Resource Practice

    DEFF Research Database (Denmark)

    Nielsen, Kjeld

    Abstract: Quality in Human Resource Practice – a process perspective The purpose of this article is to establish criteria for what quality in human resource practice (HRP) actually means. The general thesis is that quality in human resource practices is shaped within social processes in the HRM...... areas (recruitment, training, work environment etc.). Initially the concept of quality is defined in general on the basis of selections from the HRM literature, and then related to human resource practice. The question posed in the article is then answered using examples from case studies of human...... resource practice in industrial and service-related work processes. The focus in these studies is directed at behavioural processes between managers and employees, especially at individual and group level. The conclusion is that quality in human resource practice can be considered to be a social process...

  10. Diversity of faculty practice in workshop classrooms (United States)

    Franklin, Scott V.; Chapman, Tricia


    We present a temporally fine-grained characterization of faculty practice in workshop-style introductory physics courses. Practice is binned in five minute intervals and coded through two complementary observational protocols: the Reform Teaching Observation Protocol provides a summative assessment of fidelity to reform-teaching principles, while the Teaching Dimensions Observation Protocol records direct practice. We find that the TDOP's direct coding of practice explains nuances in the holistic RTOP score, with higher RTOP scores corresponding to less lecture, but not necessarily more student-directed activities. Despite using similar materials, faculty show significant differences in practice that manifests in both TDOP and RTOP scores. We also find a significant dependence of practice on course subject reflected in both RTOP and TDOP scores, with Electricity & Magnetism using more instructor-centered practices (lecture, illustration, etc.) than Mechanics courses.

  11. Academic Practice

    DEFF Research Database (Denmark)

    Nielsen, Sandro; Heine, Carmen

    Vejledning i at undgå plagiering ved at følge de normer, der gælder for good academic practice. Dette indebærer at man angiver kilder korrekt, og når det er nødvendigt, og at man har en korrekt udformet fortegnelse over referencer. Vejledningen indeholder konkrete eksempler på korrekt kildeangive......Vejledning i at undgå plagiering ved at følge de normer, der gælder for good academic practice. Dette indebærer at man angiver kilder korrekt, og når det er nødvendigt, og at man har en korrekt udformet fortegnelse over referencer. Vejledningen indeholder konkrete eksempler på korrekt...

  12. Practical procedures

    International Nuclear Information System (INIS)

    Ferreira, Paulo Roberto Rocha


    In this last chapter practical aspects to provide occupational safety in industries which produces NORM are presented. Also equipment to detect, identify and quantify the internal and external exposure is mentioned. The adequate use of these devices has the objective of reducing the radioactivity risk. The magnitude and radiation dose units for ionizing radiations are also presented. The B annex includes a suggestion of menu with basic concepts for training in occupational radiation protection

  13. Filmless radiography - present possibilities and direction of future developing

    International Nuclear Information System (INIS)

    Wocial, A.; Wojciechowski, Z.A.; Rozenblicki, Z.


    The paper presents introduction for new filmless radiography like CR Computed Radiography and DR Digital Radiography direct and non direct. The main factors are considered, which determine classification to different type of radiography. For each technique authors describe advantages and disadvantages supporting by practice examples. Paper contains a lot of practical information about a most of existing radiographic equipment at the NDT market. (author)

  14. Turbine Engine Clearance Control Systems: Current Practices and Future Directions (United States)

    Lattime, Scott B.; Steinetz, Bruce M.


    Improved blade tip sealing in the high pressure compressor (HPC) and high pressure turbine (HPT) can provide dramatic reductions in specific fuel consumption (SFC), time-on-wing, compressor stall margin, and engine efficiency as well as increased payload and mission range capabilities. Maintenance costs to overhaul large commercial gas turbine engines can easily exceed $1M. Engine removal from service is primarily due to spent exhaust gas temperature (EGT) margin caused mainly by the deterioration of HPT components. Increased blade tip clearance is a major factor in hot section component degradation. As engine designs continue to push the performance envelope with fewer parts and the market drives manufacturers to increase service life, the need for advanced sealing continues to grow. A review of aero gas turbine engine HPT performance degradation and the mechanisms that promote these losses are discussed. Benefits to the HPT due to improved clearance management are identified. Past and present sealing technologies are presented along with specifications for next generation engine clearance control systems.

  15. Teachers and Technology: Present Practice and Future Directions (United States)

    DeCoito, Isha; Richardson, Tasha


    Technology cannot be effective in the classroom without teachers who are knowledgeable about both the technology itself and its implementation to meet educational goals. While technology use in the classroom is increasing, improving learning through its application should remain the goal. In this study, the authors explored 74 middle school…

  16. Youth resistance training: past practices, new perspectives, and future directions. (United States)

    Faigenbaum, Avery D; Lloyd, Rhodri S; Myer, Gregory D


    Since the publication of the seminal review on youth resistance training by Kraemer and colleagues in 1989, a compelling body of evidence has found that resistance training can be a safe, effective, and worthwhile method of conditioning for children and adolescents. New perspectives for promoting resistance exercise as part of a long-term approach to youth physical development highlight the importance of integrating resistance training into youth fitness programs. Youth who do not enhance their muscular strength and motor skill proficiency early in life may not develop the prerequisite skills and abilities that would allow them to participate in a variety of activities and sports with confidence and vigor later in life. The identification of asymptomatic children with muscular weaknesses or imbalances may facilitate the development of a management plan which should rectify movement limitations and educate children and their families about the importance of daily physical activity.

  17. Quantitative health impact assessment: current practice and future directions

    NARCIS (Netherlands)

    J.L. Veerman (Lennert); J.J.M. Barendregt (Jan); J.P. Mackenbach (Johan)


    textabstractSTUDY OBJECTIVE: To assess what methods are used in quantitative health impact assessment (HIA), and to identify areas for future research and development. DESIGN: HIA reports were assessed for (1) methods used to quantify effects of policy on determinants of health

  18. Depression: Theory, assessment, and new directions in practice

    Directory of Open Access Journals (Sweden)

    E. Thomas Dowd


    Full Text Available Este artículo describe el fenómeno de la depresión y el uso de la terapia cognitiva como tratamiento. Se explora la naturaleza de la depresión, la terapia cognitiva,así como instrumentos de evaluación cognitiva. La depresión se muestra en cinco manifestaciones diferentes (emocional, cognitiva, motivacional, vegetativa y física, y delusoria, aunque es la manifestación emocional la que solemos considerar como depresión. Tres niveles de cognición son discutidos: autoverbalizaciones, distorsiones cognitivas y creencias cognitivas. La modificación de autoverbalizaciones (o contenido cognitivo se enfoca en la evaluación y en el cambio de los actuales pensamientos automáticos. Las distorsiones cognitivas (o procesos cognitivos son errores sistemáticos de la lógica y el razonamiento que dan resultado a pensamientos negativos automáticos. Las creencias cognitivas o esquemas son grupos de autoverbalizaciones cognitivas basadas en uno o más temas y que también se refieren a creencias condicionales o estructuras de conocimiento táctico. Se describen diversos instrumentos de evaluación cognitiva de la depresión: Automatic Thoughts Questionnaire, Beck Depression Inventory, Dysfunctional Attitude Scale, etc. Se presenta una gran variedad de intervenciones terapéuticas para superar la depresión y se advierte al lector que la pauta de recaída de la depresión es alta.

  19. The Unfair Commercial Practices Directive in the UK

    NARCIS (Netherlands)

    M. Koutsias (Marios); C. Willett (Chris)


    markdownabstract__Abstract__ This article shows that the UK has blended preventive and traditional UK criminal enforcement techniques to implement the UCPD; these techniques have been 'Europeanised' by the UCPD unfairness concepts; and the UCPD may also cause UK private law to be Europeanised in

  20. Practicing Szasz


    John Breeding


    Thomas Szasz died on September 8, 2012. With his death, many of us, not enough, are left with deep concern about his legacy and the continuing influence of his ideas. This one man’s ideas have directly or indirectly influenced my ongoing work as a psychologist. Specific areas that I will discuss below include power and language, issues of coercion, and psychiatry and the law. I will also discuss deeper and subtler infl...

  1. Setting a personal career direction. (United States)

    McCurdy, Fredrick A; Marcdante, Karen


    In summary, we believe that both you and your organization should have a set of core values, a well-defined mission (core purpose), and a vision of the future. Ideally, your projects and activities should be congruent with your mission and values, you should be pursuing your vision, and all of this should be congruent with the organization mission and values. Practically speaking, most individuals we have worked with over the years find themselves in two different groups at this point in the exercise. The minority find that their personal mission is not at all similar to the mission of their current organization and they find it necessary to seriously reevaluate their personal career direction. Sometimes, this results in them finding some other place to work. On the other hand, the majority discover their personal mission is in reasonable agreement with that of their organization. For both, this exercise has helped them clarify and better manage their personal career direction.

  2. Directed information measures in neuroscience

    CERN Document Server

    Vicente, Raul; Lizier, Joseph


    Analysis of information transfer has found rapid adoption in neuroscience, where a highly dynamic transfer of information continuously runs on top of the brain's slowly-changing anatomical connectivity. Measuring such transfer is crucial to understanding how flexible information routing and processing give rise to higher cognitive function. Directed Information Measures in Neuroscience reviews recent developments of concepts and tools for measuring information transfer, their application to neurophysiological recordings and analysis of interactions. Written by the most active researchers in the field the book discusses the state of the art, future prospects and challenges on the way to an efficient assessment of neuronal information transfer. Highlights include the theoretical quantification and practical estimation of information transfer, description of transfer locally in space and time, multivariate directed measures, information decomposition among a set of stimulus/responses variables, and the relation ...

  3. Practical knowledge

    DEFF Research Database (Denmark)

    Christensen, Jens


    The chapter aims to develop conceptions of practical knowledge, relevant to skills and Bildung in engineering science. The starting point is Francis Bacon’s ideas of new science, developed 400 years ago. It is argued that Bacon’s vision has become dogmatized during the course of history, whereas....... Furthermore, and still with reference to truth, utility, and goodness, it is claimed that unification of skills and Bildung should include the ability to deal with complexity. A second-order complexity challenges the search for adequacy between; a) the complexity of knowledge-creation; and b) the complexity...

  4. Theory into practice

    DEFF Research Database (Denmark)

    Dalsgaard, Christian


    The objective of the paper is to explore how theory is integrated into practice in students’ academic work within upper secondary education. In order to study this, the paper develops an analytical framework for situated reflection that conceptualises reflective processes in direct relation...... to practical activities of students. The framework develops a distinction between empirical and theoretical reflection, which is used as a basis for an empirical study of nine product-oriented courses in four Danish upper secondary schools. The main finding of the study is the identification of four different...... in product-oriented courses. Based on the study, the paper argues that these identified sub-processes are educationally valuable because they contain processes of reflection. The developed analytical framework can help increase awareness of these processes of situated learning and reflection that are often...

  5. Guidelines for direct radionuclide cystography in children. (United States)

    Fettich, Jure; Colarinha, Paula; Fischer, Sibylle; Frökier, Jörgen; Gordon, Isky; Hahn, Klaus; Kabasakal, Levent; Mann, Mike; Mitjavila, Mercedes; Olivier, Pierre; Piepsz, Amy; Porn, Ute; Roca, Isabel; Sixt, Rune; van Velzen, Jeannette


    These guidelines, which summarise the views of the Paediatric Committee of the European Association of Nuclear Medicine, provide a framework which may prove helpful to nuclear medicine teams in daily practice. They contain information on the indications, acquisition, processing and interpretation of direct radioisotope cystography in children. The guidelines should be taken in the context of "good practice" and any local/national rules which apply to nuclear medicine examinations.

  6. Directional spread parameter at intermediate water depth

    Digital Repository Service at National Institute of Oceanography (India)

    SanilKumar, V.; Deo, M.C.; Anand, N.M.; AshokKumar, K.

    ’ involves only the significant wave height, zero crossing wave period and water depth, the spreading function based on ‘s 3 ’ can be used for practical appli- cation. In the model based on ‘s 3 ’ the mean wave direction is an input and this has...-linearity parameter can be recommended for practical use as it provides an averaged distribution. Acknowledgements The authors would like to thank the Department of Science and Technology, New Delhi, for funding the project titled “Directional wave modelling...

  7. Using MIQUEST in General Practice

    Directory of Open Access Journals (Sweden)

    Victoria Hammersley


    Full Text Available This paper describes ten months' experience with MIQUEST software used for the collection of data from computerised databases in General Practice. We report on the following: the MIQUEST software in use, the time costs to the practice, the completeness of confidentiality barriers and the accuracy of data collected using MIQUEST compared with similar data collected by the practice system (EMIS. There were no problems encountered with installation of MIQUEST-related software. With experience, MIQUEST was equal to the practice system for speed and ease of use. The confidentiality safeguards were found to be in accordance with the GMSC/RCGP Guidelines - patients could not be directly, or indirectly, identified from the data extracted by external searches. Inaccuracies in the data collected using MIQUEST were identified, but these were largely attributable to problems with the EMIS-written interpreter available on the practice system at the time, or with the coding schemes used by the practice. In an individual practice, MIQUEST represents an alternative data collection method to the practice-based software. For data collection from multiple general practices it should prove an invaluable tool for Health Authorities and research organisations.

  8. Direct selling particularities


    Greifová, Daniela


    Bachelor thesis is focused on the parcularities of direct selling, self regulation of this industry, multi-level marketing which is the most used sales method in the field of direct selling. The part of the thesis is dedicated to the issue of customer psychology that is very important for achieving success in direct selling. Main goals are to provide readers with the general view of direct selling and analysis of growing possibilities of the industry in the future.

  9. On Paralogic Practices

    DEFF Research Database (Denmark)

    Søndergaard, Morten


    Whereas Metro-net is a personal and very direct artistic response to the internet as the metaphor of the information terminals of decentralized globalization, All that is Solid Melts Into Data is an almost clinical dissection of the material effects of data (and by inference, the internet...... at how these two concepts actually materialize in the spheres of post-internet citizens. Underneath the dissent and antagonistic attitudes, practices such as these aim to establishing a new, other logic—a para-logic—of things in the culture of ubiquitous information....

  10. Marketing the pathology practice. (United States)

    Berkowitz, E N


    Effective marketing of the pathology practice is essential in the face of an increasingly competitive market. Successful marketing begins with a market-driven planning process. As opposed to the traditional planning process used in health care organizations, a market-driven approach is externally driven. Implementing a market-driven plan also requires recognition of the definition of the service. Each market to which pathologists direct their service defines the service differently. Recognition of these different service definitions and creation of a product to meet these needs could lead to competitive advantages in the marketplace.

  11. Directed Energy Weapons (United States)


    future business . In defense systems, the key to future business is the existence of funded programs. Military commanders understand the lethality and...directed energp capabilities that can provide visibiliy into the likey futur business case for sustaining directed energy industry capabilities...the USD (I) staff to be afocalpointfor advocating improvement in all dimensions of directed energy intelligence. - The Director, Defense Inteligence

  12. Practices of Handling

    DEFF Research Database (Denmark)

    Ræbild, Ulla

    to touch, pick up, carry, or feel with the hands. Figuratively it is to manage, deal with, direct, train, or control. Additionally, as a noun, a handle is something by which we grasp or open up something. Lastly, handle also has a Nordic root, here meaning to trade, bargain or deal. Together all four...... meanings seem to merge in the fashion design process, thus opening up for an embodied engagement with matter that entails direction giving, organizational management and negotiation. By seeing processes of handling as a key fashion methodological practice, it is possible to divert the discourse away from...... introduces four ways whereby fashion designers apply their own bodies as tools for design; a) re-activating past garment-design experiences, b) testing present garment-design experiences c) probing for new garment-design experiences and d) design of future garment experiences by body proxy. The paper...

  13. Eating practices

    DEFF Research Database (Denmark)

    Christensen, Bodil Just

    The objective of the thesis is to describe and discuss how hunger and fullness are practiced (Mol and Law 2004), and emerge as multiple objects (Mol 2002). Within a theoretical framework inspired by Actor Network Theory and material semiotics, this is accomplished through a critical discussion...... changes. Methodologically the work is based on multi-site ethnographic study comprising three fieldworks among a) conscripts doing basic military training; b) an experimental performance theatre combining high-end gastronomy with performance and c) patients who have gone through obesity surgery...... at a public hospital. Through notions of partiality (Strathern 1991), multiplicity (Mol 2002) and performativity (Law 1999) the thesis attempts to develop a novel approach by drawing on aspects of material semiotics and Actor Network Theory, yet combining these with a more ethnographic orientation. In so...

  14. Practical wisdom

    DEFF Research Database (Denmark)

    Sørensen, Dorthe; Frederiksen, Kirsten; Groefte, Thorbjoern


    Objectives: To describe the reasoning and actions of experienced nurses caring for patients with non-invasive ventilation due to acute respiratory failure from chronic obstructive pulmo-nary disease. Introduction: Treatment success for patients on non-invasive ventilation remains challenging....... Understanding the reasoning and actions of experienced nurses that care for patients with non-invasive ventilation can identify how nurses contribute to treatment success, and this in-formation can be used to train less experienced nurses to provide excellent care. Design: Qualitative descriptive study....... A secondary analysis on data of qualitative participant observations during non-invasive ventilation treatment and additional 6 interviews with experi-enced ICU nurses was carried out in 2012. Results: The experienced nurses exhibited ‘practical wisdom’. Each nurse could stay alert to the patient’s condition...

  15. Advance directives: survey of primary care patients. (United States)

    O'Sullivan, Rory; Mailo, Kevin; Angeles, Ricardo; Agarwal, Gina


    To establish the prevalence of patients with advance directives in a family practice, and to describe patients' perspectives on a family doctor's role in initiating discussions about advance directives. A self-administered patient questionnaire. A busy urban family medicine teaching clinic in Hamilton, Ont. A convenience sample of adult patients attending the clinic over the course of a typical business week. The prevalence of advance directives in the patient population was determined, and the patients' expectations regarding the role of their family doctors were elucidated. The survey population consisted of 800 participants (a response rate of 72.5%) well distributed across age groups; 19.7% had written advance directives and 43.8% had previously discussed the topic of advance directives, but only 4.3% of these discussions had occurred with family doctors. In 5.7% of cases, a family physician had raised the issue; 72.3% of respondents believed patients should initiate the discussion. Patients who considered advance directives extremely important were significantly more likely to want their family doctors to start the conversation (odds ratio 3.98; P < .05). Advance directives were not routinely addressed in the family practice. Most patients preferred to initiate the discussion of advance directives. However, patients who considered the subject extremely important wanted their family doctors to initiate the discussion. Copyright© the College of Family Physicians of Canada.

  16. Radiation practices and regulatory control

    International Nuclear Information System (INIS)


    The general principles to be observed in the regulatory control of ionizing radiation use and practices are specified in the guide. It also takes into account of additions and alterations needed for for compliance with the European Union (EU) directives that have not been mentioned in other STUK/ST-guides. (6 refs.)

  17. Pediatric nephrology practice in Jordan

    Directory of Open Access Journals (Sweden)

    Kamal Akl


    Full Text Available The practice of pediatric nephrology in a developing country such as Jordan is governed by social, cultural, and economic issues. The prevalence of consanguinity contributes to the emergence of rare heredofamilial disorders and congenital anomalies of the kidneys and urinary tract. Epigenetic factors modify underlying genetic defect predisposing to symptomatic crystalluria. Future research should be directed at prevention.

  18. Radiation practices and regulatory control

    Energy Technology Data Exchange (ETDEWEB)



    The general principles to be observed in the regulatory control of ionizing radiation use and practices are specified in the guide. It also takes into account of additions and alterations needed for for compliance with the European Union (EU) directives that have not been mentioned in other STUK/ST-guides. (6 refs.).

  19. Direct access: how is it working? (United States)

    Turner, S; Ross, M


    Aim The aim of this study was to identify and survey dental hygienists and therapists working in direct access practices in the UK, obtain their views on its benefits and disadvantages, establish which treatments they provided, and what barriers they had encountered.Method The study used a purposive sample of GDC-registered hygienists and therapists working in practices offering direct access, identified through a 'Google' search. An online survey was set up through the University of Edinburgh, and non-responses followed up by post.Results The initial search identified 243 individuals working in direct access practices. Where a practice listed more than one hygienist/therapist, one was randomly selected. This gave a total of 179 potential respondents. Eighty-six responses were received, representing a response rate of 48%. A large majority of respondents (58, 73%) were favourable in their view of the GDC decision to allow direct access, and most thought advantages outnumbered disadvantages for patients, hygienists, therapists and dentists. There were no statistically significant differences in views between hygienists and therapists. Although direct access patients formed a small minority of their caseload for most respondents, it is estimated that on average respondents saw approximately 13 per month. Treatment was mainly restricted to periodontal work, irrespective of whether the respondent was singly or dually qualified. One third of respondents reported encountering barriers to successful practice, including issues relating to teamwork and dentists' unfavourable attitudes. However, almost two thirds (64%) felt that direct access had enhanced their job satisfaction, and 45% felt their clinical skills had increased.Discussion Comments were mainly positive, but sometimes raised worrying issues, for example in respect to training, lack of dental nurse support and the limited availability of periodontal treatment under NHS regulations.

  20. New directions for veterinary technology. (United States)

    Chadderdon, Linda M; Lloyd, James W; Pazak, Helene E


    Veterinary technology has generally established itself well in companion-animal and mixed-animal veterinary medical practice, but the career's growth trajectory is uncertain. Michigan State University (MSU) convened a national conference, "Creating the Future of Veterinary Technology-A National Dialogue," in November 2011 to explore ways to elevate the veterinary technician/technologist's role in the veterinary medical profession and to identify new directions in which the career could expand. Veterinary technicians/technologists might advance their place in private practice by not only improving their clinical skills, but by also focusing on areas such as practice management, leadership training, business training, conflict resolution, information technology, and marketing/communications. Some new employment settings for veterinary technicians/technologists include more participation within laboratory animal medicine and research, the rural farm industry, regulatory medicine, and shelter medicine. Achieving these ends would call for new training options beyond the current 2-year and 4-year degree programs. Participants suggested specialty training programs, hybrid programs of various types, online programs, veterinary technician residency programs of 12-18 months, and more integration of veterinary technician/technology students and veterinary medicine students at colleges of veterinary medicine.

  1. Photometric estimation of defect size in radiation direction

    International Nuclear Information System (INIS)

    Zuev, V.M.


    Factors, affecting accuracy of photometric estimation of defect size in radiation transmission direction, are analyzed. Experimentally obtained dependences of contrast of defect image on its size in radiation transmission direction are presented. Practical recommendations on improving accuracy of photometric estimation of defect size in radiation transmission direction, are developed

  2. Completely practicable

    International Nuclear Information System (INIS)

    Hartmann, P.; Preisig, H.


    This interview with Peter Hartmann and Hansruedi Preisig takes a look at the question why today's housing should be mechanically ventilated, why in spite of this such installations are quite few and far between and what must be done to change the situation. Questions covered include the reasons why housing should be equipped with such systems, the damage due to condensation and dampness resulting from too low an air-exchange rate. The use of such ventilation systems in northern countries is discussed and the history of efforts made in this direction in Switzerland is reviewed. The reasons for the limited success of fan-assisted balanced ventilation are reviewed. Health aspects are also discussed as are the main arguments for the installation of such systems in modern housing. The weak points of present day systems are looked at and measures to be taken are discussed. Finally, the role of architects in propagating the idea of fan-assisted balanced ventilation is discussed

  3. Practicing Szasz

    Directory of Open Access Journals (Sweden)

    John Breeding


    Full Text Available Thomas Szasz died on September 8, 2012. With his death, many of us, not enough, are left with deep concern about his legacy and the continuing influence of his ideas. This one man’s ideas have directly or indirectly influenced my ongoing work as a psychologist. Specific areas that I will discuss below include power and language, issues of coercion, and psychiatry and the law. I will also discuss deeper and subtler influences regarding language, as well as the effect of Szasz as a model of precision and clarity, persistence, and courage. Finally, given that I am a professional counselor, and that Szasz worked for decades as a psychoanalyst, I want to discuss his ideas about counseling per se and how they have affected my own work. I hope that my experience will have a small positive effect in keeping alive and in play the profoundly important ideas of this great man.

