Sample records for commecial practices directive

  1. Self-Directed Learning: Critical Practice. (United States)

    Hammond, Merryl; Collins, Rob

    This book describes the framework for an individualistic approach to learning--critical self-directed learning (SDL). A preface explains what is meant by "critical practice of SDL," describes educational streams that have fed into the concept, and situates the context within which the ideas about critical SDL developed. The order of the chapters…

  2. Minimally invasive direct restorations: a practical guide. (United States)

    Mackenzie, L; Banerjee, A


    The primary objectives of minimum intervention dentistry (MID) are to prevent or arrest active disease using non-operative management techniques. However, patients commonly present with cavitated caries lesions or failed restorations that are in need of operative intervention. Although much of clinical practice is devoted to preventing and managing the effects of caries and subsequent failure of the tooth-restoration complex, the clinical survival of restorations is often poor and becomes significantly worse as they increase in size and complexity. Minimally invasive (MI) restorative techniques present a range of well-documented advantages over more tissue-destructive traditional restorations by minimising unnecessary tooth tissue loss, insult to the dentine-pulp complex and reducing the risk of iatrogenic damage to adjacent hard and soft tissues. They also maximise the strength of the residual tooth structure by use of optimal adhesive restorative materials designed to restore function and aesthetics with durable, long-lasting restorations that are easy for the patient to maintain. In contemporary oral healthcare practice, if patients are to give valid consent for operative interventions, minimally invasive options must be offered, and may be expected to be the first choice of fully informed patients. This paper describes concepts of MID and provides an update of the latest materials, equipment and clinical techniques that are available for the minimally invasive restoration of anterior and posterior teeth with direct restorations.

  3. 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...

  4. Self-directed practice schedule enhances learning of suturing skills. (United States)

    Safir, Oleg; Williams, Camille K; Dubrowski, Adam; Backstein, David; Carnahan, Heather


    Most preoperative surgical training programs experience challenges with the availability of expert surgeons to teach trainees. Some research suggests that trainees may benefit from being allowed to actively shape their learning environments, which could alleviate some of the time and resource pressures in surgical training. The purpose of this study was to investigate the effects of self-directed or prescribed practice schedules (random or blocked) on learning suturing skills. Participants watched an instructional video for simple interrupted, vertical mattress and horizontal mattress suturing then completed a pretest to assess baseline skills. Participants were assigned to 1 of 4 practice groups: self-directed practice schedule, prescribed blocked practice schedule, prescribed random practice schedule or matched to the self-directed group (control). Practice of the skill was followed by a delayed (1 h) posttest. Improvement from pretest to posttest was determined based on differences in performance time and expert-based assessments. Analyses revealed a significant effect of group for difference in performance time of the simple interrupted suture. Random practice did not show the expected advantage for skill learning, but there was an advantage of self-directed practice. Self-directed practice schedules may be desirable for optimal learning of simple technical skills, even when expert instruction is available. Instructors must also take into account the interaction between task difficulty and conditions of practice to develop ideal training environments.

  5. 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...

  6. 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.

  7. The Unfair Commercial Practices Directive and Vulnerable Consumers

    DEFF Research Database (Denmark)

    Trzaskowski, Jan

    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...... Commercial Practices Directive (2005/29). The dual requirement of professional diligence and economic distortion entails that traders may distort the economic behaviour of the average consumer if the commercial practice comply with requirements of professional diligence. Also, it is legitimate to distort......, cognitive limitations, and/or bounded rationality as convincingly demonstrated in behavioural economics. Those consumers who are vulnerable in the light of the Directive are those who are at risk of having their economic behaviour distorted by lawful commercial practices. In the article, the author suggests...

  8. Practice-based comparison of direct and indirect bonding. (United States)

    Deahl, S Thomas; Salome, Norman; Hatch, John P; Rugh, John D


    The purpose of this study was to compare bond-failure prevalences, numbers of appointments, and treatment times between direct and indirect bracket bonding for patients treated in private orthodontic practices. A convenience sample was collected from 11 orthodontic offices; 5 orthodontists (772 patients) used a direct bonding technique, and 6 (596 patients) used an indirect technique. Altogether, they examined 29,963 brackets in 1,368 patients. Bond failures were recorded by tooth number and by patient during 10 consecutive practice days. In addition, the orthodontists reported the treatment time and number of visits for each of their 10 most recently completed comprehensive patients. The per-patient debond prevalences were 1.17% +/- 3.62% for direct bonding and 1.21% +/- 3.81% for indirect bonding (P = .225). Direct-bonded patients required a mean (+/- SD) treatment time of 750 +/- 220 days and 22.0 +/- 7.3 visits; indirect bonding required a mean treatment time of 745 +/- 256 days and 22.2 +/- 7.3 visits (P = .691 and P = .653, respectively). This practice-based study showed no difference in the failure rates between direct and indirect bonding. Furthermore, total treatment times and numbers of appointments did not differ between the 2 techniques.

  9. 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.

  10. The frontline clinical manager identifying direct reports' level of practice. (United States)

    Longo, M Anne; Roussel, Linda; Pennington, Sandra L; Hoying, Cheryl


    Patricia Benner applied the Dreyfus Model of Skill Acquisition to describe and interpret skill acquisition and clinical judgment in nursing practice. Operational definitions for the 5 levels of her original Novice to Expert Theory were used by the study participants in a large Midwestern pediatric hospital to self-identify their level of practice. The frontline clinical managers of these direct care registered nurses (RNs) used the same tool to rate their direct reports. The aim of this portion of a larger study was to determine if the clinical manager's perception of their direct reports was the same as that of the RNs. The results of this study are being used by one study unit's clinical managers as the basis for implementing the Hersey and Blanchard Situational Leadership Model. The clinical managers work with their direct reports depending on the level of practice and the details of the task to be performed. One example is creating therapeutic relationships with each other and with families to ensure a safe environment for all.

  11. [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.

  12. Number-theoretic method for practical indexing of crystal directions

    CERN Document Server

    Sheremetyev, I A


    The paper presents new number-theoretic approaches to the solution of orientation problems in single crystal studies. A fast method for indexing any rational crystal lattice direction was developed to be a new 3D generalization of the Euclid algorithm. Based on the latter, a method for indexing directions in any crystal lattice was developed, where the practical problem is reduced to the search of the shortest primitive lattice vector within a certain angular error for the direction in analysis. A multipurpose personal computer system for testing both real and reciprocal lattices of familiar crystals is devised. The compact-in-memory software represents a principally new 'bottomless' atlas of any crystal stereographic projections, where each point of the projection field is indexed within a desired accuracy.

  13. Direct observation of clinical practice in emergency medicine education. (United States)

    Craig, Simon


    This review aims to summarize the current literature on the effects of direct, clinical observation of residents in emergency departments (EDs) on learners, patients, and departmental functioning. A systematic literature search was conducted in Medline and ERIC, covering the years 1980-2009. Keywords were used to identify postgraduate medical staff working in the ED; direct observation of these trainees by supervising staff; and reports of outcomes relating to Kirkpatrick's levels of reaction, learning, behavior, and institutional change. From an initial 11,433 abstracts and titles, 193 full-text articles were retrieved for further study. Application of inclusion and exclusion criteria yielded seven that were relevant to the topic. These studies comprised a range of methods--descriptive, qualitative evaluation, cohort studies, and a cross-sectional survey. Learner reaction was very enthusiastic. Positive changes in behavior due to feedback provided during direct observation were suggested by two studies. A single study evaluated trainee's perceptions on patient outcomes and noted that thorough assessments and improved management decisions may be at the expense of slower throughput of patients and diversion of senior staff from direct patient care. Three studies noted the resource-intensive nature of direct observation. Direct observation of clinical practice may be useful in ED education; however, further research is required to evaluate its effects. © 2010 by the Society for Academic Emergency Medicine.

  14. A model of goal directed vegetable parenting practices. (United States)

    Hingle, Melanie; Beltran, Alicia; O'Connor, Teresia; Thompson, Deborah; Baranowski, Janice; Baranowski, Tom


    The aim of this study was to explore factors underlying parents' motivations to use vegetable parenting practices (VPP) using the Model of Goal Directed Vegetable Parenting Practices (MGDVPP) (an adaptation of the Model of Goal Directed Behavior) as the theoretical basis for qualitative interviews. In-depth interviews with parents of 3-5-year-old children were conducted over the telephone by trained interviewers following a script. MGDVPP constructs provided the theoretical framework guiding script development. Audio-recordings were transcribed and analyzed, with themes coded independently by two interviewers. Fifteen participants completed the study. Interviews elicited information about possible predictors of motivations as they related to VPP, and themes emerged related to each of the MGDVPP constructs (attitudes, positive anticipated emotions, negative anticipated emotions, subjective norms, and perceived behavioral control). Parents believed child vegetable consumption was important and associated with child health and vitality. Parents described motivations to engage in specific VPP in terms of emotional responses, influential relationships, food preferences, resources, and food preparation skills. Parents discussed specific strategies to encourage child vegetable intake. Interview data suggested parents used diverse VPP to encourage child intake and that varied factors predicted their use. Understanding these factors could inform the design of interventions to increase parents' use of parenting practices that promote long-term child consumption of vegetables. Copyright © 2011 Elsevier Ltd. All rights reserved.

  15. Direct Oral Anticoagulant Drugs in Dental Clinical Practice

    Directory of Open Access Journals (Sweden)

    Stasko J.


    Full Text Available The direct oral anticoagulant drugs (DOAC are generally safe and effective in several clinical settings including acute venous thromboembolic disease, prophylaxis in the postoperative setting, prevention of thromboembolism in patients with non-valvular atrial fibrillation, and in the management of acute coronary syndrome. The relatively short half-life, rapid onset of action, and predictable pharmacokinetics should simplify periprocedural use of the DOAC. The aim of this work is to propose and summarize periprocedural management of patients treated with the DOAC in dental practice and to inform about the principal specifications of this treatment.

  16. Cytokine release assays: current practices and future directions. (United States)

    Finco, D; Grimaldi, C; Fort, M; Walker, M; Kiessling, A; Wolf, B; Salcedo, T; Faggioni, R; Schneider, A; Ibraghimov, A; Scesney, S; Serna, D; Prell, R; Stebbings, R; Narayanan, P K


    As a result of the CD28 superagonist biotherapeutic monoclonal antibody (TGN 1412) "cytokine storm" incident, cytokine release assays (CRA) have become hazard identification and prospective risk assessment tools for screening novel biotherapeutics directed against targets having a potential risk for eliciting adverse pro-inflammatory clinical infusion reactions. Different laboratories may have different strategies, assay formats, and approaches to the reporting, interpretation, and use of data for either decision making or risk assessment. Additionally, many independent contract research organizations (CROs), academic and government laboratories are involved in some aspect of CRA work. As a result, while some pharmaceutical companies are providing CRA data as part of the regulatory submissions when necessary, technical and regulatory practices are still evolving to provide data predictive of cytokine release in humans and that are relevant to safety. This manuscript provides an overview of different approaches employed by the pharmaceutical industry and CROs, for the use and application of CRA based upon a survey and post survey follow up conducted by ILSI-Health and Environmental Sciences Institute (HESI) Immunotoxicology Committee CRA Working Group. Also discussed is ongoing research in the academic sector, the regulatory environment, current limitations of the assays, and future directions and recommendations for cytokine release assays. Copyright © 2013 Elsevier Ltd. All rights reserved.

  17. Predicting use of effective vegetable parenting practices with the Model of Goal Directed Behavior

    National Research Council Canada - National Science Library

    Diep, Cassandra S; Beltran, Alicia; Chen, Tzu-An; Thompson, Debbe; O'Connor, Teresia; Hughes, Sheryl; Baranowski, Janice; Baranowski, Tom


    .... An Internet survey was conducted with parents of pre-school children to assess their agreement with effective vegetable parenting practices and Model of Goal Directed Vegetable Parenting Practices items...

  18. Future directions in genetic counseling: practical and ethical considerations. (United States)

    Biesecker, Barbara Bowles


    The accelerated discovery of gene mutations that lead to increased risk of disease has led to the rapid development of predictive genetic tests. These tests improve the accuracy of assigning risk, but at a time when intervention or prevention strategies are largely unproved. In coming years, however, data will become increasingly available to guide treatment of genetic diseases. Eventually genetic testing will be performed for common diseases as well as for rare genetic conditions. This will challenge genetic counseling practice. The ethical principles that now guide this practice take into account the personal nature of test decision making, the need to respect individual self-determination, and the importance of client confidentiality. Certain of these principles may have to be modified as genetic testing becomes more widespread in order to meet the changing needs of clients and society. This paper offers recommendations to ensure that genetic counselors will take a leading role in the future delivery of ethical genetic services.

  19. Longevity of direct restorations in Dutch dental practices. Descriptive study out of a practice based research network.

    NARCIS (Netherlands)

    Laske, M.; Opdam, N.J.M.; Bronkhorst, E.M.; Braspenning, J.C.C.; Huysmans, M.C.D.N.J.M.


    OBJECTIVES: The aim of this retrospective practice-based study was to investigate the longevity of direct restorations placed by a group of general dental practitioners (GDPs) and to explore the effect of practice/operator, patient, and tooth/restoration related factors on restoration survival.

  20. Emergency medicine in Nepal: present practice and direction for future


    Pandey, Nishant Raj


    Emergency medicine is one of the youngest recognized specialties in Nepal, and its growth in clinical practice and academic development has been challenging. In this paper, we reviewed the current state of emergency medicine in Nepal based on review of the literature, personal observations and experience, and interviews with many Nepali and foreign emergency physicians. Most hospitals in Nepal have adopted a multi-specialist approach, where emergency room physicians are primarily general prac...

  1. Directly-Observed Treatment Strategy implementation practices in a ...

    African Journals Online (AJOL)

    The Directly-Observed Treatment Strategy (DOTS) programme is intended to ensure both treatment completion and cure of TB, as well as its evaluation. Despite improved DOTS coverage – the focus of most DOTS studies – the incidence of drug-resistant TB suggests that issues of non-compliance are centrally responsible ...

  2. Directly-Observed Treatment Strategy implementation practices in a ...

    African Journals Online (AJOL)


    Sep 9, 2014 ... The Directly-Observed Treatment Strategy (DOTS) programme is intended to ensure both treatment completion and cure of TB, as well as its evaluation. Despite improved. DOTS coverage – the focus of most DOTS studies – the incidence of drug-resistant TB suggests that issues of non-compliance are ...

  3. Emergency medicine in Nepal: present practice and direction for future. (United States)

    Pandey, Nishant Raj


    Emergency medicine is one of the youngest recognized specialties in Nepal, and its growth in clinical practice and academic development has been challenging. In this paper, we reviewed the current state of emergency medicine in Nepal based on review of the literature, personal observations and experience, and interviews with many Nepali and foreign emergency physicians. Most hospitals in Nepal have adopted a multi-specialist approach, where emergency room physicians are primarily general practitioners/family physicians or house officers. As physicians are receiving their training via various pathways, national standards in training and certification have not been developed. As a result, the scope of practice for emergency physicians and the quality of care vary greatly among hospitals. Difficult working conditions, physician recruitment, compensation, and academic enrichment remain major challenges in the development of emergency medicine. For the sustainable development of this specialty, more international guidance and local leadership is needed to standardize the training curriculum, to provide adequate funding opportunities for academic development and to promote the overall development of the emergency care system.

  4. Prospects of urban studies: possible directions and practice of realization

    Directory of Open Access Journals (Sweden)

    A. V. Demicheva


    7 Activities of local authorities, both formal and informal. Isolated directions of urban empirical studies are important in several reasons. Firstly, acquired information as a result of researches is a basis for making reasonable and adequate management decisions; secondly, these studies have an impact at the development of urban consciousness, patriotism, urban identification of population, provide guidelines and parameters for reading of the text that surrounds citizens; thirdly, sociological interpretation derived from research of the data is an interesting intellectual case for the sociologist as both for a professional and for a citizen of a certain city.

  5. 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


    Directory of Open Access Journals (Sweden)

    John Read


    Full Text Available This paper surveys some current developments in second language vocabulary assessment, with particular attention to the ways in which computer corpora can provide better quality information about the frequency of words and how they are used in specific contexts. The relative merits of different word lists are discussed, including the Academic Word List and frequency lists derived from the British National Corpus. Word frequency data is needed for measures of vocabulary size, such as the Yes/No format, which is being developed and used for a variety of purposes. The paper also reviews work on testing depth of knowledge of vocabulary, where rather less progress has been made, both in defining depth as a construct and in developing tests for practical use. Another important perspective is the use of vocabulary within particular contexts of use or registers, and recent corpus research is extending our understanding of the lexical features of academic registers. This provides a basis for assessing learners’ ability to deploy their vocabulary knowledge effectively for functional communication in specific academic contexts. It is concluded that, while current tests of vocabulary knowledge are valuable for certain purposes, they need to be complemented by more contextualised measures of vocabulary use.

  7. 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.

  8. Direct mail improves knowledge of basic life support guidelines in general practice: a randomised study. (United States)

    Secher, Niels; Mikkelsen, Mette Marie; Adelborg, Kasper; Mikkelsen, Ronni; Grove, Erik Lerkevang; Rubak, Jens Mørch; Vedsted, Peter; Løfgren, Bo


    Implementation of new guidelines into clinical practice is often incomplete. Direct mail is a simple way of providing information to physicians and may improve implementation of new guidelines on basic life support (BLS). The aim of this study was to describe knowledge of the most recent European Resuscitation Council (ERC) Guidelines for BLS among general practitioners (GPs) and investigate whether direct mail improves theoretical knowledge of these guidelines. All general practice clinics (n=351) in Central Denmark Region were randomised to receive either direct mail (intervention) or no direct mail (control). The direct mail consisted of the official ERC BLS/AED poster and a cover letter outlining changes in compression depth and frequency in the new guidelines. In general practice clinics randomised to intervention, every GP received a direct mail addressed personally to him/her. Two weeks later, a multiple-choice questionnaire on demographics and BLS guidelines were mailed to GPs in both groups. In total, 830 GPs were included in this study (direct mail, n=408; control, n=422). The response rate was 58%. The majority (91%) of GPs receiving direct mail were familiar with BLS Guidelines 2010 compared to 72% in the control group (Pguidelines and thus facilitated the implementation of this knowledge into clinical practice. Resuscitation councils and medical societies may consider using direct mail as a simple strategy to facilitate implementation of changes in clinical guidelines.

  9. An Examination of the Self-Directed Learning Practices of ESL Adult Language Learners (United States)

    Grover, Kendra S.; Miller, Michael T.; Swearingen, Brent; Wood, Nancy


    Self-directed learning is one of the preeminent theories in the field of adult education. This study explored how English as a Second Language learners directed their own learning outside of the formal classroom through the use of practices that potentially advance their English language proficiency. Results from a survey of over 400 ESL students…

  10. Academic Performance and the Practice of Self-Directed Learning: The Adult Student Perspective (United States)

    Khiat, Henry


    The practice of self-directed learning is important to adult students as it allows them to learn effectively while juggling work, family and other commitments. This study set out to examine the self-directed learning characteristics present in the adult students' study process at the case university. The relationship between the adult students'…

  11. 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"....

  12. Social Work Practice in the Digital Age: Therapeutic E-Mail as a Direct Practice Methodology (United States)

    Mattison, Marian


    The author addresses the risks and benefits of incorporating therapeutic e-mail communication into clinical social work practice. Consumer demand for online clinical services is growing faster than the professional response. E-mail, when used as an adjunct to traditional meetings with clients, offers distinct advantages and risks. Benefits include…

  13. 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.

  14. 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

  15. 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

  16. 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.

  17. Predicting use of ineffective vegetable parenting practices with the Model of Goal Directed Behavior. (United States)

    Baranowski, Tom; Beltran, Alicia; Chen, Tzu-An; Thompson, Debbe; O'Connor, Teresia; Hughes, Sheryl; Diep, Cassandra; Baranowski, Janice C


    Increasing a parent's ability to influence a child's vegetable intake may require reducing the parent's use of ineffective vegetable parenting practices. The present study was designed to understand the psychosocial influences on ineffective vegetable parenting practices. A cross-sectional web-based survey was conducted to model use of ineffective vegetable parenting practices using validated scales from a Model of Goal Directed Vegetable Parenting Practices. The dependent variable was a composite ineffective vegetable parenting practices index. The independent variables included validated subscales of intention, habit, perceived barriers, desire, competence, autonomy, relatedness, attitudes, norms, perceived behavioural control and anticipated emotions. Models were analysed using block regression with backward deletion. Parents of 307 pre-school children (3-5 years old). Variables significantly positively related to ineffective vegetable parenting practices in order of relationship strength included habit of controlling vegetable practices (standardized β=0·349, Pnegatively related to ineffective vegetable parenting practices in order of relationship strength included perceived behavioural control of negative parenting practices (standardized β=-0·215, Pchild involvement in vegetable selection (standardized β=-0·142, P=0·008), anticipated negative parent emotional response to child vegetable refusal (standardized β=-0·133, P=0·009), autonomy (standardized β=-0·118, P=0.014), attitude about negative effects of vegetables (standardized β=-0·118, P=0·015) and descriptive norms (standardized β=-0·103, P=0·032). The model accounted for 40·5 % of the variance in use of ineffective vegetable parenting practices. The present study is the first report of psychometrically tested scales to predict use of ineffective vegetable parenting practices. Innovative intervention procedures will need to be designed and tested to reduce ineffective vegetable

  18. 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

  19. 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

  20. Promoting Self-Directed Learning in a Learning Organization: Tools and Practices (United States)

    Rana, Sowath; Ardichvili, Alexandre; Polesello, Daiane


    Purpose: The purpose of this paper is to examine a set of practices that can help promote self-directed learning (SDL) in congruence with the goals of developing and maintaining a learning organization. Design/methodology/approach Findings from this study were derived from an extensive review of the SDL and the learning organization literature, as…

  1. The Practical Arithmetic Self-Study (PASS) Course. Book I--Directions and Auxiliary Materials. (United States)

    Main, R. E.

    This guidebook to a self-study course in practical mathematics contains: (1) the course description; (2) directions for testing and training; and (3) lesson progression sheets, quizzes, quiz answers, and lesson answers. The 25 quizzes cover multiplication and division of whole numbers, operations with fractions and decimals, understanding math…

  2. Repair may increase survival of direct posterior restorations - A practice based study

    NARCIS (Netherlands)

    Casagrande, L.; Laske, M.; Bronkhorst, E.M.; Huysmans, M.C.D.N.J.M.; Opdam, N.J.M.


    OBJECTIVES: To investigate repairs of direct restorations by a group of Dutch general dental practitioners (GDPs) and its consequences on longevity of restorations. METHODS: Data set was based on dental records of patients attending 11 general dental practices (24 Dentists) in the Netherlands.

  3. 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.

  4. Self-Directed Learning: A Practical Guide to Design, Development, and Implementation. First Edition. (United States)

    Piskurich, George M.

    Written mainly for the training practitioner who has some experience in the field, this book provides a practical approach for constructing good self-directed learning (SDL) programs. Chapter 1 considers SDL from the academic and business points of view, develops a working definition, and examines SDL's strengths and weaknesses. Part 1 covers…

  5. Cigarette Smoking Practices among American College Students: Review and Future Directions (United States)

    Patterson, Freda; Lerman, Caryn; Kaufmann, Vyga G.; Neuner, Geoffrey A.; Audrain-McGovern, Janet


    Cigarette smoking among college students is a critical public health problem. In this article, the authors review available research on cigarette smoking practices among college students and suggest directions for future research. Studies show that smoking by college students is associated with being White, living in housing where smoking is…

  6. A comparison of policy and direct practice stakeholder perceptions of factors affecting evidence-based practice implementation using concept mapping

    Directory of Open Access Journals (Sweden)

    Green Amy E


    Full Text Available Abstract Background 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. Methods 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. Results 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. Conclusions 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.

  7. Policymaking Opportunities for Direct Practice Social Workers in Mental Health and Addiction Services

    Directory of Open Access Journals (Sweden)

    Thomas J. Powell


    Full Text Available Direct practice social workers have potentially significant policymaking opportunities as mediators of top-down policy and as creators of policy where none exists. The power they possess stems from their ‘on the ground’ expertise and the discretion available to them in making practice decisions. By understanding their power as “street-level bureaucrats” they can significantly improve policy. Drawing on policy issues in mental health and addictions services, this article illustrates how social workers can use their power in an ethically sensitive manner to enhance policy outcomes for clients.

  8. 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.

  9. Practical direct plaque assay for coliphages in 100-ml samples of drinking water.


    Grabow, W. O.; Coubrough, P


    A practical single-agar-layer plaque assay for the direct detection of coliphages in 100-ml samples of water was designed and evaluated. With this assay a 100-ml sample of water, an agar medium containing divalent cations, and the host Escherichia coli C (ATCC 13706) were mixed in a single container, and the mixture was plated on 10 14-cm-diameter petri dishes. It was more sensitive, reliable, and accurate than various other methods and proved rapid, simple, and economic.

  10. Selbstgesteuertes Lernen. Problembereiche in Theorie und Praxis (Self-Directed Learning--Problematic Issues of Both Theory and Practice). (United States)

    Kraft, Susanne


    Explores the problematic issues, deficits, and open questions that have received little attention in the discussion on self-controlled learning although they arise in both theory formation and research practice. Discusses perspectives for a further development of both theory and research practice and of the practice of self-directed learning in…

  11. Promoting direct patient care services at community pharmacies through advanced pharmacy practice experiences. (United States)

    Kassam, Rosemin; Kwong, Mona; Collins, John B


    To determine the relative benefits of three different models of advanced pharmacy practice experience (APPE) in successfully integrating the delivery of direct patient care into students' final year community pharmacy clerkships. All fourth-year pharmacy students at the University of British Columbia were divided into one of three study arms for their community APPE: a 2 × 4-week rotation in a traditional format, a 1 × 8-week rotation where their preceptors had experienced a 2-day education course and a 1 × 8-week rotation with both preceptor education plus a 5-day pre-APPE in-store orientation and peer debriefing. All 123 students conducted patient consultations and documented their care. Students in the pre-APPE + preceptor education arm provided nearly double the number of direct patient consultations than did students in the preceptor-education-only arm or the traditional 2 × 4-week arm. Numbers of drug-related problems identified and interventions performed per patient consult did not differ across study arms. Pre-APPE orientation activities provided an enhanced learning environment, promoted greater student engagement, provided care to more patients, increased preceptor preparedness and enhanced in-store patient-centred care practice. Certain of these learning activities can also form part of third- and fourth-year introductory pharmacy practice experiences to prepare students for their final-year APPE. © 2013 Royal Pharmaceutical Society.

  12. 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.

  13. The specificity of practice hypothesis in goal-directed movements: visual dominance or proprioception neglect? (United States)

    Toussaint, Lucette; Meugnot, Aurore; Badets, Arnaud; Chesnet, David; Proteau, Luc


    The study aimed to examine whether modifying the proprioceptive feedback usually associated with a specific movement would decrease the dominance of visual feedback and/or decrease, which appears to be the neglect of proprioceptive feedback in ensuring the accuracy of goal-directed movements. We used a leg positioning recall task and measured the recall error after 15 and 165 acquisition trials performed with both vision and proprioception or proprioception only, under either a normal or a modified proprioception condition (i.e., with a 1-kg load attached to the participants' ankle). Participant learning was evaluated in transfer with proprioception only. In support of the specificity of practice hypothesis, the recall errors in acquisition were significantly smaller when practice occurred with both vision and proprioception, in either the loaded or the unloaded leg condition, and they increased significantly in transfer when vision was withdrawn. An important finding of the study highlighted that withdrawing vision after 165 acquisition trials had less deleterious effects on the recall errors when practice occurred under the loaded leg condition. Under that modified condition, recall errors in transfer were similar when practice occurred with and without vision, whereas larger errors were observed following practice with vision under the normal proprioceptive condition. Overall, these results highlighted the dominance of vision in ensuring accurate leg positioning recall and revealed that the dominance of vision is such that the processing of proprioceptive feedback may be neglected. Importantly, modifying the proprioceptive feedback has the advantage of reducing what appears to be the neglect of proprioceptive information when movement execution occurs in a visuo-proprioceptive context. Practical considerations for rehabilitation are discussed at the end of the manuscript.

  14. Estimating controlled direct effects of restrictivefeeding practices in the 'Early dieting in girls' study. (United States)

    Zhu, Yeying; Ghosh, Debashis; Coffman, Donna L; Savage, Jennifer S


    In this article, we examine the causal effect of parental restrictive feeding practices on children's weight status. An important mediator is children's self-regulation status. Recent approaches interpret mediation effects based on the potential outcomes framework. Inverse probability weighting based on propensity scores are used to adjust for confounding and reduce the dimensionality of confounders simultaneously. We show that combining machine learning algorithms and logistic regression to estimate the propensity scores can be more accurate and efficient in estimating the controlled direct effects than using logistic regression alone. A data application shows that the causal effect of mother's restrictive feeding differs according to whether the daughter eats in the absence of hunger.

  15. Alternating Direction Total Variation Image Reconstruction and Practical Decomposition for Dual-energy Computed Tomography

    CERN Document Server

    Li, Lei; Wang, Linyuan; Yan, Bin; Zhang, Hanming; Zheng, Zhizhong; Zhang, Wenkun; Lu, Wanli; Hu, Guoen


    Dual-energy computed tomography (DECT) has shown great potential and promising applications in advanced imaging fields for its capabilities of material decomposition. However, image reconstructions and decompositions under sparse views dataset suffers severely from multi factors, such as insufficiencies of data, appearances of noise, and inconsistencies of observations. Under sparse views, conventional filtered back-projection type reconstruction methods fails to provide CT images with satisfying quality. Moreover, direct image decomposition is unstable and meet with noise boost even with full views dataset. This paper proposes an iterative image reconstruction algorithm and a practical image domain decomposition method for DECT. On one hand, the reconstruction algorithm is formulated as an optimization problem, which containing total variation regularization term and data fidelity term. The alternating direction method is utilized to design the corresponding algorithm which shows faster convergence speed com...

  16. How would case managers' practice change in a consumer-directed care environment in Australia? (United States)

    You, Emily Chuanmei; Dunt, David; Doyle, Colleen


    The aim of this study was to explore case managers' perceived changes in their practice in the future when consumer-directed care (CDC) is widely implemented in Australia's community aged care system. Purposeful sampling was used and semi-structured individual and group interviews were conducted between September 2012 and March 2013. Participants were drawn from a list of all case managers who administered publicly funded community aged care packages in Victoria, Australia. Empowerment theory was used to guide the analysis and interpretation of the data. The thematic analysis revealed that case managers had mixed views about CDC. They also perceived changes in case managers' practice in the future when CDC is widely implemented. These might specifically include: first, case managers would not directly manage clients' budgets. While some case managers were concerned about losing power for this change, others believed that they would still have important financial roles to perform, such as setting rules, providing financial support and monitoring clients' use of budgets. Second, case managers would focus on performing roles in providing information, and empowering, facilitating and educating clients. These would help to strengthen clients' capacities and assist them to self-manage their care. Third, case managers would work in partnership with clients through frequent or skilful communication, mutual goal setting and goal facilitation. Fourth, case managers would manage more clients. In addition, they would provide less support to each individual client and perform less care co-ordination role. The findings suggest case managers paying attention to power balance regarding budget management in a CDC environment. Furthermore, they might frequently or skilfully communicate with, empower, facilitate and educate clients; work together with them to set up goals; and facilitate them to achieve goals. New research using empowerment theory to examine the actual practice of

  17. The lifetime direct cost of periodontal treatment: a case study from a Norwegian specialist practice. (United States)

    Fardal, Øystein; O'Neill, Ciaran; Gjermo, Per; Fardal, Elizabeth; Sandvik, Leiv; Hansen, B Frode; Linden, Gerard J


    Successful periodontal treatment requires a commitment to regular lifelong maintenance and may be perceived by patients to be costly. This study calculates the total lifetime cost of periodontal treatment in the setting of a specialist periodontal practice and investigates the cost implications of choosing not to proceed with such treatment. Data from patients treated in a specialist practice in Norway were used to calculate the total lifetime cost of periodontal treatment that included baseline periodontal treatment, regular maintenance, retreatment, and replacing teeth lost during maintenance. Incremental costs for alternative strategies based on opting to forego periodontal treatment or maintenance and to replace any teeth lost with either bridgework or implants were calculated. Patients who completed baseline periodontal treatment but did not have any additional maintenance or retreatment could replace only three teeth with bridgework or two teeth with implants before the cost of replacing additional teeth would exceed the cost of lifetime periodontal treatment. Patients who did not have any periodontal treatment could replace ≤ 4 teeth with bridgework or implants before a replacement strategy became more expensive. Within the limits of the assumptions made, periodontal treatment in a Norwegian specialist periodontal practice is cost-effective when compared to an approach that relies on opting to replace teeth lost as a result of progressive periodontitis with fixed restorations. In particular, patients who have initial comprehensive periodontal treatment but do not subsequently comply with maintenance could, on average, replace ≤ 3 teeth with bridgework or two teeth with implants before this approach would exceed the direct cost of lifetime periodontal treatment in the setting of the specialist practice studied.

  18. Student-directed retrieval practice is a predictor of medical licensing examination performance. (United States)

    Deng, Francis; Gluckstein, Jeffrey A; Larsen, Douglas P


    A large body of evidence indicates that retrieval practice (test-enhanced learning) and spaced repetition increase long-term information retention. Implementation of these strategies in medical curricula is unfortunately limited. However, students may choose to apply them autonomously when preparing for high-stakes, cumulative assessments, such as the United States Medical Licensing Examination Step 1. We examined the prevalence of specific self-directed methods of testing, with or without spaced repetition, among preclinical students and assessed the relationship between these methods and licensing examination performance. Seventy-two medical students at one institution completed a survey concerning their use of user-generated (Anki) or commercially-available (Firecracker) flashcards intended for spaced repetition and of boards-style multiple-choice questions (MCQs). Other information collected included Step 1 score, past academic performance (Medical College Admission Test [MCAT] score, preclinical grades), and psychological factors that may have affected exam preparation or performance (feelings of depression, burnout, and test anxiety). All students reported using practice MCQs (mean 3870, SD 1472). Anki and Firecracker users comprised 31 and 49 % of respondents, respectively. In a multivariate regression model, significant independent predictors of Step 1 score included MCQs completed (unstandardized beta coefficient [B] = 2.2 × 10(- 3), p academic and psychological factors. Medical students engage extensively in self-initiated retrieval practice, often with spaced repetition. These practices are associated with superior performance on a medical licensing examination and should be considered for formal support by educators.

  19. Experience in real clinical practice with new direct acting antivirals in chronic hepatitis C. (United States)

    Jiménez-Macías, Fernando Manuel; Cabanillas-Casafranca, Manuel; Maraver-Zamora, Marta; Romero-Herrera, Gema; García-García, Federico; Correia-Varela-Almeida, Antonio; Cabello-Fernández, Ana; Ramos-Lora, Manuel


    Inclusion of direct-acting antivirals into clinical practice in patients with chronic HCV (CHC) has been a milestone in medicine. Analytical, prospective study, involving 126 patients with chronic HCV treated with direct-acting antivirals. Efficacy and safety of treatment and factors associated with failure treatment were evaluated. Age 54±10. Male (70%). Cirrhosis (60%). Distribution according to genotypes: G1a (31%), G1b (42%); G3 (14%); G4 (13%). Child-Pugh B and C (n=15). Naïve (56%). SVR rate was (87.3%): Child-A (91%), Child-B (75%) and Child-C (60%). The best cure rates were achieved with a 3D/2D±ribavirin (SVR=97.4%;n=39) and sofosbuvir/ledipasvir±ribavirin (RVS=93.1%; n=29) combination. An SVR rate of 600mg/day in cirrhotic G1 or G3, who will be treated with sofosbuvir+simeprevir or daclatasvir is recommended where no baseline resistance test is available. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  20. Understanding Faculty and Non-Traditional Student Perceptions of Self-Directed Learning in a Practical Nursing Program (United States)

    Rogers, Carmen


    This study was designed to identify and investigate nursing faculty and student perspectives of self-directed learning in a practical nursing program. It also explored the degree to which student's perceptions of self-directed learning exhibited factors consistent with that of critical thinking. This study is important because self-directed…

  1. 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)

  2. Interventions to improve question formulation in professional practice and self-directed learning. (United States)

    Horsley, Tanya; O'Neill, Jennifer; McGowan, Jessie; Perrier, Laure; Kane, Gabrielle; Campbell, Craig


    Formulating questions is fundamental to the daily life of a healthcare worker and is a defining characteristic of professional competence and meaningful learning. With high expectations for healthcare providers to remain up-to-date with current evidence and the movement towards formalizing reflective practice as part of physician revalidation, it is important that curricula developed for improving the ability to formulate well-constructed questions are based on the best evidence. To assess the effectiveness of interventions for increasing the frequency and quality of questions formulated by healthcare providers in practice and the context of self-directed learning. We obtained studies from searches of electronic bibliographic databases, and supplemented these with handsearching, checking reference lists, and consultation with experts. We considered published and unpublished randomized controlled trials (RCTs), controlled clinical trials (CCTs), interrupted time-series (ITS), and controlled before-after (CBA) studies of any language examining interventions for increasing the quality and frequency of questions formulated by health professionals involved with direct patient care. Two review authors independently undertook all relevancy screening and 'Risk of bias' assessment in duplicate. Intervention characteristics, follow-up intervals, and measurement outcomes were diverse and precluded quantitative analysis. We have summarized data descriptively. Searches identified four studies examining interventions to improve question formulation in healthcare professionals. Interventions were mostly multi-component, limited within the context of EBM and primarily in physician and resident populations. We did not identify studies examining changes in frequency of questions formulated or those within the context of reflection. Risk of bias was generally rated to be 'high risk'. Three of the four studies showed improvements in question formulation in physicians, residents, or

  3. Recent Directions in Telemedicine: Review of Trends in Research and Practice (United States)

    Wilson, Laurence S.


    Objectives Healthcare is now routinely delivered by telecommunications-based services in all developed countries and an increasing number of developing countries. Telemedicine is used in many clinical specialities and across numerous healthcare settings, which range from mobile patient-centric applications to complex interactions amongst clinicians in tertiary referral hospital settings. This paper discusses some recent areas of significant development and progress in the field with the purpose of identifying strong trends in both research and practice activities. Methods To establish the breadth of new ideas and directions in the field, a review of literature was made by searching PubMed for recent publications including terms (telemedicine OR telehealth) AND (challenge OR direction OR innovation OR new OR novel OR trend), for all searchable categories. 3,433 publications were identified that have appeared since January 1, 2005 (2,172 of these since January 1, 2010), based on a search conducted on June 1, 2015. Results The current interest areas in these papers span both synchronous telemedicine, including intensive care, emergency medicine, and mental health, and asynchronous telemedicine, including wound and burns care, dermatology and ophthalmology. Conclusions It is concluded that two major drivers of contemporary tele medicine development are a high volume demand for a particular clinical service, and/or a high criticality of need for clinical exper tise to deliver the service. These areas offer promise for further study and enhancement of applicable telemedicine methods and have the potential for large-scale deployments internationally, which would contribute significantly to the advancement of healthcare. PMID:26618026

  4. 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.

  5. 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.

  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. [Promoting recovery of schizophrenic patients: discrepancy between routine practice and evidence. The SIEP-DIRECT'S Project]. (United States)

    Semisa, Domenico; Casacchia, Massimo; Di Munzio, Walter; Neri, Giovanni; Buscaglia, Giacinto; Burti, Lorenzo; Pucci, Cristina; Corlito, Giuseppe; Bacigalupi, Maurizio; Parravani, Roberto; Roncone, Rita; Cristofalo, Doriana; Lora, Antonio; Ruggeri, Mirella


    The aim of this work is to present the main discrepancies, as evidenced by the SIEP-DIRECT'S Project, between the evidence-based NICE guidelines for schizophrenia and the usual practices of the Italian mental health services in order to promote the recovery of patients with schizophrenia. Starting from the main NICE recommendations on recovery promotion, 41 indicators were developed. These were experimented in 19 participating Italian Mental Health Departments (MHD) or Psychiatric Services through self-evaluation of the activities carried out to promote patient recovery with the aim of assessing the level of adherence to the recommendations. The data required by most of the indicators were obtained from the psychiatric informative system or from the Direction of the MHD. Moreover, specific research was carried out on the clinical records and on representative patient samples. Furthermore, for 14 indicators, there was requested an assessment by the part of "multidisciplinary" or "specialistic" focus groups who then attributed a score according to a defined "ad hoc" scale. According to the data obtained, although the mental health services seem to care about the physical condition of their patients, they do not routinely examine principle parameters such as blood pressure, glycaemia etc., and collaboration with general practitioners is often complex or not uniformly practiced. Most psychiatrists and psychologists possess the basic communication skills but not enough competences in cognitive-behavioural treatments; such treatments, and every other form of structured individual psychotherapy, are seldom carried out and seem to have become marginal activities within the Services. Also family psycho-educational interventions are under-used. The Services are very active in the care of multi-problem schizophrenia patients, who make up a large percentage (almost a quarter, on average) of the patients in their care. These patients are offered specific and integrated

  8. 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.

  9. Strategy-as-practice: A review and future directions for the field


    Jarzabkowski, P.; Spee, A. P.


    This review maps and critically evaluates the rapidly growing body of research in the strategy-as-practice field. Following an introduction on the emergence and foundations of strategy-as-practice, the review is structured in three main parts, based on the terminology, issues and research agendas outlined in the field. First, the paper examines the concepts of practitioners and praxis. A typology of nine possible domains for strategy-as-practice research is developed, based on the way that di...

  10. 76 FR 19282 - Direct Investment Surveys: Alignment of Regulations With Current Practices (United States)


    ...-21), two schedules of expenditures for property, plant, and equipment of U.S. direct investment... Expenditures for Property, Plant, and Equipment of U.S. Direct Investment Abroad BE-133C, Schedule of Expenditures for Property, Plant, and Equipment of U.S. Direct Investment Abroad BE-507, Industry...

  11. 76 FR 39260 - Direct Investment Surveys: Alignment of Regulations With Current Practices (United States)


    ... direct investment in the U.S. seafood industry, two schedules of expenditures for property, plant, and... of U.S. Direct Investment Abroad BE-133C, Schedule of Expenditures for Property, Plant, and Equipment... Bureau of Economic Analysis 15 CFR Part 806 RIN 0691-AA78 Direct Investment Surveys: Alignment of...

  12. 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.…

  13. 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…

  14. 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.

  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. The role of community pharmacy-based vaccination in the USA: current practice and future directions

    Directory of Open Access Journals (Sweden)

    Bach AT


    Full Text Available Albert T Bach, Jeffery A Goad School of Pharmacy, Chapman University, Irvine, California, USA Abstract: Community pharmacy-based provision of immunizations in the USA has become commonplace in the last few decades, with success in increasing rates of immunizations. Community pharmacy-based vaccination services are provided by pharmacists educated in the practice of immunization delivery and provide a convenient and accessible option for receiving immunizations. The pharmacist's role in immunization practice has been described as serving in the roles of educator, facilitator, and immunizer. With a majority of pharmacist-provided vaccinations occurring in the community pharmacy setting, there are many examples of community pharmacists serving in these immunization roles with successful outcomes. Different community pharmacies employ a number of different models and workflow practices that usually consist of a year-round in-house service staffed by their own immunizing pharmacist. Challenges that currently exist in this setting are variability in scopes of immunization practice for pharmacists across states, inconsistent reimbursement mechanisms, and barriers in technology. Many of these challenges can be alleviated by continual education; working with legislators, state boards of pharmacy, stakeholders, and payers to standardize laws; and reimbursement design. Other challenges that may need to be addressed are improvements in communication and continuity of care between community pharmacists and the patient centered medical home. Keywords: immunization, pharmacy practice, pharmacists, continuity of care 

  17. Meaningful Peer Review in Radiology: A Review of Current Practices and Potential Future Directions. (United States)

    Moriarity, Andrew K; Hawkins, C Matthew; Geis, J Raymond; Dreyer, Keith J; Kamer, Aaron P; Khandheria, Paras; Morey, Jose; Whitfill, James; Wiggins, Richard H; Itri, Jason N


    The current practice of peer review within radiology is well developed and widely implemented compared with other medical specialties. However, there are many factors that limit current peer review practices from reducing diagnostic errors and improving patient care. The development of "meaningful peer review" requires a transition away from compliance toward quality improvement, whereby the information and insights gained facilitate education and drive systematic improvements that reduce the frequency and impact of diagnostic error. The next generation of peer review requires significant improvements in IT functionality and integration, enabling features such as anonymization, adjudication by multiple specialists, categorization and analysis of errors, tracking, feedback, and easy export into teaching files and other media that require strong partnerships with vendors. In this article, the authors assess various peer review practices, with focused discussion on current limitations and future needs for meaningful peer review in radiology. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  18. [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, pConfidence in performance was higher in the experimental group compared to the control group, but the differences were not statistically significant. However, after the complete practice, there was a statistically significant difference in overall performance confidence (t=-3.07. p=.003). Learning satisfaction was higher in the experimental group compared to the control group, but the difference was not statistically significant (t=-1.67, p=.100). Results of this study indicate that self-directed feedback practice using smartphone 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.

  19. Adding random case analysis to direct observation (ARCADO) - Updating the external clinical teaching visit to improve general practice registrar assessments. (United States)

    Ingham, Gerard; Fry, Jennifer; Ward, Bernadette


    In response to the advent of competency-based training and the increase in the number of general practice registrars, the Australian general practice education community is seeking valid, reliable, time-efficient and cost-efficient tools to assess registrars. Despite the central role of the external clinical teaching visit (ECTV) in formative assessment of general practice registrars, the ECTV has been an infrequent subject of research or evaluation. The objective of this article is to report on the development of a new approach to ECTV that adds random case analysis to direct observation of consultations - ARCADO ECTV. ARCADO ECTV is a flexible, acceptable and time-efficient formative assessment. The two assessment approaches in the ARCADO ECTV provide complementary insights into the registrar's performance. At least three observed consultations are required to ensure adequate assessment of communications skills. Medical records need to be of recent consultations. There is scope for development of the ARCADO ECTV as a summative assessment.

  20. 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…

  1. Policy and Practice in Sign Bilingual Education: Development, Challenges and Directions (United States)

    Swanwick, Ruth


    A sign bilingual approach to the education of deaf children was first introduced in the UK in 1990. This paper reviews the growth of sign bilingual education in the UK and documents significant milestones in the development of sign bilingual policy and practice since the 1980s. This overview demonstrates how key issues in sign bilingual education…

  2. Literacy and Deaf Students in Taiwan: Issues, Practices and Directions for Future Research--Part II (United States)

    Liu, Hsiu Tan; Andrews, Jean F.; Liu, Chun Jung


    In Part I, we underscore the issues surrounding young deaf and hard of hearing (DHH) learners of literacy in Taiwan who use sign to support their learning of Chinese literacy. We also described the linguistic features of Chinese writing and the visual codes used by DHH children. In Part II, we describe the reading and writing practices used with…

  3. 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…

  4. Applying Funds of Knowledge Theory in a New Zealand High School: New Directions for Pedagogical Practice (United States)

    Hogg, Linda


    In New Zealand teacher practice is expected to be inclusive and supportive of all learners (Ministry of Education, 2007). However, diverse evidence highlights inequitable school experiences for Maori and Pasifika students. This study explored the application of funds of knowledge (FoK) theory within a New Zealand high school, with a focus on…

  5. A Qualitative Analysis of an Advanced Practice Nurse-Directed Transitional Care Model Intervention (United States)

    Bradway, Christine; Trotta, Rebecca; Bixby, M. Brian; McPartland, Ellen; Wollman, M. Catherine; Kapustka, Heidi; McCauley, Kathleen; Naylor, Mary D.


    Purpose: The purpose of this study was to describe barriers and facilitators to implementing a transitional care intervention for cognitively impaired older adults and their caregivers lead by advanced practice nurses (APNs). Design and Methods: APNs implemented an evidence-based protocol to optimize transitions from hospital to home. An…

  6. Reframing Nationality through Local and Regional Social Practices – Europe Direct Bacău Relay

    Directory of Open Access Journals (Sweden)

    Camelia Cmeciu


    Full Text Available Paraphrasing the famous European syntagm “unity in diversity”, we will introduce anothersyntagm, namely “nationality in diversity”, thus laying an emphasis on the strategies (social practicesadopted by each of the thirty one Europe Direct relays in Romania in order to achieve their goals.Having as theoretical background the four semiotic systems (represented participants, interactiveparticipants, composition, modality of social semiotics (van Leeuwen, Kress, 2001, 2005, we willinterpret the 2009 campaign promoted by Europe Direct Bacău as an alternative interweaving ofcognitive, affective and behavioural effects.

  7. 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

  8. 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).

  9. Feeding infants and young children. From guidelines to practice-conclusions and future directions. (United States)

    Vereijken, C M J L; Weenen, H; Hetherington, M M


    Infant feeding is a challenging and intricate process. Food intake is shaped by prior experience of flavours derived from the maternal diet in utero and via human milk, by ongoing experience of foods eaten during the first years of life including the variety, types and frequency of foods offered. The ways in which parents interact with their children including the way foods are presented, the emotional context they cultivate and the feeding practices they use can influence their children's eating habits, either positively or negatively. There is a mismatch between what government guidelines advise parents in relation to the "when, what and how" to feed children including during the weaning period and what parents actually do. Acquisition of food preferences and the establishment of eating habits in the early years form part of an ongoing, complex developmental process, however there is a gap between experimental evidence on best practice in infant feeding and what parents receive as advice about feeding. It is timely, therefore, to translate these findings into solutions for parents. Practical support for infant feeding should be evidence based, parent-focused and contingent on the needs of the developing child since infant feeding sets the foundation of healthy eating habits for life. Copyright © 2011 Elsevier Ltd. All rights reserved.

  10. Directing and Facilitating Distributed Pedagogical Leadership: Best Practices in Early Childhood Education (United States)

    Bøe, Marit; Hognestad, Karin


    This paper uses a hybrid leadership framework to examine how formal teacher leaders at the middle management level direct and facilitate staff resources for distributed pedagogical leadership. By conducting qualitative shadowing, involving video observation, field notes and stimulated recall interviews, and abductive analysis, this study…

  11. 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.

  12. A practical one-pot synthesis of azides directly from alcohols

    Indian Academy of Sciences (India)

    azides, direct methods for the said transformation are only a few. The most familiar and versatile one is the. Mitsunobu displacement,4 where hydrazoic acid is used as ..... Lim J-O, Choi H-K, Suh Y-G, Park H-G, Oh U, Kim. H-D, Park Y-H, Ha H-J, Kin Y-H, Toth A, Wang Y, Tran. R, Pearce L V, Lundberg D J and Blumberg P M ...

  13. Individual Producer Responsibility in the WEEE Directive - From Theory to Practice?


    van Rossem, Chris


    In the current discourse over what constitutes successful Extended Producer Responsibility (EPR) policy implementation, there is an on-going debate over the ability of programme design to include an appropriate incentive mechanism to stimulate producers to improve the design of their products for reduced life cycle impacts, and especially the impacts and costs from the end-of-life management. At the centre of the debate is the Directive on Waste Electrical and Electronic Equipment (WEEE) whic...