  4. Practical occupational medicine in "practice"

    DEFF Research Database (Denmark)

    Ingemann Larsen, Anders; Schmidt, Jan; Jepsen, Jørgen Riis


    with few occupational health resources. This Editorial argues that family physicians are indeed in a position where they can make a major positive difference for their working patients and for the enterprises where they work. Without specialist knowledge in occupational medicine, the family physician......’s empiric knowledge in combination with a narrative approach to the patient permits the contribution from family medicine not only with regard to diagnosis and treatment, but also relating to actions targeted to optimize the patient’s future accommodation at work as well as to protect other similarly......In Denmark, the practice of occupational medicine tends to be carried out by specialists in occupational medicine and less so by family physicians. The provision of health service to workers is therefore limited. This constraint may also apply in other developed countries and even more in countries...

  5. Two or three decades of passive directions

    International Nuclear Information System (INIS)

    Cook, J.


    This paper presents an overview of the direction of passive solar architecture. The topics of the paper include design temperatures for buildings, active vs passive, fuel vs philosophy, engineering vs architecture, the thermal scale: heating vs cooling, fuel subsidies, divergent practices, sustainability, lighting, health, the place of passive technology

  6. Directed Energy Anechoic Chamber (United States)

    Federal Laboratory Consortium — The Directed Energy Anechoic Chamber comprises a power anechoic chamber and one transverse electromagnetic cell for characterizing radiofrequency (RF) responses of...

  7. Records Management Directive (United States)

    Office of Personnel Management — The Office of Personnel Management (OPM) Records Management Directive provides guidelines for the management of OPM records, and identifies the records management...

  8. Strategic Information Resources Management: Fundamental Practices. (United States)

    Caudle, Sharon L.


    Discusses six fundamental information resources management (IRM) practices in successful organizations that can improve government service delivery performance. Highlights include directing changes, integrating IRM decision making into a strategic management process, performance management, maintaining an investment philosophy, using business…

  9. Practice transition with intelligence and grace. (United States)

    Boyd, Marcia A


    Viable practices change with the professional and personal needs of dentists and with trends in society. There is no single way for transitioning out of practice--concluding a direct sale, remaining as an associate, and even purchasing a new practice to better match one's more mature lifestyle and practiced preferences. Changing ratios of dentists to patients currently favor a seller's market and emergence of corporate models provide new options. An analysis is given of the Canadian practice market. Planning advice is also offered.

  10. Novel Random Mutagenesis Method for Directed Evolution. (United States)

    Feng, Hong; Wang, Hai-Yan; Zhao, Hong-Yan


    Directed evolution is a powerful strategy for gene mutagenesis, and has been used for protein engineering both in scientific research and in the biotechnology industry. The routine method for directed evolution was developed by Stemmer in 1994 (Stemmer, Proc Natl Acad Sci USA 91, 10747-10751, 1994; Stemmer, Nature 370, 389-391, 1994). Since then, various methods have been introduced, each of which has advantages and limitations depending upon the targeted genes and procedure. In this chapter, a novel alternative directed evolution method which combines mutagenesis PCR with dITP and fragmentation by endonuclease V is described. The kanamycin resistance gene is used as a reporter gene to verify the novel method for directed evolution. This method for directed evolution has been demonstrated to be efficient, reproducible, and easy to manipulate in practice.

  11. Direct-to-consumer advertising of pharmaceuticals. (United States)

    Gellad, Ziad F; Lyles, Kenneth W


    Since the US Food and Drug Administration (FDA) released new guidelines on broadcast direct-to-consumer advertising in 1997, the prevalence of direct-to-consumer advertising of prescription drugs has increased exponentially. The impact on providers, patients, and the health care system is varied and dynamic, and the rapid changes in the last several years have markedly altered the health care landscape. To continue providing optimal medical care, physicians and other health care providers must be able to manage this influence on their practice, and a more thorough understanding of this phenomenon is an integral step toward this goal. This review will summarize the history of direct-to-consumer drug advertisements and the current regulations governing them. It will summarize the evidence concerning the impact of direct-to-consumer advertising on the public, providers, and the health care system, and conclude with observations regarding the future of direct-to-consumer advertising.

  12. Direct Conversion of Energy. (United States)

    Corliss, William R.

    This publication is one of a series of information booklets for the general public published by the United States Atomic Energy Commission. Direct energy conversion involves energy transformation without moving parts. The concepts of direct and dynamic energy conversion plus the laws governing energy conversion are investigated. Among the topics…

  13. Decisions Concerning Directional Dependence (United States)

    von Eye, Alexander; DeShon, Richard P.


    In this rejoinder, von Eye and DeShon discuss the decision strategies proposed in their original article ("Directional Dependence in Developmental Research," this issue), as well as the ones proposed by the authors of the commentary (Pornprasertmanit and Little, "Determining Directional Dependency in Causal Associations," this issue). In addition,…

  14. Advanced practice nurses: starting an independent practice. (United States)

    Lambert, V A; Lambert, C E


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

  15. On the Practice Architectures of Instructional Leadership (United States)

    Salo, Petri; Nylund, Jan; Stjernstrøm, Else


    This paper explores the concept of instructional leadership and principals' perceptions of the practices of instructional leadership. Despite the emphasis on the effects of school leadership regarding teaching practices and learning outcomes, research on direct instructional leadership is scarce. It is focused either on identifying overall…

  16. The Logic of Practices of Stigmergy:

    DEFF Research Database (Denmark)

    Christensen, Lars Rune


    In their cooperative design practices, architects form series of interwoven representational artifacts. On the basis of a field study of architectural design, this article presents an analysis of these practices and shows how they are partly coordinated directly through the material field of work...

  17. Redesigning Principal Internships: Practicing Principals' Perspectives (United States)

    Anast-May, Linda; Buckner, Barbara; Geer, Gregory


    Internship programs too often do not provide the types of experiences that effectively bridge the gap between theory and practice and prepare school leaders who are capable of leading and transforming schools. To help address this problem, the current study is directed at providing insight into practicing principals' views of the types of…

  18. Variation of wave directional spread parameters along the Indian coast

    Digital Repository Service at National Institute of Oceanography (India)

    SanilKumar, V.

    through a directional wave spectrum, which represents distribution of wave energies over various wave frequencies and directions. Most widely practiced technique for directional data collection involves use of the floating buoys. The data analysis.... Estimation of directional spectra from the maximum entropy principle, Proceedings 5th International Conference on Offshore Mechanics and Arctic Engineering, Tokyo, Japan 1986; vol. I: 80-85. [6] Kuik AJ, Vledder G, Holthuijsen LH. A method for the routine...

  19. Directionality of dog vocalizations (United States)

    Frommolt, Karl-Heinz; Gebler, Alban


    The directionality patterns of sound emission in domestic dogs were measured in an anechoic environment using a microphone array. Mainly long-distance signals from four dogs were investigated. The radiation pattern of the signals differed clearly from an omnidirectional one with average differences in sound-pressure level between the frontal and rear position of 3-7 dB depending from the individual. Frequency dependence of directionality was shown for the range from 250 to 3200 Hz. The results indicate that when studying acoustic communication in mammals, more attention should be paid to the directionality pattern of sound emission.

  20. Direct Wittig Olefination of Alcohols. (United States)

    Li, Qiang-Qiang; Shah, Zaher; Qu, Jian-Ping; Kang, Yan-Biao


    A base-promoted transition metal-free approach to substituted alkenes using alcohols under aerobic conditions using air as the inexpensive and clean oxidant is described. Aldehydes are relatively difficult to handle compared to corresponding alcohols due to their volatility and penchant to polymerize and autoxidize. Wittig ylides are easily oxidized to aldehydes and consequently form homo-olefination products. By the strategy of simultaneously in situ generation of ylides and aldehydes, for the first time, alcohols are directly transferred to olefins with no need of prepreparation of either aldehydes or ylides. Thus, the di/monocontrollable olefination of diols is accomplished. This synthetically practical method has been applied in the gram-scale synthesis of pharmaceuticals, such as DMU-212 and resveratrol from alcohols.

  1. Review of Participatory Epidemiology Practices in Animal Health (1980-2015 and Future Practice Directions.

    Directory of Open Access Journals (Sweden)

    Alberto Allepuz

    Full Text Available In this study we combined an inventory of the major applications, geographic regions and diseases covered by participatory epidemiology (PE activities in the field of animal health since 1980, together with an email discussion forum with PE practitioners from different regions of the world. The inventory included the search of peer-reviewed papers, master and technical reports, conference proceedings, manuals, training materials and projects. The search resulted in a low number of PE activity results until the year 2000, followed by a considerable increase (especially from 2012. Most of the identified activities were implemented in Africa and Asia, and focused on surveillance, disease survey and prioritization, and disease control. Seventy-nine PE practitioners working predominantly in Africa, Asia and Europe (29, 22 and 18 respectively contributed to the email discussion forum. They proposed various modifications to the existing PE definition and discussed different issues related to the applicatoin of PE, its institutionalization for use in policy development, as well as the priorities for future development. The need to increase the number of PE trained people together with some methodological developments and the application of this methodology in developed countries, were some of the points highlighted during the forum. These factors stress the importance of further developing PE as a useful approach for engaging communities in addressing animal and related public health risks.

  2. FAA Directives System (United States)


    Consistent with the Federal Aviation Administration's mission to foster a safe, : secure, and efficient aviation system is the need for an effective and efficient : process for communitcating policy and procedures. The FAA Directives System : provide...

  3. Assessing directionality in context

    African Journals Online (AJOL)

    Kate H

    In support of first-language interpreting as the exclusive interpreting direction, ... some light on the possible interaction between two independent variables, .... the “local context” refers to the setting, genre, participants, and aims of the event.

  4. Directed line liquids

    International Nuclear Information System (INIS)

    Kamien, R.D.


    This thesis is devoted to the study of ensembles of dense directed lines. These lines are principally to be thought of as polymers, though they also have the morphology of flux lines in high temperature superconductors, strings of colloidal spheres in electrorheological fluids and the world lines of quantum mechanical bosons. The authors discuss how directed polymer melts, string-like formations in electrorheological and ferro-fluids, flux lines in high temperature superconductors and the world lines of quantum mechanical bosons all share similar descriptions. They study a continuous transition in all of these systems, and then study the critical mixing properties of binary mixtures of directed polymers through the renormalization group. They predict the exponents for a directed polymer blend consolute point and a novel two-phase superfluid liquid-gas critical point

  5. The ''energy tax'' directive

    International Nuclear Information System (INIS)



    As Austria dropped its reservation, U.E. Economics and Finance Ministers gave, on 20 March at Brussels, their political agreement to the proposed Directive on a Community framework for the taxation of energy products. (author)

  6. Directed GF-spaces

    Directory of Open Access Journals (Sweden)

    F.G. Arenas


    Full Text Available In this paper we introduce the concept of directed fractal structure, which is a generalization of the concept of fractal structure (introduced by the authors. We study the relation with transitive quasiuniformities and inverse limits of posets. We define the concept of GF-compactification and apply it to prove that the Stone-Cech compactification can be obtained as the GF-compactification of the directed fractal structure associated to the Pervin quasi-uniformity.

  7. ¿La práctica de la siembra directa en cultivos de soja favorece las poblaciones de acridios (Orthoptera: Acrididae en el partido de Benito Juárez? Does the direct tillage practice in soybean crops favour grasshopper populations (Orthoptera: Acrididae, in Benito Juárez county?

    Directory of Open Access Journals (Sweden)

    Daniel Scuffi


    Full Text Available Considerando el desarrollo del cultivo de soja en siembra directa en el partido de Benito Juárez, y que algunos autores sostienen que esta práctica favorece los acridios, se evaluó la riqueza de especies y la abundancia en soja con siembra directa y convencional. Se registraron siete especies (Aleuas lineatus Stål, Covasacris pallidinota (Bruner, Baeacris pseudopunctulatus (Ronderos, Dichroplus elongatus Giglio-Tos, Dichroplus maculipennis (Blanchard, Dichroplus pratensis Bruner y Scotussa lemniscata (Stål. La riqueza de especies acumulada en los diferentes cultivos fue similar (p> 0,05. En soja de primera con siembra directa, se registraron 2,3 ± 0,19 especies, en soja de primera con siembra convencional 1,45 ± 0,15 especies y en soja de segunda con siembra directa 2,25 ± 0,28 especies. Dichroplus elongatus fue la especie más abundante en todos los cultivos y en todos los momentos. Las restantes presentaron baja abundancia y se registraron en algunos momentos. No existió diferencia (p> 0,05 en la abundancia de tucuras entre los cultivos y en las diferentes fechas de muestreo. La baja riqueza de especies registrada estaría relacionada con la baja diversidad vegetal de los cultivos. Este estudio no mostró diferencias en la abundancia y riqueza de especies de acuerdo a la labranza utilizada.Considering the development of the soybean crops using direct tillage in Benito Juárez county, and taking into account that for some authors this practice favours the grasshopper populations, the abundance and species richness in soybean with direct and conventional tillage were evaluated. Seven species were registered (Aleuas lineatus Stål, Covasacris pallidinota (Bruner, Baeacris pseudopunctulatus (Ronderos, Dichroplus elongatus Giglio-Tos, Dichroplus maculipennis (Blanchard, Dichroplus pratensis Bruner and Scotussa lemniscata (Stål. The accumulated richness was similar (p> 0.05, along the different crops; 2.3 ± 0.19 species were registered in

  8. Civic ecology practices: insights from practice theory

    Directory of Open Access Journals (Sweden)

    Marianne E. Krasny


    Full Text Available Our aim was to explore the use of practice theory as an approach to studying urban environmental stewardship. Urban environmental stewardship, or civic ecology practice, contributes to ecosystem services and community well-being and has been studied using social-ecological systems resilience, property rights, communities of practice, and governance frameworks. Practice theory, which previously has been applied in studies of consumer behaviors, adds a new perspective to urban stewardship research, focusing on how elements of a practice, such as competencies, meanings, and physical resource, together define the practice. We applied practice theory to eight different civic ecology practices, including oyster gardening in New York City, a civil society group engaged in litter cleanup in Iran, and village grove restoration in South Korea. Our analysis suggests that in applying practice theory to the civic ecology context, consideration should be given to social and communication competencies, how meanings can motivate volunteers and sustain practice, and the nature of the resource that is being stewarded. Future studies may want to focus on how practice elements interact within and vary across practices and may be used to more systematically analyze and share ideas among diverse civic ecology practices.

  9. Evaluation of Competence of Medical Students in Performing Direct ...

    African Journals Online (AJOL)

    medical practice had significant eye problems. This demands that .... hoped this will form a template for feature longitudinal studies directed .... drops (P < 0.002, 2 yates corrected). ... Hean S, Craddock D, O'Halloran C. Learning theories and.

  10. Reading the Song of Songs through a spiritual direction lens

    African Journals Online (AJOL)


    3) essentials of spiritual direction, .... 1998:293–294), resulting in a preference for literal, erotic, and ... the practice, a relationship that impacts on the whole person within the .... personality integration and psychic wholeness.

  11. The Direct Methanol Liquid-Feed Fuel Cell (United States)

    Halpert, Gerald


    Until the early 1990's the idea of a practical direct methanol fuel cell from transportation and other applications was just that, an idea. Several types of fuel cells that operate under near ambient conditions were under development.

  12. Directly Observed Treatment Short Course (DOTS) appears to have ...

    African Journals Online (AJOL)

    Directly Observed Treatment Short Course (DOTS) appears to have reduced the self-care role of pulmonary tuberculosis patient: evidence from a correctional study between Personal Health Beliefs (PHB) and Self Care Practices (SCP)

  13. [Advance directives, a tool to humanize care]. (United States)

    Olmari-Ebbing, M; Zumbach, C N; Forest, M I; Rapin, C H


    The relationship between the patient and a medical care giver is complex specially as it implies to the human, juridical and practical points of view. It depends on legal and deontological considerations, but also on professional habits. Today, we are confronted to a fundamental modification of this relationship. Professional guidelines exist, but are rarely applied and rarely taught in universities. However, patients are eager to move from a paternalistic relationship to a true partnership, more harmonious and more respectful of individual values ("value based medicine"). Advance directives give us an opportunity to improve our practices and to provide care consistent with the needs and wishes of each patient.

  14. [Revised practice guideline 'Anaemia in midwifery practice'

    NARCIS (Netherlands)

    Beentjes, M.; Jans, S.M.P.J.


    The practice guideline of the Royal Dutch Organization of Midwives 'Anaemia in primary care midwifery practice' published in 2000, has recently been revised. The revised guideline takes physiological haemodilution during pregnancy into consideration and provides gestation specific reference values

  15. Directional outlyingness for multivariate functional data

    KAUST Repository

    Dai, Wenlin


    The direction of outlyingness is crucial to describing the centrality of multivariate functional data. Motivated by this idea, classical depth is generalized to directional outlyingness for functional data. Theoretical properties of functional directional outlyingness are investigated and the total outlyingness can be naturally decomposed into two parts: magnitude outlyingness and shape outlyingness which represent the centrality of a curve for magnitude and shape, respectively. This decomposition serves as a visualization tool for the centrality of curves. Furthermore, an outlier detection procedure is proposed based on functional directional outlyingness. This criterion applies to both univariate and multivariate curves and simulation studies show that it outperforms competing methods. Weather and electrocardiogram data demonstrate the practical application of our proposed framework.

  16. Geothermal direct use engineering and design guidebook

    International Nuclear Information System (INIS)

    Lienau, P.J.; Lunis, B.C.


    The Geothermal Direct Use Engineering and Design Guidebook is designed to be a comprehensive, thoroughly practical reference guide for engineers and designers of direct heat projects. These projects could include the conversion of geothermal energy into space heating and cooling of buildings, district heating, greenhouse heating, aquaculture and industrial processing. The Guidebook is directed at understanding the nature of geothermal resources and the exploration of the resources, fluid sampling techniques, drilling, and completion of geothermal wells through well testing, and reservoir evaluation. It presents information useful to engineers on the specification of equipment including well pumps, piping, heat exchangers, space heating equipment, heat pumps and absorption refrigeration. A compilation of current information about greenhouse aquaculture and industrial applications is included together with a discussion of engineering cost analysis, regulation requirements, and environmental consideration. The purpose of the Guidebook is to provide an integrated view for the development of direct use projects for which there is a very large potential in the United States

  17. Geothermal direct use engineering and design guidebook

    Energy Technology Data Exchange (ETDEWEB)

    Lienau, P.J.; Lunis, B.C. (eds.)


    The Geothermal Direct Use Engineering and Design Guidebook is designed to be a comprehensive, thoroughly practical reference guide for engineers and designers of direct heat projects. These projects could include the conversion of geothermal energy into space heating and cooling of buildings, district heating, greenhouse heating, aquaculture and industrial processing. The Guidebook is directed at understanding the nature of geothermal resources and the exploration of the resources, fluid sampling techniques, drilling, and completion of geothermal wells through well testing, and reservoir evaluation. It presents information useful to engineers on the specification of equipment including well pumps, piping, heat exchangers, space heating equipment, heat pumps and absorption refrigeration. A compilation of current information about greenhouse aquaculture and industrial applications is included together with a discussion of engineering cost analysis, regulation requirements, and environmental consideration. The purpose of the Guidebook is to provide an integrated view for the development of direct use projects for which there is a very large potential in the United States.

  18. Geothermal direct use engineering and design guidebook

    Energy Technology Data Exchange (ETDEWEB)

    Bloomquist, R.G.; Culver, G.; Ellis, P.F.; Higbee, C.; Kindle, C.; Lienau, P.J.; Lunis, B.C.; Rafferty, K.; Stiger, S.; Wright, P.M.


    The Geothermal Direct Use Engineering and Design Guidebook is designed to be a comprehensive, thoroughly practical reference guide for engineers and designers of direct heat projects. These projects could include the conversion of geothermal energy into space heating cooling of buildings, district heating, greenhouse heating, aquaculture and industrial processing. The Guidebook is directed at understanding the nature of geothermal resources and the exploration of these resources, fluid sampling techniques, drilling, and completion of geothermal wells through well testing, and reservoir evaluation. It presents information useful to engineers on the specification of equipment including well pumps, piping, heat exchangers, space heating equipment, heat pumps and absorption refrigeration. A compilation of current information about greenhouse, aquaculture and industrial applications is included together with a discussion of engineering cost analysis, regulation requirements, and environmental considerations. The purpose of the Guidebook is to provide an integrated view for the development of direct use projects for which there is a very potential in the United States.

  19. Starting a nursing consultation practice. (United States)

    Schulmeister, L


    Because the clinical nurse specialist (CNS) role has been changed or eliminated in many hospital organizations, many CNSs in career transition are considering establishing collaborative or independent nursing consultation practices. Opportunities for consultants exist in diverse practice settings and specialties. Before starting a consultation practice, the CNS should carefully examine goals, identify resources, and begin contacting potential referral sources. He or she must also decide what form of business organization to establish and write a business plan to solidify ideas and prepare for the unexpected. Most CNS consultants rely on personal savings to cover initial business and personal expenses, and many continue working as a CNS until the consultation practice is established. Fees can be set based on community standards, what the market will bear, desired projected income, or a third-party payor's fee schedule. The consultation practice can be marketed by word of mouth, inexpensive advertising techniques such as distributing flyers and business cards, direct mall, and media advertising. In today's healthcare marketplace, opportunities abound for the CNS risk-taker interested in starting a nursing consultation practice.

  20. Directed network modules

    International Nuclear Information System (INIS)

    Palla, Gergely; Farkas, Illes J; Pollner, Peter; Derenyi, Imre; Vicsek, Tamas


    A search technique locating network modules, i.e. internally densely connected groups of nodes in directed networks is introduced by extending the clique percolation method originally proposed for undirected networks. After giving a suitable definition for directed modules we investigate their percolation transition in the Erdos-Renyi graph both analytically and numerically. We also analyse four real-world directed networks, including Google's own web-pages, an email network, a word association graph and the transcriptional regulatory network of the yeast Saccharomyces cerevisiae. The obtained directed modules are validated by additional information available for the nodes. We find that directed modules of real-world graphs inherently overlap and the investigated networks can be classified into two major groups in terms of the overlaps between the modules. Accordingly, in the word-association network and Google's web-pages, overlaps are likely to contain in-hubs, whereas the modules in the email and transcriptional regulatory network tend to overlap via out-hubs

  1. Directivity of singers (United States)

    Jers, Harald


    Studies of acoustical balance between singers within a choir by means of room acoustical measurements have shown that the directional sound propagation of the source is important. For this reason the directivity of female and male singers for different vowels has been measured in this investigation. Measurements of a pilot study and some first measurements in 1998 have been supplemented with new measurements and an enhanced setup. A special measurement setup with reference and recording microphones was used to collect the directivity data. A resolution of 10 deg for azimuth and elevation angle was obtained. The results will be shown in 3D spherical plots with frequency adjustments in semitones from 80 to 8000 Hz. The measurements are compared to an artificial singer's directivity, and the influence of a sheet music binder in front of a singer will be shown. The results give information on the directivity of singers and are relevant for the prediction of self-to-other-ratios that result from placement and formation aspects within a choir.

  2. Estimating directional epistasis (United States)

    Le Rouzic, Arnaud


    Epistasis, i.e., the fact that gene effects depend on the genetic background, is a direct consequence of the complexity of genetic architectures. Despite this, most of the models used in evolutionary and quantitative genetics pay scant attention to genetic interactions. For instance, the traditional decomposition of genetic effects models epistasis as noise around the evolutionarily-relevant additive effects. Such an approach is only valid if it is assumed that there is no general pattern among interactions—a highly speculative scenario. Systematic interactions generate directional epistasis, which has major evolutionary consequences. In spite of its importance, directional epistasis is rarely measured or reported by quantitative geneticists, not only because its relevance is generally ignored, but also due to the lack of simple, operational, and accessible methods for its estimation. This paper describes conceptual and statistical tools that can be used to estimate directional epistasis from various kinds of data, including QTL mapping results, phenotype measurements in mutants, and artificial selection responses. As an illustration, I measured directional epistasis from a real-life example. I then discuss the interpretation of the estimates, showing how they can be used to draw meaningful biological inferences. PMID:25071828

  3. Investigating a new material Practice

    DEFF Research Database (Denmark)

    Tamke, Martin; Nicholas, Paul; Ayres, Phil


    Investigating ways of integrating material performance as a design parameter, four presented projects employ the ability to model force and flow to parameterize and calculate material properties. According to Beylerian and Ritter material performance is today regarded as one of the richest sources...... of innovation. By understanding materials not as static or inanimate, but as engaged by complex behaviours and performances, a new dimension of design potentials can be unleashed. The notion of a new digital-material practice, in which the design and detailing of materials are directly linked to the design...... and detailing of buildings, provides the framework for an emerging field of architectural research. Aiming to innovate structural thinking and create better and more sustainable material usage, these new material practices rely on the ability to compute complex inter-scalar dependencies and link these directly...

  4. Direct reading dosimeter

    International Nuclear Information System (INIS)

    Thomson, I.


    This invention is a direct reading dosimeter which is light, small enough to be worn on a person, and measures both dose rates and total dose. It is based on a semiconductor sensor. The gate threshold voltage change rather than absolute value is measured and displayed as a direct reading of the dose rate. This is effected by continuously switching the gate of an MOS transistor from positive to negative bias. The output can directly drive a digital readout or trigger an audible alarm. The sensor device can be a MOSFET, bipolar transistor, or MOSFET capacitor which has its electrical characteristics change due to the trapped charge in the insulating layer of the device

  5. The direction of time

    CERN Document Server

    Reichenbach, Hans


    Ever a source of philosophical conjecture and debate, the concept of time represents the beating heart of physics. This final work by the distinguished physicist Hans Reichenbach represents the culmination and integration of a lifetime's philosophical contributions and inquiries into the analysis of time. The result is an outstanding overview of such qualitative, or topological, attributes of time as order and direction.Beginning with a discussion of the emotive significance of time, Reichenbach turns to an examination of the time order of mechanics, the time direction of thermodynamics and m

  6. Incretin secretion: direct mechanisms

    DEFF Research Database (Denmark)

    Balk-Møller, Emilie; Holst, Jens Juul; Kuhre, Rune Ehrenreich


    The incretin hormones glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide 1 (GLP-1) are secreted from gastro-intestinal K- and L-cells, respectively, and play an important role in post-prandial blood glucose regulation. They do this by direct stimulation of the pancreatic β...... enzyme responsible for incretin degradation (dipeptidyl peptidase-4) is inhibited (drugs are already on the market) while the secretion of endogenous GLP-1 secretion is stimulated at the same time may prove particularly rewarding. In this section we review current knowledge on the mechanisms for direct...

  7. Functional Behavior Assessment in Schools: Current Status and Future Directions (United States)

    Anderson, Cynthia M.; Rodriguez, Billie Jo; Campbell, Amy


    Functional behavior assessment is becoming a commonly used practice in school settings. Accompanying this growth has been an increase in research on functional behavior assessment. We reviewed the extant literature on documenting indirect and direct methods of functional behavior assessment in school settings. To discern best practice guidelines…

  8. On the Retrieval of the Directional Scattering Matrix from Directional Noise

    NARCIS (Netherlands)

    Wapenaar, C.P.A.; Thorbecke, J.W.


    The crosscorrelation of ambient acoustic noise observed at two receivers yields the impulse response between these receivers, assuming that the noise field is diffuse. In practical situations the noise field exhibits directionality, which imprints the angle-dependent correlation function. For the

  9. Novel robotic systems and future directions

    Directory of Open Access Journals (Sweden)

    Ki Don Chang


    Full Text Available Robot-assistance is increasingly used in surgical practice. We performed a nonsystematic literature review using PubMed/MEDLINE and Google for robotic surgical systems and compiled information on their current status. We also used this information to predict future about the direction of robotic systems based on various robotic systems currently being developed. Currently, various modifications are being made in the consoles, robotic arms, cameras, handles and instruments, and other specific functions (haptic feedback and eye tracking that make up the robotic surgery system. In addition, research for automated surgery is actively being carried out. The development of future robots will be directed to decrease the number of incisions and improve precision. With the advent of artificial intelligence, a more practical form of robotic surgery system can be introduced and will ultimately lead to the development of automated robotic surgery system.

  10. Direct Sulfation of Limestone

    DEFF Research Database (Denmark)

    Hu, Guilin; Dam-Johansen, Kim; Wedel, Stig


    The direct sulfation of limestone was studied in a laboratory fixed-bed reactor. It is found that the direct sulfation of limestone involves nucleation and crystal grain growth of the solid product (anhydrite). At 823 K and at low-conversions (less than about 0.5 %), the influences of SO2, O-2...... and CO2 on the direct sulfation of limestone corresponds to apparent reaction orders of about 0.2, 0.2 and -0.5, respectively. Water is observed to promote the sulfation reaction and increase the apparent reaction orders of SO2 and O-2. The influence of O-2 at high O-2 concentrations (> about 15...... %) becomes negligible. In the temperature interval from 723 K to 973 K, an apparent activation energy of about 104 kJ/mol is observed for the direct sulfation of limestone. At low temperatures and low conversions, the sulfation process is most likely under mixed control by chemical reaction and solid...

  11. Danish directional adverbs:

    DEFF Research Database (Denmark)

    Hovmark, Henrik


    Danish directional adverbs (DDA) (for instance op ’up’, ned ’down’, and ud ’out’) are characterized by an important special feature as satellites – they have different forms: a zero-form (ud-Ø), a form with a derivative e-suffix (ud-e), and a third form with a prepositional ad-suffix (‘ wards’). ...

  12. Directional loudness perception

    DEFF Research Database (Denmark)

    Sivonen, Ville Pekka

    developed. The research and modeling of loudness have mainly been concerned with the temporal and spectral aspects of sounds, while the spatial aspects have mostly been overlooked. This PhD thesis investigates the spatial aspects of loudness perception, namely, how does the direction from which a sound...

  13. Direct contamination - seasonality

    International Nuclear Information System (INIS)

    Aarkrog, A.


    Direct contamination is the primary pathway to terrestrial vegetation in the first period after an activity release to the atmosphere. All radionuclides are able to be transferred via this pathway. Deposition, interception and retention are the three processes involved in direct contamination of crops. Wet deposition is more important than dry deposition in temperature regions. Resuspension and rainsplash both belong to secondary direct deposition and became evident for e.g. radiocaesium after the Chernobyl accident. Seasonality is the varying response to radioactive contamination of crops according to the time of the year when the contamination occurs. Shortlived radionuclides (as 131 I) and those that mainly enter the foodchain by direct contamination (e.g. 137 Cs) are especially important in this connection. In particular, the contamination of cereal crops is influenced by seasonality. As a result of seasonality the impact of the Chernobyl accident on the radioactive contamination of human diet was for the same deposition density higher in southern than in northern Europe. (orig.)

  14. Direct vision internal urethrotomy

    DEFF Research Database (Denmark)

    Jakobsen, H; Willumsen, H; Søndergaard Jensen, L


    During a five-year period, direct vision internal urethrotomy was used for the treatment of urethral strictures in 34 men. After the primary operation the patients were followed for an average period of 29 months (range 3-73 months). During this period 53% of the patients were found to have one...

  15. Direct photon experiments

    International Nuclear Information System (INIS)

    Boeggild, H.


    The author reviews the experiments on direct photon production in hadronic collisions. After a description of the experimental methods for the study of such processes he presents some results on differential cross sections and the γ/π 0 ratio in π - p, π + p, pp, and anti pp processes as well as in reactions of π - , π + , and p on carbon. (HSI)

  16. Polymer Directed Protein Assemblies

    Directory of Open Access Journals (Sweden)

    Patrick van Rijn


    Full Text Available Protein aggregation and protein self-assembly is an important occurrence in natural systems, and is in some form or other dictated by biopolymers. Very obvious influences of biopolymers on protein assemblies are, e.g., virus particles. Viruses are a multi-protein assembly of which the morphology is dictated by poly-nucleotides namely RNA or DNA. This “biopolymer” directs the proteins and imposes limitations on the structure like the length or diameter of the particle. Not only do these bionanoparticles use polymer-directed self-assembly, also processes like amyloid formation are in a way a result of directed protein assembly by partial unfolded/misfolded biopolymers namely, polypeptides. The combination of proteins and synthetic polymers, inspired by the natural processes, are therefore regarded as a highly promising area of research. Directed protein assembly is versatile with respect to the possible interactions which brings together the protein and polymer, e.g., electrostatic, v.d. Waals forces or covalent conjugation, and possible combinations are numerous due to the large amounts of different polymers and proteins available. The protein-polymer interacting behavior and overall morphology is envisioned to aid in clarifying protein-protein interactions and are thought to entail some interesting new functions and properties which will ultimately lead to novel bio-hybrid materials.

  17. Direct Lending Works. (United States)

    Riley, Richard W.


    In its third year, direct lending is working well for college students and administration. It is a simpler, faster, more efficient way of getting loan funds to students that cuts out financial middlemen. It helps students manage their finances better when repaying loans, promotes competition, stimulates program innovation, leads to greater…

  18. Direction of Attentional Focus in Biofeedback Treatment for /R/ Misarticulation (United States)

    McAllister Byun, Tara; Swartz, Michelle T.; Halpin, Peter F.; Szeredi, Daniel; Maas, Edwin


    Background: Maintaining an external direction of focus during practice is reported to facilitate acquisition of non-speech motor skills, but it is not known whether these findings also apply to treatment for speech errors. This question has particular relevance for treatment incorporating visual biofeedback, where clinician cueing can direct the…

  19. Direct oxide reducing method

    International Nuclear Information System (INIS)

    Tokiwai, Moriyasu.


    Calcium oxides and magnetic oxides as wastes generated upon direct reduction are subjected to molten salt electrolysis, and reduced metallic calcium and magnesium are separated and recovered. Then calcium and magnesium are used recyclically as the reducing agent upon conducting direct oxide reduction. Even calcium oxides and magnesium oxides, which have high melting points and difficult to be melted usually, can be melted in molten salts of mixed fluorides or chlorides by molten-salt electrolysis. Oxides are decomposed by electrolysis, and oxygen is removed in the form of carbon monoxide, while the reduced metallic calcium and magnesium rise above the molten salts on the side of a cathode, and then separated. Since only carbon monoxide is generated as radioactive wastes upon molten salt electrolysis, the amount of radioactive wastes can be greatly reduced, and the amount of the reducing agent used can also be decreased remarkably. (N.H.)

  20. Direct use in Hawaii

    International Nuclear Information System (INIS)

    Beck, A.G.


    This paper reports on a public laboratory, Noi'i O Puna, that was established in Hawaii to support direct use research in 1985, tapping the previously unutilized heat in brines from the HGP-A well. Two rounds of small grants were offered to entrepreneurs. With the closure of the HGP-A power plant in late 1989, Noi'i O Puna is expanding its facilities. When the HGP-A well is back in service, Noi'i O Puna will be able to support additional research and development projects, as well as pre-commercial ventures. Direct use industries, which support existing agricultural activities in the region have good potential

  1. Direct Communication Systems


    Krajačić, Ivan


    Today we use numerous methods of direct communications, for which we use a technical term Unified Communications. It is almost impossible to imagine the business world today without Unified Communications, which are improving productivity and reducing costs. The goal of using Unified Communications is to ensure a consistent user experience at any location and any device. Skype for Business, a Microsoft product, is one of the solutions for Unified Communications and is described in this thesis...

  2. Directional borehole antenna - Theory

    International Nuclear Information System (INIS)

    Falk, L.


    A directional antenna has been developed for the borehole radar constructed during phase 2 of the Stripa project. The new antenna can determine the azimuth of a strong reflector with an accuracy of about 3 degrees as confirmed during experiments in Stripa, although the ratio of borehole diameter to wavelength is small, about 0.03. The antenna synthesizes the effect of a loop antenna rotating in the borehole from four signals measured in turn by a stationary antenna. These signals are also used to calculate an electric dipole signal and a check sum which is used to examine the function of the system. The theory of directional antennas is reviewed and used to design an antenna consisting of four parallel wires. The radiation pattern of this antenna is calculated using transmission line theory with due regard to polarization, which is of fundamental importance for the analysis of directional data. In particular the multipole expansion of the field is calculated to describe the antenna radiation pattern. Various sources of error, e.g. the effect of the borehole, are discussed and the methods of calibrating the antenna are reviewed. The ambiguity inherent in a loop antenna can be removed by taking the phase of the signal into account. Typical reflectors in rock, e.g. fracture zones an tunnels, may be modelled as simple geometrical structures. The corresponding analysis is described and exemplified on measurements from Stripa. Radar data is nowadays usually analyzed directly on the computer screen using the program RADINTER developed within the Stripa project. An algorithm for automatic estimation of the parameters of a reflector have been tested with some success. The relation between measured radar data and external coordinates as determined by rotational indicators is finally expressed in terms of Euler angles. (au)

  3. Direct hydrocarbon fuel cells (United States)

    Barnett, Scott A.; Lai, Tammy; Liu, Jiang


    The direct electrochemical oxidation of hydrocarbons in solid oxide fuel cells, to generate greater power densities at lower temperatures without carbon deposition. The performance obtained is comparable to that of fuel cells used for hydrogen, and is achieved by using novel anode composites at low operating temperatures. Such solid oxide fuel cells, regardless of fuel source or operation, can be configured advantageously using the structural geometries of this invention.

  4. Future directions for QCD

    International Nuclear Information System (INIS)

    Bjorken, J.D.


    New directions for exploring QCD at future high-energy colliders are sketched. These include jets within jets. BFKL dynamics, soft and hard diffraction, searches for disoriented chiral condensate, and doing a better job on minimum bias physics. The new experimental opportunities include electron-ion collisions at HERA, a new collider detector at the C0 region of the TeVatron, and the FELIX initiative at the LHC

  5. Perspective on direct conversion

    Energy Technology Data Exchange (ETDEWEB)

    Lewis, W B


    The objective of direct conversion is high electrical output for minimum total cost, and not always high conversion efficiency. The wide range of techniques embracing cryogenics and hot plasma derives from the special requirements of source, environment, and application. Sources include solar and other radiation, nuclear fission and fusion, chemical energy, and heat. Environments and applications range from space vehicles to submarines and from giant power networks to isolated buoys and pocket devices. (auth)

  6. Farm Management: rethinking directions?


    Kemp, David R.; Girdwood, John; Parton, Kevin A.; Charry, Al A.


    Farms and farming are major contributors to the world economy, directly responsible for a large part of GDP. These achievements are not trivial and imply that farms are being managed in reasonably effective ways, else agricultural industries would not be sustained. However has the study of Farm Management within Australia made significant contributions to agriculture or lagged in the background. Is it contributing to better Farm Management or merely cataloguing what has happened? Is it leadin...

  7. Challenges to Safe Injection Practices in Ambulatory Care. (United States)

    Anderson, Laura; Weissburg, Benjamin; Rogers, Kelli; Musuuza, Jackson; Safdar, Nasia; Shirley, Daniel


    Most recent infection outbreaks caused by unsafe injection practices in the United States have occurred in ambulatory settings. We utilized direct observation and a survey to assess injection practices at 31 clinics. Improper vial use was observed at 13 clinics (41.9%). Pharmacy support and healthcare worker education may improve injection practices. Infect Control Hosp Epidemiol 2017;38:614-616.

  8. Direct marketing a automobilový trh


    Humaj, Matúš


    Bachelor's thesis focuses on direct marketing in close links with car market in Czech republic. Theoretical part points to direct marketing like event of marketing communication, it mentions about advantages and disadvantages, functions, tools and about adjustmen. In practical part I try to find the weak site of the market by the help of market's analysis and questionnaire and I propose the concept of direct marketing utilization.

  9. Geodetic analysis of disputed accurate qibla direction (United States)

    Saksono, Tono; Fulazzaky, Mohamad Ali; Sari, Zamah


    Muslims perform the prayers facing towards the correct qibla direction would be the only one of the practical issues in linking theoretical studies with practice. The concept of facing towards the Kaaba in Mecca during the prayers has long been the source of controversy among the muslim communities to not only in poor and developing countries but also in developed countries. The aims of this study were to analyse the geodetic azimuths of qibla calculated using three different models of the Earth. The use of ellipsoidal model of the Earth could be the best method for determining the accurate direction of Kaaba from anywhere on the Earth's surface. A muslim cannot direct himself towards the qibla correctly if he cannot see the Kaaba due to setting out process and certain motions during the prayer this can significantly shift the qibla direction from the actual position of the Kaaba. The requirement of muslim prayed facing towards the Kaaba is more as spiritual prerequisite rather than physical evidence.

  10. Transfusion practices in trauma

    Directory of Open Access Journals (Sweden)

    V Trichur Ramakrishnan


    Full Text Available Resuscitation of a severely traumatised patient with the administration of crystalloids, or colloids along with blood products is a common transfusion practice in trauma patients. The determination of this review article is to update on current transfusion practices in trauma. A search of PubMed, Google Scholar, and bibliographies of published studies were conducted using a combination of key-words. Recent articles addressing the transfusion practises in trauma from 2000 to 2014 were identified and reviewed. Trauma induced consumption and dilution of clotting factors, acidosis and hypothermia in a severely injured patient commonly causes trauma-induced coagulopathy. Early infusion of blood products and early control of bleeding decreases trauma-induced coagulopathy. Hypothermia and dilutional coagulopathy are associated with infusion of large volumes of crystalloids. Hence, the predominant focus is on damage control resuscitation, which is a combination of permissive hypotension, haemorrhage control and haemostatic resuscitation. Massive transfusion protocols improve survival in severely injured patients. Early recognition that the patient will need massive blood transfusion will limit the use of crystalloids. Initially during resuscitation, fresh frozen plasma, packed red blood cells (PRBCs and platelets should be transfused in the ratio of 1:1:1 in severely injured patients. Fresh whole blood can be an alternative in patients who need a transfusion of 1:1:1 thawed plasma, PRBCs and platelets. Close monitoring of bleeding and point of care coagulation tests are employed, to allow goal-directed plasma, PRBCs and platelets transfusions, in order to decrease the risk of transfusion-related acute lung injury.

  11. Empirical validation of directed functional connectivity. (United States)

    Mill, Ravi D; Bagic, Anto; Bostan, Andreea; Schneider, Walter; Cole, Michael W


    Mapping directions of influence in the human brain connectome represents the next phase in understanding its functional architecture. However, a host of methodological uncertainties have impeded the application of directed connectivity methods, which have primarily been validated via "ground truth" connectivity patterns embedded in simulated functional MRI (fMRI) and magneto-/electro-encephalography (MEG/EEG) datasets. Such simulations rely on many generative assumptions, and we hence utilized a different strategy involving empirical data in which a ground truth directed connectivity pattern could be anticipated with confidence. Specifically, we exploited the established "sensory reactivation" effect in episodic memory, in which retrieval of sensory information reactivates regions involved in perceiving that sensory modality. Subjects performed a paired associate task in separate fMRI and MEG sessions, in which a ground truth reversal in directed connectivity between auditory and visual sensory regions was instantiated across task conditions. This directed connectivity reversal was successfully recovered across different algorithms, including Granger causality and Bayes network (IMAGES) approaches, and across fMRI ("raw" and deconvolved) and source-modeled MEG. These results extend simulation studies of directed connectivity, and offer practical guidelines for the use of such methods in clarifying causal mechanisms of neural processing. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Bioenergy good practice

    Energy Technology Data Exchange (ETDEWEB)

    Birse, J.; Chambers, K.


    This report gives details of a project to make the Good Practice Guidelines, which were developed to help the UK Bioenergy industry, the national and local governments, and the public, more widely available. Details concerning the designing of a Good Practice Programme, and the proposed codes of Good Practice programme are given, and general relevant good practice guidance documents are discussed. The stakeholder survey and workshop, and the proposed codes of a Good Practice Programme are presented in Annexes. (UK)

  13. Direct probability mapping of contaminants

    International Nuclear Information System (INIS)

    Rautman, C.A.


    Exhaustive characterization of a contaminated site is a physical and practical impossibility. Descriptions of the nature, extent, and level of contamination, as well as decisions regarding proposed remediation activities, must be made in a state of uncertainty based upon limited physical sampling. Geostatistical simulation provides powerful tools for investigating contaminant levels, and in particular, for identifying and using the spatial interrelationships among a set of isolated sample values. This additional information can be used to assess the likelihood of encountering contamination at unsampled locations and to evaluate the risk associated with decisions to remediate or not to remediate specific regions within a site. Past operation of the DOE Feed Materials Production Center has contaminated a site near Fernald, Ohio, with natural uranium. Soil geochemical data have been collected as part of the Uranium-in-Soils Integrated Demonstration Project. These data have been used to construct a number of stochastic images of potential contamination for parcels approximately the size of a selective remediation unit. Each such image accurately reflects the actual measured sample values, and reproduces the univariate statistics and spatial character of the extant data. Post-processing of a large number of these equally likely, statistically similar images produces maps directly showing the probability of exceeding specified levels of contamination. Evaluation of the geostatistical simulations can yield maps representing the expected magnitude of the contamination for various regions and other information that may be important in determining a suitable remediation process or in sizing equipment to accomplish the restoration

  14. Direct Fast-Neutron Detection

    International Nuclear Information System (INIS)

    DC Stromswold; AJ Peurrung; RR Hansen; PL Reeder


    Direct fast-neutron detection is the detection of fast neutrons before they are moderated to thermal energy. We have investigated two approaches for using proton-recoil in plastic scintillators to detect fast neutrons and distinguish them from gamma-ray interactions. Both approaches use the difference in travel speed between neutrons and gamma rays as the basis for separating the types of events. In the first method, we examined the pulses generated during scattering in a plastic scintillator to see if they provide a means for distinguishing fast-neutron events from gamma-ray events. The slower speed of neutrons compared to gamma rays results in the production of broader pulses when neutrons scatter several times within a plastic scintillator. In contrast, gamma-ray interactions should produce narrow pulses, even if multiple scattering takes place, because the time between successive scattering is small. Experiments using a fast scintillator confirmed the presence of broader pulses from neutrons than from gamma rays. However, the difference in pulse widths between neutrons and gamma rays using the best commercially available scintillators was not sufficiently large to provide a practical means for distinguishing fast neutrons and gamma rays on a pulse-by-pulse basis. A faster scintillator is needed, and that scintillator might become available in the literature. Results of the pulse-width studies were presented in a previous report (peurrung et al. 1998), and they are only summarized here

  15. The direct manipulation shell

    International Nuclear Information System (INIS)

    Allen, M.E.; Christiansen, M.