  14. Female Athlete Triad: Future Directions for Energy Availability and Eating Disorder Research and Practice. (United States)

    Williams, Nancy I; Statuta, Siobhan M; Austin, Ashley


    Despite more than 3 decades of research on the Female Athlete Triad, research gaps remain. Although low energy availability (EA) is the key etiologic factor in the Triad and the pathways to low EA are varied, its effects can be modified by several factors. Accurate screening, diagnosis, and treatment of disordered eating are a challenge; however, recent techniques combined with novel educational and behavior interventions prove promising. Recently published practice-based guidelines have helped to translate Triad science and should improve as they are refined. This article identifies the current state of research and distinguishes areas that require further investigation. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. The role of central reading centers - current practices and future directions

    Directory of Open Access Journals (Sweden)

    Colin S Tan


    Full Text Available Central reading centers (CRCs have several crucial roles in the conduct of clinical trials, providing key input during the study design, preparation of the operations manual, as well as site and photographer certification. They provide objective, standardized grading of images from study subjects, which determines study eligibility, and also evaluate lesion features at subsequent study visits. CRCs need to adhere strictly to Good Clinical Practice (GCP guidelines, as well as the established standard operating procedures in order to ensure that images are graded properly. The role of CRCs will continue to evolve, and include the use of web-based image transmission and grading platforms.

  16. Direct Laser Desorption Ionization of Endogenous and Exogenous Compounds from Insect Cuticles: Practical and Methodologic Aspects (United States)

    Yew, Joanne Y.; Soltwisch, Jens; Pirkl, Alexander; Dreisewerd, Klaus


    We recently demonstrated that ultraviolet laser desorption ionization orthogonal time-of-flight mass spectrometry (UV-LDI o-TOF MS) could be used for the matrix-free analysis of cuticular lipids (unsaturated aliphatic and oxygen-containing hydrocarbons and triacylglycerides) directly from individual Drosophila melanogaster fruit flies (Yew, J. Y.; Dreisewerd, K.; Luftmann, H.; Pohlentz, G.; Kravitz, E. A., Curr. Biol. 2009, 19, 1245-1254). In this report, we show that the cuticular hydrocarbon, fatty acid, and triglyceride profiles of other insects and spiders can also be directly analyzed from intact body parts. Mandibular pheromones from the jaw of a queen honey bee are provided as one example. In addition, we describe analytical features and examine mechanisms underlying the methodology. Molecular ions of lipids can be generated by direct UV-LDI when non-endogenous compounds are applied to insect wings or other body parts. Current sensitivity limits are in the 10 pmol range. We show also the dependence of ion signal intensity on collisional cooling gas pressure in the ion source, laser wavelength (varied between 280-380 nm and set to 2.94 μm for infrared LDI), and laser pulse energy.

  17. 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.

  18. Parenting styles and practices in children's obesogenic behaviors: scientific gaps and future research directions. (United States)

    Patrick, Heather; Hennessy, Erin; McSpadden, Kate; Oh, April


    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.

  19. Practicalities of individual producer responsibility under the WEEE directive: experiences in Germany. (United States)

    Rotter, Vera Susanne; Chancerel, Perrine; Schill, Wolf-Peter


    In theory, individual producer responsibility (IPR) creates incentives for 'design-for-recycling'. Yet in practice, implementing IPR is challenging, particularly if applied to waste electric and electronic equipment. This article discusses different options for implementing IPR schemes under German WEEE legislation. In addition, practical aspects of a German 'return share' brand sampling scheme are examined. Concerning 'new' WEEE put on the market after 13 August 2006, producers in Germany can choose between two different methods of calculating take-back obligations. These can be determined on the basis of 'return shares' or 'market shares'. While market shares are regularly monitored by a national clearing house, the 'return share' option requires sampling and sorting of WEEE. Herein it is shown that the specifics of the German WEEE take-back scheme require high sample sizes and multi-step test procedures to ensure a statistically sound sampling approach. Since the market share allocation continues to apply for historic waste, producers lack incentives for choosing the costly brand sampling option. However, even return share allocation might not imply a decisive step towards IPR, as it merely represents an alternative calculation of market shares. Yet the fundamental characteristics of the German take-back system remain unchanged: the same anonymous mix of WEEE goes to the same treatment operations.

  20. 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

  1. 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

  2. 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.

  3. 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.

  4. 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.

  5. Venovenous Extracorporeal Membrane Oxygenation in Intractable Pulmonary Insufficiency: Practical Issues and Future Directions

    Directory of Open Access Journals (Sweden)

    T. S. R. Delnoij


    Full Text Available Venovenous extracorporeal membrane oxygenation (vv-ECMO is a highly invasive method for organ support that is gaining in popularity due to recent technical advances and its successful application in the recent H1N1 epidemic. Although running a vv-ECMO program is potentially feasible for many hospitals, there are many theoretical concepts and practical issues that merit attention and require expertise. In this review, we focus on indications for vv-ECMO, components of the circuit, and management of patients on vv-ECMO. Concepts regarding oxygenation and decarboxylation and how they can be influenced are discussed. Day-to-day management, weaning, and most frequent complications are covered in light of the recent literature.

  6. Improving medication practices for persons with intellectual and developmental disability: Educating direct support staff using simulation, debriefing, and reflection. (United States)

    Auberry, Kathy; Wills, Katherine; Shaver, Carrie


    Direct support professionals (DSPs) are increasingly active in medication administration for people with intellectual and developmental disabilities, thus supplementing nursing and family caretakers. Providing workplace training for DSPs is often the duty of nursing personnel. This article presents empirical data and design suggestions for including simulations, debriefing, and written reflective practice during in-service training for DSPs in order to improve DSPs' skills and confidence related to medication administration. Quantitative study results demonstrate that DSPs acknowledge that their skill level and confidence rose significantly after hands-on simulations. The skill-level effect was statistically significant for general medication management -4.5 ( p debriefing with written reflective practice in DSP continuing education.

  7. Tax-exempt hospitals and community benefit: new directions in policy and practice. (United States)

    Rubin, Daniel B; Singh, Simone R; Young, Gary J


    The current community benefit standard for nonprofit hospital tax exemption has been the subject of mounting criticism. Many different constituencies have advanced the view that in its present form it fails to ensure that nonprofit hospitals provide adequate benefits to their communities in exchange for their tax exemption. In contrast, hospitals have often expressed the concern that the community benefit standard in its current form is vague and therefore difficult to comply with. Various suggestions have been made regarding how the existing community benefit standard could be improved or even replaced. In this article, we first discuss the historical and legal development of the community benefit standard. We then present the key controversies that have emerged in recent years and the policy responses attempted thus far. Finally, we evaluate possible future policy directions, which reform efforts could follow.

  8. 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.

  9. Long-term survivals of 'direct-wax' cast gold onlays: a retrospective study in a general dental practice. (United States)

    Bandlish, Lalit Kumar; Mariatos, G


    Compared to other restoration types, indirect cast posterior restorations of partial coverage exhibit one of the longest survivals. The purpose of the current study was to estimate the success rates of 'direct-wax' cast gold onlays. According to the direct wax technique, the wax pattern is shaped intra-orally followed by direct casting without the need for impressions, resulting in low cost and short processing time. A retrospective survival study was undertaken at a mixed National Health Service and private general dental practice based in London. Patients with direct-wax onlays attending over a period of four months for regular check-ups or dental treatment were recruited. Patient discomfort, pain or sensitivity was recorded. Restoration location, extension, marginal fit, and tooth vitality were also recorded. Restoration failure was defined in the event of recurrent caries, pulp infection for vital teeth, increase in the size of periapical radiolucency for non-vital teeth, and restoration decementation. Survival estimates were calculated using the Kaplan-Meier algorithm. One hundred and ninety-four onlays in 56 patients were examined. Four restorations (2.1%) had failed, mainly due to recurrent caries. The cumulative survival probability was estimated at 415.3 (95% Confidence Interval: 403.0, 427.7) months (34.6, 95% CI: 33.6, 35.6 years), while the 10-year and 20-year survival rates were 97.0% and 94.1% respectively. Vital teeth, compared to non-vital ones, and onlay extension encompassing both the mesial and distal tooth surfaces exhibited significantly (P cast gold restorations of partial coverage were a highly successful treatment option for posterior restorations in a general dental practice environment.

  10. Obesity and health--new perspectives from bioscience research suggest directions for clinical practice. (United States)

    Penny, Suzi; Carryer, Jenny


    This viewpoint is written from the dual perspectives of a metabolic biochemist and a nurse academic who met at the Oxford University Round Table Forum on Obesity in 2008. Forty invited participants from around the world spent a week presenting and debating research and practice in the area of obesity. A unique feature of this forum was that it was cross-disciplinary with participants ranging from those working in public health with a background in medicine, paediatrics, nutrition, nursing, education, policy analysis, behaviour and social sciences, and exercise physiology to those working in the food industry and health insurance. The link between our current affluent lifestyle and increasing obesity, cardiovascular disease, type 2 diabetes mellitus and the associated morbidity and mortality is well established. Interventions have involved individual patient clinician encounters aimed at weight loss and broader public health interventions with the goal of prevention and management of obesity. However, what is often overlooked is the need to also understand the psychosocial implications and issues for those living with a large body in a society where the prevailing culture, including that of health professionals, espouses a lean body as the ideal and excess weight as a testimony to greed, sloth and lack of will power. In this paper we share observations and learning from Round Table participation together with some of our own research interests.

  11. 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.

  12. 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.

  13. Theory and practice of enzyme bioaffinity electrodes. Direct electrochemical product detection. (United States)

    Limoges, Benoît; Marchal, Damien; Mavré, François; Savéant, Jean-Michel; Schöllhorn, Bernd


    The use of enzyme labeling techniques to convert biorecognition events into high sensitivity electrochemical signals may follow two different strategies. One, in which the current is the electrocatalytic response of a redox couple serving as cosubstrate to a redox enzyme label and another that consists in the detection of an electrochemically active product of the enzyme label. The theoretical relationships that link, in the latter case, the electrochemical current response to the amount of recognized labeled target analyte are established for steady-state diffusion-convection chronoamperometric regimes. Two governing parameters thus emerge. One measures the Michaelis-Menten competition in the enzyme kinetics. The other characterizes the competition between the enzymatic kinetics and the diffusion of the substrate. The electrochemical response is finally related to the labeled target analyte concentration in solution through the recognition isotherm. The direct electrochemical product detection thus provides a route to the characteristics of the recognition isotherm, which serves as a calibration curve in analytical applications. The establishment of further theoretical relationships allows one to surmise the increase in sensitivity that may be obtained by using cyclic voltammetry instead of steady-state chronoamperometry in standard electrochemical cells or by accumulation of the enzyme-product in cells of small volume/surface ratios. The theoretical predictions are tested with the example of the avidin-biotin recognition process in a system that involves alkaline phosphatase as enzyme label and 4-amino-2,6-dichlorophenyl phosphate as substrate, generating 4-amino-2,6-dichlorophenol as electrochemically active product. The advantages of the dichloro-substitution are discussed. The theoretical analysis is a requisite for a rational and realistic discussion of the analytical performances of the steady-state chronoamperometric and cyclic voltammetric approaches

  14. The impact of direct healthcare professional communication on prescribing practice in the UK hospital setting: an interrupted time series analysis. (United States)

    Thomas, Sarah K; Hodson, James; McIlroy, Graham; Dhami, Annjeet; Coleman, Jamie J


    Direct Healthcare Professional Communications (DHPCs) aim to quickly disseminate information to key healthcare professionals to inform practice and minimize patient harm. The Medicines and Healthcare products Regulatory Agency (MHRA) issues warnings and alerts to communicate safety information effectively in the UK. To investigate the impact of MHRA DHPCs on prescribing practice in the secondary-care setting, looking specifically at a drug-drug interaction-the concomitant use of clopidogrel and proton pump inhibitors (PPIs) [as omeprazole]-and a drug-disease contraindication-the use of conventional (typical) antipsychotics in dementia. The effects of the MHRA DHPCs were analysed using segmented binary logistic regression of interrupted time series. This allowed for the detection of any significant changes in prescribing practice occurring after the MHRA warnings were issued, whilst controlling for the baseline period. Of the patients concomitantly prescribed clopidogrel and omeprazole on admission, the rate at which omeprazole was substituted for either another PPI (with the exception of esomeprazole), or for a histamine H2-antagonist showed a significant step-change increase after the DHPC was issued. The modelled rate increased from 5.1 % in the month directly before the intervention to 25.1 % in the following month (odds ratio [OR] 6.18; p declining significantly by 3.9 % per quarter prior to the DHPC being issued (OR 0.970; p = 0.035). No significant step-change was detected immediately after the DHPC (p = 0.962). However, the rate of decline increased significantly in the post-warning period to 12.3 % per quarter (OR 0.938; p = 0.006). This study has shown that DHPCs issued by the MHRA as warnings are associated with changes in prescribing practices in secondary care. However, their impact is variable depending on the intervention described by the warning. A national initiative to ensure patient safety information is effectively translated into

  15. Trainers' perceptions of the direct observation of practical skills assessment in histopathology training: a qualitative pilot study. (United States)

    Finall, Alison


    This pilot study of the direct observation of practical skills (DOPS) assessment of histopathology trainees is needed in the absence of existing information on histopathology in the UK. The aim of the study was to explore the experiences and perceptions of trainers in using the DOPS tool with histopathology trainees. A qualitative approach was taken using paper-based questionnaires to consultants in a single teaching hospital histopathology department. DOPS was perceived by all trainers as a valid form of assessment. There was a spread of opinion regarding its feasibility, with some respondents raising concern about its impact on time. 28% of respondents were doubtful about the formative nature of DOPS. All stated the assessment was fair. Themes that have emerged include concerns about impact on trainer time, whether DOPS is used in a formative manner and concerns about the amount of guidance provided to trainers. Further research is required to expand on these points.

  16. 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.

  17. 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.

  18. Overview of the WEEE Directive and Its Implementation in the Nordic Countries: National Realisations and Best Practices

    Directory of Open Access Journals (Sweden)

    Jenni Ylä-Mella


    Full Text Available Electronic devices and mobile applications have become a part of everyday life. Fast technological progress and rapid product obsolescence have led to the rapid growth of waste electrical and electronic equipment (WEEE. Due to hazardous substances and also substantial amounts of valuable materials contained in electrical and electronic equipment, the European Union has implemented Directives related to WEEE, in order to reduce negative environmental and health impacts and to improve material recovery of valuable substances from WEEE. This paper provides an overview of the WEEE Directive and its implementation to national legislations in Finland, Sweden, and Norway and, further, describes how the nationwide WEEE recovery infrastructures in the Nordic countries have been built. The Nordic WEEE management systems are evaluated from the point of resource efficiency and best practices. Evidently, the WEEE management systems as established in the Nordic countries have advantages because the WEEE collection rates in 2012 were 12 kg/inhab./year, in Finland, 16 kg/inhab./year, in Sweden, and 27 kg/ inhab./year, in Norway, despite their sparsely populated nature. The Swedish and Norwegian experiences, especially, with long history of WEEE recovery indicate that increasing consumer awareness leads to more environmentally sound behaviour and improves recovery efficiency.

  19. Hand hygiene practices among nursing staff in public secondary care hospitals in Kuwait: self-report and direct observation. (United States)

    Al-Wazzan, Batool; Salmeen, Yasmeen; Al-Amiri, Eisa; Abul, Ala'a; Bouhaimed, Manal; Al-Taiar, Abdullah


    To assess the compliance with hand hygiene guidelines among nursing staff in secondary care hospitals in Kuwait. A cross-sectional study was conducted through direct observation using the Lewisham observation tool and self-administered questionnaire in six major public secondary care hospitals in Kuwait. Only patient care activities that are described as 'dirty contacts' by the Fulkerson scale were considered as indications for hand hygiene while any attempt for hand hygiene was considered as compliance. A self-administered questionnaire was prepared and pilot tested and then distributed to nursing staff at each ward immediately after conducting the inspection; 550 were distributed and 454 were completed and returned. Among 204 observation sessions, a total of 935 opportunities and 312 hand hygiene practices were recorded. The overall compliance was 33.4%. The observed compliance significantly varied between different ward categories from 14.7% in emergency to 55% in medical wards. Of the 454 nursing staff who participated in self-reported compliance, 409 (90%) indicated that they always washed their hands upon practicing patient care activities. Nurses consistently reported higher compliance after conducting patient care activities rather than before. Being busy with work (42.2%), having sore/dry hands (30.4%) and wearing gloves (20.3%) were the most frequently reported hindrances to improving hand hygiene. Observed hand hygiene compliance among nursing staff in secondary care hospitals in Kuwait was poor. High self-reported compliance may reflect a high level of awareness of hand hygiene but may also suggest that improving compliance through increasing awareness has probably reached saturation. Copyright © 2011 S. Karger AG, Basel.

  20. 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.

  1. 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

  2. Testing the direction of effects between child body composition and restrictive feeding practices: results from a population-based cohort. (United States)

    Derks, Ivonne Pm; Tiemeier, Henning; Sijbrands, Eric Jg; Nicholson, Jan M; Voortman, Trudy; Verhulst, Frank C; Jaddoe, Vincent Wv; Jansen, Pauline W


    Background: Parental restrictive feeding (i.e., limiting food intake of children) has been linked to childhood overweight. However, the directionality of the causal pathway remains unknown.Objective: The objectives of this study were to examine the bidirectional association of maternal restrictive feeding with children's weight and body composition across childhood and to explore a possible mediating role of maternal concern about child weight.Design: Data were available for 4689 mother-child dyads participating in Generation R, a prospective birth cohort in the Netherlands. At ages 4 and 10 y, restrictive feeding was assessed with the parent-reported Child Feeding Questionnaire, and children's body mass index (BMI) was measured. At age 6 y, fat mass index (FMI) and fat-free mass index (FFMI) were measured with dual-energy X-ray absorptiometry. Both directions of the relation between restriction and child body composition were examined with multivariable linear regression analyses and cross-lagged modeling. Mediation analyses were performed to examine concern about child weight (mother reported at child age of 10 y) as a potential mediator.Results: Higher child sex- and age-adjusted BMI SD scores (zBMI) at age 4 y predicted more restrictive feeding at age 10 y (B = 0.15; 95% CI: 0.11, 0.18). Both sex- and age-adjusted FMI SD scores (zFMI) and sex-and age-adjusted FFMI SD scores (zFFMI) at 6 y were also positively associated with restrictive feeding at 10 y. Maternal concern about child weight partially mediated these associations from child body composition to restrictive feeding (e.g., for zBMI at 4 y: Bindirect = 0.10; 95% CI: 0.07, 0.13). There was no temporal association from restrictive feeding at age 4 y to child zBMI at age 10 y after adjustment for baseline zBMI.Conclusions: The continued use of restrictive feeding practices at age 10 y appeared to be primarily a response of mothers to an unhealthy weight of their child rather than a cause of children

  3. 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.

  4. Integrating Public Health and Health Promotion Practice in the Medical Curriculum: A Self-Directed Team-Based Project Approach. (United States)

    Kershaw, Geraldine; Grivna, Michal; Elbarazi, Iffat; AliHassan, Souheila; Aziz, Faisal; Al Dhaheri, Aysha Ibrahim


    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.

  5. 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…

  6. 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...... included as a chapter in the Handbook are possible measures for best practices of implementation, designed for those who wish to tailor direct democracy instruments to their specific needs. In order to further complement the best practices, a variety of global case studies detail the practical uses...... of direct democracy mechanisms in specific contexts. These country case studies allow for in depth discussion of particular issues, including signature collection and voter participation, campaign financing, media coverage, national variations in the usage of direct democracy procedures and national lessons...

  7. A study of the directional response of ultraviolet radiometers: I. Practical evaluation and implications for ultraviolet measurement standards. (United States)

    Pye, S D; Martin, C J


    The directional responses of a range of ultraviolet radiometers commonly used for irradiance measurements of UVB and UVC have been studied. Radiometers with 24 diffuser/filter combinations were assessed using a deuterium source, and three different diffuser/filter designs were assessed using a monochromatic source. The directional responses of the radiometers have been calculated and expressed in terms of figures of merit similar to those described for (photopic) illuminance meters in BS 667 and CIE 69. Those radiometers that performed best for the measurement of both small and extended sources of UVB and UVC had raised PTFE diffusers. We conclude that UV radiometers with a directional response error f2 radiometer.

  8. The interaction between practice and performance pressure on the planning and control of fast target directed movement. (United States)

    Allsop, Jonathan E; Lawrence, Gavin P; Gray, Robert; Khan, Michael A


    Pressure to perform often results in decrements to both outcome accuracy and the kinematics of motor skills. Furthermore, this pressure-performance relationship is moderated by the amount of accumulated practice or the experience of the performer. However, the interactive effects of performance pressure and practice on the underlying processes of motor skills are far from clear. Movement execution involves both an offline pre-planning process and an online control process. The present experiment aimed to investigate the interaction between pressure and practice on these two motor control processes. Two groups of participants (control and pressure; N = 12 and 12, respectively) practiced a video aiming amplitude task and were transferred to either a non-pressure (control group) or a pressure condition (pressure group) both early and late in practice. Results revealed similar accuracy and movement kinematics between the control and pressure groups at early transfer. However, at late transfer, the introduction of pressure was associated with increased performance compared to control conditions. Analysis of kinematic variability throughout the movement suggested that the performance increase was due to participants adopting strategies to improve movement planning in response to pressure reducing the effectiveness of the online control system.

  9. '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.

  10. 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

  11. 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.

  12. Coupling Financial Incentives with Direct Mail in Population-Based Practice: A Randomized Trial of Mammography Promotion (United States)

    Slater, Jonathan S.; Parks, Michael J.; Malone, Michael E.; Henly, George A.; Nelson, Christina L.


    Financial incentives are being used increasingly to encourage a wide array of health behaviors because of their well-established efficacy. However, little is known about how to translate incentive-based strategies to public health practice geared toward improving population-level health, and a dearth of research exists on how individuals respond…

  13. 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…

  14. 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,…

  15. 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.

  16. 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.

  17. Perspectives of US Direct Care Workers on the Grief Process of Persons with Intellectual and Developmental Disabilities: Implications for Practice (United States)

    Gray, Jennifer A.; Abendroth, Maryann


    Background: The study explored the grief process of persons with intellectual and developmental disabilities (PWIDDs) as perceived by direct care workers (DCWs) and how such workers can guide and support PWIDDs experiencing grief. Materials and Methods: A thematic analysis approach was used to examine data from nine focus groups with 60 DCWs from…

  18. Use of POHEM to Estimate Direct Medical Costs of Current Practice and New Treatments Associated with Lung Cancer in Canada


    Houle, Christian; Berthelot, Jean-Marie; Evans, William K.; Will, Phyllis


    Context : Lung cancer has been the leading cause of cancer deaths in Canadian males for many years, and since 1994, this has been the case for Canadian femalesas well. It is therefore important to evaluate the resources required for its diagnosis and treatment. This article presents an estimate of the direct medical costsassociated with the diagnosis and treatment of lung cancer calculated through the use of a micro-simulation model. For disease incidence, 1992 was chosen as thereference year...

  19. Health Care Providers Attitudes and Practices Regarding the Purpose and Use of Advance Directives in a Military Health Care Setting (United States)


    advance directives to health care providers’ erroneous beliefs that these documents are mainly for the terminally ill and elderly . secondary infection or malnourishment . Today’s soldiers can be treated more successfully on the front line with sophisticated and portable medical...of elderly outpatients thought the discussion should occur when they are healthy. Some of the statements elicited mixed responses. Mixed responses

  20. 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.

  1. [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.

  2. 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.

  3. [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.

  4. [Trauma-focused Cognitive-behavioral Therapy with children and adolescents: Practice, evidence base, and future directions]. (United States)

    Sachser, Cedric; Rassenhofer, Miriam; Goldbeck, Lutz


    Trauma-focused cognitive behavioral therapy (Tf-CBT) is an evidence-based trauma therapy for children and adolescents aged 3–17 years with posttraumatic stress disorder (PTSD). One supportive caregiver is regularly included in the therapeutic process. Tf-CBT consists of eight components and can be summarized by the acronym P.R.A.C.T.I.C.E: Psychoeducation and Parenting skills, Relaxation skills, Affective modulation skills, Cognitive coping skills, Trauma narrative and cognitive processing of the traumatic event(s), In vivo mastery of trauma reminders, Conjoint child-parent sessions, and Enhancing safety and future developmental trajectory. Based on a total of 13 randomized controlled trials, several meta-analyses and systematic reviews confirm the efficacy of Tf-CBT, which received evidence level Ia in several international guidelines and is therefore recommended as first-line treatment for children and adolescents with PTSD.

  5. 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

  6. 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.

  7. All your data (effectively) belong to us: data practices among direct-to-consumer genetic testing firms. (United States)

    Laestadius, Linnea I; Rich, Jennifer R; Auer, Paul L


    Direct-to-consumer genetic testing (DTC-GT) has become a convenient method to help people to understand their genetic makeup. Owing in part to concerns regarding confidentiality, privacy, and secondary use of data, professional and government bodies created guidelines to promote transparency among these companies. Using a comprehensive and systematic approach, this study assessed DTC-GT company compliance with international transparency guidelines. A framework analysis was performed on 30 DTC-GT health and/or ancestry websites identified using a US-based online search strategy during the summer of 2015. A codebook was developed from a synthesis of relevant guidelines from seven DTC-GT guideline documents and applied to each website. Although most companies met guidelines related to transparency regarding security protocols, storage procedures, and third-party disclosures, few met guidelines regarding sharing risks from data disclosures. Additionally, few companies disclosed how long data would be kept for services or research. Use of data for research was frequently mentioned only in privacy policies and terms of service documents, and only two-thirds of companies required an additional consent to use consumer data for health-related research. Our analysis shows that DTC-GT companies do not consistently meet international transparency guidelines related to confidentiality, privacy, and secondary use of data.Genet Med advance online publication 22 September 2016.