    Accelerator controls systems provide parameter display pages which allow the operator to monitor and manipulate selected control points in the system. Display pages are generally implemented as either hand-crafted, purpose-built programs; or by using a specialized display page layout tool. These two methods of display page development exhibit the classic trade-off between functionality vs. ease of implementation. In the Direct Manipulation Shell we approach the process of developing a display page in a manifestly object-oriented manner. This is done by providing a general framework for interactively instantiating and manipulating display objects. (author)

  16. Does direct experience matter?

    DEFF Research Database (Denmark)

    Miralles, Francesc; Giones, Ferran; Gozun, Brian


    of being engaged in entrepreneurial behavior on entrepreneurial intention. We aim to shed light on whether the direct experience reinforces an individual’s entrepreneurial intention or reduces it. Building on an extended version of the planned behavior theory, we use the behavioral reasoning theory...... and an individual’s intention by introducing behavioral reasoning theory. These results provide support to initiatives to adapt entrepreneurship promotion efforts to the specific characteristics of the participants.......Entrepreneurial behavior research has used intention models to explain how an individual’s beliefs shape the attitudes and motivations that influence entrepreneurial intention. Nevertheless, as entrepreneurship promotion initiatives become global, it becomes relevant to explore the consequences...

  17. Directions for further research

    DEFF Research Database (Denmark)

    Minsaas, Atle; Psaraftis, Harilaos N.


    Green transportation logistics is an area that combines the following: (a) it is relatively new in terms of research carried out thus far, (b) it has become increasingly important for both industry and society, and (c) it is rich in topics for further research, both basic and applied. In this final...... chapter of this book we discuss directions for further research in this area. We do so by taking stock of (1) related recommendations of project SuperGreen, and (2) related activities mainly in European research. Links between research and policy-making as two activities that should go hand in hand...

  18. Directionally Solidified Multifunctional Ceramics (United States)


    Vidrio , Vol. 44 [5] (2005) pp 347 - 352. 9. F. W. Dynys and A. Sayir, "Self Assemble Silicide Architectures by Directional Solidification," Journal...Sociedad Espanola de Ceramica y Vidrio , Vol. 43 [4] (2004) pp 753 - 758. 21. A. Sayir and F. S. Lowery, "Combustion-Resistance of Silicon-Based Ceramics...Espafiola de Cerdmica y Vidrio , Vol. 43 [3], 2004. ISSN-0366-3175-BSCVB9. 14 37. P. Berger, A. Sayir and M. H. Berger, "Nuclear Microprobe using Elastic

  19. Direct access to INIS

    International Nuclear Information System (INIS)

    Zheludev, I.S.; Romanenko, A.G.


    Librarians, researchers, and information specialists throughout the world now have the opportunity for direct access to coverage of almost 95% of the world's literature dealing with the peaceful uses of atomic energy and nuclear science. This opportunity has been provided by the International Nuclear Information System (INIS) of the IAEA. INIS, with the voluntary collaboration of more than 60 of the Agency's Member States, maintains a comprehensive, computer-resident data-base, containing the bibliographic details plus informative abstracts of the bulk of the world's literature on nuclear science and technology. Since this data-base is growing at a rate of 75,000 items per year, and already contains more than 500,000 items, it is obviously important to be able to search this collection conveniently and efficiently. The usefulness of this ability is enhanced when other data-bases on related subjects are made available on an information network. During the early 1970s, on-line interrogation of large bibliographic data-bases became the accepted method for searching this type of information resource. Direct interaction between the searcher and the data-base provides quick feed-back resulting in improved literature listings for launching research and development projects. On-line access enables organizations which cannot store a large data-base on their own computer to expand the information resources at their command. Because of these advantages, INIS undertook to extend to interested Member States on-line access to its data-base in Vienna

  20. Direct thermal dyes (United States)

    Ehlinger, Edward


    Direct thermal dyes are members of a class of compounds referred to in the imaging industry as color formers or leuco dyes. The oldest members of that class have simple triarylmethane structures, and have been employed for years in various dyeing applications. More complex triarylmethane compounds, such as phthalides and fluorans, are now used in various imaging systems to produce color. Color is derived from all of these compounds via the same mechanism, on a molecular level. That is, an event of activation produces a highly resonating cationic system whose interaction with incident light produces reflected light of a specific color. The activation event in the case of a direct thermal system is the creation of a melt on the paper involving dye and an acidic developer. The three major performance parameters in a thermal system are background color, image density, and image stability. The three major dye physical parameters affecting thermal performance are chemical constituency, purity, and particle size. Those dyes having the best combination of characteristics which can also be manufactured economically dominate the marketplace. Manufacturing high performance dyes for the thermal market involves multi-step, convergent reaction sequences performed on large scale. Intermediates must be manufactured at the right time, and at the right quality to be useful.

  1. Remote direct memory access (United States)

    Archer, Charles J.; Blocksome, Michael A.


    Methods, parallel computers, and computer program products are disclosed for remote direct memory access. Embodiments include transmitting, from an origin DMA engine on an origin compute node to a plurality target DMA engines on target compute nodes, a request to send message, the request to send message specifying a data to be transferred from the origin DMA engine to data storage on each target compute node; receiving, by each target DMA engine on each target compute node, the request to send message; preparing, by each target DMA engine, to store data according to the data storage reference and the data length, including assigning a base storage address for the data storage reference; sending, by one or more of the target DMA engines, an acknowledgment message acknowledging that all the target DMA engines are prepared to receive a data transmission from the origin DMA engine; receiving, by the origin DMA engine, the acknowledgement message from the one or more of the target DMA engines; and transferring, by the origin DMA engine, data to data storage on each of the target compute nodes according to the data storage reference using a single direct put operation.

  2. Direct neutrino mass measurements

    Energy Technology Data Exchange (ETDEWEB)

    Weinheimer, Christian, E-mail: [Westfaelische Wilhelms-Universitaet, Institut fuer Kernphysik (Germany)


    Direct neutrino mass experiments are complementary to searches for neutrinoless double {beta}-decay and to analyses of cosmological data. The previous tritium beta decay experiments at Mainz and at Troitsk have achieved upper limits on the neutrino mass of about 2 eV/c{sup 2} . The KATRIN experiment under construction will improve the neutrino mass sensitivity down to 200 meV/c{sup 2} by increasing strongly the statistics and-at the same time-reducing the systematic uncertainties. Huge improvements have been made to operate the system extremely stably and at very low background rate. The latter comprises new methods to reject secondary electrons from the walls as well as to avoid and to eject electrons stored in traps. As an alternative to tritium {beta}-decay experiments cryo-bolometers investigating the endpoint region of {sup 187}Re {beta}-decay or the electron capture of {sup 163}Ho are being developed. This article briefly reviews the current status of the direct neutrino mass measurements.

  3. Cutting out the middleman: physicians can contract directly with employers--a viable alternative to adversarial managed care agreements. (United States)

    Lester, Howard


    HMOs, PPOs, and other managed care "middlemen" control the means by which most physicians do business with employers. As physicians face dwindling reimbursements, greater practice restrictions, and increased pressure to sign adversarial middleman contracts, interest in direct contracting has grown. This article introduces direct contracting as an important alternative to commercial managed care agreements; cites the key advantages and process of direct contracting; and offers practical recommendations for helping physician practices successfully negotiate direct physician/employer agreements.

  4. Previous Experience a Model of Practice UNAE


    Ormary Barberi Ruiz; María Dolores Pesántez Palacios


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

  5. Studying Engineering Practice

    DEFF Research Database (Denmark)

    Buch, Anders


    The study of engineering practices has been the focus of Engineering Studies over the last three decades. Theses studies have used ethnographic and grounded methods in order to investigate engineering practices as they unfold in natural settings - in workplaces and engineering education. However......, engineering studies have not given much attention to conceptually clarifying what should be understood by 'engineering practices' and more precisely account for the composition and organization of the entities and phenomena that make up the practices. This chapter investigates and discusses how a 'practice...... will draw out some methodological consequences and discuss the ramifications of a practice theoretical approach for Engineering Studies....

  6. Direct saccharification of milo

    Energy Technology Data Exchange (ETDEWEB)


    Crude or unrefined milo grain is pulverized to less than 100 mesh, suspended in water, and directly saccharified with enzymes. Thus, 10 kg of pulverized milo (100 mesh) was suspended in 20 liters water, liquified in the presence of bacterial amylase at 90/sup 0/ for 30 minutes and autoclaved for 10 minutes at 120/sup 0/, the liquifaction autoclave procedures were then repeated. The liquified preparation was saccharified in the presence of bacterial glucoamylase at 55/sup 0/ for 72 hours. The percentage saccharification of unrefined milo was 92-97%, which was comparable to that obtained with refined milo or a milo starch preparation. The saccharified milo preparation, when used as a sugar source in glutamic acid, lysine, or inosine fermentation, also showed similar efficiency to that of saccharified milo starch.

  7. Site directed recombination (United States)

    Jurka, Jerzy W.


    Enhanced homologous recombination is obtained by employing a consensus sequence which has been found to be associated with integration of repeat sequences, such as Alu and ID. The consensus sequence or sequence having a single transition mutation determines one site of a double break which allows for high efficiency of integration at the site. By introducing single or double stranded DNA having the consensus sequence flanking region joined to a sequence of interest, one can reproducibly direct integration of the sequence of interest at one or a limited number of sites. In this way, specific sites can be identified and homologous recombination achieved at the site by employing a second flanking sequence associated with a sequence proximal to the 3'-nick.

  8. Nanoparticles and direct immunosuppression (United States)

    Ngobili, Terrika A


    Targeting the immune system with nanomaterials is an intensely active area of research. Specifically, the capability to induce immunosuppression is a promising complement for drug delivery and regenerative medicine therapies. Many novel strategies for immunosuppression rely on nanoparticles as delivery vehicles for small-molecule immunosuppressive compounds. As a consequence, efforts in understanding the mechanisms in which nanoparticles directly interact with the immune system have been overshadowed. The immunological activity of nanoparticles is dependent on the physiochemical properties of the nanoparticles and its subsequent cellular internalization. As the underlying factors for these reactions are elucidated, more nanoparticles may be engineered and evaluated for inducing immunosuppression and complementing immunosuppressive drugs. This review will briefly summarize the state-of-the-art and developments in understanding how nanoparticles induce immunosuppressive responses, compare the inherent properties of nanomaterials which induce these immunological reactions, and comment on the potential for using nanomaterials to modulate and control the immune system. PMID:27229901

  9. Directionally positionable neutron beam

    International Nuclear Information System (INIS)

    Dance, W.E.; Bumgardner, H.M.


    Disclosed is apparatus for forming and directionally positioning a neutron beam. The apparatus includes an enclosed housing rotatable about a first axis with a neutron source axially positioned on the axis of rotation of the enclosed housing but not rotating with the housing. The rotatable housing is carried by a vertically positionable arm carried on a mobile transport. A collimator is supported by the rotatable housing and projects into the housing to orientationally position its inlet window at an adjustably fixed axial and radial spacing from the neutron source so that rotation of the enclosed housing causes the inlet window to rotate about a circle which is a fixed axial distance from the neutron source and has the axis of rotation of the housing as its center. (author)

  10. Directional epithermal neutron detector

    International Nuclear Information System (INIS)

    Givens, W.W.; Mills, W.R. Jr.


    A borehole tool for epithermal neutron die-away logging of subterranean formations surrounding a borehole is described which consists of: (a) a pulsed source of fast neutrons for irradiating the formations surrounding a borehole, (b) at least one neutron counter for counting epithermal neutrons returning to the borehole from the irradiated formations, (c) a neutron moderating material, (d) an outer thermal neutron shield providing a housing for the counter and the moderating material, (e) an inner thermal neutron shield dividing the housing so as to provide a first compartment bounded by the inner thermal neutron shield and a first portion of the outer thermal neutron shield and a second compartment bounded by the inner thermal neutron shield and a second portion of the outer thermal neutron shield, the counter being positioned within the first compartment and the moderating material being positioned within the second compartment, and (f) means for positioning the borehole tool against one side of the borehole wall and azimuthally orienting the borehole tool such that the first chamber is in juxtaposition with the borehole wall, the formation epithermal neutrons penetrating into the first chamber through the first portion of the outer thermal neutron shield are detected by the neutron counter for die-away measurement, thereby maximizing the directional sensitivty of the neutron counter to formation epithermal neutrons, the borehole fluid epithermal neutrons penetrating into the second chamber through the second chamber through the second portion of the outer thermal neutron shield are largely slowed down and lowered in energy by the moderating material and absorbed by the inner thermal neutron shield before penetrating into the first chamber, thereby minimizing the directional sensitivity of the neutron counter to borehole fluid epithermal neutrons

  11. Meeting the challenge of a group practice turnaround. (United States)

    Porn, L M


    Many healthcare organizations that acquired group practices to enhance their market share have found that the practices have not met their financial goals. Turning around a financially troubled, hospital-owned group practice is challenging but not impossible for healthcare organizations that take certain basic actions. Direction, data, desire, dedication, and drive must be present to effect the financial turnaround of a group practice. The healthcare organization needs to evaluate the practice's strategy and operations and identify the issues that are hindering the practice's ability to optimize revenues. Efforts to achieve profitable operations have to be ongoing.

  12. Drug promotion practices: A review. (United States)

    Jacob, Nilan T


    Over the years, the pharmaceutical industry has been at the forefront of research and innovation in drug discovery and development. The process of drug discovery extending from preclinical studies to multicentric clinical trials and postmarketing phase is a costly affair running into billions of dollars. On the flip side, not all investigational molecules clear the trial phases and get approved, which puts pressure on the manufacturers to maximize the profit from approved drugs. It is in this key area that the practice of drug promotion plays its role. The World Health Organization defines drug promotion as "all informational and persuasive activities by manufacturers and distributors, the effect of which is to influence the prescription, supply, purchase or use of medicinal drugs". With its humble intent of creating awareness among healthcare professionals and updating their knowledge on recent advances in treatment options, drug promotion has been an important tool, but gradually it has evolved to embrace aggressive marketing strategies and sometimes unethical business and scientific practices where the need for profit-making eclipses commitment to patient care and scientific exploration. In this review, we discuss the evolution of drug promotion practices, the various types, its merits and demerits, the influence of drug promotion on physician prescribing behaviour, the role of regulatory bodies, unethical promotional practices and finally summarize with future directions. © 2018 The British Pharmacological Society.

  13. Developing a Strong Direct Care Workforce. (United States)

    Stear, Lynda A

    The aging population of the United States has led to a need for more direct care workers to provide personal care to older adults and disabled people in their homes. The U.S. Bureau of Labor Statistics predicts employment of paraprofessionals in home care will grow 49% between 2012 and 2022 as the baby boomer generation ages and requires more assistance in activities of daily living. The typical direct care worker is a female aged 25 to 54 years old, a demographic that is projected to remain flat in the coming years. Direct care workers typically are poorly paid for work that is labor-intensive and often work in less than optimal working conditions. It is important that agencies hiring direct care workers understand the challenges these workers face and institute sound hiring practices and provide proper training and ongoing supervision. It is possible to have a quality direct care team. Proper training, role modeling, and supervision will improve employee satisfaction, decrease turnover, and improve care outcomes for patients.

  14. Exploring network organization in practice

    DEFF Research Database (Denmark)

    Hu, Yimei; Sørensen, Olav Jull

    Constructing a network organization for global R&D is presented as a common sense practice in existing literature. However, there are still queries about the network organization, such as the persistence of hierarchies which make a network organization merely a “bureaucracy-lite” organization....... Furthermore, in practice, we rarely see radical organizational change towards a network organization that adopts an internal market. The co-existence of market, hierarchy and network triggered research interest. A multiple case study of three transnational corporations’ global R&D organization shows...... that there are different logical considerations when designing a network organization to facilitate innovation. I identify three types of network organizations: market-led, directed and culture-led network organizations. Different types of network organizations show that organizations are dual and even ternary systems...

  15. Knowledge management systems in practice

    DEFF Research Database (Denmark)

    Tørning, Kristian

    which has the strategy of working with knowledge in the form of "best practices" meant to boost performance. The thesis explores the situation that workers are in, since they are meant to share and develop "best practices" knowledge in a portal based Knowledge Management System (KMS). The study...... indentifies a set of problems that prevents knowledge sharing from taking place to the degree to which management was specifically aiming. It was explored whether these problems could, to some degree, be mitigated by employing persuasive design, which is a new stance towards design where the aim...... is to directly seek to change the user's behavior, i.e., persuading more knowledge sharing. The main contribution is an indication of an anomaly with regards to the strategic approach towards knowledge management, where knowledge sharing is seen as an effort by which companies can gain a competitive advantage...


    Directory of Open Access Journals (Sweden)

    Андрей Владимирович Феоктистов


    Full Text Available The article is devoted to problems of origin and development of destructive educational practices at university. The authors focus on complex of interactions that disturb the existing in the academic environment norms and ethical principles. The most vivid evidence of destructive educational practice is the corruption issue. On the basis of the analyzed publications dealing with dynamics of corruption in the Russian higher education and the results of the survey by questionnaire, carried out at the technical university, the complex of recommendations has been prepared and suggested that is directed at minimization of destructive behavior at university.DOI:

  17. Cooperation of a university with business practice

    Directory of Open Access Journals (Sweden)

    Sojkin Bogdan


    Full Text Available The article presents forms of cooperation and social benefits resulting from cooperation between universities and business practice. Basic kinds and directions of mutual relations arising from common areas of interest, possibilities, needs and conditions for the functioning of each side, have been presented. Solutions carried out by universities with the participation of business practice have been discussed. In case of business practice, potential areas of cooperation with schools and joint ventures in the area of R&D have been discussed.

  18. Future methods in pharmacy practice research

    DEFF Research Database (Denmark)

    Almarsdottir, A B; Babar, Z U D


    research. These are demographics, technology and professional standards. Second, deriving from this, it seeks to predict and forecast the future shifts in use of methodologies. Third, new research areas and availability of data impacting on future methods are discussed. These include the impact of aging...... of the trends for pharmacy practice research methods are discussed. © 2016, Springer International Publishing.......This article describes the current and future practice of pharmacy scenario underpinning and guiding this research and then suggests future directions and strategies for such research. First, it sets the scene by discussing the key drivers which could influence the change in pharmacy practice...

  19. Preventive psychiatry in clinical practice

    Directory of Open Access Journals (Sweden)

    Mamta Sood


    Full Text Available In the last two and a half decades, there have been series of global burden of disease studies which have highlighted significant disability attributable to mental and behavioral disorders with a huge treatment gap. Integration of the preventive strategies in the clinical practice has the potential to reduce the disability due to mental illnesses. The patients come to the clinic with an intention to get treated and investigated for the symptoms they have. At this point, they may also be amenable to the advice related to prevention. Therefore, the clinical encounter can be seen as an opportunity to implement preventive strategies. Preventive efforts in clinical practice must be guided by knowledge about the epidemiological data related to specific mental illnesses and about the evidence-based preventive strategies available for specific mental illnesses. These should be directed toward all those persons (patients, caregivers accompanying and at home, teachers, employers, etc. who are present and also toward those who are not present during the clinical encounter and must be age, gender, and culture sensitive. Sociodemographic characteristics of a person seeking relief from a problem in the clinical encounter help in directing the preventive efforts. The preventive efforts are also driven by the fact that the patient has the first episode or established or treatment refractory mental illness and the short or long duration of illness. For prevention-minded clinical practice, it helps to have a template so that the assessments and interventions relevant for prevention can be carried out as per that scheme; it also helps in orienting the practicing mental health professionals. While making various assessments, making a list of the likely issues to be addressed by preventive efforts during clinical encounter ( first and subsequent is also helpful.

  20. Protecting your practice. (United States)

    Kerr, Joseph


    Dentists have much invested in their practices. They need to protect their practices from fraud and noncompliance. The author provides practical suggestions for how to significantly reduce the risk of fraud and theft in the practice without disrupting day-to-day operations. By adhering to nonintrusive policy and procedure changes, dental practice owners can reduce inherent risks of fraud and theft, while increasing financial and human resource knowledge regarding their practice. Practice owners with the appropriate policies and procedures benefit from significantly lower risk of loss from fraud and theft. Furthermore, they have a better understanding of their practice's finances and human resources. Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.

  1. Practice in TESOL

    CERN Document Server

    Farr, Fiona


    Do you want to improve your teaching practice? Do you need to know more about getting the most out of student feedback? This textbook covers all topics in preparing TESOL teachers for the practical component of their programme.

  2. Radioimmunoassay in clinical practice

    Energy Technology Data Exchange (ETDEWEB)

    Ametov, A S


    A wide application of radioimmunoassay in clinical practice is shown. The main theoretical aspects of radioimmunoassay and the fields of application in clinical practice - endocrinology, oncology, allergology, cardiology, pharmacology, pediatrics, hematology, obstetrics and gynecology, are presented.

  3. Human resource management practices stimulating knowledge sharing

    Directory of Open Access Journals (Sweden)

    Matošková Jana


    Full Text Available The major goal of the paper was to develop a theoretical framework that conceptualizes the indirect impact on human resource management practice on knowledge sharing in the organization. In the current competitive environment, the ability to use knowledge assets and to continuously renovate it is required for organizational success. Therefore, the field of human resource management should dedicate great effort to understanding how to enhance the knowledge flows within the organization. Theoretical indications were provided about HRM practices that influence the quality and quantity of knowledge sharing within an organization. Further, a conceptual model of relations between HRM practices and factors influencing knowledge sharing within an organization was introduced. It is supposed that HRM practices have direct impacts on personality traits of employees, organizational culture, characteristics of managers, and instruments used for knowledge sharing. Subsequently, these factors have direct effects on the perceived intensity of knowledge sharing. The paper offers 12 testable propositions for the indirect relation between HRM practices and knowledge sharing in the organization. The suggested model could assist future research to examine the influence of HRM practices upon managing knowledge is a more complex way. Via a theoretical contribution to the debate on the influence on HRM practices upon managing knowledge, the study contributes to further research development in this field.

  4. Education of advanced practice nurses in Canada. (United States)

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


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

  5. Thinking about changing mobility practices: how a social practice approach can help. (United States)

    Nettleton, Sarah; Green, Judith


    Policy efforts directed at encouraging physical activity have had minimal success to date. Drawing on Bourdieu's theory of practice, we suggest that a social practice framing might provide useful ways of thinking about why and how some practices do and could change. This article takes three case studies of transformations in mobility practices to explore conditions of possibility for change, using a secondary analysis of qualitative data from studies on cycling in London and fell running in the English Lake District. Three modes of transformation: unthinkable, thwarted and resisted, are rooted in differential interrelationships of field, habitus and doxa in these contrasting cases. We suggest that the notion of tacit, practical knowledge is more useful to understanding why change is thinkable or unthinkable than participants' reasoned accounts of their practice; that where new social fields are available that are congruent with habitus, change is possible and that where field and habitus are tightly aligned, the conditions of possibility for change are reduced. Efforts directed at changing practice might usefully focus not on behaviour or environments but on identifying the social fields in which mobility practices are likely to be malleable. The sociology of public health needs to focus less on health behaviour and more on social practice. © 2013 The Authors. Sociology of Health & Illness © 2013 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

  6. Diversity in marketing practice


    Torres, Ann Marie


    Theory development in marketing has received periodic debate. In the spirit of reappraisal, this thesis endeavours to explain the nature of diversity in marketing practice found among firms and the manner in which marketing practice is related to organisational performance. The specific research goals are to explore: the nature of diversity in marketing practice, as linked to strategic archetypes; whether there is evidence of order in the diversity of marketing practice that can be linked to ...

  7. Practical radiation monitoring

    International Nuclear Information System (INIS)

    Keightley, Lynsey; Burgess, Peter; Delahunty, Denise; Richards, Tony; Simpson, John; Woods, Mike


    This Good Practice Guide has been written by a working party of experts from the UK Ionising Radiation Metrology Forum. It describes procedures and methods for assessing radiation levels, outlines the thought processes needed to carry out the measurements and gives practical advice. The methods described are general and based on currently accepted good practice

  8. The practice portrait

    DEFF Research Database (Denmark)

    Thomsen, Rie


    The ability of the individual practitioner to grasp how her own practice is interwoven with different societal structures and interests can be seen as the first step on the way to social justice. This article investigates how the practice portrait can be used as an analytical and practical method...

  9. Why Macro Practice Matters (United States)

    Reisch, Michael


    This article asserts that macro practice is increasingly important in today's rapidly changing and complex practice environment. It briefly explores the history of macro practice in U.S. social work, summarizes its major contributions to the profession and to U.S. society, and provides some suggestions for how social work programs can expand…

  10. Deconstructing medical practice marketing. (United States)

    Kasbo, Abe


    The healthcare marketing game has radically changed. Medical practices must rely on strategies instead of tactics to better separate themselves from the competition. The Internet has become a disruptive force in marketing, tipping the balance and control of the reputations of medical practices to the patient. Done right, medical practices can harness this new energy to attract new patients and keep current patients loyal.

  11. Coatings for directional eutectics (United States)

    Rairden, J. R.; Jackson, M. R.


    Coatings developed to provide oxidation protection for the directionally-solidified eutectic alloy NiTaC-B (4.4 weight percent Cr) were evaluated. Of seven Co-, Fe- and Ni-base coatings that were initially investigated, best resistance to cyclic oxidation was demonstrated by duplex coatings fabricated by depositing a layer of NiCrAl(Y) by vacuum evaporation from an electron beam source followed by deposition of an Al overlayer using the pack cementation process. It was found that addition of carbon to the coating alloy substantially eliminated the problem of fiber denudation in TaC-type eutectic alloys. Burner rig cycled NiTaC-B samples coated with Ni-20Cr-5Al-0.1C-0.1Y+Al and rupture-tested at 1100 deg C performed as well as or better than uncoated, vacuum cycled and air-tested NiTaC-13; however, a slight degradation with respect to uncoated material was noted in air-stress rupture tests at 870 deg C for both cycled and uncycled samples.

  12. New directions in Guatemala. (United States)


    This news brief relates some new directions, since its inception in 1988, which the Family Welfare Association of Guatemala (APROFAM) will be undertaking during 1996-97. In December 1997, APROFAM restructured its program to include reproductive health services with family planning services. The program will target rural Mayan communities. The program will be working toward service sustainability, due to reduced external support. In October 1996 a new board was established that will focus on marketing, IEC, finance and administration, rural development, and clinical services. Meetings between the new board of directors of APROFAM and JOICFP focused on the use of integrated programs as a model for widespread programming among the rural Mayan population. The integrated program that was implemented by JOICFP was successful in reaching Mayan communities of Solola. This population was difficult to reach with conventional family planning approaches. The integrated program was successful in establishing trust with and participation of the rural Mayans. Activities such as parasite control, skills training, and income generation for women were useful in establishing trust and promoting self-reliance. Integrated programs will refocus on family planning and developing self-reliance. The UNFPA will be conducting an annual internal evaluation as a means of sharing information and deepening understanding of project implementation.

  13. Plastic apron wear during direct patient care. (United States)

    Candlin, Josie; Stark, Sheila

    To identify factors that influence nurses' practice in apron use during direct patient care. A small-scale documentary analysis of a purposive sample of 15 journal articles relating to nurses' apron use during patient care was undertaken. The analysis sought to address what factors affect nurses' decisions in relation to apron use. Nurses' decisions regarding apron use during patient care tend to be ritualistic rather than evidence-based. Their knowledge of infection control is limited. Although there is current literature available on infection control, as well as health and safety regulations, if local policy regarding apron use in nursing care is scant this can result in inconsistent and, perhaps, less desirable practices.

  14. Direct UV-written broadband directional broadband planar waveguide couplers

    DEFF Research Database (Denmark)

    Olivero, Massimo; Svalgaard, Mikael


    We report the fabrication of broadband directional couplers by direct UV-writing. The fabrication process is shown to be beneficial, robust and flexible. The components are compact and show superior performance in terms of loss and broadband operation.......We report the fabrication of broadband directional couplers by direct UV-writing. The fabrication process is shown to be beneficial, robust and flexible. The components are compact and show superior performance in terms of loss and broadband operation....

  15. Work Practice Characteristics

    DEFF Research Database (Denmark)

    Pors, Jens Kaaber; Simonsen, Jesper


    and work practice. To understand these issues a framework of characteristics is identified and termed work practice characteristics to describe important aspects of the hybrid configuration of groupware and situated work practices. Drawing on concepts and work practice studies in the field of computer...... investigation of how groupware is employed to support new ways of working in a large European financial organisation are analysed to illustrate situations with high and low integration of groupware. The framework of work practice characteristics is discussed in the light of these findings and implications...

  16. Pro NET Best Practices

    CERN Document Server

    Ritchie, Stephen D


    Pro .NET Best Practices is a practical reference to the best practices that you can apply to your .NET projects today. You will learn standards, techniques, and conventions that are sharply focused, realistic and helpful for achieving results, steering clear of unproven, idealistic, and impractical recommendations. Pro .NET Best Practices covers a broad range of practices and principles that development experts agree are the right ways to develop software, which includes continuous integration, automated testing, automated deployment, and code analysis. Whether the solution is from a free and

  17. Contemporary analysis of practicing otolaryngologists. (United States)

    Harrill, Willard C; Melon, David E; Seshul, Merritt J; Katz, Marc S; Zanation, Adam M


    To investigate contemporary issues facing practicing otolaryngologists including workforce dynamics, ancillary service modeling, otolaryngic allergy integration, ambulatory surgery center utilization, and relevant certificate of need legislation. A cross-sectional survey analysis of academic and private practicing otolaryngologists in North and South Carolina in 2016. A cross-sectional survey was e-mailed to 510 practicing otolaryngologists in North and South Carolina. A 21.3% survey response rate was achieved. Otolaryngology workforce was defined by horizontal aggregation of otolaryngologists into larger group models, with fewer solo practitioners being replaced by younger otolaryngologists or employing otolaryngology extenders. Excluding academic practice, few otolaryngologists have chosen direct hospital employment as a career option, although otolaryngologists with fewer years of practice are pursuing that option with greater frequency. Ancillary services showed audiology and hearing aid services being the most common, followed by otolaryngic allergy, point-of-service computed tomography, and ultrasound. Although otolaryngologists tend to avoid vertical integration, ambulatory surgery center (ASC) ownership trends favor a joint venture model with a hospital system partner. Most otolaryngologists favor changes to certificate of need legislation to improve patient access to these lower-cost facilities, regardless of whether they currently utilize or have access to an ASC. Otolaryngology is uniquely positioned to adapt and respond to current paradigm shifts within ambulatory medicine. Further analysis is needed to prepare current and future otolaryngologists for the demands and opportunities these challenges pose as patient-centered care models and consumer dynamics shape future patient expectations and utilization of healthcare. 5. Laryngoscope, 2018. © 2018 The American Laryngological, Rhinological and Otological Society, Inc.

  18. The European Energy Performance of Buildings Directive

    DEFF Research Database (Denmark)

    Petersen, Steffen; Hviid, Christian Anker

    This paper investigates the actual energy use for building operation with the calculated energy use according to the Danish implementation of the European Energy Performance of Buildings Directive (EPBD). This is important to various stakeholders in the building industry as the calculated energy...... performance is used for estimating investment security, operating budgets and for policy making. A case study shows that the actual and calculated energy use is practically the same in an average scenario. In the worst-case uncertainty scenario, the actual energy use is 20 % higher than the corrected...

  19. New directions for academic liaison librarians

    CERN Document Server

    Crawford, Alice


    Aimed at practitioners and students of librarianship, this book is about interesting and unusual practical projects currently being run by academic liaison librarians. It shows how liaison librarians can extend their roles beyond the established one of information literacy teaching and showcases areas in which they can engage in collaborative ventures with academic and administrative staff. Designed to excite and inspire, New Directions for Academic Liaison Librarians demonstrates the potential of the liaison role and emphasises the need for flexibility, imagination and initiative in those who

  20. Aligning Responsible Business Practices

    DEFF Research Database (Denmark)

    Weller, Angeli E.


    This article offers an in-depth case study of a global high tech manufacturer that aligned its ethics and compliance, corporate social responsibility, and sustainability practices. Few large companies organize their responsible business practices this way, despite conceptual relevance and calls t...... and managers interested in understanding how responsible business practices may be collectively organized.......This article offers an in-depth case study of a global high tech manufacturer that aligned its ethics and compliance, corporate social responsibility, and sustainability practices. Few large companies organize their responsible business practices this way, despite conceptual relevance and calls...... to manage them comprehensively. A communities of practice theoretical lens suggests that intentional effort would be needed to bridge meaning between the relevant managers and practices in order to achieve alignment. The findings call attention to the important role played by employees who broker...

  1. Quantum Secure Direct Communication with Quantum Memory. (United States)

    Zhang, Wei; Ding, Dong-Sheng; Sheng, Yu-Bo; Zhou, Lan; Shi, Bao-Sen; Guo, Guang-Can


    Quantum communication provides an absolute security advantage, and it has been widely developed over the past 30 years. As an important branch of quantum communication, quantum secure direct communication (QSDC) promotes high security and instantaneousness in communication through directly transmitting messages over a quantum channel. The full implementation of a quantum protocol always requires the ability to control the transfer of a message effectively in the time domain; thus, it is essential to combine QSDC with quantum memory to accomplish the communication task. In this Letter, we report the experimental demonstration of QSDC with state-of-the-art atomic quantum memory for the first time in principle. We use the polarization degrees of freedom of photons as the information carrier, and the fidelity of entanglement decoding is verified as approximately 90%. Our work completes a fundamental step toward practical QSDC and demonstrates a potential application for long-distance quantum communication in a quantum network.

  2. Treating infidelity: clinical and ethical directions. (United States)

    Snyder, Douglas K; Doss, Brian D


    This article addresses clinical and ethical directions in treating clients coping with infidelity. Developing competence in this domain requires familiarity with empirical research regarding infidelity, individual and cultural differences involving non-monogamy, and assessment and intervention skills related to treating infidelity. Practical directions will entail distinguishing among responsibilities to individual partners versus their relationship and managing related potential conflicts of interest with other involved parties. Confidentiality assumes increased complexity when confronting undisclosed infidelity in couple therapy and when a client engaging in high-risk behaviors for contracting STDs or testing seropositive for HIV has not informed his or her partner(s). Finally, we discuss therapists' need to concretely articulate their values that influence treatment of infidelity.

  3. Orthodontic practices in Australasia: practice activity. (United States)

    Mathew, Rachael; Sampson, Wayne J; Spencer, A John


    To collect baseline data on practice types and services provided by orthodontists in Australia and New Zealand. A total of 510 questionnaires was sent and 258 were returned. The response rate was 53 per cent. The average age of respondents was 50 years (SD: 9.8 years) with female orthodontists being younger (Mean: 42.3 years; SD: 6.5). The ratio of responding female to male orthodontists was 1:8.8. Overall, more orthodontists were in solo private practice than associateships or partnerships. New Zealand orthodontists were more likely to be in associateships. Australian orthodontists had twice the number of practices (Mean: 2.4; SD: 1.4) than their New Zealand counterparts (Mean: 1.1; SD: 0.3). Orthodontists estimated they saw a mean of 21.3 (SD: 11.3) patients per day. Older orthodontists saw few patients in a day and spent fewer hours in any practice activity in a week. The mean waiting time for a consultation appointment in the private sector in New Zealand was nearly twice that in Australia. There was a significant association between male orthodontists and referral of patients by general dental practitioners. More than three quarters of respondents incorporated retention fees into the treatment fee. Overall, orthodontists were satisfied with the workload and did not want more orthodontists in their geographical area. This study provides a sound basis for consideration of challenges in practice and changes over time.

  4. Theorising Practice in Single-Sex Work. (United States)

    Tett, Lyn


    The practice of adult educators in single-sex settings is directed by "theories-in-use" about the social construction of gender, such as gender is culturally constructed but people internalize gender stereotypes; gender stereotypes can be challenged and changed; and power to define gender roles lies in patriarchy, but it can be contested…

  5. Nursing Student Teachers' experiences during teaching practice:

    African Journals Online (AJOL)


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

  6. Issues in practical model-based diagnosis

    NARCIS (Netherlands)

    Bakker, R.R.; Bakker, R.R.; van den Bempt, P.C.A.; van den Bempt, P.C.A.; Mars, Nicolaas; Out, D.-J.; Out, D.J.; van Soest, D.C.; van Soes, D.C.


    The model-based diagnosis project at the University of Twente has been directed at improving the practical usefulness of model-based diagnosis. In cooperation with industrial partners, the research addressed the modeling problem and the efficiency problem in model-based reasoning. Main results of

  7. Sustainable practices in hospitality : A research framework

    NARCIS (Netherlands)

    Rheede, van A.; Blomme, R.J.


    The hospitality industry is starting to take responsibility for environmental sustainability. A strong focus on energy, waste, and water usage is directly linked with financial benefits in the operation of the hoteliers. Practices connected to the social aspect of sustainability are less developed.

  8. Estimation of directional wave spreading

    Digital Repository Service at National Institute of Oceanography (India)

    Mandal, S.; Bhat, S.S.; Anand, N.M.; Nayak, B.U.

    Directional properties of ocean waves are of great economic interest. The knowledge of wave directionality is important for the design of maritime structures and offshore operations. Two main aspects are considered for this study for the data...

  9. Estimation of wave directional spreading

    Digital Repository Service at National Institute of Oceanography (India)

    Deo, M.C.; Gondane, D.S.; SanilKumar, V.

    One of the useful measures of waves directional spreading at a given location is the directional spreading parameter. This paper presents a new approach to arrive at its characteristic value using the computational technique of Artificial Neural...

  10. Geothermal Technologies Program: Direct Use

    Energy Technology Data Exchange (ETDEWEB)


    This general publication describes geothermal direct use systems, and how they have been effectively used throughout the country. It also describes the DOE program R&D efforts in this area, and summarizes several projects using direct use technology.

  11. Innovative tool of direct marketing


    T.S. Maksymova


    The aspects of direct marketing activation on the basis of interactive applications introduction are examined. Basic advantages, linked with the use of the integrated marketing communications during formation of direct marketing strategies are open up.

  12. Direct channel problems and phenomena

    International Nuclear Information System (INIS)

    Cutkosky, R.E.


    Direct channel problems and phenomena are considered covering the need for precision hadron spectroscopy, the data base for precision hadron spectroscopy, some relations between direct-channel and cross-channel effects, and spin rotation phenomena

  13. Directional wave measurements and modelling

    Digital Repository Service at National Institute of Oceanography (India)

    Anand, N.M.; Nayak, B.U.; Bhat, S.S.; SanilKumar, V.

    Some of the results obtained from analysis of the monsoon directional wave data measured over 4 years in shallow waters off the west coast of India are presented. The directional spectrum computed from the time series data seems to indicate...

  14. Psychiatric Advance Directives: Getting Started (United States)

    ... News Legal Issues Search for: About PADs A psychiatric advance directive (PAD) is a legal document that ... decisions during a mental health crisis. Getting Started Psychiatric advance directives (PADs) are relatively new legal instruments ...

  15. Practice management companies improve practices' financial position. (United States)

    Dupell, T


    To maintain control over healthcare delivery and financial decisions, as well as increase access to capital markets, some group practices are forming their own physician practice management companies. These companies should be organized to balance the expectations of physicians with the values of capital markets. This organization should include retained earnings, financial reporting in accordance with generally accepted accounting principles (GAAP), predictable earnings and cash flow, physician ownership and leadership, and incentives for high-quality management. Three large, primary care and multispecialty clinics that merged to form a new physician practice management company increased their access to capital markets and improved their overall financial position, which will help them achieve long-term survival.

  16. Center for Practical Bioethics (United States)

    ... DOWNLOADS Caring Conversations Advanced Directives DNR Directives Durable Power of Attorney Healthcare Resources RESOURCES Bioethics Case Studies End of Life Planning Advanced Care Planning Chronic Pain Resources TPOPP Document 1111 Main Street, Suite 500 ...

  17. Knowledge and Architectural Practice

    DEFF Research Database (Denmark)

    Verbeke, Johan


    of the level of research methods and will explain that the research methods and processes in creative practice research are very similar to grounded theory which is an established research method in the social sciences. Finally, an argument will be made for a more explicit research attitude in architectural......This paper focuses on the specific knowledge residing in architectural practice. It is based on the research of 35 PhD fellows in the ADAPT-r (Architecture, Design and Art Practice Training-research) project. The ADAPT-r project innovates architectural research in combining expertise from academia...... and from practice in order to highlight and extract the specific kind of knowledge which resides and is developed in architectural practice (creative practice research). The paper will discuss three ongoing and completed PhD projects and focusses on the outcomes and their contribution to the field...

  18. Pragmatism and practice theory

    DEFF Research Database (Denmark)

    Buch, Anders; Elkjær, Bente

    Proponents of the ‘practice turn’ in the social sciences rarely mention American pragmatism as a source of inspiration or refer to pragmatist philosophy. This strikes us as not only odd, but also a disadvantage since the pragmatist legacy has much to offer practice theory in the study of organiza......Proponents of the ‘practice turn’ in the social sciences rarely mention American pragmatism as a source of inspiration or refer to pragmatist philosophy. This strikes us as not only odd, but also a disadvantage since the pragmatist legacy has much to offer practice theory in the study...... of organizations. In this paper we want to spell out the theoretical similarities and divergences between practice theory and pragmatism to consider whether the two traditions can find common ground when gazing upon organization studies. We suggest that pragmatism should be included in the ‘tool-kit’ of practice...

  19. Presenting practice financial information. (United States)

    Webster, Lee Ann H


    Medical practice leadership teams, often consisting primarily of physicians with limited financial backgrounds, must make important business decisions and continuously monitor practice operations. In order to competently perform this duty, they need financial reports that are relevant and easy to understand. This article explores financial reporting and decision-making in a physician practice. It discusses reports and tools, such as ratios, graphs, and comparisons, that practices typically include in their reports. Because profitability and cash flow are often the most important financial considerations for physician practices, reports should generally focus on the impact of various activities and potential decisions upon these concerns. This article also provides communication tips for both those presenting practice financial information and those making the decisions. By communicating effectively, these leaders can best use financial information to improve decision-making and maximize financial performance.

  20. Seveso directive: the leading innovations

    International Nuclear Information System (INIS)

    Cozzani, V.; Zanelli, S.


    Directive 96/82/EC on the control of major accident hazards caused by dangerous substances, also known as 'Seveso-II' Directive, was adopted by the European Council on December 1996. The member states of the European Community shall bring into force the Directive not later than February 1999. Some innovative aspects of the Directive are discussed. In particular, this paper focuses on the effects of the new criteria for the identification of establishments to which the Directive obligations will apply and for land use planning in the vicinity of the establishments [it

  1. New directions for psychiatric rehabilitation in the USA. (United States)

    Bond, G R; Drake, R E


    American researchers have led the world in developing, evaluating, and disseminating evidence-based psychiatric rehabilitation practices for people with serious mental illness. Paradoxically, however, the USA lags behind most industrialized nations in providing access to high-quality mental health and psychiatric services. This essay examines several evidence-based practices developed in the USA, the spread of these practices, the barriers to ensuring availability to people who could benefit from these services, and some promising directions for overcoming the barriers. Factors influencing the growth and sustainment of effective client-centred practices include the availability of adequate and stable funding, committed leadership, and the influence of vested interests. Two strategies for promoting the spread and sustainment of well-implemented evidence-based practices are the adoption of fidelity scales and learning communities.

  2. practice managers in Scotland

    Directory of Open Access Journals (Sweden)

    Lisa Hanna


    Conclusion Practice managers are likely to play a central role in the introduction of new consultation/ communication technologies within general practice. They hold varying views on the appropriateness of these technologies, influenced by a complex mix of contextual characteristics.Managers from areas in which the ethos of the practice prioritises personalised care in service delivery are less enthusiastic about the adoption of remote consultation/ communication technologies.

  3. The Tectonic Practice

    DEFF Research Database (Denmark)

    Schmidt, Anne Marie Due

    has the consequence that it is difficult to create architecture where the technical concerns are an inherent part of the architectural expression. The aim of the thesis is to discuss the role of digital tools in overcoming the distance between the professional specializations and thereby support...... a tectonic practice. The project develops a framework to understand the role of digital tools in the tectonic practice from and discusses how and in which areas the tectonic practice could become supported by digital tools....

  4. Drawing Between Practices

    DEFF Research Database (Denmark)

    Wallace, Jamie

    The fusion of art making and research enables the artist's practice to be understood as a unique form of enquiry.  Notions such as 'material thinking' go some way to explain complex creative phenomena normally shrouded within the peculiarities of individual practice. But, are such notions useful...... is that the reflexive personal interaction of art practice adopted within professional inquiry can offer new inspirations, new creative contradictions and ways of thinking...

  5. Information Technology Management: Social Security Administration Practices Can Be Improved

    National Research Council Canada - National Science Library

    Shaw, Clay


    To improve SSAs IT management practices, we recommend that the Acting Commissioner of Social Security direct the Chief Information Officer and the Deputy Commissioner for Systems to complete the following actions...

  6. PRACTICE POINTS: AIDS Vaccine 2001: Looking to the Future ...

    African Journals Online (AJOL)

    PRACTICE POINTS: AIDS Vaccine 2001: Looking to the Future. ... The 3-day meeting in Philadelphia provided considerable information on the preclinical ... deal of effort and considerable expertise is now being directed towards dissecting the ...

  7. Experimenting with practice

    DEFF Research Database (Denmark)

    Knudsen, Hanne; Adriansen, Hanne Kirstine


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

  8. Agile practice guide

    CERN Document Server


    Agile Practice Guide – First Edition has been developed as a resource to understand, evaluate, and use agile and hybrid agile approaches. This practice guide provides guidance on when, where, and how to apply agile approaches and provides practical tools for practitioners and organizations wanting to increase agility. This practice guide is aligned with other PMI standards, including A Guide to the Project Management Body of Knowledge (PMBOK® Guide) – Sixth Edition, and was developed as the result of collaboration between the Project Management Institute and the Agile Alliance.

  9. Modern wiring practice

    CERN Document Server

    Steward, W E


    Continuously in print since 1952, Modern Wiring Practice has now been fully revised to provide an up-to-date source of reference to building services design and installation in the 21st century. This compact and practical guide addresses wiring systems design and electrical installation together in one volume, creating a comprehensive overview of the whole process for contractors and architects, as well as electricians and other installation engineers. Best practice is incorporated throughout, combining theory and practice with clear and accessible explanation, all

  10. Costing Practices in Healthcare

    DEFF Research Database (Denmark)

    Chapman, Christopher; Kern, Anja; Laguecir, Aziza


    .e., Diagnosis Related Group (DRG) systems, and costing practices. DRG-based payment systems strongly influence costing practices in multiple ways. In particular, setting DRG tariffs requires highly standardized costing practices linked with specific skill sets from management accountants and brings other...... jurisdictions (e.g., clinical coding) to bear on costing practice. These factors contribute to the fragmentation of the jurisdiction of management accounting.......The rising cost of healthcare is a globally pressing concern. This makes detailed attention to the way in which costing is carried out of central importance. This article offers a framework for considering the interdependencies between a dominant element of the contemporary healthcare context, i...