  8. Evidence-Based Psychological Interventions for the Management of Pediatric Chronic Pain: New Directions in Research and Clinical Practice

    Directory of Open Access Journals (Sweden)

    Rachael Coakley


    Full Text Available Over the past 20 years our knowledge about evidence-based psychological interventions for pediatric chronic pain has dramatically increased. Overall, the evidence in support of psychological interventions for pediatric chronic pain is strong, demonstrating positive psychological and behavioral effects for a variety of children with a range of pain conditions. However, wide scale access to effective psychologically-based pain management treatments remains a challenge for many children who suffer with pain. Increasing access to care and reducing persistent biomedical biases that inhibit attainment of psychological services are a central focus of current pain treatment interventions. Additionally, as the number of evidence-based treatments increase, tailoring treatments to a child or family’s particular needs is increasingly possible. This article will (1 discuss the theoretical frameworks as well as the specific psychological skills and strategies that currently hold promise as effective agents of change; (2 review and summarize trends in the development of well-researched outpatient interventions over the past ten years; and (3 discuss future directions for intervention research on pediatric chronic pain.

  9. 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.

  10. The SIEP-DIRECT'S Project on the discrepancy between routine practice and evidence. An outline of main findings and practical implications for the future of community based mental health services. (United States)

    Ruggeri, Mirella; Lora, Antonio; Semisa, Domenico


    To highlight the major discrepancies that emerged between evidence and routine practice in the framework of the SIEP-DIRECT'S Project (DIscrepancy between Routine practice and Evidence in psychiatric Community Treatments on Schizophrenia). The Project was conducted in 19 Italian mental health services (MHS), with the aims of: (a) evaluating the appropriateness of the NICE Guidelines for Schizophrenia in the Italian context, (b) developing and testing a set of 103 indicators that operationalised preferred clinical practice requirements according to the NICE Guidelines, and (c) evaluating their actual application in Italian MHSs. The indicators investigated five different areas: common elements in all phases of schizophrenia; first episode treatment; crisis treatment; promoting recovery; the aggressive behaviour management. The NICE recommendations examined were judged in most instances to be appropriate to the Italian MHS context, and the indicators fairly easy to use. The more severe and frequently encountered evidence-practice discrepancies were: lack of written material, guidelines, and information to be systematically provided to users; lack of intervention monitoring and evaluation; difficulty in implementing specific and structured forms of intervention; difficulty in considering patients' family members as figures requiring targeted support themselves and who should also be regularly involved in the patient care process. The key actions to be undertaken to favour implementation of evidence-based routine practices are: focussing on mental illness onset and family support/involvement in care; planning training activities aimed at achieving specific treatment goals; encouraging MHS participation in evaluation activities; identifying thresholds for guideline application and promoting specific guideline implementation actions; and activating decision making and resource allocation processes that rely more strictly on evidence and epidemiological assessment. These

  11. 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

  12. A survey of the potential impact of the European Union Physical Agents Directive (EU PAD) on electromagnetic fields (EMF) on MRI research practice in the United Kingdom. (United States)

    Perrin, Nicola M R; Morris, Clive J


    To assess concerns that the European Union Physical Agents Directive (EU PAD) on Electromagnetic Fields (EMF) could seriously restrict the use of MRI for research, diagnosis, and treatment, this study was conducted to examine the impact of the EU PAD on research practice, following a previous survey that assessed its impact on clinical practice. Data were collected through an online survey. E-mail invitations were sent to every UK grant-holder funded by Cancer Research UK, Engineering and Physical Sciences Research Council (EPSRC), Medical Research Council (MRC), and the Wellcome Trust in the last three years, who use MRI technology. A total of 70% of researchers responding to the survey reported that some of their MR research is conducted with at least one researcher in the scanner room during operation. Of those researchers in the scanner room, more than three-quarters are within 1 m of the scanner, for any scanner strength, and would therefore exceed the limits set in the Directive. Over half of these researchers also reach into the magnet bore, while at least one in five researchers spend over an hour in the scanner room during operation. The results suggest the EU PAD could have a very prohibitive impact on research practice. The current exposure limits would prohibit interventional MRI, limit the provision of patient care, and restrict researchers from reaching into the magnet bore to position and check equipment or to provide technical support. The use of new, more powerful high-field scanners will be particularly restricted. (c) 2008 Wiley-Liss, Inc.

  13. 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 (Pao2), ARDS Network [Net] positive end-expiratory pressure [PEEP]/fraction of inspired oxygen [Fio2] 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/Fio2 table.

  14. Spatially explicit groundwater vulnerability assessment to support the implementation of the Water Framework Directive - a practical approach with stakeholders (United States)

    Berkhoff, K.


    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 exposure and

  15. 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

  16. Assisting undergraduate nursing students to learn evidence-based practice through self-directed learning and workshop strategies during clinical practicum. (United States)

    Zhang, Qi; Zeng, Tieying; Chen, Ying; Li, Xiaopan


    To equip undergraduate nursing students with basic knowledge and skills and foster positive attitudes toward evidence-based practice (EBP), a pilot learning program during their clinical practicum was developed in a teaching hospital in China. This article describes the specific learning process through which self-directed learning and workshop strategies were used, and a pre- and post-intervention survey were conducted to evaluate the effectiveness of the learning strategies. The findings show a significant improvement in their perceptions of EBP knowledge, attitudes and beliefs, and behavior levels. Beginning competencies in EBP were achieved. Participants reported great satisfaction and have found this program helpful in promoting their analytical and problem-solving abilities, independent learning ability, and cooperative and communication abilities as well. Copyright © 2011 Elsevier Ltd. All rights reserved.

  17. Knowledge, attitude and practice of community drug distributors' about onchocerciasis and community directed treatment with ivermectin in Quara district, North Western Ethiopia. (United States)

    Weldegebreal, Fitsum; Medhin, Girmay; Weldegebriel, Zemichael; Legesse, Mengistu


    Onchocerciasis is one of the most important public health problems over large areas of tropical Africa countries including Ethiopia. The African Program for Onchocerciasis Control (APOC) has been working with ultimate goal of reducing the public health and socio-economic problems of onchocerciasis through administration of the tablet for continuous 12-15 years using the strategy of yearly community-directed treatment with ivermectin (CDTI) in endemic areas of Africa to kill the microfilariae that invade the eyes and are present in the skin to be transported to another victim by the black fly. The objective of this study was to assess knowledge, attitude and practice of community drug distributors (CDDs) towards onchocerciasis and CDTI in Quara district. Of all the study participating CDD 11.4% (9/79) said that they knew about the etiology of the disease, 35.4% (28/79) had good level of knowledge, 19 (24.1%) had good level of positive attitude and 18 (22.8%) had good level of positive practice about onchocerciasis. Similarly, 45.6% (36/79), 81.0% (64/79) and 29.1% (23/79) had good level of knowledge, attitude and practice about CDTIP, respectively. Being a female CDD (adjusted OR 7.246, P = 0.035, 95% CI 1.147, 45.455) and being older than 35 years (adjusted OR 8.435, P = 0.001, 95% CI 4.53, 9.003) were significantly associated with the likelihood of having good level of knowledge about the disease. Although onchocerciasis is endemic in Quara district, large proportion of the CDDs had misconceptions about its causation, transmission and prevention. Therefore, CDTIP for onchocerciasis control need to be supported by proper and continuous training, and health education about different aspects of the disease.


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    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.

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

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    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

  1. Direct-acting antiviral agents in the treatment of chronic Hepatitis C - "Real-life" experience from an academic centre and two specialized clinical practices. (United States)

    Groß, Manuel Jonathan; Härter, Georg; Backhus, Johanna; Zizer, Eugen; Seufferlein, Thomas; Ludwig, Leopold; Dikopoulos, Nektarios


    The introduction of the new direct antiviral agents has revolutionized the therapy of chronic hepatitis C. Today we are able to cure the vast majority of our patients with an 8- to 12-week therapy course of an antiviral combination therapy with an excellent safety profile. Real-life data are very important to further develop our experience with the new therapeutics and help us to improve the care of our patients in our everyday clinical practice.In our study, we present the retrospective analysis of a representative German cohort of 344 patients with chronic hepatitis C treated with the new direct antiviral agents. The patients were recruited in an academic center of southern Germany (University Clinic of Ulm, Clinic of Internal Medicine I) and in 2 highly specialized clinical practices in the city center and the near region of Ulm. Within this in-detail characterized study cohort, we analyzed the efficacy and safety of antiviral therapy under real-life conditions.In 322 patients, we could document SVR12 data and found an excellent overall SVR12 rate of 97.8 % across all genotypes. In more detail, we could show comparable SVR12 results of 99 % and 99.2 % in patients with the hepatitis C virus subtypes 1a and 1b of and an excellent SVR12 rate of 93.1 % in genotype 3 patients without liver cirrhosis. Nevertheless, SVR12 rates tend to be lower in patients with the presence of liver cirrhosis, especially in genotype 3 patients with the lowest SVR12 rate in the whole study group of only 80 %. In general, there were no major safety issues except of 1 patient treated with a protease-inhibitor-based regimen who developed a generalized skin reaction and needed hospitalization and premature end of antiviral therapy.In summary, our analysis of this well characterized representative cohort of 344 patients adds more information in the field of real-life experience with the new antiviral therapeutics and could therefore contribute to improve the care of our patients

  2. 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

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

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    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.

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

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    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

  5. [Management of violent behaviour and rapid tranquillisation during acute psychotic episode: discrepancy between routine practice and evidence. The SIEP-DIRECT'S Project]. (United States)

    Lora, Antonio; Morganti, Carla; Erlicher, Arcadio; Burti, Lorenzo; Buscaglia, Giacinto; Pegoraro, Marco; Davide, Jacchetti; Cristofalo, Doriana; Ruggeri, Mirella; Domenico, Semisa


    To evaluate the quality of acute psychiatric care concerning the management of violent behaviour and rapid tranquilization. Data concerning 13 indicators, drawn from NICE recommendations, were collected in 19 Departments of Mental Health, in the frame of the SIEP-DIRECT'S Project, to evaluate the implementation of NICE recommendations in Italian Mental Health Services. In about two thirds of Departments of Mental Health (DMHs) professionals were trained in the management of violent behaviour, while written procedures existed only in one fourth of DMHs. About a half of the professionals working in Psychiatric Wards in General Hospital were trained in rapid tranquilization, while procedures on this topic are practically absent and specific care for monitoring intensively the heavily sedated patient was not frequent. Management of violent behaviour and rapid tranquilization are two critical areas in the care performed by Psychiatric Wards in General Hospital. Training on these topics is more frequent than implementation of procedures. NICE recommendations and SIEP indicators are useful tools for improving the quality of acute psychiatric care.

  6. 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.

  7. Assessment of community’s knowledge, attitude and practice about onchocerciasis and community directed treatment with Ivermectin in Quara District, north western Ethiopia (United States)


    Background The African Program for Onchocerciasis Control (APOC) has been working with ultimate goal of reducing the public health and socio-economic problems associated with onchocerciasis within a period of 12–15 years. Although dedicated community engagement is crucial for the success of the program, there is little/no information on the levels of community’s knowledge, attitude and practice about onchocerciasis as well as about the ongoing control program in Ethiopia. In this study, we have assessed the level of knowledge, attitude and practice of Quara district residents about onchocerciasis and the current control strategies in the area. Methods This community-based cross-sectional study was conducted between October 2012 and January 2013 in Quara District, Amhara Regional State, North West of Ethiopia. The study participants were recruited from randomly selected kebeles (small administrative units) of the study area and were interviewed about onchocerciasis and about community directed treatment with ivermectin (CDTI) using structured questionnaire. The collected data were double entered into a data entry file using EpiData software, V.3.1. The data were transferred to SPSS soft-ware V.16 and analyzed according to the different variables. Results Out of 418 respondents, 401 (95.9%) of the respondents have heard about onchocerciasis (locally known as ‘wara’) and 11.2% said that they knew about the etiology of the disease, which was named as filarial worm. However, 356 (88.8%) had at least one misconception about the causative agent of onchocerciasis. More than half (69.4%) knew that the transmission of the disease is related to black fly biting. Overall, 93.3% participants believed that onchocerciasis is preventable, of whom 49.5% indicated use of drug as the means of preventing the disease. Majority (95.5%) of the participants perceived CDTI as very useful program. Conclusion Although onchocerciasis is endemic disease in the study area, large

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

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    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

  9. 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.

  10. Guidance for patients considering direct-to-consumer genetic testing and health professionals involved in their care: development of a practical decision tool. (United States)

    Jackson, Leigh; Goldsmith, Lesley; Skirton, Heather


    Direct-to-consumer (DTC) genetic tests are available online, but there is little practical guidance for health professionals and consumers concerning their use. Work to produce such guidance was initially informed by three systematic reviews assessing the evidence on views and experiences of users and health professionals and policies of professional and bioethics organizations. The evidence suggested that consumers' motivations include general curiosity, improving their general health, ascertaining the risk of a particular condition or planning for future children. However, health professionals and bioethics organizations expressed concerns about potential harms resulting from these tests. Using this evidence, we constructed a list of topics to be included in proposed guidelines. Using an expert group technique, we aimed to develop guidance for (i) potential consumers and (ii) health professionals approached by patients considering or having undertaken such tests. We considered it important to involve a wide range of participants with relevant experience. Accordingly, researchers and clinicians based in four countries were invited to a 2-day workshop in August 2012. Following an iterative process, we decided to produce clinically relevant and pragmatic guidance in the form of a decision support tool for use in primary care. By utilizing both the relevant literature and the experience of the expert group, we identified seven key underlying reasons that might prompt individuals to consider DTC testing. We considered primary care physicians as the most likely health professionals from whom individuals would seek advice. Based on the outcomes of the workshop, we developed a decision support tool encompassing varied clinical scenarios. Health professionals and patients are guided through a pathway that includes relevant actions and information on the appropriateness of the test. This tool will be freely accessible to health professionals and patients online. © The

  11. 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.

  12. Student Appropriation of Writing Lessons through Hybrid Composing Practices: Direct, Diffuse, and Indirect Use of Teacher-Offered Writing Tools in an ESL Classroom (United States)

    Ranker, Jason


    This is a qualitative case study (conducted in an urban, public school classroom in the United States) of the collaborative composing processes of two groups of first-grade students designated as English Language Learners (ELLs) as they wrote in a writing workshop context. I focused on a specific type of the students' hybrid composing practices:…

  13. [Care across all phases of schizophrenia and initiation of treatment: discrepancy between routine practice and evidence. The SIEP-DIRECT'S Project]. (United States)

    Ruggeri, Mirella; Bacigalupi, Maurizio; Casacchia, Massimo; Miceli, Maurizio; Morganti, Carla; Scavo, Vincenzo; Allevi, Liliana; Lupoi, Sergio; Cristofalo, Doriana; Lasalvia, Antonio; Lora, Antonio; Semina, Domenico


    To evaluate the quality of psychiatric care in Italian community-based services and the discrepancy between real practices and NICE recommendations for the treatment of schizophrenia concerning the elements common to all phases of care and the first episode of psychosis. Data concerning 14 indicators on common aspects of care in all phases and 11 indicators concerning psychosis onset, drawn from NICE Recommendations, were collected in 19 Departments of Mental Health. An optimistic attitude seems to prevail in the staff in all phases of care, while remarkable discrepancies between service practice and recommendations have been found in relation to systematic assessment, availability of informative leaflets and support to relatives. Concerning the treatment of first episode, a lack of specific services and differentiated activities, and paucity of practices based on specific guidelines has been detected. However, Italian community based services proved to have a good capacity to provide help quickly to those seeking help for a psychotic onset, to maintain regular contact with them in the subsequent year, and provide pharmacological treatment reasonably in line with the scientific evidence. Instead, little specific support is provided to the relatives. The results show critical points concerning capacity of assessment and treatment standardization, in all aspects of care and specifically in the treatment for the first episode. Differentiation of activities specifically dedicated to the patients at their first episode should be promoted as well as strategies to support relatives in a more specific way.

  14. 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

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    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.

  15. Clinical Validity and Utility of Tumor-Infiltrating Lymphocytes in Routine Clinical Practice for Breast Cancer Patients: Current and Future Directions. (United States)

    Wein, Lironne; Savas, Peter; Luen, Stephen J; Virassamy, Balaji; Salgado, Roberto; Loi, Sherene


    The interest in tumor-infiltrating lymphocytes (TILs) as a prognostic biomarker in breast cancer has grown in recent years. Biomarkers must undergo comprehensive evaluation in terms of analytical validity, clinical validity and clinical utility before they can be accepted as part of clinical practice. The International Immuno-Oncology Biomarker Working Group has developed a practice guideline on scoring TILs in breast cancer in order to standardize TIL assessment. The prognostic value of TILs as a biomarker in early-stage breast cancer has been established by assessing tumor samples in thousands of patients from large prospective clinical trials of adjuvant therapy. There is a strong linear relationship between increase in TILs and improved disease-free survival for triple-negative and HER2-positive disease. Higher levels of TILs have also been associated with increased rates of pathological complete response to neoadjuvant therapy. TILs have potential clinical utility in breast cancer in a number of areas. These include prediction of responders to immune checkpoint blockade, identification of primary HER2-positive and triple-negative patients who have excellent prognoses and may thus be appropriate for treatment de-escalation, and potentially incorporation into a neoadjuvant endpoint which may be a better surrogate maker for drug development.

  16. 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.

  18. 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...

  19. A Practical Non-Extraction Direct Liquid Chromatography Method for Determination of Thiopurine S-Methyltransferase Activity in Inflammatory Bowel Disease

    Directory of Open Access Journals (Sweden)

    Fariborz Bahrehmand


    Full Text Available Thiopurine drugs remain pivotal therapies for the wide varieties of diseases such as inflammatory bowel disease (IBD. Here, thiopurine S-methyltransferase (TPMT phenotype, the main metabolizing enzyme of thiopurine-drugs, was studied. This is for the first time that TPMT activity is measured in Iranian IBD patients. We used an improved direct liquid chromatography assay without need for solvent extraction and minimize excess labor handling making it ideal for use in routine referral medical centers. TPMT activity in whole blood was determined by a non-extraction HPLC method. We evaluated 427 individuals including 215 IBD patients and 212 unrelated healthy individuals as control group from Iran’s western population. TPMT phenotyping of this study demonstrated no frequency for deficient, 2.8 % for low and 97.2% for normal activity, which is different with results of other studies. There was a significant negative correlation between TPMT activities as calculated based on nmol/grHb/h and the Hb-levels in IBD and control groups (r= -0.54, P<0.001 and r= -0.27, P<0.001, respectively. Interestingly a significant positive correlation between Hb levels and TPMT-activities were seen when the activity calculated in mU/L in IBD patients and control subjects (r=0.14, P=0.05 and r=0.43, P<0.001, respectively. We strongly suggest the use of international unit (mU/L is more appropriate than nmol6MTG/grHb/h for expressing TPMT-activity in IBD patients. In addition, in comparison with other providers of TPMT test activity and centers around the world the risk of toxicity is much lower after utilizing thiopurine drugs for IBD patients in this region.

  20. 48 CFR 9904.407 - Use of standard costs for direct material and direct labor. (United States)


    ... direct material and direct labor. 9904.407 Section 9904.407 Federal Acquisition Regulations System COST... PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.407 Use of standard costs for direct material and direct labor. ...

  1. Directed homology

    DEFF Research Database (Denmark)

    Fahrenberg, Uli


    We introduce a new notion of directed homology for semicubical sets. We show that it respects directed homotopy and is functorial, and that it appears to enjoy some good algebraic properties. Our work has applications to higher-dimensional automata.......We introduce a new notion of directed homology for semicubical sets. We show that it respects directed homotopy and is functorial, and that it appears to enjoy some good algebraic properties. Our work has applications to higher-dimensional automata....

  2. 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.

  3. Optimal selection for direct mail

    NARCIS (Netherlands)

    Bult, [No Value; Wansbeek, T


    Direct marketing (mail) is a growing area of marketing practice, yet the academic journals contain very little research on this topic. The most important issue for direct marketers is how to sample targets from a population for a direct mail campaign. Although some selection methods are described in

  4. 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.

  5. Practice changing practices

    DEFF Research Database (Denmark)

    Thomsen, Rikke; Buch, Anders


    study about the practices of a study administration unit in a university college in Denmark. The study includes ten weeks of participation observation study and five qualitative interviews, both in the central part and in three local study administrations. Managerial initiated organizational change...... makes work intelligible. This provides possibilities for action and change. We claim that the practice-based studies can become an integrated part of doing critical action research, and we investigate and reflect upon our stewardship of the practices we engaged in....

  6. 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....

  7. 16 CFR 1000.13 - Directives System. (United States)


    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Directives System. 1000.13 Section 1000.13 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION GENERAL COMMISSION ORGANIZATION AND FUNCTIONS § 1000.13 Directives System. The Commission maintains a Directives System which contains delegations of...

  8. AAGL Practice Report

    DEFF Research Database (Denmark)

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


    and hysteroscopically-directed procedures, distending media, if absorbed systemically in sufficient amounts, can have associated adverse events, including life-threatening complications. Consequently, understanding the physical properties and the potential risks associated with the use of the various distending media...... 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....

  9. Practice-audit-publish: A practice reflection. (United States)

    Ferrari, Robert


    Practice audits are useful opportunities to improve practice efficiency and effectiveness, reduce clinical errors, demonstrate quality care to stakeholders, promote high standards of practice, lower the risk of liability, and foster practice change. However, a benefit that is usually overlooked is the possibility of publication of the results of a practice audit. Publication (research) has a number of benefits for the clinician, including skill development as a scholar, communicator, professional, and collaborator. A practice audit is beneficial to an individual physician; furthermore, publication of the audit results could be beneficial for many others such as health care providers, patients, and other stakeholders in a health care system. The problem is that practice audits often begin without a clear plan. The important steps in planning and carrying out a practice audit can be captured by thinking about how a research publication evolves. Thus, a good researcher is a good practice auditor. This paper reviews the author's experience and provides examples and directions of the process of practice-audit-publish.

  10. 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 ...

  11. 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...

  12. 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.

  13. 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

  14. Following Directions. (United States)

    Bolger, Charlene

    Activities in this elementary unit focus on developing students' locational skills while strengthening their ability to read and follow instructions. Seven maps of varying complexity are accompanied by worksheets containing 8 to 13 direction exercises. Students are instructed to place buildings, landmarks, and labels in accurate locations on each…

  15. Direct ELISA. (United States)

    Lin, Alice V


    First described by Engvall and Perlmann, the enzyme-linked immunosorbent assay (ELISA) is a rapid and sensitive method for detection and quantitation of an antigen using an enzyme-labeled antibody. Besides routine laboratory usage, ELISA has been utilized in medical field and food industry as diagnostic and quality control tools. Traditionally performed in 96-well or 384-well polystyrene plates, the technology has expanded to other platforms with increase in automation. Depending on the antigen epitope and availability of specific antibody, there are variations in ELISA setup. The four basic formats are direct, indirect, sandwich, and competitive ELISAs. Direct ELISA is the simplest format requiring an antigen and an enzyme-conjugated antibody specific to the antigen. This chapter describes the individual steps for detection of a plate-bound antigen using a horseradish peroxidase (HRP)-conjugated antibody and luminol-based enhanced chemiluminescence (ECL) substrate. The methodological approach to optimize the assay by chessboard titration is also provided.

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. [Theory? Practice?]. (United States)

    Medina Moya, José Luis


    This second article about the difficult balance between academic and professional development in pre-European Spain poses the issue of the theory-practice, or learning-treatment, relationship as the historical dissolution of the practical in the theoretical.

  1. Clinical Practice

    DEFF Research Database (Denmark)

    Contarino, Maria Fiorella; Van Den Dool, Joost; Balash, Yacov


    issues still remain open in the clinical practice. We performed a systematic review of the literature on botulinum toxin treatment for CD based on a question-oriented approach, with the aim to provide practical recommendations for the treating clinicians. Key questions from the clinical practice were...... of anticoagulants, neurological comorbidities) should also be further explored....

  2. Tracking federal land management: Report No. 3 on federal land management actions impacting geothermal commecialization at selected target prospects in the five Pacific Rim states

    Energy Technology Data Exchange (ETDEWEB)


    Generic land management actions affecting geothermal commerializtion in Pacific River states are reviewed. Specific federal land management actions affecting geothermal prospects in California and the Pacific Northwest are described. (MHR)

  3. Best practices

    NARCIS (Netherlands)

    Baar, J.; Roestel, van A.J.J.


    In het convenant gewasbescherming wordt het zichtbaar maken van 'best practices' benoemd als één van de acties om meer innovatie een een beter management te krijgen. Het ministerie van LNV gaf in april 2003 het Praktijkonderzoek Plant en Omgeving (PPO) de opdracht om deze 'best practices' van

  4. 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...

  5. 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.

  6. 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

  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...

  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....

  9. 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...... 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...... 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....

  10. Advising Practices. (United States)

    Kopenhaver, Lillian Lodge


    Suggests that those who work with collegiate student publications must understand and practice freedom of the press on their campuses. Provides evidence for this argument from a survey of college publications advisers. (RL)

  11. Modelling Practice

    DEFF Research Database (Denmark)

    Cameron, Ian; Gani, Rafiqul


    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...

  12. Best practices

    National Research Council Canada - National Science Library

    Zaring, David


    ..., touching every aspect of administrative law. This paper describes and evaluates best practices rulemaking, tracking its origins in business management, its adoption by the public sector, and analyzing how it works in that sector...

  13. Tomographic Reconstruction Methods for Decomposing Directional Components

    DEFF Research Database (Denmark)

    Kongskov, Rasmus Dalgas; Dong, Yiqiu

    X-ray computed tomography technique has many different practical applications. In this paper, we propose two new reconstruction methods that can decompose objects at the same time. By incorporating direction information, the proposed methods can decompose objects into various directional components...

  14. Self-Directed Learning: Consensus & Conflict. (United States)

    Long, Huey B.; And Others

    The following papers are presented in this book: "Self-Directed Learning: Consensus and Conflict" (Long); "Challenges in the Study and Practice of Self-Directed Learning" (Long); "A Conceptual Model of Autodidactism" (Tremblay, Theil); "Functional and Dysfunctional Uses of Self-Directedness in Adult…

  15. Teacher educators and student-directed learning

    NARCIS (Netherlands)

    Lunenberg, Mieke; Korthagen, Fred A J

    This article describes the results of a study on the views of teacher educators, and the way these views are expressed in practice. The study focuses on views of learning and teaching that can promote a shift from teacher educator-directed learning to student-directed learning. We found that teacher

  16. 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.

  17. 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

  18. 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......) on the future conditions of the city. It is possible, I will claim in the following, to see both Metro-net and All that is Solid Melts Into Data as evidence of a new kind of practice in the post-internet city; a practice that is skeptical of existing iterations of both the “city” and “technology” and looks...... 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....

  19. 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.

  20. Practicing physiotherapy in Danish private practice: an ethical perspective. (United States)

    Praestegaard, Jeanette; Gard, Gunvor; Glasdam, Stinne


    Despite an increasingly growth of professional guidelines, textbooks and research about ethics in health care, awareness about ethics in Danish physiotherapy private practice seen vague. This article explores how physiotherapists in Danish private practice, from an ethical perspective, perceive to practice physiotherapy. The empirical data consists of interviews with twenty-one physiotherapists. The interviews are analysed from a hermeneutic approach, inspired by Ricoeur's textual interpretation of distanciation. The analysis follows three phases: naïve reading, structural analysis and comprehensive analysis. Four main themes are constructed: Beneficence as the driving force; Disciplining the patient through the course of physiotherapy; Balancing between being a trustworthy professional and a businessperson; The dream of a code of practice. Private practice physiotherapy is embedded in a structural frame directed by both political and economical conditions that shape the conditions for practicing physiotherapy. It means that beneficence in practice is a balance between the patient, the physiotherapists themselves and the business. Beneficence towards the patient is expressed as an implicit demand. Physiotherapeutic practice is expressed as being an integration of professionalism and personality which implies that the physiotherapists also have to benefit themselves. Private practice seems to be driven by a paternalistic approach towards the patient, where disciplining the patient is a crucial element of practice, in order to optimise profit. Physiotherapists wish for a more beneficent practice in the future by aiming at bridging 'to be' and 'ought to be'.

  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. Professional and Organizational Best Practices

    Directory of Open Access Journals (Sweden)

    Robert L. SCHALOCK


    Full Text Available By focusing on evidence-based practices this article asks us to pursue jointly what are best practices, who is a professional, and what does it mean to be an effective and efficient organization. Both professionals and organizations provide services and supports that enhance the personal well-being and personal growth of their clientele. In discussing professional and organizational practices, I will suggest that professional best practices begin with respect for the individual and embrace professional standards, professional ethics, evidence-based practices, and impact evaluation. Analogously, I will suggest that organization best practices begin with a commitment to being a values-based entity that is effective and efficient in the provision of services and supports. This organization commitment is reflected in best practices related to high performance teams, the supports paradigm, outcomes evaluation, and continuous quality improvement.As depicted in Figure 1, the presentation will discuss each of these components of professional and organizational best practices. Additionally, I will suggest that through their reciprocal action, the best practices exhibited by professionals and organizations also create a cultural milieu that directly enhances not only the services and supports provided to the organization’s clientele, but also directly impacts the personal wellbeing and growth of organization personnel, which in turn enhances their effectiveness and efficiency.

  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 demonstrator, has become a shared research tool. This paper asks how this practice has formed by tracing the different roles of the prototype from ideation and design, to analysis and evaluation. Taking point of departure in CITA’s own prototyping practice, we explore the relationships between physical...... and digital prototyping as a particular means of validation and verification. Here, a breadth of physical prototypes take on varying roles, in turn informing, testing and proving the research enquiry. The paper addresses how we can differentiate between these modes of prototyping and how....

  4. Exploring determinants of vegetable parenting practices (United States)

    The purpose of this study was to find out if food parenting practices show promise for positively influencing child dietary intake. However, it is unclear what factors motivate parents to engage in vegetable parenting practices. We developed a Model of Goal Directed Vegetable Parenting Practices (MG...

  5. Ergonomics--future directions. (United States)

    Caple, David C


    The International Ergonomics Association plays a leadership role in shaping the future of ergonomics. Having formed nearly 50 years ago for researchers to meet and exchange their findings, it still provides a wide range of opportunities for promoting research and teaching. In 2006, the IEA is also an outward looking organisation with linkages to governments, international agencies and other professional associations. We have many opportunities to extend our engagement with industry and the community through the IEA communication strategy and Technical Committees. Whilst the IEA now has 20 Technical Committees that demonstrate the diversity of ergonomics research there is a growing trend towards integration of specialist areas. The emergence of a holistic approach to research and application of ergonomics is making a new direction for the ergonomics profession. Apart from the role of a technical specialist, the Ergonomist is also a team member with a range of other stakeholders. To be effective in practice, the Ergonomist needs to be a good communicator and "agent of change" who can mentor others to develop simple cost effective interventions. Research is fundamental to the science of ergonomics. Evaluation of interventions remains a major component of future ergonomics research. Sustainable positive outcomes based on a holistic approach will result in a broad uptake of ergonomics findings. In industry future challenges relating to psychological health in developed countries and the informal sector in developing countries are emerging as new areas for research and application of ergonomics.

  6. Quality in Human Resource Practice

    DEFF Research Database (Denmark)

    Nielsen, Kjeld

    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......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...

  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 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....

  9. 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.

  10. 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 techniqu...

  11. Experience and convergence in spiritual direction. (United States)

    Evans, Jean


    The practice of spiritual direction concerns the human experience of God. As praxis, spiritual direction has a long tradition in Western Christianity. It is a process rooted in spirituality with theology as its foundation. This paper explores the convergences between aspects of philosophy (contemplative awareness), psychology (Rogerian client-centered approach) and phenomenology. There are significant points of convergence between phenomenology and spiritual direction: first, in Ignatius of Loyola's phenomenological approach to his religious experience; second, in the appropriation by spiritual directors of concepts of epochē and empathy; third, in the process of "unpacking" religious experience within a spiritual direction interview.

  12. 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...

  13. Practical Nonlinearities (United States)


    architectures , practical nonlinearities, nonlinear dynamics 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT: SAR 8. NUMBER OF PAGES...performers from Mesodynamic Architectures (MESO) and uPNT all to include devices in these runs. This cost-sharing was planned, and is necessary for...contributions to the performance of MEMS gyroscopes. In particular, we have demonstrated for the first time that Parametric Amplification can improve the

  14. Best Practices: Exploring the Effect of Context

    DEFF Research Database (Denmark)

    Laugen, Bjørge; Boer, Harry; Acur, Nuran

    The best practice stream of manufacturing strategy literature has emerged and grown significantly during the last decades. Still, the understanding of how context affects the adoption and usefulness of best practices is limited. This paper analyses the relationships between fourteen contingency...... factors and six best practices, the direct performance effects of four of these contingency factors, and the moderating effects of these four factors on the best practice-performance relationships....

  15. Trends in nephrology practice. (United States)

    Huneycutt, Jennifer


    The analysis of this benchmarking data tells us several things. Nephrology practices are more complex. Physicians are generating more RVUs for less money and a greater percentage of income is coming from things other than direct patient care. Practices have responded partly by becoming larger and looking for revenue stream diversification. The ability to predict the financial future from the historical data is problematic. We know from the most recent survey that a significant number of nephrology practices are already participating in accountable care organizations, shared savings programs, and even risk sharing contracts. We know that the incentive for participation in government quality reporting programs and meaningful use is transitioning from the carrot to the stick and that reductions in reimbursement will be applied to those who are unsuccessful. In order to take on the challenges and complexity that the future holds, successful nephrology practices will likely be larger, more sophisticated and tightly aligned with all stakeholders in the pursuit to provide high quality, low cost care to patients with kidney disease.

  16. Constant training in direct ophthalmoscopy

    Directory of Open Access Journals (Sweden)

    Younan HC


    Full Text Available Helen-Cara Younan, Rishi Iyer, Janaki Natasha DesaiFaculty of Medicine, Imperial College London, London, UKWe read with great interest the review by Ricci and Ferraz on the advances in training and practice in ophthalmoscopy simulation.1As final year medical students, we have recently experienced direct ophthalmoscopy teaching and agree with the authors that “simulation is a helpful tool in ophthalmoscopy training”.1 Indeed, in our experience, simulation is useful in teaching a wide variety of clinical skills including venepuncture, intravenous cannulation, and catheterization. We were taught all of these clinical skills in our first clinical year of study through use of simulation models. With regards to our direct ophthalmoscopy teaching, we were first taught to recognize the normal retina and different retinal pathologies using images, before practicing our technique and recognition of those images in a model similar to the THELMA (The Human Eye Learning Model Assistant described by the authors.1However, we feel that the use of simulation models alone is not enough to provide confidence and competency in direct ophthalmoscopy among medical students. The authors conclude that “constant training is a well-known strategy for skill enhancement”,1 and we have found that a lack of constant training in direct ophthalmoscopy is evident. After learning venepuncture, cannulation, and catheterization on the simulation models, we were able to observe doctors performing these skills before performing them on patients either in the wards or in theatre. These are skills that we are constantly trained in across a wide variety of medical and surgical attachments. However, opportunities to observe and practice ophthalmoscopy during our attachments are more limited, and thus we are not continuing to use the skills we learn.Authors' replyLucas Holderegger Ricci,1 Caroline Amaral Ferraz21Department of Ophthalmology, School of Medicine, Laureate

  17. Clinical practice guidelines: directions for a new program

    National Research Council Canada - National Science Library

    Field, Marilyn Jane; Lohr, Kathleen N; Lohr, K. N


    ... of Medicine Marilyn J. Field and Kathleen N. Lohr, editors National Academy Press Washington, D.C. 1990 i Copyrightthe cannot be not from book, paper however, version for formatting, original authoritative the typesetting-specific the as from created publication files XML from other this and of recomposed styles, version he...

  18. Inflammatory bowel disease imaging: Current practice and future directions. (United States)

    Kilcoyne, Aoife; Kaplan, Jess L; Gee, Michael S


    The purpose of this paper is to evaluate the role of imaging in inflammatory bowel disease (IBD), including detection of extraluminal complications and extraintestinal manifestations of IBD, assessment of disease activity and treatment response, and discrimination of inflammatory from fibrotic strictures. IBD is a chronic idiopathic disease affecting the gastrointestinal tract that is comprised of two separate, but related intestinal disorders; Crohn's disease and ulcerative colitis. The paper discusses, in detail the pros and cons of the different IBD imaging modalities that need to be considered in order to optimize the imaging and clinical evaluation of patients with IBD. Historically, IBD evaluation of the bowel has included imaging to assess the portions of the small bowel that are inaccessible to optical endoscopic visualization. This traditionally was performed using barium fluoroscopic techniques; however, cross-sectional imaging techniques (computed tomography and magnetic resonance imaging) are being increasingly utilized for IBD evaluation because they can simultaneously assess mural and extramural IBD manifestations. Recent advances in imaging technology, that continue to improve the ability of imaging to noninvasively follow disease activity and treatment response, are also discussed. This review article summarizes the current imaging approach in inflammatory bowel disease as well as the role of emerging imaging modalities.

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


    E. Thomas Dowd


    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,...

  20. 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.

  1. Self-directed practice schedule enhances learning of suturing skills

    National Research Council Canada - National Science Library

    Safir, Oleg; Williams, Camille K; Dubrowski, Adam; Backstein, David; Carnahan, Heather


    ...) on learning suturing skills. Participants watched an instructional video for simple interrupted, vertical mattress and horizontal mattress suturing then completed a pretest to assess baseline skills...

  2. 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

  3. 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...... phases of student activities. Each of these phases involves different kinds of situated reflection that result in different learning outcomes within the same subject area. From the utilisation of the analytical framework, the study further identifies a number of sub-processes within student work...

  4. 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 ...

  5. 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.

  6. 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...

  7. Difficulties in the Nitrates Directive Implementation in Romania




    The EU Nitrates Directive (Council Directive 91/676/EEC) forms an integrate part of the Water FrameworkDirective and is one of the key instruments in the protection of waters against agricultural pressures [6]. The NitratesDirective aims to protect water quality across Europe by reducing water pollution caused or induced by nitrates fromagricultural sources and by promoting the use of good agricultural practices. Implementation of this directive hasproved to be a major challenge for Member St...

  8. Practices of Handling

    DEFF Research Database (Denmark)

    Ræbild, Ulla

    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...... a dichotomized idea of design as combined, alternating or parallel processes of thinking and doing. In other words, the notion of handling is not about reflection in or on action, as brought to the fore by Schön (1984), but about reflection as action. Below the methodological macro level of handling, the paper...

  9. 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...... phases of student activities. Each of these phases involves different kinds of situated reflection that result in different learning outcomes within the same subject area. From the utilisation of the analytical framework, the study further identifies a number of sub-processes within student work...


    A new type of direct oxidation ammonia fuel cell was investigated. This cell is based on the use of a non-aqueous fused hydroxide electrolyte matrix...EMF’s of 0.5 to 0.6 volts. At practical levels of current density the direct ammonia fuel cell has an overall efficiency of about 60% compared to 30-35% for the indirect-type fuel cell . (Author)

  11. Clinical Homework Directives: A Qualitative Exploratory Study


    Harker, Emil F.


    A qualitative study was conducted to better understand how marriage and family therapists use homework directives in their work with couples. Eleven therapists of different marital therapy orientations were interviewed. Remarkably, all of the therapists reported using clinical homework directives in their practice with couples, including those clinicians who primarily identify themselves with psychodynamic models- -models that do not typically include homework in their constructs. Four themes...

  12. DirectX-pelimoottori


    Heiskanen, Juha


    Opinnäytetyön tarkoituksena oli opiskella ja tutkia DirectX 11 -ohjelmistorajapintoja ja tavoitteena oli ohjelmoida toimiva pelimoottorin runko Windows-ympäristöön. Työssä tutustuttiin Windows-ohjelmistokehitysympäristöön ja DirectX:n eri osa-alueisiin. Microsoftin kehittämä DirectX on kokoelma etenkin pelintekoon suunnattuja ohjelmointirajapintoja. DirectX tarjoaa yhtenäisen kehitysympäristön mm. grafiikanluontiin, äänien hallintaan ja ohjauslaitteita varten. DirectX esiintyi ensimmäisen...

  13. Gender performance and cosmopolitan practice

    DEFF Research Database (Denmark)

    Woodward, Ian; Høy-Petersen, Nina; Skrbis, Zlatko

    Although empirically grounded accounts of cosmopolitanism have explored the impact of class, education, and ethnicity on cosmopolitan practices, no direct attention has yet been given to whether and how men and women might differently understand and frame cultural diversity. Indeed, as critical a...

  14. Pediatric nephrology practice in Jordan. (United States)

    Akl, Kamal; Hazza, Issa


    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.

  15. 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.

  16. The Social Work Practice Doctorate (United States)

    Hartocollis, Lina; Cnaan, Ram A.; Ledwith, Kate


    This article provides a systematic review of the emerging practice doctorate in social work. Based on the experience of the first such Doctor of Social Work (DSW) program, we provide information regarding the program origins and rationale, development, current structure, and future direction. Such information will enrich the discussion on the role…

  17. 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.).

  18. 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.

  19. 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.

  20. Radiation directivity rotation by acoustic metamaterials

    Energy Technology Data Exchange (ETDEWEB)

    Jiang, Xue; Liang, Bin, E-mail:, E-mail:; Zou, Xin-ye; Cheng, Jian-chun, E-mail:, E-mail: [Key Laboratory of Modern Acoustics, MOE, Department of Physics, Institute of Acoustics, Nanjing University, Nanjing 210093 (China); Collaborative Innovation Center of Advanced Microstructures, Nanjing University, Nanjing 210093 (China); Zhang, Likun [Department of Physics and Center for Nonlinear Dynamics, University of Texas at Austin, Austin, Texas 78712 (United States)


    We use a metamaterial-based scheme to rotate the radiation directivity of sound radiated by a source surrounded by the structure. The rotation is demonstrated through both numerical simulations and experiments. The performance persists within a broadband and is entirely independent of the location and pattern of source inside, suggesting great potential in various practical scenarios where both the signal frequency and source position may vary significantly. We have also investigated the possibility to realize versatile controls of radiation direction by tailoring the structural parameters. Our design with special directivity-steering capability may open route to loudspeaker and auditorium acoustics designs and medical ultrasound applications.

  1. Practical occupational medicine in "practice"

    DEFF Research Database (Denmark)

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


    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...... 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...

  2. Intuitive Direction Concepts

    Directory of Open Access Journals (Sweden)

    Alexander Klippel


    Full Text Available Experiments in this article test the hypothesis that formal direction models used in artificial intelligence correspond to intuitive direction concepts of humans. Cognitively adequate formal models of spatial relations are important for information retrieval tasks, cognitive robotics, and multiple spatial reasoning applications. We detail two experiments using two objects (airplanes systematically located in relation to each other. Participants performed a grouping task to make their intuitive direction concepts explicit. The results reveal an important, so far insufficiently discussed aspect of cognitive direction concepts: Intuitive (natural direction concepts do not follow a one-size-fits-all strategy. The behavioral data only forms a clear picture after participants' competing strategies are identified and separated into categories (groups themselves. The results are important for researchers and designers of spatial formalisms as they demonstrate that modeling cognitive direction concepts formally requires a flexible approach to capture group differences.

  3. Practically Saline

    Directory of Open Access Journals (Sweden)

    Jonathan Schroeder MD


    Full Text Available Introduction. In December 2014, the Food and Drug Administration issued a recall of all Wallcur simulation products due to reports of their use in clinical practice. We present a case of septic shock and multiorgan failure after the accidental intravenous infusion of a nonsterile Wallcur simulation product. Case. The patient presented with symptoms of rigors and dyspnea occurring immediately after infusion of Wallcur Practi-0.9% saline. Initial laboratory evidence was consistent with severe septic shock and multiorgan dysfunction. His initial lactic acid level was 9 mmol/L (reference range = 0.5-2.2, and he had evidence of acute kidney injury and markers of disseminated intravascular coagulation. All 4 blood culture bottles isolated multidrug-resistant Empedobacter brevis. The patient recovered from his illness and was discharged with ciprofloxacin therapy per susceptibilities. Discussion. This patient represents the first described case of severe septic shock associated with the infusion of a Wallcur simulation product. Intravenous inoculation of a nonsterile fluid is rare and exposes the patient to unusual environmental organisms, toxins, or unsafe fluid characteristics such as tonicity. During course of treatment, we identified the possible culprit to be a multidrug-resistant isolate of Empedobacter brevis. We also discuss the systemic failures that led to this outbreak.

  4. Direct Sowing of Maize


    Alföldi, Thomas; Böhler, Daniel; Dierauer, Hansueli; Hegglin, Django; Böhler, Josef; Breiter, Hanspeter


    In organic farming, the plough is generally used in maize cultivation because it provides a simple way to control weed. Unfortunately, regarding soil erosion, compaction and runoff, ploughing is especially harmful in maize cultivation. Direct sowing of maize could largely solve these problems. The video presents the technique of direct sowing of maize, for example in a field of rolled field pea. In the last years, FiBL tests have shown that under optimal conditions, the direct s...

  5. Directional radiation detectors

    Energy Technology Data Exchange (ETDEWEB)

    Dowell, Jonathan L.


    Directional radiation detectors and systems, methods, and computer-readable media for using directional radiation detectors to locate a radiation source are provided herein. A directional radiation detector includes a radiation sensor. A radiation attenuator partially surrounds the radiation sensor and defines an aperture through which incident radiation is received by the radiation sensor. The aperture is positioned such that when incident radiation is received directly through the aperture and by the radiation sensor, a source of the incident radiation is located within a solid angle defined by the aperture. The radiation sensor senses at least one of alpha particles, beta particles, gamma particles, or neutrons.

  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. Colposcopy - directed biopsy (United States)

    ... squamous cells - colposcopy; Pap smear - colposcopy; HPV - colposcopy; Human papilloma virus - colposcopy; Cervix - colposcopy; Colposcopy Images Female reproductive anatomy Colposcopy-directed biopsy Uterus References American College of ...

  8. Direct-to-Consumer Advertising of Pharmaceuticals (United States)

    Gellad, Ziad F.; Lyles, Kenneth W.


    Since the 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. PMID:17524744

  9. 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.

  10. 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…

  11. On directed coverings

    DEFF Research Database (Denmark)

    Fajstrup, Lisbeth

    In [1], we study coverings in the setting of directed topology. Unfortunately, there is a condition missing in the definition of a directed covering. Some of the results in [1] require this extra condition and in fact it was claimed to follow from the original definition. It is the purpose...

  12. Direct current transformer (United States)

    Khanna, S. M.; Urban, E. W. (Inventor)


    A direct current transformer in which the primary consists of an elongated strip of superconductive material, across the ends of which is direct current potential is described. Parallel and closely spaced to the primary is positioned a transformer secondary consisting of a thin strip of magnetoresistive material.

  13. 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…

  14. Directionality effects in percolation (United States)

    Redner, Sidney

    The percolation properties of random networks containing resistors (two-way streets) and/or diodes (one-way streets) are considered. The directionality constraints of the diodes are found to lead to novel geometrical behavior. As a simple example, various random cluster models with a preferred direction, such as directed random walks or directed lattice animals, are shown to be anisotropic in character. The critical behavior of directed percolation is then treated and its connection with branching Markov processes is explained. A closely related "reverse" percolation problem, a transition from one-way percolation to isotropic percolation, is introduced. Finally, the geometrical properties of a network containing arbitrarily oriented diodes are treated. Symmetry and duality arguments are applied to yield exact results for certain aspects of its critical behavior.

  15. Review of Participatory Epidemiology Practices in Animal Health (1980-2015) and Future Practice Directions (United States)

    Allepuz, Alberto; de Balogh, Katinka; Aguanno, Ryan; Heilmann, Martin; Beltran-Alcrudo, Daniel


    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. PMID:28095472

  16. 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.

  17. New directions in folklore

    National Research Council Canada - National Science Library

    New Directions in Folklore (NDiF) is the refereed online journal of NewFolk, a community of over one hundred scholars, professionals, students, and interested laypersons dedicated to pushing the envelope of scholarship...

  18. Direct Conversion of Energy

    Energy Technology Data Exchange (ETDEWEB)

    Corliss, William R


    Topics include: direct versus dynamic energy conversion; laws governing energy conversion; thermoelectricity; thermionic conversion; magnetohydrodynamic conversion; chemical batteries; the fuel cell; solar cells; nuclear batteries; and advanced concepts including ferroelectric conversion and thermomagnetic conversion.

  19. Advance Directives - Multiple Languages (United States)

    ... Supplements Videos & Tools You Are Here: Home → Multiple Languages → All Health Topics → Advance Directives URL of this page: Other topics A-Z Expand Section ...

  20. 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.

  1. Practical theology: A critically engaged practical reason approach of practice, theory, practice and theory


    John S. Klaasen


    Browning’s influential use of practical reason for his fundamental practical theology is analysed. His correlation of theory and practice in his three stages of theory, practice and theory is also critiqued because his approach reduces practical theology almost to professionalism and principles for ministry. His approach could also result in an antagonistic relationship between practice and theory as practice is reduced to theory or academics. This article seeks to present a critically engage...

  2. 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.

  3. Geothermal direct use engineering and design guidebook (United States)

    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.

  4. 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, we generalize classical depth to directional outlyingness for functional data. We investigate theoretical properties of functional directional outlyingness and find that 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. Using this decomposition, we provide a visualization tool for the centrality of curves. Furthermore, we design an outlier detection procedure 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.

  5. 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.

  6. 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.

  7. Direct Interval Forecasting of Wind Power

    DEFF Research Database (Denmark)

    Wan, Can; Xu, Zhao; Pinson, Pierre


    This letter proposes a novel approach to directly formulate the prediction intervals of wind power generation based on extreme learning machine and particle swarm optimization, where prediction intervals are generated through direct optimization of both the coverage probability and sharpness, wit......, without the prior knowledge of forecasting errors. The proposed approach has been proved to be highly efficient and reliable through preliminary case studies using real-world wind farm data, indicating a high potential of practical application.......This letter proposes a novel approach to directly formulate the prediction intervals of wind power generation based on extreme learning machine and particle swarm optimization, where prediction intervals are generated through direct optimization of both the coverage probability and sharpness...

  8. [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

  9. Directivity of Antenna Arrays (United States)

    Bulgakova, A. A.; Gorobets, N. N.; Katrich, V. A.; Lyashchenko, V. A.


    Purpose: Theoretical investigation of directive gains of linear and planar antenna arrays depending on the distance between radiators and wavelength. Design/methodology/approach: Computing methods in applied mathematics in MathCad were used to calculate the twofold integrals of the radiation pattern over power throughout the whole space observed, defining the directivity in the most general terms. Patterns of radiators, i. e. elements of antenna arrays, are specified by mathematical models. The calculation accounts for the subintegral fast oscillating function. Findings: Calculations and analysis of a directive gain according to the number of radiators and distances between them in fractions of wavelength are made. It is shown that at the ratio of distance between radiators to wave-length being d/λ =0.5 the directivity of array of isotropic radiators is 1.5N², N - number of radiators. When increasing the d/λ to 0.65÷0.97 the directivity increases according to the law close to the linear one up to the maximum possible value for the specified number of radiators. With the increase of d/λ to the values greater than one, the directivity is significantly reduced (the “blinding” effect of non-phased antenna arrays) and its dependence with the growth of d/λ is decaying and oscillating in character. By that, the transfer function of antenna arrays has some vital difference from the transfer function of continuous antennas. Conclusions: Antenna arrays distort the waveform and spectrum of radiated and received signals as a result of irregular changes of their directivity depending on wavelength. The detected “blinding” effect of non-phased antenna arrays of large electrical dimensions must be taken into account in wideband and superwideband radio-electronics systems, especially in radio astronomy, telecommunications systems and superwideband radar.