  11. Materiality, Practice and Body

    DEFF Research Database (Denmark)

    Johansen, Stine Liv; Skovbjerg-Karoff, Helle


    In order to understand the interaction between human and technology, the relationship must be emphasized as a triangulation between materiality, body and practice. By introducing play situations from a just finished empirical study in three bigger cities in Denmark, this paper will address...... the interplay from the human‟s point of view, as a body doing a certain practice, which is constantly produced by taking approaches which comes from phenomenology and practice theory. We introduce aspects of play understood as a dynamic between materiality, body and practice with the goal of inspiring not only...

  12. Consumer focus can spur group practice turnaround. (United States)

    Foreman, M S; Draper, A


    Many healthcare organizations have lost money on their employed group practices. The solution to this dilemma is not necessarily divestment of the group practices. Instead, some healthcare organizations should view their physicians as an asset. Healthcare organizations and physicians need to develop a new framework for their relationship to optimize their competitive advantage. Three guiding principles that will help accomplish this objective are to recast the healthcare organization-physician relationship to focus on the consumer, reconfigure the economic model to exceed consumer demands, and restructure the group practice to encourage fiscal and service excellence. In developing a new relationship framework, the stakeholders need to define the group practice's mission, strategic direction, composition, infrastructure, compensation model, and structure.

  13. Future directions of ecosystem science (United States)

    Baron, Jill S.; Galvin, Kathleen A.


    Scientific knowledge about ecosystem structure and function has expanded greatly during the past few decades. Terrestrial and aquatic nutrient cycling, ecosystem energetics, population dynamics, belowground processes, and food webs have been studied at the plot, stand, watershed, and landscape levels at many locations around the globe. Ideas about terrestrial-atmospheric interactions and human interference in these processes have changed dramatically. There is new appreciation of the need to incorporate into ecosystem studies the interactions between human populations and the ecosystem, not only because humans affect ecosystem processes, but because these systems support human populations (Glantz 1988, Holden 1988, Parry et al. 1988, WCED 1987). Recent advances in ecosystem science are due, in part, to technological improvements in computing power, new laboratory and field physical and chemical analytical techniques, and satellite imagery for remote sensing of Earth's structure and dynamics. Modeling and geographic information systems have provided the capability for integrating multiple data sets with process simulations to generate hypotheses about regional ecosystem function. Concurrent with these scientific developments has been a growing concern about the links between the health of the environment and world-wide industrial, land, and resource-management practices. Environmental damage at the local level was widely recognized in the 1960s, prompting the environmental movement of that decade. Regional environmental problems with multiple effects and politically difficult solutions have been perceived more recently; the issue of acidic deposition provides an example of such a second-generation concern (Clark and Holling 1985). Today there is a growing awareness of global-scale environmental degradation brought about by the combined actions of all peoples on Earth (Clark 1989, Woodmansee et al. 1988). The three levels of environmental concern--local, regional

  14. Extending the Direct Behavior Rating: An Examination of Schoolwide Behavior Ratings and Academic Engagement (United States)

    Bruhn, Allison; Barron, Sheila; Fernando, Josephine; Balint-Langel, Kinga


    Direct behavior ratings have been identified as a practical and feasible alternative to direct observation of behavior for monitoring behavioral progress. Despite the evidence of usability, there have been calls for further examination of direct behavior ratings using different behaviors and scales. To this end, we examined the ratings of…

  15. Direct economic benefits associated with dietetic internships. (United States)

    Conklin, M T; Simko, M D


    We explored the direct economic benefits of hospital dietetics departments sponsoring an internship for dietetics studies. Forty-five dietetics departments in US hospitals participated in a mail survey that involved comprehensive data collection procedures using three instruments, including activity logs recorded by 298 dietitians and interns. Direct benefits were defined as the net student labor provided to the department during routine and staff relief experiences that released professional labor for other work. Net student productivity during routine assignments was calculated by subtracting the time dietitians spent teaching during a typical work week from the amount of time dietetic interns spent performing professional services without direct supervision. Student productivity during staff relief rotations was calculated by multiplying the number of students assigned to this type of experience by the length of the rotation. While involved in routine learning experiences, dietetic interns provided a direct benefit. The difference between the time interns spent in independent, professional service in the departments and the time dietitians spent in activities designed specifically for teaching was a mean of 29 hours in favor of the students. All departments received a direct benefit from assigning dietetic interns to a staff relief rotation. The median number of weeks of student labor gained by the departments per year was 24. A paired t test was used to analyze the difference between the time dietitians devoted to teaching interns and the time students spent in independent, professional service in the departments. The difference was very highly significant (P impact of their supervised practice program on the sponsoring organization.

  16. Experience gained at the NEA Data Bank with a commercial data base management system

    International Nuclear Information System (INIS)

    Johnson, D.; Pellegrino, L.; Schuler, W.; Tubbs, N.


    The Nuclear Energy Agency Data Bank of the OECD has recently converted the computer storage of large numerical and bibliographic files to a commecial data base management system (DBMS). Such systems are relatively new in scientific use, but they are well-developed and are widely applied in commercial and industrial environments. This application is of particular interest in that it involves scientific information and the size of the data approaches what is feasible with a DBMS on a small computer. In this paper, the experience gained throughout the project is documented for the benefit of others who way be contemplating a similar application. Some of the points considered with be specific to this actual base and to the system used, but the paper also contains much information of general interest. Our viewpoint is that of applications software developers with limited previous DBMS experience and the emphasis is on the practical details of establishing a CODASYL-type data base

  17. Microcontrollers in practice

    CERN Document Server

    Susnea, Ioan


    Stressing common characteristics and real applications of the most used microcontrollers, this practical guide provides readers with hands-on knowledge of how to implement three families of microcontrollers (HC11, AVR, and 8051). It has practical examples and exercises, including several extended projects.

  18. Community of Practice

    DEFF Research Database (Denmark)

    Busch-Jensen, Peter


    A clear and informative description of the theoretical and methodological content and implications of the concept of Community of Practice......A clear and informative description of the theoretical and methodological content and implications of the concept of Community of Practice...

  19. Nigerian Hospital Practice

    African Journals Online (AJOL)

    Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives. Journal Homepage Image. The aim of the Nigerian Hospital Practice Journal is to aid in enhancing the advancement of medicine globally by acting as a medium for disseminating information on current clinical and drug practices in ...

  20. Hypothyroidism in clinical practice

    Directory of Open Access Journals (Sweden)

    Faiza Qari


    Full Text Available Background: Hypothyroidism is the most common endocrine disease that was seen in the clinical practice especially for family physicians. Methods: This review article covered the important practical clinical issues for managing overt hypothyroidism, subclinical hypothyroidism and hypothyroidism during pregnancy. Conclusions: The clinical issues were addressed by clinical scenario followed by questions and stressed on the important clinical points.

  1. Meaningful and Purposeful Practice (United States)

    Clementi, Donna


    This article describes a graphic, designed by Clementi and Terrill, the authors of "Keys to Planning for Learning" (2013), visually representing the components that contribute to meaningful and purposeful practice in learning a world language, practice that leads to greater proficiency. The entire graphic is centered around the letter…

  2. Pedagogical practices in VET

    DEFF Research Database (Denmark)

    Louw, Arnt Vestergaard


    This article deals with pedagogical practices on the basic carpentry VET programme in Denmark. On the basis of an anthropologically inspired study among carpentry students at two VET schools, the prime objective of analysis is to understand the various pedagogical practices from the students...

  3. Practical data analysis

    CERN Document Server

    Cuesta, Hector


    Each chapter of the book quickly introduces a key 'theme' of Data Analysis, before immersing you in the practical aspects of each theme. You'll learn quickly how to perform all aspects of Data Analysis.Practical Data Analysis is a book ideal for home and small business users who want to slice & dice the data they have on hand with minimum hassle.

  4. To practice mobility

    DEFF Research Database (Denmark)

    Winther, Ida Wentzel


    Children’s perspectives are practically absent in new mobility studies. In this article, I wish to describe and analyze how a number of children handle having to move between homes, parents and siblings, and how they practically, emotionally and socially navigate in this changeable landscape. My...

  5. Business ethics as practice

    NARCIS (Netherlands)

    Clegg, S.R.; Kornberger, M.; Rhodes, C.


    In this article we develop a conceptualization of business ethics as practice. Starting from the view that the ethics that organizations display in practice will have been forged through an ongoing process of debate and contestation over moral choices, we examine ethics in relation to the ambiguous,

  6. Preschool Teachers' Endorsement of Instructional Practices: An Interprofessional Exploration (United States)

    Koutsoftas, Anthony D.; Dubasik, Virginia L.; Moss DiDonato, Alicia


    Background: Preschool teacher's instructional practices are one component of high-quality early education classrooms that have the potential to directly influence young children's school readiness and success; therefore, the type and quality of instructional practices used by preschool teachers should be explored. Purpose: The purpose of this…

  7. Using Action Research Projects to Examine Teacher Technology Integration Practices (United States)

    Dawson, Kara


    This study examined the technology integration practices of teachers involved in a statewide initiative via one cycle of action research. It differs from other studies of teacher technology integration practices because it simultaneously involved and provided direct benefits to teachers and researchers. The study used thematic analysis to provide…

  8. 12 CFR 563g.10 - Unsafe or unsound practices. (United States)


    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Unsafe or unsound practices. 563g.10 Section 563g.10 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY SECURITIES OFFERINGS § 563g.10 Unsafe or unsound practices. (a) No person shall directly or indirectly, (1) Employ any device...

  9. Fostering Critical Thinking Practices at Primary Science Classrooms in Nepal (United States)

    Acharya, Kamal Prasad


    This article examines the socio-cultural activities that have direct and indirect impacts on critical thinking practices in primary science classrooms and what kinds of teachers' activities help to foster the development of critical thinking practices in children. Meanwhile, the constructivist and the socio-cultural theoretical dimensions have…

  10. Authenticity through Reflexivity: Connecting Teaching Philosophy and Practice (United States)

    Jenkins, Catherine


    Adult educators have strong beliefs. This will surprise no-one, but where do their beliefs come from, and how do they influence future development of their teaching practice? Drawing on my PhD research, I explore the multi-directional relationship between teaching beliefs and practices, considering the influence of past traditions of adult…

  11. Physical Education and Health: Global Perspectives and Best Practice (United States)

    Chin, Ming-Kai, Ed.; Edginton, Christopher R.


    "Physical Education and Health: Global Perspectives and Best Practice" draws together global scholars, researchers, and practitioners to provide a review and analysis of new directions in physical education and health worldwide. The book provides descriptive information from 40 countries regarding contemporary practices, models, and…

  12. Informal Theory: The Ignored Link in Theory-to-Practice (United States)

    Love, Patrick


    Applying theory to practice in student affairs is dominated by the assumption that formal theory is directly applied to practice. Among the problems with this assumption is that many practitioners believe they must choose between their lived experiences and formal theory, and that graduate students are taught that their experience "does not…

  13. Education(al) Research, Educational Policy-Making and Practice (United States)

    Clark, Charles


    Professor Whitty has endorsed the consensus that research into education is empirical social science, distinguishing "educational research" which seeks directly to influence practice, and "education research" that has substantive value but no necessary practical application. The status of the science here is problematic. The positivist approach is…

  14. Dynamic behaviors in directed networks

    International Nuclear Information System (INIS)

    Park, Sung Min; Kim, Beom Jun


    Motivated by the abundance of directed synaptic couplings in a real biological neuronal network, we investigate the synchronization behavior of the Hodgkin-Huxley model in a directed network. We start from the standard model of the Watts-Strogatz undirected network and then change undirected edges to directed arcs with a given probability, still preserving the connectivity of the network. A generalized clustering coefficient for directed networks is defined and used to investigate the interplay between the synchronization behavior and underlying structural properties of directed networks. We observe that the directedness of complex networks plays an important role in emerging dynamical behaviors, which is also confirmed by a numerical study of the sociological game theoretic voter model on directed networks

  15. A new material practice

    DEFF Research Database (Denmark)

    Tamke, Martin; Nicholas, Paul; Ramsgaard Thomsen, Mette


    The first generation of digital architecture was fascinated with the extension of digital possibilities into the physical world. Today, we are seeing the emergence of a new material practice. This practice is focusing on a design and production process that is seeking an understanding of the aggr......The first generation of digital architecture was fascinated with the extension of digital possibilities into the physical world. Today, we are seeing the emergence of a new material practice. This practice is focusing on a design and production process that is seeking an understanding...... of the aggregated behavior of matter in an environment. Advances in material science and in computational tools are creating new opportunities within architectural design. However, these approaches are challenging the current practices of design and representation....

  16. Practical RF system design

    CERN Document Server

    Egan, William F


    he ultimate practical resource for today's RF system design professionals Radio frequency components and circuits form the backbone of today's mobile and satellite communications networks. Consequently, both practicing and aspiring industry professionals need to be able to solve ever more complex problems of RF design. Blending theoretical rigor with a wealth of practical expertise, Practical RF System Design addresses a variety of complex, real-world problems that system engineers are likely to encounter in today's burgeoning communications industry with solutions that are not easily available in the existing literature. The author, an expert in the field of RF module and system design, provides powerful techniques for analyzing real RF systems, with emphasis on some that are currently not well understood. Combining theoretical results and models with examples, he challenges readers to address such practical issues as: * How standing wave ratio affects system gain * How noise on a local oscillator will affec...

  17. Direct photons in WA98

    CERN Document Server

    Aggarwal, M M; Ahammed, Z; Angelis, Aris L S; Antonenko, V G; Arefev, V; Astakhov, V A; Avdeichikov, V; Awes, T C; Baba, P V K S; Badyal, S K; Barlag, C; Bathe, S; Batyunya, B; Bernier, T; Bhalla, K B; Bhatia, V S; Blume, C; Bock, R; Bohne, E M; Böröcz, Z K; Bucher, D; Buijs, A; Büsching, H; Carlén, L; Chalyshev, V; Chattopadhyay, S; Cherbachev, R; Chujo, T; Claussen, A; Das, A C; Decowski, M P; Delagrange, H; Dzhordzhadze, V; Dönni, P; Dubovik, I; Dutt, S; Dutta-Majumdar, M R; El-Chenawi, K F; Eliseev, S; Enosawa, K; Foka, P Y; Fokin, S L; Ganti, M S; Garpman, S; Gavrishchuk, O P; Geurts, F J M; Ghosh, T K; Glasow, R; Gupta, S K; Guskov, B; Gustafsson, Hans Åke; Gutbrod, H H; Higuchi, R; Hrivnacova, I; Ippolitov, M S; Kalechofsky, H; Kamermans, R; Kampert, K H; Karadzhev, K; Karpio, K; Kato, S; Kees, S; Klein-Bösing, C; Knoche, S; Kolb, B W; Kosarev, I G; Kucheryaev, I; Krümpel, T; Kugler, A; Kulinich, P A; Kurata, M; Kurita, K; Kuzmin, N A; Langbein, I; Lee, Y Y; Löhner, H; Luquin, Lionel; Mahapatra, D P; Man'ko, V I; Martin, M; Martínez, G; Maksimov, A; Mgebrishvili, G; Miake, Y; Mir, M F; Mishra, G C; Miyamoto, Y; Mohanty, B; Morrison, D; Mukhopadhyay, D S; Naef, H; Nandi, B K; Nayak, S K; Nayak, T K; Neumaier, S; Nyanin, A; Nikitin, V A; Nikolaev, S; Nilsson, P O; Nishimura, S; Nomokonov, V P; Nystrand, J; Obenshain, F E; Oskarsson, A; Otterlund, I; Pachr, M; Pavlyuk, S; Peitzmann, Thomas; Petracek, V; Pinganaud, W; Plasil, F; Von Poblotzki, U; Purschke, M L; Rak, J; Raniwala, R; Raniwala, S; Ramamurthy, V S; Rao, N K; Retière, F; Reygers, K; Roland, G; Rosselet, L; Rufanov, I A; Roy, C; Rubio, J M; Sako, H; Sambyal, S S; Santo, R; Sato, S; Schlagheck, H; Schmidt, H R; Schutz, Y; Shabratova, G; Shah, T H; Sibiryak, Yu; Siemiarczuk, T; Silvermyr, D; Sinha, B C; Slavin, N V; Söderström, K; Solomey, Nickolas; Sood, G; Sørensen, S P; Stankus, P; Stefanek, G; Steinberg, P; Stenlund, E; Stüken, D; Sumbera, M; Svensson, S; Trivedi, M D; Tsvetkov, A A; Tykarski, L; Urbahn, J; Van den Pijll, E C; van Eijndhoven, N; van Nieuwenhuizen, G J; Vinogradov, A; Viyogi, Y P; Vodopyanov, A S; Vörös, S; Wyslouch, B; Yagi, K; Yokota, Y; Young, G R


    A measurement of direct photon production in /sup 208/Pb+/sup 208/Pb collisions at 158 A GeV has been carried out in the CERN WA98 experiment. The invariant yield of direct photons was extracted as a function of transverse momentum in the interval 0.51.5 GeV/c. the result constitutes the first observation of direct photons in ultrarelativistic heavy-ion collisions. (19 refs).

  18. Effects of flow gradients on directional radiation of human voice. (United States)

    Pulkki, Ville; Lähivaara, Timo; Huhtakallio, Ilkka


    In voice communication in windy outdoor conditions, complex velocity gradients appear in the flow field around the source, the receiver, and also in the atmosphere. It is commonly known that voice emanates stronger towards the downstream direction when compared with the upstream direction. In literature, the atmospheric effects are used to explain the stronger emanation in the downstream direction. This work shows that the wind also has an effect to the directivity of voice also favouring the downstream direction. The effect is addressed by measurements and simulations. Laboratory measurements are conducted by using a large pendulum with a loudspeaker mimicking the human head, whereas practical measurements utilizing the human voice are realized by placing a subject through the roof window of a moving car. The measurements and a simulation indicate congruent results in the speech frequency range: When the source faces the downstream direction, stronger radiation coinciding with the wind direction is observed, and when it faces the upstream direction, radiation is not affected notably. The simulated flow gradients show a wake region in the downstream direction, and the simulated acoustic field in the flow show that the region causes a wave-guide effect focusing the sound in the direction.

  19. Learning to practice: Practicing to learn


    McBride, F.


    There is clearly a lack of consensus regarding the terminology used to describe the APStraciJ eXp 0jtatjon of knowledge in an organisational context. The theory of knowledge exploitation is bound up in various concepts, the most familiar being Organisational Learning, Knowledge Management and the Learning Organisation. This report is an enquiry into the applicability of these concepts to the design led architectural practice. Implicit within this study is a suggestion that the firm can be suc...

  20. Training directionally selective motion pathways can significantly improve reading efficiency (United States)

    Lawton, Teri


    This study examined whether perceptual learning at early levels of visual processing would facilitate learning at higher levels of processing. This was examined by determining whether training the motion pathways by practicing leftright movement discrimination, as found previously, would improve the reading skills of inefficient readers significantly more than another computer game, a word discrimination game, or the reading program offered by the school. This controlled validation study found that practicing left-right movement discrimination 5-10 minutes twice a week (rapidly) for 15 weeks doubled reading fluency, and significantly improved all reading skills by more than one grade level, whereas inefficient readers in the control groups barely improved on these reading skills. In contrast to previous studies of perceptual learning, these experiments show that perceptual learning of direction discrimination significantly improved reading skills determined at higher levels of cognitive processing, thereby being generalized to a new task. The deficits in reading performance and attentional focus experienced by the person who struggles when reading are suggested to result from an information overload, resulting from timing deficits in the direction-selectivity network proposed by Russell De Valois et al. (2000), that following practice on direction discrimination goes away. This study found that practicing direction discrimination rapidly transitions the inefficient 7-year-old reader to an efficient reader.

  1. 78 FR 43770 - Airworthiness Directives; The Boeing Company Airplanes (United States)


    ... elevator rear spar stiffener assembly, which could adversely affect elevator structural stiffness, which... aircraft in air commerce by prescribing regulations for practices, methods, and procedures the... 13132. This AD will not have a substantial direct effect on the States, on the relationship between the...

  2. Direct maximum parsimony phylogeny reconstruction from genotype data. (United States)

    Sridhar, Srinath; Lam, Fumei; Blelloch, Guy E; Ravi, R; Schwartz, Russell


    Maximum parsimony phylogenetic tree reconstruction from genetic variation data is a fundamental problem in computational genetics with many practical applications in population genetics, whole genome analysis, and the search for genetic predictors of disease. Efficient methods are available for reconstruction of maximum parsimony trees from haplotype data, but such data are difficult to determine directly for autosomal DNA. Data more commonly is available in the form of genotypes, which consist of conflated combinations of pairs of haplotypes from homologous chromosomes. Currently, there are no general algorithms for the direct reconstruction of maximum parsimony phylogenies from genotype data. Hence phylogenetic applications for autosomal data must therefore rely on other methods for first computationally inferring haplotypes from genotypes. In this work, we develop the first practical method for computing maximum parsimony phylogenies directly from genotype data. We show that the standard practice of first inferring haplotypes from genotypes and then reconstructing a phylogeny on the haplotypes often substantially overestimates phylogeny size. As an immediate application, our method can be used to determine the minimum number of mutations required to explain a given set of observed genotypes. Phylogeny reconstruction directly from unphased data is computationally feasible for moderate-sized problem instances and can lead to substantially more accurate tree size inferences than the standard practice of treating phasing and phylogeny construction as two separate analysis stages. The difference between the approaches is particularly important for downstream applications that require a lower-bound on the number of mutations that the genetic region has undergone.

  3. Direct cooled power electronics substrate (United States)

    Wiles, Randy H [Powell, TN; Wereszczak, Andrew A [Oak Ridge, TN; Ayers, Curtis W [Kingston, TN; Lowe, Kirk T [Knoxville, TN


    The disclosure describes directly cooling a three-dimensional, direct metallization (DM) layer in a power electronics device. To enable sufficient cooling, coolant flow channels are formed within the ceramic substrate. The direct metallization layer (typically copper) may be bonded to the ceramic substrate, and semiconductor chips (such as IGBT and diodes) may be soldered or sintered onto the direct metallization layer to form a power electronics module. Multiple modules may be attached to cooling headers that provide in-flow and out-flow of coolant through the channels in the ceramic substrate. The modules and cooling header assembly are preferably sized to fit inside the core of a toroidal shaped capacitor.

  4. The practical skills of newly qualified nurses. (United States)

    Danbjørg, Dorthe Boe; Birkelund, Regner


    This paper reports the findings from a study of newly qualified nurses and which subjects the nurses regarded as the most important in order to be able to live up to the requirements of clinical practice, and how they experience their potential for developing practical and moral skills, after the decrease in practical training. A qualitative approach guided the research process and the analysis of the data. The data was collected by participant observation and qualitative interviews with four nurses as informants. The conclusions made in this study are based on the statements and the observations of the newly qualified nurses. Our findings are discussed in relation to the Aristotelian concept and other relevant literature. The main message is that the newly qualified nurses did not feel equipped when they finished their training. This could be interpreted as a direct consequence of the decrease in practical training. Our study also underlines that the way nursing theory is perceived and taught is problematic. The interviews revealed that the nurses think that nursing theories should be applied directly in practice. This misunderstanding is probably also applicable to the teachers of the theories. Copyright © 2010 Elsevier Ltd. All rights reserved.

  5. Professional Education: Some New Directions. (United States)

    Schein, Edgar H.; Kommers, Diane W.