  10. Sonorizing Melodramatic Stage Directions

    DEFF Research Database (Denmark)

    Hesselager, Jens


    the reconstructed, composite melodramatic text, and reflect on the types of theatrical acts it may testify to. The article suggests the term ‘reflexive performance’ for the type of performance that should be practiced within this workshop format. ‘Reflexive performance’ is defined as a type of ‘restored behaviour...

  11. 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…

  12. Selection of direct restorative and rooting filling materials by Kenyan ...

    African Journals Online (AJOL)

    Objectives: To establish the categories of direct restorative and root filling materials used by dentists in Kenya as well as the factors considered in their selection. Design: A descriptive cross-sectional study. Setting: Public and private dental practices in major towns in Kenya. Participants: Registered, practicing dentists in ...

  13. 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

  14. 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.

  15. Managerial practices of nonprofit organizations

    Directory of Open Access Journals (Sweden)

    Venet Shala


    Full Text Available The increasing number of non-governmental organizations around the world, their transformation from citizen initiatives into small civic organizations, and then into international organizations in the most powerful countries, created enough room for more contribution to citizen’s welfare. This also proves that these NGOs have used their experience driven success manuals and have those incorporated within their management practices to achieve their goals. During the last years, the number of books and studies that have been published on understanding the importance of managerial practices in non-profit t organizations at international level has increased. This research will try to explain the irreplaceable role that management practices have in the development and strengthening of an NGO, and in the implementation of financial and human resource management. Also, we will try to present the most realistic situation of NGOs studied in this research, so that our work could directly affect them to improve their performance.

  16. Pipeline purging principles and practice

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, J.E.; Svedeman, S.J.; Kuhl, C.A. [Southwest Research Inst., San Antonio, TX (United States); Gregor, J.G. [Gas Research Inst., Chicago, IL (United States); Lambeth, A.K. [Texas Eastern Transmission Corp., Houston, TX (United States)


    Gas purging, a process of displacing one gas by another gas, occurs on a routine basis in the natural gas industry when pipelines are purged into and out of service. In a project sponsored by the Gas Research Institute and in cooperation with the American Gas Association (A.G.A.) the purging practices as outlined in the A.G.A.`s Purging Principles and Practices manual are being reviewed because many of today`s pipeline purging operations occur under conditions not addressed directly in the manual. The program focus is on the purging procedures outlined in Chapter 8 of the manual entitled Gas Transmission and Distribution pipes. The technical objective of the project is to develop an understanding of the scientific principles upon which safe, practical purging practices can be based. Direct displacement and inert gas slug purging operations are explained in terms of dispersion and mixing parameters and their relationship to the gas velocity. Field data is compared to the results of an analytical mixing model. Computer software for planning safe and cost effective pipeline purges has been developed. Finally, recommendations for revising Chapter 8 of the A.G.A. manual are presented.


    Directory of Open Access Journals (Sweden)

    Izet Kahrović


    Full Text Available Hit directly, giving any impact maximum muscle strength is skill, and it is neces- sary to the exercise and learning to make it perfect. Training begins with oral statement, so that students get to know with the techni- que that works. After oral exposure, it is necessary to create a good notion on technology that is adopted. The best way for the creation of good notion is a good demonstration. In direct training kicks in the box, you need patience and gradualness and there- fore uses a large number of additional exercises. In their work with beginners, in the first class, individual elements of technology, and also direct blow, it is necessary to separate the parts and run them on multiple commands, to later come to the confluence in one command. Direct wounds, with left and right hand, can be run from the towns, on the head and body, from the movement, to step forward, step back and step aside, the remedy to the left and right side. Left direct is taking out from a running protrusion hands, but kick, which is a pro- duct of the system, ankle-knee-pelvis and shoulder forward horizontaly. Set at the time of stripes, body weight over the left leg. Right direct from the place, starting ekscentrical reflecsive impuls of a extensor muscle in ankle, knee and joint of a hip.This kind of a sud- den movement is running simultaneously with the rotation of the body around vertical (longitudinal axis, with the transfer body weight on the left leg. Further movement to the hand which serves as a lever, which is transmitted through the power stroke

  18. Incretin secretion: direct mechanisms

    DEFF Research Database (Denmark)

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


    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......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...

  19. 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

  20. Directed Line Liquids (United States)

    Kamien, Randall David

    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. We first study nematic polymers dissolved in a nematic solvent. We show that in the dense phase nematic polymers interacting directly through excluded volume and indirectly through nematic solvent fluctuations are, at long wavelengths, identical to nematic polymers in an isotropic solvent, interacting through, again, excluded volume as well as their nematic degrees of freedom. By including the effects of free ends we study ferro- and electrorheological fluids and finite chain length polymers. In the dilute phase, near the transition to the semi-dilute phase, a renormalization group treatment is performed, in the physical and critical dimension 3. For sufficiently dilute systems we find logarithmic corrections to polymer wandering, predicted by de Gennes. However, at higher densities, the logarithmic enhancement is suppressed, and the polymers execute conventional random walks along the preferred axis. We then study the isotropic to nematic transition in this same system of liquid-crystalline polymers. Using the replica technique introduced by de Gennes to study isotropic polymers, we formulate a fully isotropic theory of liquid-crystalline polymers dissolved in a liquid crystal matrix. The first order transition from isotropic to nematic ordering occurs, and leads to the original directed polymer theory previously studied. In agreement with physical expectations, the nematic ordering temperature is depressed by polymerization. Finally, we go back to directed systems, in this case directed by an explicit symmetry violation instead of spontaneously. We discuss how directed polymer melts, string-like formations in electrorheological and ferro

  1. Direct Photons at RHIC


    David, G.; Collaboration, for the PHENIX


    Direct photons are ideal tools to investigate kinematical and thermodynamical conditions of heavy ion collisions since they are emitted from all stages of the collision and once produced they leave the interaction region without further modification by the medium. The PHENIX experiment at RHIC has measured direct photon production in p+p and Au+Au collisions at 200 GeV over a wide transverse momentum ($p_T$) range. The $p$ + $p$ measurements allow a fundamental test of QCD, and serve as a bas...


    Directory of Open Access Journals (Sweden)

    A. V. Vedeneev


    Full Text Available Analysis of the world practice and comparison with the competitors data shows, that for keeping up of RUP “BMZ'' competitiveness it is necessary to carry out works in directions of perfection of the steel wire cord production technology, development of steel wire cord, development of the breaker constructions with the high infiltration of rubber of wire with superstandard diameter and etc.

  3. 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...

  4. Directional gamma detector (United States)

    LeVert, Francis E.; Cox, Samson A.


    An improved directional gamma radiation detector has a collector sandwiched etween two layers of insulation of varying thicknesses. The collector and insulation layers are contained within an evacuated casing, or emitter, which releases electrons upon exposure to gamma radiation. Delayed electrons and electrons entering the collector at oblique angles are attenuated as they pass through the insulation layers on route to the collector.

  5. Assessing directionality in context

    African Journals Online (AJOL)

    Kate H

    The directionality debate in interpreting revolves around the question of whether and how. (simultaneous) ... factor, namely interpreters' familiarity with the context of the speech to be interpreted, and interpreting ...... Translation Studies: Selected Contributions from the EST Congress, Copenhagen 2001. Amsterdam and ...

  6. Summary and future directions

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Summary and future directions. Reservoirs of HEV. Subclinical infection: likely; Animals: unlikely to be important in India. HEV infection in cirrhosis leads to decompensation. Immune responses. CD8 cells unlikely to play a role in liver injury; Non-specific immune ...

  7. [Direct bonding in orthodontics]. (United States)

    Hablützel, W


    Composite materials have been used to attach orthodontic brackets on the conditioned enamel surface. A method of direct bonding with Enamelite of metal brackets with a mechanical retention on the basis is described. Clinical experience with the adhesive technique, its range of indication and possible failures are discussed in several case reports.

  8. 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...

  9. 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...

  10. Conclusions and Future Directions (United States)

    Lillibridge, Fred


    Benchmarking, when done properly, offers a lot of promise for higher education units that want to improve how they do business. It is clear that much is known, but still more needs to be learned before it reaches its full potential as a useful tool. Readers of this issue of "New Directions for Institutional Research" have been treated to useful…

  11. 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.

  12. The Directed Case Method. (United States)

    Cliff, William H.; Curtin, Leslie Nesbitt


    Provides an example of a directed case on human anatomy and physiology. Uses brief real life newspaper articles and clinical descriptions of medical reference texts to describe an actual, fictitious, or composite event. Includes interrelated human anatomy and physiology topics in the scenario. (YDS)

  13. Direction des Publications

    African Journals Online (AJOL)


    oxydation diminue avec l‟augmentation de la teneur en Al. Mots clés: Alliage Fe -Al- Mécanosynthèse – Nanomatériaux - oxydation haute température. Absract. Currently, research is directed towards the production of materials ...

  14. 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...

  15. General practice registrars. (United States)

    Harding, Catherine; Seal, Alexa; McGirr, Joe; Caton, Tim


    The models of practice that general practice registrars (GPRs) envisage undertaking will affect workforce supply. The aim of this research was to determine practice intentions of current GPRs in a regional general practice training program (Coast City Country General Practice Training). Questionnaires were circulated to 220 GPRs undertaking general practice placements to determine characteristics of ideal practice models and intentions for future practice. Responses were received for 99 participants (45%). Current GPRs intend to work an average of less than eight half-day sessions/week, with male participants intending to work more hours (t(91) = 3.528, P = 0.001). More than one-third of this regional cohort intends to practice in metropolitan centres. Proximity to family and friends was the most important factor influencing the choice of practice location. Men ranked remuneration for work as more important (t (88) = -4.280, P GPRs into rural practice.

  16. Measuring health literate discharge practices. (United States)

    Innis, Jennifer; Barnsley, Jan; Berta, Whitney; Daniel, Imtiaz


    Purpose Health literate discharge practices meet patient and family health literacy needs in preparation for care transitions from hospital to home. The purpose of this paper is to measure health literate discharge practices in Ontario hospitals using a new organizational survey questionnaire tool and to perform psychometric testing of this new survey. Design/methodology/approach This survey was administered to hospitals in Ontario, Canada. Exploratory factor analysis and reliability testing were performed. Findings The participation rate of hospitals was 46 percent. Exploratory factor analysis demonstrated that there were five factors. The survey, and each of the five factors, had moderate to high levels of reliability. Research limitations/implications There is a need to expand the focus of further research to examine the experiences of patients and families. Repeating this study with a larger sample would facilitate further survey development. Practical implications Measuring health literate discharge practices with an organizational survey will help hospital managers to understand their performance and will help direct quality improvement efforts to improve patient care at hospital discharge and to decrease hospital readmission. Originality/value There has been little research into how patients are discharged from hospital. This study is the first to use an organizational survey tool to measure health literate discharge practices.

  17. 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...... to propose a research design to study the influence of being currently engaged in entrepreneurial behavior on entrepreneurial intention. We introduce individual’s age as an additional moderator of the effects of directly experiencing entrepreneurial behavior. We use PLS-MGA to complete a multi-group SEM...... analysis for different groups of individuals (from a sample of 430), comparing groups based on their entrepreneurial activity and age group. Results of this research work evidence that current engagement in entrepreneurship activities produces significant differences in the intention to start a new venture...

  18. 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.

  19. Analysis of Direct Costs


    Terri W. Thomas


    DroTech and VectorCal are both operating in drone navigation system industry. Both DroTech and VectorCal are proficient organizations, equipped with adequate resources to enhance the value of services which are offered in relevance to drone technology, ranging from, leisure travel expeditions, construction zoning, and requirements for military applications. This paper discusses the main production costs which incur in production of VectorCal’s drone navigation system, the direct and indirect ...

  20. Future directions for QCD

    Energy Technology Data Exchange (ETDEWEB)

    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.

  1. The practice portrait

    DEFF Research Database (Denmark)

    Thomsen, Rie


    to nurture this ability. The practice portrait was developed within the tradition of critical psychology to reduce the gap between research and practice by giving voice to practitioners in various social practices. In this article, I use the practice portrait alongside practitioners at a university career...

  2. [Advance directives. Representatives' opinions]. (United States)

    Busquets I Font, J M; Hernando Robles, P; Font I Canals, R; Diestre Ortin, G; Quintana, S

    The use and usefulness of Advance Directives has led to a lot of controversy about their validity and effectiveness. Those areas are unexplored in our country from the perspective of representatives. To determine the opinion of the representatives appointed in a registered Statement of Advance Directives (SAD) on the use of this document. Telephone survey of representatives of 146 already dead people and who, since February 2012, had registered a SAD document. More the two-thirds (98) of respondents recalled that the SAD was consulted, with 86 (58.9%) saying that their opinion as representative was consulted, and 120 (82.1%) believe that the patient's will was respected. Of those interviewed, 102 (69.9%) believe that patients who had previously planned their care using a SAD had a good death, with 33 (22.4%) saying it could have been better, and 10 (6.9%) believe they suffered greatly. The SAD were mostly respected and consulted, and possibly this is related to the fact that most of the representatives declare that the death of those they represented was perceived as comfortable. It would be desirable to conduct further studies addressed at health personnel in order to know their perceptions regarding the use of Advance Directives in the process of dying. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Direct imaging of exoplanets. (United States)

    Lagrange, Anne-Marie


    Most of the exoplanets known today have been discovered by indirect techniques, based on the study of the host star radial velocity or photometric temporal variations. These detections allowed the study of the planet populations in the first 5-8 AU from the central stars and have provided precious information on the way planets form and evolve at such separations. Direct imaging on 8-10 m class telescopes allows the detection of giant planets at larger separations (currently typically more than 5-10 AU) complementing the indirect techniques. So far, only a few planets have been imaged around young stars, but each of them provides an opportunity for unique dedicated studies of their orbital, physical and atmospheric properties and sometimes also on the interaction with the 'second-generation', debris discs. These few detections already challenge formation theories. In this paper, I present the results of direct imaging surveys obtained so far, and what they already tell us about giant planet (GP) formation and evolution. Individual and emblematic cases are detailed; they illustrate what future instruments will routinely deliver for a much larger number of stars. I also point out the limitations of this approach, as well as the needs for further work in terms of planet formation modelling. I finally present the progress expected in direct imaging in the near future, thanks in particular to forthcoming planet imagers on 8-10 m class telescopes.

  4. 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.

  5. Stress and practical assessments


    Clarke, Neil D.; Gardiner, Nick


    This paper explores the role of stress in practical assessments, which have long been used in an academic Sports Science and Sports Therapy setting. Practical exams have the potential to assess many aspects of both theory and practice. They are especially important for assessing a student’s competence in performance of a particular skill. In addition, practical exams are designed to recreate the stresses of a clinical environment (Rushforth, 2006). The practical exams for Sports Therapy also ...

  6. Practical ways to facilitate ergonomics improvements in occupational health practice. (United States)

    Kogi, Kazutaka


    Recent advances in participatory programs for improving workplace conditions are discussed to examine practical ways to facilitate ergonomics improvements. Participatory training programs are gaining importance, particularly in promoting occupational health and safety in small-scale workplaces. These programs have led to many improvements that can reduce work-related risks in varied situations. Recent experiences in participatory action-oriented training programs in small workplaces and agriculture are reviewed.The emphasis of the review is on training steps, types of improvements achieved, and the use of action tools by trainers and training participants. Immediate improvements in multiple technical areas are targeted, including materials handling,workstation design, physical environment, welfare facilities, and work organization. In facilitating ergonomics improvements in each local situation, it is important to focus on (a) building on local good practices; (b) applying practical, simple improvements that apply the basic principles of ergonomics; and (c) developing action-oriented toolkits for direct use by workers and managers. This facilitation process is effective when locally designed action toolkits are used by trainers, including local good examples, action checklists, and illustrated how-to guides. Intervention studies demonstrate the effectiveness of participatory steps that use these toolkits in promoting good practices and reducing work-related risks. In facilitating ergonomics improvements in small-scale workplaces, it is important to focus on practical, low-cost improvements that build on local good practices. The use of action-oriented toolkits reflecting basic ergonomics principles is helpful.The promotion of the intercountry networking of positive experiences in participatory training is suggested.


    Directory of Open Access Journals (Sweden)



    Full Text Available Direct selling, as a type of relationship marketing, facilitates the construction of a customized relation between the company and its clients and assures a long term collaboration between the two parts. For a direct selling company, direct marketing is a powerfull tool used to build strong relationships with the clients. There are more viewpoints regarding the relation between direct selling and direct marketing. The purpose of the research is to investigate the relation between direct selling through salesmen and/or catalogues and direct marketing. The objectives are: (1 to synthetize the approaches regarding the direct selling through salesmen and/or catalogues as a type of direct marketing; (2 to present and to argue the researcher’s own viewpoint. We consider that direct selling is a component of direct marketing.

  8. Previous Experience a Model of Practice UNAE


    Ruiz, Ormary Barberi; Pesántez Palacios, María Dolores


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

  9. Communication Technology Integration into Social Work Practice


    Angela N. Bullock; Alex D. Colvin


    The uses for communication technology continue to grow in the United States. Technology is changing how people collect and share information and is reshaping how people interact with one another. As a result of this transformation, the use of technology has evolved in social work practice. Communication technology is being incorporated into traditional social work practice for administrative and therapeutic purposes. This article will examine a theoretically based direction for the future c...

  10. Practical Tips for Increasing Listening Practice Time (United States)

    McCaughey, Kevin


    Learning a language--like learning to dance ballet, weaving carpets, or playing the saxophone--takes time and practice. In general, it is safe to say that the more practice one gets, the better one will become. This article will help teachers of English reconsider how to think about listening tasks. It will provide guidance for increasing…

  11. Practical Epistemologies in Physical Education Practice (United States)

    Quennerstedt, Mikael


    With a point of departure in a transactional understanding of epistemology, the purpose of this paper is to explore practical epistemologies in physical education (PE) by investigating how knowledge is produced and reproduced in students' and teachers' actions in PE practices posted as clips on the user-generated video-sharing website…

  12. On Direct Social Perception. (United States)

    Spaulding, Shannon


    Direct Social Perception (DSP) is the idea that we can non-inferentially perceive others' mental states. In this paper, I argue that the standard way of framing DSP leaves the debate at an impasse. I suggest two alternative interpretations of the idea that we see others' mental states: others' mental states are represented in the content of our perception, and we have basic perceptual beliefs about others' mental states. I argue that the latter interpretation of DSP is more promising and examine the kinds of mental states that plausibly could satisfy this version of DSP. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. 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...

  14. Reciprocity in directed networks (United States)

    Yin, Mei; Zhu, Lingjiong


    Reciprocity is an important characteristic of directed networks and has been widely used in the modeling of World Wide Web, email, social, and other complex networks. In this paper, we take a statistical physics point of view and study the limiting entropy and free energy densities from the microcanonical ensemble, the canonical ensemble, and the grand canonical ensemble whose sufficient statistics are given by edge and reciprocal densities. The sparse case is also studied for the grand canonical ensemble. Extensions to more general reciprocal models including reciprocal triangle and star densities will likewise be discussed.

  15. 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.

  16. 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....

  17. Center for Practical Bioethics (United States)

    ... 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 ...

  18. The Amherst study of hospital marketing practices. (United States)

    Robbins, S A; Kane, C M; Sullivan, D J


    The study findings identify two major area of concern related to marketing and the direction the field is taking. First, health care marketing--though much discussed and expensive--is still in a stage of immaturity. As practiced in hospitals today, marketing is frequently synonymous with advertising. Second, marketing in health care will not ultimately be a "clone" of marketing practices in industry and retailing. Though hospitals are looking to those areas for knowledge and expertise, the unique character of the product will cause health care marketing to evolve into a practice uniquely different from that in other industries.

  19. The practical skills of newly qualified nurses

    DEFF Research Database (Denmark)

    Danbjørg, Dorthe Boe; Birkelund, Regner


    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...... 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....

  20. 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...

  1. Knowledge management systems in practice

    DEFF Research Database (Denmark)

    Tørning, Kristian

    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...... 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...

  2. Community of practice and situated learning

    Directory of Open Access Journals (Sweden)

    Nives Ličen


    Full Text Available The importance of everyday life learning or situated learning is growing, and new models for interpretation and re- search are being developed in concordance with new knowledge concepts and theories of learning. The article brings an analysis of situated learning as a type of learning without a fixed structure which develops (transforms into an organized and structured learning form. The first part examines the concept of situated learning and the theoretical context of the model of communities of practice. The second part presents a comparative analysis of two models of situ- ated learning, action learning and the community of practice, as the forms which support transmission of information and knowledge and imply innovation development. Both models are rooted in the context of poststructuralist practice theory and transformative learning theories. Advantages and deficiencies of the analysed models direct the practical use of action learning or communities of practice.

  3. Practical theology: A critically engaged practical reason approach of practice, theory, practice and theory

    Directory of Open Access Journals (Sweden)

    John S. Klaasen


    Full Text Available Browning’s influential use of practical reason for his fundamental practical theology is analysed. His correlation of theory and practice in his three stages of theory, practice and theory is also critiqued because his approach reduces practical theology almost to professionalism and principles for ministry. His approach could also result in an antagonistic relationship between practice and theory as practice is reduced to theory or academics. This article seeks to present a critically engaged practical reasoning approach in which theory and practice have an in-ter-dependent relationship. Practical reason is an activity in which engagement happens at every stage. For this to happen, theory and practice interact as equal variables that have a bearing on each other not to reduce the one to the other, but to complement each other in a lateral hermeneutical process. This process has four stages, unlike Browning’s three-stage correlation. The stages are schematically presented as practice, theory, practice and theory.

  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. 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.

  6. Direct diverticular inguinal hernia

    Energy Technology Data Exchange (ETDEWEB)

    Ekberg, O.; Kullenberg, K.

    Nineteen patients with direct diverticular inguinal hernia (DDIH) were examined with herniography and surgically explored. A lump medially in the groin and pain were the prominent clinical manifestations in 18 patients. Physical examination indicated the presence of a DDIH in 6 patients. In 16 patients herniography revealed hernial sacs protruding from the supravesical fossa in 5 and from the medial inguinal fossa in 11. At operation a circumscribed defect was found in the transverse fascia laterally and cranially to the pubic tubercle in all patients. In 16 patients peritoneal hernial sacs were demonstrated at surgery while in 3 only lipomas (fatty hernia) were contained within the defect. In our opinion DDIH is a specific variety of inguinal hernia with a fairly typical clinical presentation and radiographic appearance but probably often overlooked at surgery.


    Directory of Open Access Journals (Sweden)

    M. Bláha


    Full Text Available UAV systems have become an attractive data acquisition platform in emerging applications. As measuring instrument they extend the lineup of possible surveying methods in the field of geomatics. However, most of UAVs are equipped with low-cost navigation sensors such as GPS or INS, allowing a positioning accuracy of 3 to 5 m. As a result the acquired position- and orientation data fea- tures a low accuracy which implicates that it cannot be used in applications that require high precision data on cm-level (e.g. direct georeferencing. In this paper we will analyze the potential of differential post-processing of GPS data from UAV in order to im- prove the positioning accuracy for applications basing on direct georeferencing. Subsequently, the obtained results are compared and verified with a track of the octocopter carried out with a total station simultaneously to the GPS data acquisition. The results show that the differential post-processing essentially improved the accuracy of the Falcon position data. Thereby the average offset be- tween the data sets (GPS data, track and the corresponding standard deviation is 0.82 m and 0.45 m, respectively. However, under ideal conditions it is even possible to improve this positioning accuracy to the cm-range. Furthermore, there are still several sources of error such as the offset between the GPS antenna of the Falcon 8 and the prism which is used for the track. Considering this fact there is further room for improvement regarding the here discussed positioning method.

  8. 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.

  9. Educating Advanced Practice Nurses for Practice Reality. (United States)

    Hamric, Ann B.; Hanson, Charlene M.


    Explains why content related to role acquisition and transition is critical in preparing advanced practice nurses. Recommends teaching strategies and timing and placement options for role content in graduate education. (Contains 26 references.) (SK)

  10. Danish Chiropractic Practice

    DEFF Research Database (Denmark)

    Myburgh, Cornelius; Boyle, Eleanor; Christensen, Henrik Wulff

    Objectives: To develop a contemporary, patient-oriented perspective of chiropractic private practice, as reflected by the setting, practice models and clinical interactions observable in Denmark. Methods: A qualitative point-of-view investigation was conducted making use of participant observation...... value competence and professionalism in their clinical encounter with their chiropractor. Conclusion: Danish chiropractic practice is strongly influenced by modern consumer behaviour and team-oriented practice trends. Furthermore, the administrative hub plays an important role in operationalizing...

  11. Motivating students through practice


    Dzamtoska-Zdravkovska, Suzana


    Application of theory in practice is a challenge for every teacher who seeks knowledge gained during the class to be implemented in practice by the students. In fact, the practical application is a proof of knowledge. If students during their studies have the opportunity to practically apply and upgraded their knowledge, we certainly can confirm that the student has acquired the necessary knowledge and skills provided by the study program (or subject). Within the study program in Journali...

  12. Renegotiating "best treatment practice"

    DEFF Research Database (Denmark)

    Søndergaard, Katia Dupret


    This paper discusses re-accentuated ways of practicing psychiatric treatment. More generally it discusses how an initiative to change local practices in an organisation is taken up and fought for and against by people and things with different competing interests.......This paper discusses re-accentuated ways of practicing psychiatric treatment. More generally it discusses how an initiative to change local practices in an organisation is taken up and fought for and against by people and things with different competing interests....

  13. 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 ...

  14. 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.

  15. 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...... and managers interested in understanding how responsible business practices may be collectively organized....

  16. Directed polymerase evolution. (United States)

    Chen, Tingjian; Romesberg, Floyd E


    Polymerases evolved in nature to synthesize DNA and RNA, and they underlie the storage and flow of genetic information in all cells. The availability of these enzymes for use at the bench has driven a revolution in biotechnology and medicinal research; however, polymerases did not evolve to function efficiently under the conditions required for some applications and their high substrate fidelity precludes their use for most applications that involve modified substrates. To circumvent these limitations, researchers have turned to directed evolution to tailor the properties and/or substrate repertoire of polymerases for different applications, and several systems have been developed for this purpose. These systems draw on different methods of creating a pool of randomly mutated polymerases and are differentiated by the process used to isolate the most fit members. A variety of polymerases have been evolved, providing new or improved functionality, as well as interesting new insight into the factors governing activity. Copyright © 2013 Federation of European Biochemical Societies. Published by Elsevier B.V. All rights reserved.

  17. 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

  18. 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....

  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. Anatomical applications of a new direct Ceromer. (United States)

    Dietschi, D


    Composite resin materials have become the basic restorative materials of the modern aesthetics-oriented practice. However, the application of composite resin in posterior teeth remains a challenge as a result of its handling characteristics and chairside stratification. New ceramic optimized polymers (ceromers), such as Tetric Ceram (Ivoclar Vivadent, Amherst, NY), now offer versatility and improved handling properties in response to increasing clinical demand for producing high-quality natural restorations. With a well-designed instrumentation, the work of the clinician may be greatly facilitated. This article evaluates the selection and utilization of a direct ceromer material for posterior restorations and presents a predictable method to achieve aesthetic restorations.

  1. Lexical Concept Distribution Reflects Clinical Practice


    Breydo, Eugene; Shubina, Maria; Shalaby, James W.; Einbinder, Jonathan S.; Turchin, Alexander


    It is not known whether narrative medical text directly reflects clinical reality. We have tested the hypothesis that the pattern of distribution of lexical concept of medication intensification in narrative provider notes correlates with clinical practice as reflected in electronic medication records.

  2. 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.

  3. Do Hiring Practices Affect Retention Rates? (United States)

    Ash, Karin S.


    Examines the influence of rotational training and direct hire programs on attrition. Survey of graduates (N=311) reveals that there was no significant difference in the respondents' length of stay with their employers, regardless of the organizations' hiring practices. Voluntary departure from employment was attributable more often to young adult…

  4. Traditional ecological knowledge and restoration practice (United States)

    René Senos; Frank K. Lake; Nancy Turner; Dennis Martinez


    Ecological restoration is a process, a directed action aimed at repairing damage to ecocultural systems for which humans are responsible. Environmental degradation has impaired the functioning of both ecological and cultural systems and disrupted traditional practices that maintained these systems over several millennia. Indigenous and local peoples who depend...

  5. Knowledge and Architectural Practice

    DEFF Research Database (Denmark)

    Verbeke, Johan


    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....... Specific to these research projects is that the researcher is within academia but stays emerged in architectural practice. The projects contribute to a better understanding of architectural practice, how it develops and what kind of knowledge is crucial. Furthermore, the paper will develop a reflection...

  6. Communication as practice

    DEFF Research Database (Denmark)

    Gholamian, Jamshid


    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 eve...... empirical examples from a conversation between teachers and parents in a school context. Keywords: practice, practice theory, dialogue, Bakhtin, conversation analysis, communication as practice....... 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...

  7. 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.

  8. 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.

  9. 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.

  10. Efficient multi-site-directed mutagenesis directly from genomic ...

    Indian Academy of Sciences (India)

    In this article, the traditional multi-site-directed mutagenesis method based on overlap extension PCR was improved specifically for complicated templates, such as genomic sequence or complementary DNA. This method was effectively applied for multi-site-directed mutagenesis directly from mouse genomic DNA, as well ...

  11. Future directions of MDSplus

    Energy Technology Data Exchange (ETDEWEB)

    Manduchi, G., E-mail: [Consorzio RFX, Corso Stati Uniti 4, 35127 Padova (Italy); Fredian, T., E-mail: [Massachusetts Institute of Technology, 175 Albany Street, Cambridge, MA 02139 (United States); Stillerman, J., E-mail: [Massachusetts Institute of Technology, 175 Albany Street, Cambridge, MA 02139 (United States)


    Highlights: • This paper describes the directions in the evolution of the MDSplus data system. • It describes three Use Cases in data streaming. • It shows the performance of MDSplus in local and remote data streaming. • It describes the main concepts in decoupling data access. • It presents the last features and tools. - Abstract: The first version of MDSplus was released in 1991 for VAX/VMS. Since then MDSplus has been progressively adopted in an increasing number of fusion experiments and its original implementation has been extended during these years to cover new requirements and toward a multi-platform implementation. Currently MDSplus is in use at more than 30 laboratories and is being used both for pulsed applications as well as for continuous data streaming for long lasting experiments. Thanks to its large user base, it has been possible to collect requirements driving the evolution of the system toward improved usability and better performance. An important recent feature of the MDSplus is its ability of handling a continuous stream of data, which is readily available as soon at it has been stored in the pulse files. Current development is oriented toward an improved modularity of MDSplus and the integration of new functionality. Improved modularity is achieved by moving away from monolithic implementation toward a plug-ins approach. This has already been achieved recently for the management of remote data access, where the original TCP/IP implementation can now be integrated with new user-provided network protocols. Following a similar approach, work is in progress to let new back-ends be integrated in the MDSplus data access layer. By decoupling the MDSplus data management from the disk data file format it is possible to integrate new solutions such as data cloud without affecting the user Application Programming Interface.

  12. Identification of Directional Couplings (United States)

    Bezruchko, Boris P.; Smirnov, Dmitry A.

    An important piece of information, which can be extracted from parameters of empirical models, is quantitative characteristics of couplings between processes under study. The problem of coupling detection is encountered in multiple fields including physics (Bezruchko et al., 2003), geophysics (Maraun and Kurths, 2005; Mokhov and Smirnov, 2006, 2008; Mosedale et al., 2006; Palus and Novotna, 2006; Verdes, 2005; Wang et al., 2004), cardiology (Rosenblum et al., 2002; Palus and Stefanovska, 2003) and neurophysiology (Arnhold et al., 1999; Brea et al., 2006; Faes et al., 2008; Friston et al., 2003; Kreuz et al., 2007; Kiemel et al., 2003; Le Van Quyen et al., 1999; Mormann et al., 2000; Osterhage et al., 2007; Pereda et al., 2005; Prusseit and Lehnertz, 2008; Smirnov et al., 2005; Romano et al., 2007; Schelter et al., 2006; Schiff et al., 1996; Sitnikova et al., 2008; Smirnov et al., 2008, Staniek and Lehnertz, 2008; Tass, 1999; Tass et al., 2003). Numerous investigations are devoted to synchronisation, which is an effect of interaction between non-linear oscillatory systems (see, e.g., Balanov et al., 2008; Boccaletti et al., 2002; Hramov and Koronovskii, 2004; Kreuz et al., 2007; Maraun and Kurths, 2005; Mormann et al., 2000; Mosekilde et al., 2002; Osipov et al., 2007; Palus and Novotna, 2006; Pikovsky et al., 2001; Prokhorov et al., 2003; Tass et al., 2003). In the last decade, more careful attention is paid to directional coupling analysis. Such characteristics might help, e.g., to localise an epileptic focus (a pathologic area) in the brain from electroencephalogram (EEG) or magnetoencephalogram (MEG) recordings: hypothetically, an increasing influence of an epileptic focus on adjacent areas leads to the seizure onset for some kinds of epilepsy.

  13. Improving clinical practice guidelines for practicing cardiologists. (United States)

    Benhorin, Jesaia; Bodenheimer, Monty; Brown, Mary; Case, Robert; Dwyer, Edward M; Eberly, Shirley; Francis, Charles; Gillespie, John A; Goldstein, Robert E; Greenberg, Henry; Haigney, Mark; Krone, Ronald J; Klein, Helmut; Lichstein, Edgar; Locati, Emanuela; Marcus, Frank I; Moss, Arthur J; Oakes, David; Ryan, Daniel H; Bloch Thomsen, Poul E; Zareba, Wojciech


    Cardiac-related clinical practice guidelines have become an integral part of the practice of cardiology. Unfortunately, these guidelines are often long, complex, and difficult for practicing cardiologists to use. Guidelines should be condensed and their format upgraded, so that the key messages are easier to comprehend and can be applied more readily by those involved in patient care. After presenting the historical background and describing the guideline structure, we make several recommendations to make clinical practice guidelines more user-friendly for clinical cardiologists. Our most important recommendations are that the clinical cardiology guidelines should focus exclusively on (1) class I recommendations with established benefits that are supported by randomized clinical trials and (2) class III recommendations for diagnostic or therapeutic approaches in which quality studies show no benefit or possible harm. Class II recommendations are not evidence based but reflect expert opinions related to published clinical studies, with potential for personal bias by members of the guideline committee. Class II recommendations should be published separately as "Expert Consensus Statements" or "Task Force Committee Opinions," so that both majority and minority expert opinions can be presented in a less dogmatic form than the way these recommendations currently appear in clinical practice guidelines. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Achieving optimal business performance through business practices ...

    African Journals Online (AJOL)

    marketing practices, strategic planning practices, human resource management practices, risk management practices, performance management practices and teamwork practices) have a positive and significant relationship with SME performance.

  15. 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 source...... to digital fabrication. However appropriate methods and techniques are just surfacing and need further development as they remain sequential in nature and lack an understanding of the inter-scalar relationship within material organization....... 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...

  16. 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.

  17. Forman curvature for directed networks

    CERN Document Server

    Sreejith, R P; Saucan, Emil; Samal, Areejit


    A goal in network science is the geometrical characterization of complex networks. In this direction, we have recently introduced the Forman's discretization of Ricci curvature to the realm of undirected networks. Investigation of Forman curvature in diverse model and real-world undirected networks revealed that this measure captures several aspects of the organization of complex undirected networks. However, many important real-world networks are inherently directed in nature, and the Forman curvature for undirected networks is unsuitable for analysis of such directed networks. Hence, we here extend the Forman curvature for undirected networks to the case of directed networks. The simple mathematical formula for the Forman curvature in directed networks elegantly incorporates node weights, edge weights and edge direction. By applying the Forman curvature for directed networks to a variety of model and real-world directed networks, we show that the measure can be used to characterize the structure of complex ...

  18. 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...

  19. Sputum direct fluorescent antibody (DFA) (United States)

    ... ency/article/003553.htm Sputum direct fluorescent antibody (DFA) test To use the sharing features on this page, please enable JavaScript. Sputum direct fluorescent antibody (DFA) is a lab test that looks for micro- ...

  20. Indigenous Brazilian Management Practices

    Directory of Open Access Journals (Sweden)

    Zandra Balbinot


    Full Text Available The present research seeks to understand to what extent companies in emerging countries, specifically, Brazilian, adopt dominant management practices, the so-called Euro-American practices, possess their one, or show a syncretism between the two. Methods: Mixed research. One phase was to collect data using a survey about cultural dimensions adopted from GLOBE (House 1998 management practices and also from Brazilian academy. Another was to collect data through interviews, which were analyzed in parallel. Results: Of the seven dominant cultural dimensions, indigenous practices influenced two. Another three were influenced by dominant management practices. Two of the local dimensions, even with internationalization, merged practices with Brazilian cultural traits. Even so, the practices derived from Jeitinho diminished relative to the international relations and experience of managers. Conclusions: The paper shows the existence of powerful Brazilian Indigenous Managerial Practices such as personalism and formalism. These practices have great influence on international business negotiations. On the other hand, it also shows that there are still dominant managerial practices specially in the case of more internationalized Brazilian managers

  1. High pressure direct injection

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, J. [Cummins Westport Inc., Vancouver, BC (Canada)


    A brief overview of Cummins Westport was provided, indicating that Westport originated in the 1980s through a research team at the University of British Columbia, and the hiring of the first employees began in 1996. The joint venture between Cummins and Westport was formed in March 2001. Cummins is the largest builder of commercial diesels in the world, and Westport is a small incubation technology company with emphasis on natural gas. The contribution of each company benefits the joint venture. Cummins brings traditional expertise in product and process development and distribution system, while Westport contributes new high pressure direct injection (HPDI) technology, funding and enthusiasm. The same base engine is kept and only the fuel system is changed. HPDI uses diesel cycle combustion and diesel pilot ignites natural gas. It allows for low emissions, high performance, high efficiency and economic payback. The pilot-ignited HPDI technology was explained, and its application to large class-8 trucks was discussed. The efficiency and performance of diesel engines is maintained by HPDI technology, there are 40 per cent reductions in nitrous oxide emissions, particulate matter emissions are reduced by 60 per cent, and carbon dioxide emissions are reduced by 20 per cent. A field demonstration was reviewed, and the major test at Norcal in San Francisco was discussed. The key success factors were found to be: formalized customer support plan, on-site technical support, parts availability, driver support and interaction, and training. Liquid natural gas fuel contamination was found to cause component wear. The emphasis has now been placed on three issues: injector life improvements, fuel debris and liquid natural gas pump/dome regulator life, and fuel economy improvements. The accomplishments for 2001 were identified, such as rapidly improving reliability, 17 HPDI trucks are upfit and in-service to name a few. The goals for 2002 include the placement of permanent fuel

  2. New directions at NSF (United States)

    Harvey, Albert B.


    The mission and scope of the National Science Foundation (NSF) and lightwave technology will be very briefly discussed. The focus of the presentation will be directed toward changes in research support that are taking place and the opportunities we have for aiming our research to meet the challenges and needs that face the nation. In the USA it is very clear that defense oriented research is downsizing and is being redirected into economy driven aresas, such as manufacturing, business, and industry. For those researchers who are willing to move into these areas and find a niche, the rewards may be very great. Industrial research partners should also seize these opportunities to enhance their resources in an otherwise bleak future for industrial support of basic research in lightwave technology and many other reserach disciplines. These activities of bringing together industry and academia will have the value added benefit of providing increased job opportunities for students. An outline of some of these opportunities and incentives will be presented. On the international front, there has never been a better time for the encouragement of joint research and collaboration across borders. The economic potential for involvement in Eastern Europe and Asia are enormous. Agencies like ourselves are open to help support of visiting scientist/engineer exchange, international conferences and forums and support of innovative ideas to help further enhance economic developemnt of the world and hence the quality of life. The presence of the Russian delegation here at these SPIE meetings in in part the result of NSF support. Concomitant with these changes is a growing interest in education. Academia is gradually realizing that education includes training for students to acquire jobs and hence we complete the cycle of the importance of interacting with industry. At the NSF a major new initiative is being introduced in Optical Science and Engineering (OSE). This effort has been

  3. Directional detector of gamma rays (United States)

    Cox, Samson A.; Levert, Francis E.


    A directional detector of gamma rays comprises a strip of an electrical cuctor of high atomic number backed with a strip of a second electrical conductor of low atomic number. These elements are enclosed within an electrical conductor that establishes an electrical ground, maintains a vacuum enclosure and screens out low-energy gamma rays. The detector exhibits a directional sensitivity marked by an increased output in the favored direction by a factor of ten over the output in the unfavored direction.

  4. Social Inclusion and Integrative Practices

    Directory of Open Access Journals (Sweden)

    David Cappo


    Full Text Available With the passage of time valuable lessons have been learnt about both effective practices for program and system integration and the sizable barriers, including the challenges in sustaining constructive integration. This paper is a reflection on sustainable integrative practices and is grounded in the direct experience of one of the authors, who held the post of the South Australian Social Inclusion Commissioner. We reflect upon the structure and mechanism of the South Australian Social Inclusion Initiative (2002–2011 as well as using a case study of a successful integrative program of the Social Inclusion Initiative, a program in South Australia’s School Retention Action Plan 2004 Making the Connections (South Australian Social Inclusion Board, 2004 that was implemented to improve school retention. The case study draws out salient factors of clear rationale, coordination, collaboration, communication, team work and trust as skills and ingredients to bring about integration in policy and programs. While the integration literature affirms that these ingredients are primary skills for the development of an integrative framework, we also assert that they are not enough for successful and sustained integration. Absent from much of the literature is a discussion about the use of power and the manner in which horizontal integrative work occurs. We take up this theme to draw out some implications for analysis of sustainable integrative practices.

  5. Best Practices Guide for Conferences Funded with an Assistance Agreement (United States)

    Conferences may be funded with an assistance agreement if the principal purpose is not for the direct benefit of the Government The Best Practices Guide for Conferences attached here, will help Agency and recipient personnel make correct planning and

  6. Formatting a Paper-based Survey Questionnaire: Best Practices

    Directory of Open Access Journals (Sweden)

    Elizabeth Fanning


    Full Text Available This paper summarizes best practices with regard to paper-based survey questionnaire design. Initial design considerations, the cover and cover page, directions, ordering of questions, navigational path (branching, and page design are discussed.

  7. Practices and People

    Directory of Open Access Journals (Sweden)

    Ted Schatzki


    Full Text Available A perennial issue in social thought is the relationship of people to enveloping social phenomena such as structures, institutions, and systems. The present essay explores this relationship through the lens of practice theory. Theories of practice have said much about practices, a type of enveloping social phenomena, but relatively little about people. This general inattention probably has something to do with the fact that theorists of practice deny that they are individualists. The neglect is nonetheless surprising, for people are everywhere in the plenum of practices. The present essay aims to help address this situation, offering a way of thinking about practices and people according to which these two phenomena are equally real while mutually dependent and co-responsible for social life.

  8. Diffusing Best Practices

    DEFF Research Database (Denmark)

    Pries-Heje, Jan; Baskerville, Richard


    Both the practice and the research literature on information systems attach great value to the identification and dissemination of information on “best practices”. In the philosophy of science, this type of knowledge is regarded as technological knowledge because it becomes manifest...... in the successful techniques in one context. While the value for other contexts is unproven, knowledge of best practices circulates under an assumption that the practices will usefully self-diffuse through innovation and adoption in other contexts. We study diffusion of best practices using a design science...... in the presence of two concordant factors. On the context side, the qualities of the selected opinion leader were necessary to provide the subjective norm described in TPB. On the best practice side, the technological qualities of the best practice itself were necessary to instill the ideal attitude (belief...

  9. 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...

  10. Spirituality in nursing practice. (United States)

    Rogers, Melanie; Wattis, John


    Spirituality is an important aspect of holistic care that is frequently overlooked. This is because of difficulties in conceptualising spirituality and confusion about how it should be integrated into nursing care. This article explores what is meant by spirituality and spiritually competent practice. It examines attitudes to spirituality, describes factors that might affect the integration of spirituality into nursing care and offers practical guidance to equip nurses to incorporate spirituality into their practice.

  11. Agile practice guide (English)

    CERN Document Server


    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.

  12. 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.

  13. Do preventive medicine physicians practice medicine? (United States)

    Jung, Paul; Lushniak, Boris D


    As some preventive medicine physicians have been denied medical licenses for not engaging in direct patient care, this paper attempts to answer the question, "Do preventive medicine physicians practice medicine?" by exploring the requirements of licensure, the definition of "practice" in the context of modern medicine, and by comparing the specialty of preventive medicine to other specialties which should invite similar scrutiny. The authors could find no explicit licensure requirement for either a certain amount of time in patient care or a number of patients seen. No physicians board certified in Public Health and General Preventive Medicine sit on any state medical boards. The authors propose that state medical boards accept a broad standard of medical practice, which includes the practice of preventive medicine specialists, for licensing purposes. Published by Elsevier Inc.

  14. Medical practice management in a nutshell. (United States)

    Longest, Beaufort B


    Obviously, an endeavor as complicated as managing a medical practice cannot be reduced to a "nutshell." However, the array of activities involved can be modeled in a comprehensive manner. This article does just that, providing practice managers with a blueprint for their management work. Management is defined in terms of a set of activities through which the goals or purposes of a practice are established and pursued. The work of managers, which is contrasted to direct and support work, is described in terms of helping establish the goals and creating the conditions under which these goals can be accomplished. A comprehensive model of the eight separate, but related, activities comprising management work in a medical practice is presented. A set of core activities is described as developing/strategizing, designing, and leading. A set of facilitative activities is described as communicating, decision-making, managing quality, marketing, and evaluating.

  15. Observation: A Practice That Must Be Practiced (United States)

    Lontz, Karey M.


    Karey Lontz's article on learning how to "dominate by observation" (to master the practice of observation so as to use it most effectively for the benefit of the children) takes us from a general to specific understanding of observation. She begins with a look at the importance of observation in human history and in the history of…

  16. 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

  17. 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...

  18. 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...... aim is to explore mobility as an embodied and emotional practice in which children employ different strategies. I focus on bodily micro practices, routines and coping strategies, the intermediate space that occurs on their continual journeys, and the feeling of being dispensable. It is an ethnographic...

  19. 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.

  20. Costing Practices in Healthcare

    DEFF Research Database (Denmark)

    Chapman, Christopher; Kern, Anja; Laguecir, Aziza


    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.......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....

  1. Applications of Payload Directed Flight (United States)

    Ippolito, Corey; Fladeland, Matthew M.; Yeh, Yoo Hsiu


    Next generation aviation flight control concepts require autonomous and intelligent control system architectures that close control loops directly around payload sensors in manner more integrated and cohesive that in traditional autopilot designs. Research into payload directed flight control at NASA Ames Research Center is investigating new and novel architectures that can satisfy the requirements for next generation control and automation concepts for aviation. Tighter integration between sensor and machine requires definition of specific sensor-directed control modes to tie the sensor data directly into a vehicle control structures throughout the entire control architecture, from low-level stability- and control loops, to higher level mission planning and scheduling reasoning systems. Payload directed flight systems can thus provide guidance, navigation, and control for vehicle platforms hosting a suite of onboard payload sensors. This paper outlines related research into the field of payload directed flight; and outlines requirements and operating concepts for payload directed flight systems based on identified needs from the scientific literature.'

  2. 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…

  3. Donor Conception Disclosure: Directive or Non-Directive Counselling? (United States)

    Raes, Inez; Ravelingien, An; Pennings, Guido


    It is widely agreed among health professionals that couples using donor insemination should be offered counselling on the topic of donor conception disclosure. However, it is clear from the literature that there has long been a lack of agreement about which counselling approach should be used in this case: a directive or a non-directive approach. In this paper we investigate which approach is ethically justifiable by balancing the two underlying principles of autonomy (non-directive approach) and beneficence (directive approach). To overrule one principle in favour of another, six conditions should be fulfilled. We analyse the arguments in favour of the beneficence principle, and consequently, a directive approach. This analysis shows that two conditions are not met; the principle of autonomy should not be overridden. Therefore, at this moment, a directive counselling approach on donor conception disclosure cannot be ethically justified.

  4. Future directions of ecosystem science (United States)

    Baron, Jill; 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

  5. Double Blind: Supervising Women as Creative Practice-Led Researchers (United States)

    Pedersen, Courtney; Haynes, Rachael


    Many women creative practice-led researchers appear inhibited by a number of factors directly connected to their gender. This article discusses these factors, including the culture of visual arts professional practice, the circumstances surrounding women postgraduate students and unproductive self-theories about intelligence and creativity. A…

  6. A survey on the participation of optometric practices in health ...

    African Journals Online (AJOL)

    Optometric services are well integrated in health insurance programs in the developed world. This study was designed to assess the level of participation of optometric practices in health insurance systems in Nigeria. By convenience, 40 optometric practices in the country were interviewed directly, or by telephone or email ...

  7. 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…

  8. 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…

  9. 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…

  10. 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…

  11. 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…

  12. Complexity theory and the "puzzling" competencies: Systems-based Practice And Practice-based Learning explored. (United States)

    Gonnering, Russell S


    Of all the clinical competencies, the least understood are Systems-Based Practice and Practice-Based Learning and Improvement. With a shift to competency-based education and evaluation across the spectrum of surgical education and practice, a clear understanding of the power and utility of each competency is paramount. Health care operates as a complex adaptive system, with dynamics foreign to many health care professionals and educators. The adaptation and evolution of such a system is related directly to both the individual and the organizational learning of the agents within the system and knowledge management strategies. Far from being "difficult," Systems-Based Practice and Practice-Based Learning form the heart of quality improvement initiatives and future productivity advances in health care. Copyright 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  13. Evidence-Based Practice: On the Function of Evidence in Practical Reasoning

    Directory of Open Access Journals (Sweden)

    Tone Kvernbekk


    Full Text Available There is a vast literature on evidence-based practice (EBP in education. What function does evidence have in practical deliberations toward decisions about what to do? Most writers on EBP seem to think of evidence largely as quantitative data, serving as a foundation from which practice could and should be directly derived. In this paper I argue that we are better served by according a different and more indirect function to evidence in practical reasoning. To establish this claim I employ Toulmin’s model of argumentation. On this model the evidence-as-foundation view amounts to evidence as data/grounds. The model also offers a different function for evidence, as backing of the warrant, and I argue in this paper that this is a more adequate understanding of the function of evidence in practical reasoning

  14. Nurse managers describe their practice environments. (United States)

    Warshawsky, Nora E; Lake, Sharon W; Brandford, Arica


    Hospital work environments that support the professional practice of nurses are critical to patient safety. Nurse managers are responsible for creating these professional practice environments for staff nurses, yet little is known about the environments needed to support nurse managers. Domains of nurse managers' practice environment have recently been defined. This is a secondary analysis of 2 cross-sectional studies of organizational characteristics that influence nurse manager practice. Content analysis of the free text comments from 127 nurse managers was used to illustrate the 8 domains of nurse managers' practice environments. Nurse managers valued time spent with their staff; therefore, workloads must permit meaningful interaction. Directors demonstrated trust when they empowered nurse managers to make decisions. Administrative leaders should build patient safety cultures on the basis of shared accountability and mutual respect among the health care team. The expectations of nurse managers have greatly expanded in the volume and complexity of direct reports, patient care areas, and job functions. The nurse managers in this analysis reported characteristics of their practice environments that limit their role effectiveness and may negatively impact organizational performance. Further research is needed to understand the effects of nurse managers' practice environments on staff and patient outcomes.

  15. Critical Practice Leadership in Post-compulsory Education


    Elliott, Geoffrey


    This article questions why leaders in post-compulsory education tend not to view leadership research positively or utilise it in improving their practice. Drawing on the theoretical literature of educational management and leadership, and the current political and economic context of post-compulsory education, it proposes a new direction of critical practice leadership informed by advanced practitioner research. Challenging assumptions about leadership practice and leadership research creates...