    This is a plea for planning for impending changes in professional education. The author analyzes new features of professional practice and shifting expectations of professional students and then undertakes a perceptive analysis of the anatomy of change itself. (MJM)

  6. Practicing on Newly Dead

    Directory of Open Access Journals (Sweden)

    Jewel Abraham


    Full Text Available A newly dead cadaver simulation is practiced on the physical remains of the dead before the onset of rigor mortis. This technique has potential benefits for providing real-life in-situ experience for novice providers in health care practices. Evolving ethical views in health care brings into question some of the ethical aspects associated with newly dead cadaver simulation in terms of justification for practice, autonomy, consent, and the need of disclosure. A clear statement of policies and procedures on newly dead cadaver simulation has yet to be implemented. Although there are benefits and disadvantages to an in-situ cadaver simulation, such practices should not be carried out in secrecy as there is no compelling evidence that suggests such training as imperative. Secrecy in these practices is a violation of honor code of nursing ethics. As health care providers, practitioners are obliged to be ethically honest and trustworthy to their patients. The author explores the ethical aspects of using newly dead cadaver simulation in training novice nursing providers to gain competency in various lifesaving skills, which otherwise cannot be practiced on a living individual. The author explores multiple views on cadaver simulation in relation to ethical theories and practices such as consent and disclosure to family.

  7. Spiritual practices of taoism

    Directory of Open Access Journals (Sweden)

    Yulia L. Butko


    Full Text Available In the article the spiritual practices of Taoism. Established that the spiritual path in Taoism is the main ultimate goal - achieving eternal, indestructible personality transformation through meditation and the reduction of lower mental strength to their upper classes. To achieve this, the Taoist practices, special practices that include, along with the meditative contemplation technique classes and various gymnastics, breathing exercises and the like, and (for a significant period of its history - Laboratory (“foreign” alchemy. Among the spiritual practices of Taoism is the main meditation that has little to do with certain external techniques. Taoist meditation leads people to unity, the only person that connects with the cosmos and society. The author concluded that the path of self-improvement Taoist, under the guidance of a teacher, is a series of distinct stages, gaining purely individual instruction. Spiritual practices like Taoist, were widely known in other religious and philosophical systems. However, the semantics of Taoist practices are significantly different, as well as their function in the structure of religious practices in general.

  8. Practice Bulletin No. 161: External Cephalic Version. (United States)


    In the United States, there is a widespread belief that the overall cesarean delivery rate is higher than necessary. Efforts are being directed toward decreasing the number of these procedures, in part by encouraging physicians to make changes in their management practices. Because breech presentations are associated with a high rate of cesarean delivery, there is renewed interest in techniques such as external cephalic version (ECV) and vaginal breech delivery. The purpose of this document is to provide information about ECV by summarizing the relevant evidence presented in published studies and to make recommendations regarding its use in obstetric practice.

  9. The History and Practice of Ancient Astronomy

    CERN Document Server

    Evans, James


    The History and Practice of Ancient Astronomy combines new scholarship with hands-on science to bring readers into direct contact with the work of ancient astronomers. While tracing ideas from ancient Babylon to sixteenth-century Europe, the book places its greatest emphasis on the Greek period, when astronomers developed the geometric and philosophical ideas that have determined the subsequent character of Western astronomy. The author approaches this history through the concrete details of ancient astronomical practice. Carefully organized and generously illustrated, the book can teach reade

  10. Effective enforcement of the forest practices code

    Energy Technology Data Exchange (ETDEWEB)



    The British Columbia Forest Practices Code establishes a scheme to guide and direct forest harvesting and other forest uses in concert with other related acts. The Code is made up of the Forest Practices Code of British Columbia Act, regulations, standards, and guidebooks. This document provides information on Code enforcement. It reviews the roles of the three provincial resource ministries and the Attorney General in enforcing the code, the various activities undertaken to ensure compliance (including inspections, investigations, and responses to noncompliance), and the role of the public in helping to enforce the Code. The appendix contains a list of Ministry of Forests office locations and telephone numbers.

  11. Pharmacogenetics in the oncological clinical practice

    International Nuclear Information System (INIS)

    Gruber, S.


    The genetic control of drug metabolism allows new insights into the bioavailability, toxicity, and efficacy of chemotherapy. In addition, molecular expression profiles of tumors offers the potential for targeted therapy to be directed more specifically to the biologic behavior of the cancer. Together these strategies are likely to change the practice of clinical oncology. However, appropriate clinical trials will be required to demonstrate the utility of these approaches before they are broadly implemented the biologic behavior of the cancer. Together these strategies are likely to change the practice of clinical oncology. However, appropriate clinical trials will be required to demonstrate the utility of these approaches before they are broadly implemented

  12. Adaptive change in corporate control practices. (United States)

    Alexander, J A


    Multidivisional organizations are not concerned with what structure to adopt but with how they should exercise control within the divisional form to achieve economic efficiencies. Using an information-processing framework, I examined control arrangements between the headquarters and operating divisions of such organizations and how managers adapted control practices to accommodate increasing environmental uncertainty. Also considered were the moderating effects of contextual attributes on such adaptive behavior. Analyses of panel data from 97 multihospital systems suggested that organizations generally practice selective decentralization under conditions of increasing uncertainty but that organizational age, dispersion, and initial control arrangements significantly moderate the direction and magnitude of such changes.

  13. Epidemic threshold in directed networks (United States)

    Li, Cong; Wang, Huijuan; Van Mieghem, Piet


    Epidemics have so far been mostly studied in undirected networks. However, many real-world networks, such as the online social network Twitter and the world wide web, on which information, emotion, or malware spreads, are directed networks, composed of both unidirectional links and bidirectional links. We define the directionality ξ as the percentage of unidirectional links. The epidemic threshold τc for the susceptible-infected-susceptible (SIS) epidemic is lower bounded by 1/λ1 in directed networks, where λ1, also called the spectral radius, is the largest eigenvalue of the adjacency matrix. In this work, we propose two algorithms to generate directed networks with a given directionality ξ. The effect of ξ on the spectral radius λ1, principal eigenvector x1, spectral gap (λ1-λ2), and algebraic connectivity μN-1 is studied. Important findings are that the spectral radius λ1 decreases with the directionality ξ, whereas the spectral gap and the algebraic connectivity increase with the directionality ξ. The extent of the decrease of the spectral radius depends on both the degree distribution and the degree-degree correlation ρD. Hence, in directed networks, the epidemic threshold is larger and a random walk converges to its steady state faster than that in undirected networks with the same degree distribution.

  14. Seeking coherence among environmental directives

    NARCIS (Netherlands)

    Beijen, Barbara


    European environmental law consists of a large number of directives and regulations dealing with environmental domains such as air, water, or waste, or with issues such as greenhouse gases, chemicals or industrial emissions. These directives and regulations do not form a comprehensive system of

  15. Direct activation of microcrystalline zeolites

    NARCIS (Netherlands)

    Ortiz-Iniesta, Maria Jesus; Heeres, Hero Jan; Melian-Cabrera, Ignacio


    In this work a direct activation route of zeolites is assessed. It consists of NH4-exchanging the as-synthesized solids before removing the organic template. Calcination afterwards serves to combust the organic template and creates the Bronsted sites directly; thus applying merely a single thermal

  16. Exchange effects in direct reactions

    International Nuclear Information System (INIS)

    LeMere, M.; Kanellopoulos, E.J.; Suenkel, W.; Tang, Y.C.


    The effect of antisymmetrization in direct reactions is examined by studying the properties of the coupling-normalization kernel function occurring in a resonating-group formulation. From this study, one obtains useful information concerning the general behavior of direct-reactiion processes and some justification for the use of three-body models in phenomenological analyses

  17. Eldercare at Home: Advanced Directives (United States)

    ... permanently? Helping the person fill out a living will (advance directive) A living will states a person's wishes about medical care if ... never be in a situation where another person will have to make decisions ... it is to have an advance directive. However, don't assume that your loved ...

  18. Target selection for direct marketing.

    NARCIS (Netherlands)

    Bult, Jan Roelf


    In this thesis we concentrated on the use ol direct mail for targeting potential buyers. The major characteristics that influences the success of a plomotional direct mail campaign are the of-fbr,the communication elements, the timing or sequence of these communication elements, and the list of

  19. Between Theory and Practice

    DEFF Research Database (Denmark)

    Dindler, Christian; Dalsgaard, Peter


    We present the notion of ‘bridging concepts’ as a particular form of intermediary knowledge in HCI research, residing between theory and practice. We argue that bridging concepts address the challenge of facilitating exchange between theory and practice in HCI, and we compare it to other....... These constituents specify how bridging concepts, as a form of knowledge, are accountable to both theory and practice. We present an analysis of the concept of ‘peepholes’ as an example of a bridging concept aimed at spurring user curiosity and engagement....

  20. Exemplary Design Practice

    DEFF Research Database (Denmark)

    Jørgensen, Niels

    The didactic principle of exemplary learning may be defined briefly as 'learning by example'. In design education, working with a practical example is particularly appropriate, because design by definition is about creating a solution to a practical problem. Indeed, some design theorists claim......, including: If design knowing is bound to a given practical design context, how is it possible to generalize such knowing, as presumably required by an exemplary learning approach? To explore these questions, an account is given of the theories of exemplary learning proposed by Martin Wagenschein and Oskar...

  1. Creating a practice website. (United States)

    Downes, P K


    A website is a window to the outside world. For a dental practice, it may be the first point of contact for a prospective new patient and will therefore provide them with their 'first impression'; this may be days or weeks before actually visiting the practice. This section considers the different ways of creating a dental practice website and lists some of the main dental website design companies. It also describes what factors make a successful website and offers advice on how to ensure that it complies with current regulations and recommendations.

  2. Vaccines and Immunization Practice. (United States)

    Hogue, Michael D; Meador, Anna E


    Vaccines are among most cost-effective public health strategies. Despite effective vaccines for many bacterial and viral illnesses, tens of thousands of adults and hundreds of children die each year in the United States from vaccine-preventable diseases. Underutilization of vaccines requires rethinking the approach to incorporating vaccines into practice. Arguably, immunizations could be a part all health care encounters. Shared responsibility is paramount if deaths are to be reduced. This article reviews the available vaccines in the US market, as well as practice recommendations of the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Comparative EMP design practices

    International Nuclear Information System (INIS)

    Martin, L.C.


    A large amount of effort is devoted to the hardening of systems against various effects. The nuclear electromagnetic pulse (EMP) creates potentially severe protection problems in hardening against electromagnetic effects. Each hardening effort is usually supported through development or application of sets of rules, practices, constraints, etc., which aid in decision-making throughout the design process. Several excerpts from a few sets of EMP design rules and practices taken from relatively independent sources are presented for comparison of essential features and mode of expression. A general objective is to clarify some of the EMP practices present in general EMC work and to encourage further interchange of relevant information. (auth)

  4. Direct oral anticoagulants: An update. (United States)

    Franco Moreno, Ana Isabel; Martín Díaz, Rosa María; García Navarro, María José


    Vitamin K antagonists were the only choice for chronic oral anticoagulation for more than half a century. Over the past few years, direct oral anticoagulants have emerged, including one direct thrombin inhibitor (dabigatran etexilate) and three factor Xa inhibitors (apixaban, edoxaban and rivaroxaban). In randomised controlled trials comparing direct oral anticoagulants with traditional vitamin K antagonists, the direct oral anticoagulants all showed a favourable benefit-risk balance in their safety and efficacy profile, in prevention of thromboembolic events in patients with atrial fibrillation and in the prevention and treatment of venous thromboembolism and acute coronary syndrome. In 2008, dabigatran was the first direct oral anticoagulant approved by the European Medicine Agency. Subsequently, rivaroxaban, apixaban and edoxaban were also authorised. This article reviews the evidence related to the use of these drugs. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  5. Efficient Placement of Directional Antennas

    Energy Technology Data Exchange (ETDEWEB)

    Pan, Feng [Los Alamos National Laboratory; Kasiviswanathan, Shiva [Los Alamos National Laboratory


    Directional antenna is an technology for the proliferation of wireless networks. In centralized wireless network, wireless devices communicate through base stations. Directed antennas are placed on base stations and form a backbone of communication. The communication between base stations and wireless devices can be interfered due to a large number of wireless device. Methodically positioning and orienting directed antennas can help to reduce the interference while saving energy. An integer linear programming is developed for siting and directing antennas on multiple base stations, and this formulation can be extended to model non-overlapping channels. Through the integer programming formulation, optimal antenna positions can be used to analyze the performance of directed antennas with different parameters like the number base stations and the number of non-overlapping channels.

  6. Direct catastrophic injury in sports. (United States)

    Boden, Barry P


    Catastrophic sports injuries are rare but tragic events. Direct (traumatic) catastrophic injury results from participating in the skills of a sport, such as a collision in football. Football is associated with the greatest number of direct catastrophic injuries for all major team sports in the United States. Pole vaulting, gymnastics, ice hockey, and football have the highest incidence of direct catastrophic injuries for sports in which males participate. In most sports, the rate of catastrophic injury is higher at the collegiate than at the high school level. Cheerleading is associated with the highest number of direct catastrophic injuries for all sports in which females participate. Indirect (nontraumatic) injury is caused by systemic failure as a result of exertion while participating in a sport. Cardiovascular conditions, heat illness, exertional hyponatremia, and dehydration can cause indirect catastrophic injury. Understanding the common mechanisms of injury and prevention strategies for direct catastrophic injuries is critical in caring for athletes.

  7. Professional courtesy--current practices and attitudes. (United States)

    Levy, M A; Arnold, R M; Fine, M J; Kapoor, W N


    Physicians have long provided care free of charge or at a reduced rate as a professional courtesy to other physicians and their families. We conducted a stratified national mail survey to assess the extent to which this practice has changed in recent years. Using the American Medical Association's 1991 master list of physicians, we selected a random sample of 4800 practicing physicians from 12 direct-care specialties. These physicians were asked about their current policy and opinions regarding professional courtesy. Of the 2224 respondents, 2127 (96 percent) offered professional courtesy, defined as providing free or discounted health care to physicians and their families. Psychiatrists were less likely to offer professional courtesy than physicians in any of the other specialties (80 percent vs. 91 to 99 percent, P courtesy included billing only the insurance company (75 percent), providing care at no charge (49 percent), and giving a partial discount (23 percent). Twenty-three percent of the respondents reported that they had changed their policy regarding professional courtesy since starting to practice. Among those who had changed their policy, the most common changes were to increase the practice of billing only the insurance company (67 percent) and to provide care at no charge less often (58 percent). The majority of physicians responding to the survey thought that professional courtesy solidified bonds between physicians (79 percent) and was sound business practice (62 percent); 12 percent believed that it was too expensive to offer free or discounted care as a professional courtesy, and 14 percent thought that the practice had negative effects on the physician-patient interaction. Our survey of physicians involved in direct patient care indicates that, with the exception of psychiatrists, almost all American physicians offer free or discounted care as a professional courtesy and support the practice.

  8. Professional convergence in forensic practice. (United States)

    Mercer, D; Mason, T; Richman, J


    This paper outlines the development and convergence of forensic science and secure psychiatric services in the UK, locating the professionalization of forensic nursing within a complex web of political, economic, and ideological structures. It is suggested that a stagnation of the therapeutic enterprise in high and medium security provision has witnessed an intrusion of medical power into the societal body. Expanding technologies of control and surveillance are discussed in relation to the move from modernity to postmodernity and the ongoing dynamic of medicalized offending. Four aspects of globalization are identified as impacting upon the organization and application of forensic practice: (i) organized capitalism and the exhaustion of the welfare state; (ii) security versus danger and trust versus risk; (iii) science as a meta-language; and (iv) foreclosure as a mechanism of censorship. Finally, as a challenge for the profession, some predictions are offered about the future directions or demise of forensic nursing.

  9. Institutional Financial Autonomy in Practice

    DEFF Research Database (Denmark)

    Szwebs, Witold


    The article reveals how university autonomy may in practice prove to be restrictive for units within the university. The need to implement and interpret external regulations and protect the institution may, argued in the paper, lead to a risk averse, conservative approach which is experienced...... by departments as bureaucratic and hampering effective research. Thus autonomy has produced new internal tensions between the central management/administration and the departments which it is argued is counter-productive and not beneficial for research and could be seen as a perverse aspect of greater autonomy....... Indeed because university policy and ‘interference’ is much closer to the researcher than in former less autonomous times and the university may now exercise other direct incentives through resource allocation, promotion and salary enhancement, the department and the individual may view autonomy...

  10. Determinants of leisure-time physical activity and future intention to practice in Spanish college students. (United States)

    Molina-García, Javier; Castillo, Isabel; Pablos, Carlos


    Few studies analyze determinants and patterns of physical activity among college students, so it has not been possible to carry out effective interventions to promote this practice. The aim of this study was to analyze the associations between some personal, social, and environmental determinants, practice of physical activity and future intention to practice in a sample of 639 university students (321 men and 318 women), mean age 21.43 years (+/- 2.78). Physical fitness self-perception, physical activity history, and coach's support to practice physical activity have a direct effect on the practice of physical activity and an indirect effect on future intention to practice, both in men and women. The practice of physical activity has also a direct effect on future intention to practice. Likewise, the participation in sport competitions predicts practice of physical activity and future intention in men, whereas being a member of a sports club predicts practice and future intention in women.

  11. Referrals and relationships: in-practice referrals meetings in a general practice. (United States)

    Rowlands, G; Willis, S; Singleton, A


    GP referrals to secondary care are an important factor in the cost of running the NHS. The known variation in referral rates between doctors has the potential to cause tension within primary care which will be exacerbated by the latest reorganization of primary care and the trend towards capitation-based budgets. The importance of postgraduate learning for GPs has been recognized; continuing professional development is moving towards self-directed practice-based learning programmes. Educational interventions have been shown to alter doctors' prescribing behaviour. This, together with the pressure on accounting for referral activity, makes the prospect of improving, and possibly reducing, referral activity through educational interventions very attractive. This study complemented a randomized controlled trial (RCT) which investigated whether an intervention of the type which had reduced prescribing costs would have a similar effect on referral activity. The context of the study, description of the characteristics of the practice and the issues seen as important by the doctors and practice manager were identified through preliminary semi-structured interviews. The practice then held a series of educational in-practice meetings to discuss referrals and issues arising from referrals. The audio- and videotaped transcripts were interpreted using content and group dynamic analysis. Participants commented upon our preliminary findings. In addition, we used dimensional analysis to induce a preliminary theory describing the effect of the intervention on this general practice which enabled us to review the findings of the parallel RCT. The educational value of the meetings and the learning needs of the participants were also assessed. Our complementary study showed no alteration of practice referral rates following the educational intervention. The qualitative study, unencumbered by the assumptions inherent in the development of the hypothesis tested in the RCT, highlighted

  12. Practical applications of phosphors

    CERN Document Server

    Yen, William M; Yamamoto, Hajime


    Drawn from the second edition of the best-selling Phosphor Handbook, Practical Applications of Phosphors outlines methods for the production of various phosphors and discusses a broad spectrum of applications. Beginning with methods for synthesis and related technologies, the book sets the stage by classifying and then explaining practical phosphors according to usage. It describes the operating principle and structure of phosphor devices and the phosphor characteristics required for a given device, then covers the manufacturing processes and characteristics of phosphors. The book discusses research and development currently under way on phosphors with potential for practical usage and touches briefly on phosphors that have played a historical role, but are no longer of practical use. It provides a comprehensive treatment of applications including lamps and cathode-ray tubes, x-ray and ionizing radiation, and for vacuum fluorescent and field emission displays and covers inorganic and organic electroluminescen...

  13. Communication as practice

    DEFF Research Database (Denmark)

    Gholamian, Jamshid


    sort of human activity also include communication as practice. Inspired by Bakhtin, I believe that dialogical relationship is almost a universal phenomenon that permeates all human speech and in general all relationships and manifestations of human life, and "everything in life is dialogue", (Dysthe...... of communicational practices within conversations contexts. Based on Bakhtin’s thought, I understand any conversation as a sociocultural communicative practice. In this concept, the focus will be on how participants via interaction create meaning. In order to elaborate and examine these notions, I will include some......According to Schatzki "Practice" brings into view activities which are situated, corporeal, and shaped by habits without reflection. This notion has been extraordinarily successful and has now been extended to cover every sort of human activity” (Schatzki 2001:2). And I would like to add that every...

  14. Learning in Practice

    DEFF Research Database (Denmark)

    Helth, Poula

    on theories of aesthetic performance and transformative learning, and on empirical studies through interventive methods within action research and ethnography. Transformative learning in my study has been developed based on aesthetic performance addressing leaders’ learning in practice. This kind of learning......The thesis presents the essence of my study of how leaders transform their practice through aesthetic performance. The background of the study is leaders' need for learning in and through practice, as an alternative to learning in classrooms and to leadership education programs. The study is based...... happens when leaders become aware of the potential for transformation of their leadership practice when they experiment with aesthetic performance integrated in a learning process. The greatest impact in relation to organisational transformation is, when leaders base their learning on a collective...

  15. Practical goal programming

    CERN Document Server

    Jones, Dylan


    This book and its treatment of goal programming will help organizations meet targets and objectives. The book includes many worked-out examples and tutorial exercises, and is designed to demostrate and teach its readers good modeling practice.

  16. Ecohealth Research in Practice

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

    Research, education, and practice in ecohealth have seen almost logarithmic ... Health Organization; Instituto Nacional de Salud Publica, Mexico; and IDRC). ..... rates and improving the control of major diseases like tuberculosis and malaria, ...

  17. Creative Digital Media Practices

    DEFF Research Database (Denmark)

    Frølunde, Lisbeth

    , 2006, 2009), machinima (machine + cinema + anime, real-time animation captured in games etc.), and the digital storytelling movement. A dialogic perspective on the diversity of digital media practices opens up for understanding the complex evolution of language on socio-historical, cultural......The presentation reviews the interplay of dialogic (Bakhtin, 1981) and multimodal theories on media production practices, with attention to visual communication (Kress and van Leeuwen, 2001, 2006). This theoretical approach aids in reflecting on digital media practices as novel (new) sign systems...... develop a collaborative digital storytelling showcase for their own digital stories about Roskilde University. This course is intended to bring up reflections on the wider phenomenon of contemporary media practices, such as: YouTube, DIY (do-it-yourself) filmmaking or homemade, garage cinema (Jenkins...

  18. Musical Students’ Concert Practice

    Directory of Open Access Journals (Sweden)

    Aleksandr S. Plokhotnyuk


    Full Text Available . The article presents detailed analysis of performance training of future teachers of music at higher educational establishments and offers ways to overcome the problem of musical students’ concert practice organization.

  19. Operations Strategy in practice

    DEFF Research Database (Denmark)

    Rytter, Niels Gorm; Koch, Christian; Boer, Harry


    In this paper, we describe and illustrate a new, action-based longitudinal case study approach, which aims at helping scholars narrow the gap between the theory and practice of Operations Strategy (OS). First, we elaborate on the need for new research methods for studying OS in practice. Then, we...... and disadvantages of the method. Finally, we draw conclusions on its potential for operations strategy and operations management studies.......In this paper, we describe and illustrate a new, action-based longitudinal case study approach, which aims at helping scholars narrow the gap between the theory and practice of Operations Strategy (OS). First, we elaborate on the need for new research methods for studying OS in practice. Then, we...

  20. Improving Practice through Research. (United States)

    Rose, Terry L.


    The article discusses the need for communication of research findings involving exceptional individuals, the need for resolution of the research-practice dichotomy, and the types of papers which will appear in the new column. (JDD)

  1. Port Authority Best Practices (United States)

    Best practices for port authorities include near-port community collaboration, anti-idling policies, expanding off-peak hours, development of EMS, developing an emissions inventory, education, electric power and substituting trucking for rail or barge.

  2. Governing Social Practice

    DEFF Research Database (Denmark)

    Kallinikos, Jannis; Hasselbladh, Hans; Marton, Attila


    the last two decades, the operations of memory institutions increasingly mingle with those of information aggregators and search engines. These developments reframe longstanding professional practices of memory organizations and, in this process, challenge their institutional mandate....

  3. Diffusing Best Practices

    DEFF Research Database (Denmark)

    Pries-Heje, Jan; Baskerville, Richard


    approach. The study context is a design case in which an organization desires to diffuse its best practices across different groups. The design goal is embodied in organizational mechanisms to achieve this diffusion. The study used Theory of Planned Behavior (TPB) as a kernel theory. The artifacts...... resulting from the design were two-day training workshops conceptually anchored to TBP. The design theory was evaluated through execution of eight diffusion workshops involving three different groups in the same company. The findings indicate that the match between the practice and the context materialized...... that the behavior will be effective). These two factors were especially critical if the source context of the best practice is qualitatively different from the target context into which the organization is seeking to diffuse the best practice....

  4. Transfer and Social Practice. (United States)

    Billett, Stephen


    Transfer involves disembodying knowledge and transferring it for use in different contexts. Vocational knowledge arises in communities of practice, and difficulties arise in transferring it from one distinct community, such as a workplace, to another, such as a classroom. (SK)

  5. Best Practice Life Expectancy

    DEFF Research Database (Denmark)

    Medford, Anthony


    been reported previously by various authors. Though remarkable, this is simply an empirical observation. Objective: We examine best-practice life expectancy more formally by using extreme value theory. Methods: Extreme value distributions are fit to the time series (1900 to 2012) of maximum life......Background: Whereas the rise in human life expectancy has been extensively studied, the evolution of maximum life expectancies, i.e., the rise in best-practice life expectancy in a group of populations, has not been examined to the same extent. The linear rise in best-practice life expectancy has...... expectancies at birth and age 65, for both sexes, using data from the Human Mortality Database and the United Nations. Conclusions: Generalized extreme value distributions offer a theoretically justified way to model best-practice life expectancies. Using this framework one can straightforwardly obtain...

  6. Practice Hospital Bed Safety (United States)

    ... Home For Consumers Consumer Updates Practice Hospital Bed Safety Share Tweet Linkedin Pin it More sharing options ... It depends on the complexity of the bed." Safety Tips CDRH offers the following safety tips for ...

  7. Pharmacogenetics in clinical practice

    NARCIS (Netherlands)

    Derijks, Luc J. J.; Derijks, H. Jeroen; Touw, Daan J.; Conemans, Jean M. H.; Egberts, Antoine C. G.


    The availability of data from pharmacogenetic studies is reflected in therapeutic practice, and pharmacogenetics is slowly entering the medical arena. Preconditions for the utilisation of pharmacogenetic knowledge are that: 1) genetic variation and prevalence are known 2) pharmacological

  8. Practicing (Dis)connections

    DEFF Research Database (Denmark)

    The paper addresses the reciprocal notions of mobility and mobilisation in medical imaging practice, in view of the contingent and multiple character of the knowledge-practices involving such images – and their interpretation – within and across situated settings. Based on an ethnographically......’s development of in-house examination protocols as a consequence of its having replaced an older, pre-existing MRI scanner with a new model. This re-domestication of MRI as occasioned by the replacement scanner offers a range of sociomaterial and sociotechnical contingencies in the practice to come to light...... of the epistemic underpinnings which render, and condition, how connections are mediated across extended settings of practice (in the MRI unit, at interdisciplinary case conferences, and at other hospitals, etc.). This relational view allows for the heterogeneity entailed in the domestication of the MRI scanner...

  9. Branding your medical practice. (United States)

    Maley, Catherine; Baum, Neil


    Branding is the process of differentiating your medical practice from all other practices in the industry. Branding takes into account the "look and feel" of your office, you and your staff your materials, and every other detail that gives your patients clues as to who you are and what you value. This article will review the strategies that go into building your own solid brand so your existing patients, as well as prospective ones, are attracted and loyal to you and your brand.

  10. Stakeholders: theory and practice

    National Research Council Canada - National Science Library

    Friedman, Andrew L; Miles, Samantha


    ... of the concept on practice and policy. However, as the concept has become more popular, the path has become tangled with the many different ways the concept has been used. For example, different practices have come to be called stakeholder activities, particularly by those seeking to use the label to legitimize their actions. Also, a range of different definitions as to what a stakeholder is has emerged. Concentrating on these issues encourages a view of a second future path of the stake...

  11. The systematization of practice

    DEFF Research Database (Denmark)

    Vidal, Rene Victor Valqui


    this paper presents an approach for the systematization of practical experiences whitin Operations Research, Community work, Systems Sciences, Action Research, etc. A case study is presented: the systematization of the activities of a development center in Denmark.......this paper presents an approach for the systematization of practical experiences whitin Operations Research, Community work, Systems Sciences, Action Research, etc. A case study is presented: the systematization of the activities of a development center in Denmark....

  12. Code of Practice

    International Nuclear Information System (INIS)

    Doyle, Colin; Hone, Christopher; Nowlan, N.V.


    This Code of Practice introduces accepted safety procedures associated with the use of alpha, beta, gamma and X-radiation in secondary schools (pupils aged 12 to 18) in Ireland, and summarises good practice and procedures as they apply to radiation protection. Typical dose rates at various distances from sealed sources are quoted, and simplified equations are used to demonstrate dose and shielding calculations. The regulatory aspects of radiation protection are outlined, and references to statutory documents are given

  13. Surfaces of Building Practice


    Surynková, Petra


    My diploma thesis Surfaces of Building Practice deals with the basic properties of surfaces, their mathematical description, categorization, and application in technical practice. Each studied surface is defined and its process of construction and parametrical description is listed. The thesis studies selected types of surfaces in details - these surfaces include surfaces of revolution, ruled surfaces, screw surfaces, and translational surfaces. An application of each studied surfaces is show...

  14. Practical knowledge engineering

    CERN Document Server

    Kelly, Richard


    This book provides knowledge engineers with practical methods for initiating, designing, building, managing, and demonstrating successful commercial expert systems. It is a record of what actually works (and does not work) in the construction of expert systems, drawn from the author's decade of experience in building expert systems in all major areas of application for American, European, and Japanese organizations.The book features:* knowledge engineering programming techniques* useful skills for demonstrating expert systems * practical costing and metrics* guidelines for using knowledge repr

  15. Practicing like Thomas Edison. (United States)

    Baum, Neil; Ornstein, Hal


    For many centuries, medicine has practiced in a vacuum, and the healthcare profession has been isolated from other scientific disciplines. Beginning in the 20th century, doctors and scientists have looked to others for ideas, suggestions, innovations, and new technologies. Probably no one in the past hundred years has done so much to change the world than Thomas Edison. This article will discuss eight principles of Edison and how they may apply to our profession and our practices.

  16. Improving Corporate Governance Practices


    M. Huse; J. Gabrielsson; A. Minichilli


    Peak performing organizations may benefit from active value creating boards. Suggestions to improve board behaviour and corporate governance practices are presented in this article. The suggestions result from findings in the “Valued Creating Board” research programme. However, active boards working in a shareholder activism framework may destroy rather than support value creation processes within firms. In peak performing organizations corporate governance practices should be designed and de...

  17. Culture, mind, and the brain: current evidence and future directions. (United States)

    Kitayama, Shinobu; Uskul, Ayse K


    Current research on culture focuses on independence and interdependence and documents numerous East-West psychological differences, with an increasing emphasis placed on cognitive mediating mechanisms. Lost in this literature is a time-honored idea of culture as a collective process composed of cross-generationally transmitted values and associated behavioral patterns (i.e., practices). A new model of neuro-culture interaction proposed here addresses this conceptual gap by hypothesizing that the brain serves as a crucial site that accumulates effects of cultural experience, insofar as neural connectivity is likely modified through sustained engagement in cultural practices. Thus, culture is "embrained," and moreover, this process requires no cognitive mediation. The model is supported in a review of empirical evidence regarding (a) collective-level factors involved in both production and adoption of cultural values and practices and (b) neural changes that result from engagement in cultural practices. Future directions of research on culture, mind, and the brain are discussed.

  18. The evolution of physician-directed managed care. (United States)

    Unland, J J


    The health care industry is evolving. In the near term, POs will become the state of the art in physician-directed managed care. Eventually, POs will merge into fully integrated group practices. From there, regional POs and group practices will develop their own insurance products. But because these organizations will be dominated by physicians who wish to practice medicine, rather than sell insurance, money will be made by appropriately managing risk and providing high-quality care. In time, physicians will take control and "manage" managed care, as they are the only ones--not administrators, executives, or other business people--who are in a position to fundamentally revise the way medicine is practiced.

  19. Restaurant food cooling practices. (United States)

    Brown, Laura Green; Ripley, Danny; Blade, Henry; Reimann, Dave; Everstine, Karen; Nicholas, Dave; Egan, Jessica; Koktavy, Nicole; Quilliam, Daniela N


    Improper food cooling practices are a significant cause of foodborne illness, yet little is known about restaurant food cooling practices. This study was conducted to examine food cooling practices in restaurants. Specifically, the study assesses the frequency with which restaurants meet U.S. Food and Drug Administration (FDA) recommendations aimed at reducing pathogen proliferation during food cooling. Members of the Centers for Disease Control and Prevention's Environmental Health Specialists Network collected data on food cooling practices in 420 restaurants. The data collected indicate that many restaurants are not meeting FDA recommendations concerning cooling. Although most restaurant kitchen managers report that they have formal cooling processes (86%) and provide training to food workers on proper cooling (91%), many managers said that they do not have tested and verified cooling processes (39%), do not monitor time or temperature during cooling processes (41%), or do not calibrate thermometers used for monitoring temperatures (15%). Indeed, 86% of managers reported cooling processes that did not incorporate all FDA-recommended components. Additionally, restaurants do not always follow recommendations concerning specific cooling methods, such as refrigerating cooling food at shallow depths, ventilating cooling food, providing open-air space around the tops and sides of cooling food containers, and refraining from stacking cooling food containers on top of each other. Data from this study could be used by food safety programs and the restaurant industry to target training and intervention efforts concerning cooling practices. These efforts should focus on the most frequent poor cooling practices, as identified by this study.

  20. Potential theory for directed networks.

    Directory of Open Access Journals (Sweden)

    Qian-Ming Zhang

    Full Text Available Uncovering factors underlying the network formation is a long-standing challenge for data mining and network analysis. In particular, the microscopic organizing principles of directed networks are less understood than those of undirected networks. This article proposes a hypothesis named potential theory, which assumes that every directed link corresponds to a decrease of a unit potential and subgraphs with definable potential values for all nodes are preferred. Combining the potential theory with the clustering and homophily mechanisms, it is deduced that the Bi-fan structure consisting of 4 nodes and 4 directed links is the most favored local structure in directed networks. Our hypothesis receives strongly positive supports from extensive experiments on 15 directed networks drawn from disparate fields, as indicated by the most accurate and robust performance of Bi-fan predictor within the link prediction framework. In summary, our main contribution is twofold: (i We propose a new mechanism for the local organization of directed networks; (ii We design the corresponding link prediction algorithm, which can not only testify our hypothesis, but also find out direct applications in missing link prediction and friendship recommendation.

  1. Direct Manipulation in Virtual Reality (United States)

    Bryson, Steve


    Virtual Reality interfaces offer several advantages for scientific visualization such as the ability to perceive three-dimensional data structures in a natural way. The focus of this chapter is direct manipulation, the ability for a user in virtual reality to control objects in the virtual environment in a direct and natural way, much as objects are manipulated in the real world. Direct manipulation provides many advantages for the exploration of complex, multi-dimensional data sets, by allowing the investigator the ability to intuitively explore the data environment. Because direct manipulation is essentially a control interface, it is better suited for the exploration and analysis of a data set than for the publishing or communication of features found in that data set. Thus direct manipulation is most relevant to the analysis of complex data that fills a volume of three-dimensional space, such as a fluid flow data set. Direct manipulation allows the intuitive exploration of that data, which facilitates the discovery of data features that would be difficult to find using more conventional visualization methods. Using a direct manipulation interface in virtual reality, an investigator can, for example, move a data probe about in space, watching the results and getting a sense of how the data varies within its spatial volume.

  2. Potential Theory for Directed Networks (United States)

    Zhang, Qian-Ming; Lü, Linyuan; Wang, Wen-Qiang; Zhou, Tao


    Uncovering factors underlying the network formation is a long-standing challenge for data mining and network analysis. In particular, the microscopic organizing principles of directed networks are less understood than those of undirected networks. This article proposes a hypothesis named potential theory, which assumes that every directed link corresponds to a decrease of a unit potential and subgraphs with definable potential values for all nodes are preferred. Combining the potential theory with the clustering and homophily mechanisms, it is deduced that the Bi-fan structure consisting of 4 nodes and 4 directed links is the most favored local structure in directed networks. Our hypothesis receives strongly positive supports from extensive experiments on 15 directed networks drawn from disparate fields, as indicated by the most accurate and robust performance of Bi-fan predictor within the link prediction framework. In summary, our main contribution is twofold: (i) We propose a new mechanism for the local organization of directed networks; (ii) We design the corresponding link prediction algorithm, which can not only testify our hypothesis, but also find out direct applications in missing link prediction and friendship recommendation. PMID:23408979

  3. Developments of directional detectors with NaI(Tl)/BGO scintillators

    International Nuclear Information System (INIS)

    Shirakawa, Y.


    This paper describes directional gamma ray detectors with different types of scintillators. The detectors, which positively increase directional sensitivity to incident gamma rays, have been developed to measure directions, energies and counts of gamma rays, and to search for radioactive materials such as orphan radioisotopes or contaminations. Experimental results have shown that proposed directional detectors have a potential for practical use in real fields and will contribute to radiation protection and safety

  4. European Gas Appliances Directive and the Dutch Decree on Gas Appliances. Special section

    International Nuclear Information System (INIS)

    De Bruin, B.; Venhorst, T.; Van Tricht, A.


    The Gas Appliances Decree is the Dutch translation of the European Gas Appliances Directive. The Decree and the EU Directive contain substantial information, provided they will be read carefully. The EU Directive lays down general safety requirements for gas appliances. They serve as a practical tool for manufacturers and service engineers. In two articles, the Directive is explained, addressing uncertainties and answering important questions. 5 ills

  5. Previous Experience a Model of Practice UNAE

    Directory of Open Access Journals (Sweden)

    Ormary Barberi Ruiz


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

  6. Remote Sensing and Cropping Practices: A Review

    Directory of Open Access Journals (Sweden)

    Agnès Bégué


    Full Text Available For agronomic, environmental, and economic reasons, the need for spatialized information about agricultural practices is expected to rapidly increase. In this context, we reviewed the literature on remote sensing for mapping cropping practices. The reviewed studies were grouped into three categories of practices: crop succession (crop rotation and fallowing, cropping pattern (single tree crop planting pattern, sequential cropping, and intercropping/agroforestry, and cropping techniques (irrigation, soil tillage, harvest and post-harvest practices, crop varieties, and agro-ecological infrastructures. We observed that the majority of the studies were exploratory investigations, tested on a local scale with a high dependence on ground data, and used only one type of remote sensing sensor. Furthermore, to be correctly implemented, most of the methods relied heavily on local knowledge on the management practices, the environment, and the biological material. These limitations point to future research directions, such as the use of land stratification, multi-sensor data combination, and expert knowledge-driven methods. Finally, the new spatial technologies, and particularly the Sentinel constellation, are expected to improve the monitoring of cropping practices in the challenging context of food security and better management of agro-environmental issues.

  7. Quality measures for nurse practitioner practice evaluation. (United States)

    Kleinpell, Ruth; Kapu, April N


    Evaluating the impact of nurse practitioner (NP) practice has become a priority area of focus for demonstrating outcomes. A number of quality measures are available to enable practice-specific evaluation of NP roles and initiatives. This article reviews sources of quality measures that can be used to facilitate quantifying the outcomes of NP practice as part of an overall evaluation agenda. National resources and published literature on NP quality measures were reviewed. Various resources and toolkits exist to assist NPs in identifying outcomes of practice using quality measures. The need to demonstrate outcomes of NP practice remains an ongoing priority area regardless of the clinical practice setting. A variety of sources of quality measures exist that can be used to showcase the effect of NP care. The use of quality measures can be effectively integrated into evaluation of NP role and NP-directed initiatives to demonstrate impact, and enhance the conduct of an NP outcomes assessment. The use of organizational, NP-specific, and national-related quality measures can help to showcase how NP care improves the quality, safety, and costs of health care. ©2017 American Association of Nurse Practitioners.

  8. New Directions in Chronic Disease Management

    Directory of Open Access Journals (Sweden)

    Hun-Sung Kim


    Full Text Available A worldwide epidemic of chronic disease, and complications thereof, is underway, with no sign of abatement. Healthcare costs have increased tremendously, principally because of the need to treat chronic complications of non-communicable diseases including cardiovascular disease, blindness, end-stage renal disease, and amputation of extremities. Current healthcare systems fail to provide an appropriate quality of care to prevent the development of chronic complications without additional healthcare costs. A new paradigm for prevention and treatment of chronic disease and the complications thereof is urgently required. Several clinical studies have clearly shown that frequent communication between physicians and patients, based on electronic data transmission from medical devices, greatly assists in the management of chronic disease. However, for various reasons, these advantages have not translated effectively into real clinical practice. In the present review, we describe current relevant studies, and trends in the use of information technology for chronic disease management. We also discuss limitations and future directions.

  9. Teaching Practice in Distance Education Context

    Directory of Open Access Journals (Sweden)

    Fatmasari Rhini


    The results showed the level of independence of students doing PKM was quite high (72%. This level of independence needs to be supported by a 43% improvement in preparation and administrative services at UT Regional Office. In the implementation of teaching practice in schools, in average 53.14% Supervisor 1 and 63.86% Supervisor 2 always provide direction in accordance with UT standards. While 62.5% of Headmaster Sentra has role in accordance with its function.

  10. Hand decontamination practices in paediatric wards

    Directory of Open Access Journals (Sweden)

    S Jelly


    Full Text Available The purpose of this study was to determine and describe hand decontamination practices of health care professionals in the paediatric wards of an academic hospital in Johannesburg. The purpose was addressed within a survey design and through the use of descriptive and comparative methods. Data were collected through direct observation conducted with the use of a researcher-administered checklist. A sample of sixtysix health professionals was obtained through convenience sampling.

  11. Applying adult learning practices in medical education. (United States)

    Reed, Suzanne; Shell, Richard; Kassis, Karyn; Tartaglia, Kimberly; Wallihan, Rebecca; Smith, Keely; Hurtubise, Larry; Martin, Bryan; Ledford, Cynthia; Bradbury, Scott; Bernstein, Henry Hank; Mahan, John D


    The application of the best practices of teaching adults to the education of adults in medical education settings is important in the process of transforming learners to become and remain effective physicians. Medical education at all levels should be designed to equip physicians with the knowledge, clinical skills, and professionalism that are required to deliver quality patient care. The ultimate outcome is the health of the patient and the health status of the society. In the translational science of medical education, improved patient outcomes linked directly to educational events are the ultimate goal and are best defined by rigorous medical education research efforts. To best develop faculty, the same principles of adult education and teaching adults apply. In a systematic review of faculty development initiatives designed to improve teaching effectiveness in medical education, the use of experiential learning, feedback, effective relationships with peers, and diverse educational methods were found to be most important in the success of these programs. In this article, we present 5 examples of applying the best practices in teaching adults and utilizing the emerging understanding of the neurobiology of learning in teaching students, trainees, and practitioners. These include (1) use of standardized patients to develop communication skills, (2) use of online quizzes to assess knowledge and aid self-directed learning, (3) use of practice sessions and video clips to enhance significant learning of teaching skills, (4) use of case-based discussions to develop professionalism concepts and skills, and (5) use of the American Academy of Pediatrics PediaLink as a model for individualized learner-directed online learning. These examples highlight how experiential leaning, providing valuable feedback, opportunities for practice, and stimulation of self-directed learning can be utilized as medical education continues its dynamic transformation in the years ahead

  12. Proximinality in generalized direct sums

    Directory of Open Access Journals (Sweden)

    Darapaneni Narayana


    Full Text Available We consider proximinality and transitivity of proximinality for subspaces of finite codimension in generalized direct sums of Banach spaces. We give several examples of Banach spaces where proximinality is transitive among subspaces of finite codimension.

  13. EOP Current Magnitude and Direction (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — These data contain shipboard current magnitudes and directions collected in the Pacific, both pelagic and near shore environments. Data is collected using an RD...

  14. Law, autonomy and advance directives. (United States)

    Willmott, Lindy; White, Ben; Mathews, Ben


    The principle of autonomy underpins legal regulation of advance directives that refuse life-sustaining medical treatment. The primacy of autonomy in this domain is recognised expressly in the case law, through judicial pronouncement, and implicitly in most Australian jurisdictions, through enactment into statute of the right to make an advance directive. This article seeks to justify autonomy as an appropriate principle for regulating advance directives and relies on three arguments: the necessity of autonomy in a liberal democracy; the primacy of autonomy in medical ethics discourse; and the uncontested importance of autonomy in the law on contemporaneous refusal of medical treatment. This article also responds to key criticisms that autonomy is not an appropriate organising principle to underpin legal regulation of advance directives.

  15. Directed Energy for Interstellar Study (United States)

    National Aeronautics and Space Administration — We propose to expand our investigations started in our NIAC Phase I of using directed energy to allow the achievement of relativistic flight to pave the way to the...

  16. Foreign direct investment in China


    Bredero, Q.S.


    Foreign Direct Investment in China is one of the most comprehensive studies of FDI in China and provides a remarkable background of information on the evolution of China’s FDI policies over the last 30 years.

  17. Direction-dependent exponential biassing

    International Nuclear Information System (INIS)

    Bending, R.C.


    When Monte Carlo methods are applied to penetration problems, the use of variance reduction techniques is essential if realistic computing times are to be achieved. A technique known as direction-dependent exponential biassing is described which is simple to apply and therefore suitable for problems with difficult geometry. The material cross section in any region is multiplied by a factor which depends on the particle direction, so that particles travelling in a preferred direction ''see'' a smaller cross section than those travelling in the opposite direction. A theoretical study shows that substantial gains may be obtained, and that the choice of biassing parameter is not critical. The method has been implemented alongside other importance sampling techniques in the general Monte Carlo code SPARTAN, and results obtained for simple problems using this code are included. 4 references. (U.S.)

  18. New directions in tokamak reactors

    International Nuclear Information System (INIS)

    Baker, C.C.


    New directions for tokamak research are briefly mentioned. Some of the areas for new considerations are the following: reactor size, beta ratio, current drivers, blankets, impurity control, and modular designs

  19. Directional spectrum of ocean waves

    Digital Repository Service at National Institute of Oceanography (India)

    Fernandes, A.A; Gouveia, A; Nagarajan, R.

    This paper describes a methodology for obtaining the directional spectrum of ocean waves from time series measurement of wave elevation at several gauges arranged in linear or polygonal arrays. Results of simulated studies using sinusoidal wave...

  20. Directed Innovation of Business Models

    Directory of Open Access Journals (Sweden)

    Stelian Brad


    Full Text Available Business model innovation is an important issue to keep business competitive and increase company’s profits. Due to many market attractors, identification of appropriate paths of business model evolution is a painful and risky process. To improve decision’s effectiveness in this process, an architectural construct of analysis and conceptualization for business model innovation that combines directed evolution and blue ocean concepts is proposed in this paper under the name of directed innovation. It displays the key points where innovations would happen to direct adaptation of the business model towards sustainable competitiveness. Formulation of mature solutions is supported by inventive problem solving tools. The significance of the directed innovation approach is demonstrated in a case study dealing with business model innovation of a software company.