  16. How do Entrepreneurial Human Resource Practices Determine Small Firms’ Performance?


    Sulaimiah; Sulhaini


    This study examines the effects of entrepreneurial human resource practices on market-oriented behaviour, relational capability, and business performance at small-sized firms. For the purpose of the study, a survey was carried out for two different product types, namely handi crafts and food/drink, and sample firms were purposively selected. Interestingly, the findings suggest that, though practices may not directly improve firms’ performance, implementing practices characterised by entrepren...

  17. Archives: Nigerian Endocrine Practice

    African Journals Online (AJOL)

    Archives: Nigerian Endocrine Practice. Journal Home > Archives: Nigerian Endocrine Practice. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives. 1 - 4 of 4 Items. 2013. Vol 7, No 1 ...

  18. Toward practicing privacy. (United States)

    Dwork, Cynthia; Pottenger, Rebecca


    Private data analysis-the useful analysis of confidential data-requires a rigorous and practicable definition of privacy. Differential privacy, an emerging standard, is the subject of intensive investigation in several diverse research communities. We review the definition, explain its motivation, and discuss some of the challenges to bringing this concept to practice.

  19. 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...

  20. Breastfeeding practices and growth

    African Journals Online (AJOL)


    Aug 10, 2015 ... questionnaire, we assessed breast- feeding practice of attendees and the growth of babies and docu- mented information on the socio demographic characteristics, breastfeeding practices, previous weights of infants' and their An- thropometric measurements. Results: There were 97 mother- infant/ pairs.

  1. 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.

  2. 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.

  3. Thought and Practice

    African Journals Online (AJOL)

    The journal Thought & Practice is a biannual publication of the Philosophical Association of Kenya. Vision A forum for incisive philosophic reflection on intellectual, social and political issues within the African context. Mission Thought and Practice serves scholars with broad interests in the humanities and social sciences by ...

  4. Intention in Nursing Practice. (United States)

    Sofhauser, Cynthia


    The purpose of this column is to explore the meaning of intention in nursing practice and distinguish it from the concept of intentionality. The notion that nurses engage in a purposeful act of setting intention prior to delivery of nursing care is introduced, and nursing implications for setting intention in practice is offered. © The Author(s) 2015.

  5. Archives: Thought and Practice

    African Journals Online (AJOL)

    Items 1 - 14 of 14 ... Archives: Thought and Practice. Journal Home > Archives: Thought and Practice. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives. 1 - 14 of 14 Items. 2015 ...

  6. Survey of Testing Practices. (United States)

    Malarkey, Cynthia J.; Aiken, Lewis R.

    The Survey of Testing Practices was administered to 470 undergraduate students at Pepperdine University and the Univesity of California Los Angeles. The items concerned testing practices in three or four classes taken the previous term: type of test, test administration, class size, procedures for returning tests, test difficulty, and observed…

  7. 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...

  8. Teachers' Classroom Assessment Practices (United States)

    Frey, Bruce B.; Schmitt, Vicki L.


    This study examined classroom assessment practices of 3rd- through 12th-grade teachers in a Midwestern state. In addition to determining the frequency with which specific assessment item formats were utilized, the level of use of selected "best practice" approaches to assessment was considered ("performance-based assessment,…

  9. 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.

  10. Best Practices. Premiere PD (United States)

    Brown, Ryan; Ernst, Jeremy; Clark, Aaron; DeLuca, Bill; Kelly, Daniel


    Educators who engage in best practices utilize a variety of instructional delivery methods to assist all learners in achieving success in concept mastery. Best practices help educators set expectations for completing activities/lessons/projects/units, differentiate instruction, integrate curricula, and provide active learning opportunities for…

  11. Teaching as Reflective Practice. (United States)

    Kennedy, Rosa L.; Wyrick, Amy M.

    This paper describes a method of reflective practice called "critical incident" which was used to examine teacher trainees' educational assumptions. A qualitative case study of one fifth-year teaching intern (Amy) at the University of Tennessee represents the experience of seven other master's level students already practicing within the…

  12. Business model innovation: Past research, current debates, and future directions

    DEFF Research Database (Denmark)

    Hossain, Mokter


    in the research Q1 and highlights new directions for research. Research limitations/implications – This study analyzed articles that were found based on a systematic literature review approach. Practical implications – This study identifies some fundamental issues that managers need to understand regarding BMI...

  13. [Effect of the GCP Directive on academic drug trials

    DEFF Research Database (Denmark)

    Berendt, L.; Hakansson, C.; Bach, K.F.


    Since 2004, adherence to Good Clinical Practice has been mandatory for all clinical drug trials. This was new to the investigator-initiated trials. Our study showed no association between the implementation of the Directive and investigator or industry-initiated trials. However, a steady decline ...

  14. 77 FR 55768 - Airworthiness Directives; The Boeing Company Airplanes (United States)


    ... II, Practices and Procedures, of the Boeing 777 Aircraft Maintenance Manual, Revision 65, May 5, 2012... Federal Aviation Administration 14 CFR Part 39 RIN 2120-AA64 Airworthiness Directives; The Boeing Company... Federal holidays. For service information identified in this proposed AD, contact Boeing Commercial...

  15. Advance directives in dementia: issues of validity and effectiveness

    NARCIS (Netherlands)

    Boer, de M.E.; Hertogh, C.M.P.M.; Dröes, R.M.; Jonker, C.; Eefsting, J.A.


    ABSTRACTBackground: Although advance directives may seem useful instruments in decision-making regarding incompetent patients, their validity in cases of dementia has been a much debated subject and little is known about their effectiveness in practice. This paper assesses the contribution of

  16. Advance directives in dementia: issues of validity and effectiveness

    NARCIS (Netherlands)

    de Boer, M.E.; Hertogh, C.M.P.M.; Dröes, R.M.; Jonker, C.; Eefsting, J.A.


    Background: Although advance directives may seem useful instruments in decision-making regarding incompetent patients, their validity in cases of dementia has been a much debated subject and little is known about their effectiveness in practice. This paper assesses the contribution of advance

  17. Learning for Life: Creating Classrooms for Self-Directed Learning. (United States)

    Areglado, Ronald J.; And Others

    This book explores concepts and methods of self-directed learning (SDL), documenting and illustrating the SDL methodology with practical examples. SDL is a synergistic process in which a teacher helps learners use various strategies and perceptual skills to learn on their own, become more responsible for their learning, and take charge of their…

  18. Career counselling with secondary school-aged youth: Directions for ...

    African Journals Online (AJOL)

    Career counselling with secondary school-aged youth: Directions for theory, research, and practice. ... Abstract. In the midst of an information age and a global economy, people around the world continue to face significant inequities at school and in the workforce. Career counselling thus finds itself in a paradigm shift that ...

  19. 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...... 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.......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...

  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...... that design knowledge and knowing is inseparable from practice, as in Donald Schön's suggestion that design education could be organized as a 'practicum' and based theoretically on an 'epistemology of practice'. However, the combination of exemplary learning and design studies does raise several questions......, 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. Diffusing Best Practices

    DEFF Research Database (Denmark)

    Pries-Heje, Jan; Baskerville, Richard


    Both the practice and the research literature on information systems attach great value to the identification and dissemination of information on “best practices”. In the philosophy of science, this type of knowledge is regarded as technological knowledge because it becomes manifest...... in the successful techniques in one context. While the value for other contexts is unproven, knowledge of best practices circulates under an assumption that the practices will usefully self-diffuse through innovation and adoption in other contexts. We study diffusion of best practices using a design science...... 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...

  2. Directed Graph Based Image Registration (United States)

    Jia, Hongjun; Wu, Guorong; Wang, Qian; Wang, Yaping; Kim, Minjeong; Shen, Dinggang


    In this paper, a novel image registration method is proposed to achieve accurate registration between images having large shape differences with the help of a set of appropriate intermediate templates. We first demonstrate that directionality is a key factor in both pairwise image registration and groupwise registration, which is defined in this paper to describe the influence of the registration direction and paths on the registration performance. In our solution, the intermediate template selection and intermediate template guided registration are two coherent steps with directionality being considered. To take advantage of the directionality, a directed graph is built based on the asymmetric distance defined on all ordered image pairs in the image population, which is fundamentally different from the undirected graph with symmetric distance metrics in all previous methods, and the shortest distance between template and subject on the directed graph is calculated. The allocated directed path can be thus utilized to better guide the registration by successively registering the subject through the intermediate templates one by one on the path towards the template. The proposed directed graph based solution can also be used in groupwise registration. Specifically, by building a minimum spanning arborescence (MSA) on the directed graph, the population center, i.e., a selected template, as well as the directed registration paths from all the rest of images to the population center, is determined simultaneously. The performance of directed graph based registration algorithm is demonstrated by the spatial normalization on both synthetic dataset and real brain MR images. It is shown that our method can achieve more accurate registration results than both the undirected graph based solution and the direct pairwise registration. PMID:22014476

  3. 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).

  4. Clustering signatures classify directed networks (United States)

    Ahnert, S. E.; Fink, T. M. A.


    We use a clustering signature, based on a recently introduced generalization of the clustering coefficient to directed networks, to analyze 16 directed real-world networks of five different types: social networks, genetic transcription networks, word adjacency networks, food webs, and electric circuits. We show that these five classes of networks are cleanly separated in the space of clustering signatures due to the statistical properties of their local neighborhoods, demonstrating the usefulness of clustering signatures as a classifier of directed networks.

  5. Source arrays for directional and non-directional sound generation

    NARCIS (Netherlands)

    Berkhoff, A.P.; Genechten, B. Van


    In this paper, methods are presented to design an acoustic source array for both directional sound generation and non-directional sound generation. The methods are based on measured transfer functions to be able to take into account different source sensitivities, to use extended sources that cannot

  6. 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.

  7. 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

  8. Transition from Training to Surgical Practice. (United States)

    Cogbill, Thomas H; Shapiro, Stephen B


    Surgical training graduates require a period of adjustment as they transform from trainees to experienced surgeons. Making a smooth transition is important for patient safety and new surgeon success. A subset of current graduates does not feel confident to enter directly into practice. Residency design with curriculum refocus, credentialing to encourage graded responsibility, and increased operative exposure is necessary. Onboarding programs should include formal mentoring, career counseling, proctoring by senior surgeons, and objective review of outcomes. The ACS developed a one-year TTP program to provide independent decision-making, operative autonomy, mentoring by senior surgeons, and practice management experience. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Guide to good practices for communications

    Energy Technology Data Exchange (ETDEWEB)



    This Guide to Good Practices is written to enhance understanding of, and provide direction for, Communications, Chapter 4 of Department of Energy (DOE) Order 5480.19, Conduct of Operations Requirements for DOE Facilities. The practices in this guide should be considered when planning or reviewing communication programs. Contractors are advised to adopt procedures that meet the intent of DOE Order 5480.19. ``Communications`` is an element of an effective Conduct of Operations program. The complexity and array of activities performed in DOE facilities dictate the necessity for high reliability in communications to promote safe and efficient operations.

  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. 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.

  12. 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.

  13. 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.

  14. 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....

  15. 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.

  16. 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

  17. 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

  18. 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.

    -dimensional spectra and sech@u2@@ (beta theta) spreading function seem to provide a better estimate of the directional energy distribution for the monsoon conditions. While non-linear wave-wave interaction seems to be the major governing factor in the directional...

  19. Direct Photon Results from CDF

    Directory of Open Access Journals (Sweden)

    Yang Tingjun


    Full Text Available Direct (prompt photon production is a field of very high interest in hadron colliders. It provides probes to search for new phenomena and to test QCD predictions. In this article, two recent cross-section results for direct photon production using the full CDF Run II data set are presented: diphoton production and photon production in association with a heavy quark.

  20. Practical theology: A critically engaged practical reason approach of ...

    African Journals Online (AJOL)

    Browning's influential use of practical reason for his fundamental practical theology is analysed. His correlation of theory and practice in his three stages of theory, practice and theory is also critiqued because his approach reduces practical theology almost to professionalism and principles for ministry. His approach could ...

  1. 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.

  2. Chapter 1: Direct Normal Radiation

    Energy Technology Data Exchange (ETDEWEB)

    Myer, Daryl R.


    This chapter addresses the quantitative and qualitative aspects of the solar resource, the direct solar radiation. It discusses the total or integrated broadband direct beam extraterrestrial radiation (ETR). This total integrated irradiance is comprised of photons of electromagnetic radiation. The chapter also discusses the impact of the atmosphere and its effect upon the direct normal irradiance (DNI) beam radiation. The gases and particulates present in the atmosphere traversed by the direct beam reflect, absorb, and scatter differing spectral regions and proportions of the direct beam, and act as a variable filter. Knowledge of the available broadband DNI beam radiation resource data is essential in designing a concentrating photovoltaic (CPV) system. Spectral variations in the DNI beam radiation affect the performance of a CPV system depending on the solar cell technology used. The chapter describes propagation and scattering processes of circumsolar radiation (CSR), which includes the Mie scattering from large particles.

  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......The thesis investigates tectonics as a contemporary architectural practice and how changes in the building industry create challenges to this manner of creating architecture. The challenge focused on is the specialization in the building industry between architects and engineering consultants which...... 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. 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...

  5. 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.

  6. Practice Hospital Bed Safety (United States)

    ... Updates Practice Hospital Bed Safety Share Tweet Linkedin Pin it More sharing options Linkedin Pin it Email Print Hospital Bed Entrapment Zones An ... the side edge of the head or foot board 7. between the head or foot board and ...

  7. Best Practice Life Expectancy

    DEFF Research Database (Denmark)

    Medford, Anthony


    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...... 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...... 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...


    National Research Council Canada - National Science Library

    Romic, Lidija


    Standard accounting practices require publicly-traded companies to follow certain accounting rules when presenting financial statements so that the readers of the statements can easily compare different companies...

  9. Computerizing clinical practice guidelines

    DEFF Research Database (Denmark)

    Lyng, Karen Marie

    . The analysis focuses on the emergence of general clinical work practice demands on guidance • An analysis of guidance demands from clinical work practice and business strategy, focusing on implications for the design of computerised CPGs. In my research, I have applied observation studies, interviews......It is well described that hospitals have problems with sustaining high quality of care and expedient introduction of new medical knowledge. Clinical practice guidelines (CPGs) have been promoted as a remedy to deal with these problems. It is, however, also well described that application...... and compliance with CPGs in most areas of clinical practice are deficient. Computerization of CPGs has been brought forward as a method to disseminate and to support application of CPGs. Until now, CPG-computerization has focused on development of formal expressions of CPGs. The developed systems have, however...

  10. Clinical radiopharmacy: principles and practices. (United States)

    Rhodes, B A; Hladik, W B; Norenberg, J P


    On the average, radiopharmacists spend about 17.2% of their time in clinical activities if their practice setting is in an institution, and about 8.5% of their time if their practice setting is in a centralized nuclear pharmacy. A recent survey of radiopharmacists was conducted to determine: (1) the percentage of time they spend engaged in selected activities, and (2) the specific clinical activities in which they are involved. A few radiopharmacists spend as much as 50% of their time in clinical activities, but most spend only 5% to 20% of their time. Some of the clinical activities involve direct interactions with patients, such as explaining the reasons for administering the radioactive material or actually administering the dose. Other clinical activities are indirect, such as reviewing charts before or after studies and making recommendations to other health care professionals. About half of the pharmacists surveyed see a need for increasing their clinical activities. The need to maximize the time involved in providing pharmaceutical care is discussed and several patient-care activities/responsibilities are proposed.

  11. Patient centred leadership in practice. (United States)

    Hiscock, Michele; Shuldham, Caroline


    To explore patient centred leadership at every level in an organisation and provide practical examples of how this was demonstrated in an acute tertiary NHS Trust. There is a direct relationship between leadership and quality of care. With increasing expansion of their role nurses are in a key position to influence and lead colleagues to improve patient care. The Leadership Qualities Framework (NHS Institute of Innovation and Improvement 2006) is used to illustrate the various qualities used by clinical leaders in examples of leadership in practice. Leadership development with the emphasis on the patient drives improvements in service delivery and patient safety. Patient centred leadership is demonstrated when there is support at the top of the organisation. Politically aware nurses make effective patient centred leaders. Leadership development programmes provide staff with opportunities to acquire essential skills and qualities in order to contribute to the vision of the organisation. Managers should support staff and take risks in order to empower nurses to implement initiatives which improve patient care. A process of communication using a variety of tools can have a impact on a range of staff. Patient centred leaders are role models for tomorrow's leaders, their impact has lasting effect and wider implications within an organisation and beyond.

  12. 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.

  13. 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.

  14. 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....

  15. Practice and Economic Geography


    Jones, A.; Murphy, J. T.


    Economic geography has over the last decade become increasingly interested in the role of practice, conceptualised as the regularised or stabilised social actions through which economic agents organize or coordinate production, marketing, service provision, exchange and/or innovation activities. Interest in practice is most clearly manifest in a growing body of research concerned to conceptualise how the regularized social relations and interactions linking economic actors (e.g. entrepreneurs...

  16. 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

  17. Mobile Music Listening Practices


    Detry, Lionel; Music, Digitisation, Mediation. Towards Interdisciplinary Music Studies


    This poster presents my PhD research about the appropriation of the practice of mobile music listening. Following an exploratory phase, I have described and interpreted some of the salient characteristics of that practice. It broadly shows that it is an automatic, background, unfocused listening used as an accompaniment to another activity. The music is therefore functional: it helps to relax, change mood, block unwanted sounds (or people), make non-places (Augé, 1992) more pleasant. This ban...

  18. 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...

  19. Old Assyrian Legal Practices

    DEFF Research Database (Denmark)

    Hertel, Thomas Klitgaard

    This work presents a comprehensive analysis of legal practices and dispute processing in Old Assyrian society c. 1950-1800 B.C. in the ancient Near East.......This work presents a comprehensive analysis of legal practices and dispute processing in Old Assyrian society c. 1950-1800 B.C. in the ancient Near East....

  20. George Engel's Epistemology of Clinical Practice. (United States)

    Saraga, Michael; Fuks, Abraham; Boudreau, J Donald


    George Engel's (1913-1999) biopsychosocial model, one of the most significant proposals for the renewal of medicine in the latter half of the 20th century, has been understood primarily as a multi-factorial approach to the etiology of disease and as a call to re-humanize clinical practice. This common reading of Engel's model misses the central aspect of his proposal, that the biopsychosocial model is an epistemology for clinical work. By stating the simple fact that the clinician is not dealing directly with a body, but first, and inevitably, with a person, Engel challenged the epistemology implicit in the classical clinical method-a method predicated on the possibility of direct access to the body. Framed in epistemological terms, the issue at stake is not the need to complement medical science with humane virtues, but rather to acknowledge that the object of clinical practice is not the body but the patient.

  1. Computers in ophthalmology practice

    Directory of Open Access Journals (Sweden)

    Rajeev B


    Full Text Available Computers are already in widespread use in medical practice throughout the world and their utility and popularity is increasing day by day. While future generations of medical professionals will be computer literate with a corresponding increase in use of computers in medical practice, the current generation finds itself in a dilemma of how best to adapt to the fast-evolving world of information technology. In addition to practice management, information technology has already had a substantial impact on diagnostic medicine, especially in imaging techniques and maintenance of medical records. This information technology is now poised to make a big impact on the way we deliver medical care in India. Ophthalmology is no exception to this, but at present very few practices are either fully or partially computerized. This article provides a practical account of the uses and advantages of computers in ophthalmic practice, as well as a step-by-step approach to the optimal utilization of available computer technology.

  2. 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.

  3. 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.

  4. 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

  5. Directional hearing: from biophysical binaural cues to directional hearing outdoors. (United States)

    Römer, Heiner


    When insects communicate by sound, or use acoustic cues to escape predators or detect prey or hosts they have to localize the sound in most cases, to perform adaptive behavioral responses. In the case of particle velocity receivers such as the antennae of mosquitoes, directionality is no problem because such receivers are inherently directional. Insects equipped with bilateral pairs of tympanate ears could principally make use of binaural cues for sound localization, like all other animals with two ears. However, their small size is a major problem to create sufficiently large binaural cues, with respect to both interaural time differences (ITDs, because interaural distances are so small), but also with respect to interaural intensity differences (IIDs), since the ratio of body size to the wavelength of sound is rather unfavorable for diffractive effects. In my review, I will only shortly cover these biophysical aspects of directional hearing. Instead, I will focus on aspects of directional hearing which received relatively little attention previously, the evolution of a pressure difference receiver, 3D-hearing, directional hearing outdoors, and directional hearing for auditory scene analysis.

  6. Reaction Engineering of Direct Coal Liquefaction

    Directory of Open Access Journals (Sweden)

    Ken K. Robinson


    Full Text Available Direct coal liquefaction has been studied and practiced since the 1930s. It was used in Germany during World War II to produce synthetic fuels when there was no oil allowed into the country. Since then, it has been studied in the United States and many different technologies have been investigated. Since the US is rich in coal resources, this is one way to be energy independent. Most of the development activity occurred in the 1980s and numerous technologies were studied, the most notable of these being H-Coal, Exxon Donor Solvent, Solvent Refined Coal, and Two Stage Liquefaction. The key elements of these technologies, particularly the reaction/reactor scheme, are discussed in this review.


    Directory of Open Access Journals (Sweden)

    Gheorghe SĂVOIU


    Full Text Available This paper analyzes some characteristics of economic and econometricliterature in the field of FDI after 1990, in Romania, as well as some specific issues in the process of practical modelling. A more detailed presentation of John Harry Dunning’s eclectic theory and a simple presentation of the theory of de-investment complete the general theoretical presentation of FDI. A first problem after the definition, life cycle, similarities and differences betweenportfolio and direct foreign investment, after the benefits of FDI, is given by the outstanding dynamics and structure of FDI. Some characteristic features of the value oscillation and structural dynamics of gross capital formation (GCF, gross capital fixed capital formation (GFCF and gross domestic savings (GDS in GDP are relevant for the specificity of the phenomenon of FDI in Romania after 1990.

  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. [Children and traditional practices]. (United States)

    Aholi, P


    African traditional practices can be both beneficial and harmful to the newly born. This article describes these practices from 4 perspectives: 1) the period following childbirth or "maternage;" 2) nutrition; 3) curative care; and 4) social customs. The beneficial practices include: 1) giving the baby water as soon as he is washed to prevent neonatal hypoglycemia; 2) breast feeding; 3) carrying the baby on the mother's back and 4) the traditional massage. The harmful practices during maternage include: 1) the baby is rolled in the dirt to protect him and "give birth to his race;" 2) after birth the baby is given lemon juice or gin to prevent the obstruction of the respiratory cords; 3) mother and baby are "put in the dark" or a separate room for the rest of the family and community for 6 days to protect them against evil influences. The harmful nutritional practices are based on superstitions that relate to all animal products because they might produce diseases. 1) Eggs are known to cause diarrhea and throughout Africa eggs are forbidden because of their effect on children's physical development. 2) Chicken and pigeon and "everything that flies" causes convulsions. 3) Palm oil, oranges and bananas cause coughing. 4) Sugar cane, manioc leaves and everything with natural sugar cause intestinal ailments. Traditional health cures are used during an illness and are aimed at reestablishing the balance between man and his environment. Examples described include treatment for measles and chicken pox; fevers; diarrhea, and vomiting and convulsions. The positive traditional African practices need to be combined with those of modern medicine while discouraging the harmful practices.

  11. Practice-based research: the Oregon experience. (United States)

    Nyiendo, J; Lloyd, C; Haas, M


    Practice-based research links community-based physicians and their patients with investigators at academic institutions. In 1992, Western States Chiropractic College developed an infrastructure, the Center for Outcomes Studies, to support practice-based research. The Low Back Pain Study, undertaken in collaboration with Oregon Health Sciences University, 111 medical physicians, and 60 chiropractors, relied on the Center for Outcomes Studies infrastructure for support in project implementation and maintenance. Challenges, many of them critical, were a regular occurrence: dealing with unforeseen obstacles, establishing and maintaining physician buy-in, establishing and maintaining staff buy-in, implementing the protocol as directed and with minimal intrusiveness, maintaining enthusiasm for the project over time, and knowing where (and where not) to allocate the Study's time, energy, and money. Strategies were developed to overcome or minimize the impact of problems on a case-by-case basis. Successful practice-based research requires an awareness of study design issues and an appreciation of clinical practice logistics and priorities. Every effort must be made to include doctors and office staff in the implementation of the study in a manner that minimizes the study's intrusiveness and its economic impact on office organization, routine, and personnel. Investigators must understand and accept that there will be areas of the research environment over which they have no direct control. The challenges will be many, but they will be diminished by the rewards.

  12. Stability of direct oral anticoagulants in whole blood and plasma from patients in steady state treatment

    DEFF Research Database (Denmark)

    McGrail, Rie; Revsholm, Jesper; Nissen, Peter H


    Using functional haemostasis assays, we demonstrated important differences in stability of direct oral anticoagulants (DOACs) in citrated whole blood and plasma from DOAC treated patients. Laboratories and clinicians should take this into consideration and adjust clinical practices accordingly....

  13. Multi-Directional Experimental Facility (United States)

    Federal Laboratory Consortium — The ATLSS Multi-directional Experimental Laboratory was constructed in 1987 under funding from the National Science Foundation to be a major facility for large-scale...

  14. 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.

  15. 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...

  16. Direct Broadcast Satellite: Radio Program (United States)

    Hollansworth, James E.


    NASA is committed to providing technology development that leads to the introduction of new commercial applications for communications satellites. The Direct Broadcast Satellite-Radio (DBS-R) Program is a joint effort between The National Aeronautics and Space Administration (NASA) and The United States Information Agency/Voice of America (USIA/VOA) directed at this objective. The purpose of this program is to define the service and develop the technology for a direct-to-listener satellite sound broadcasting system. The DBS-R Program, as structured by NASA and VOA, is now a three-phase program designed to help the U.S. commercial communications satellite and receiver industry bring about this new communications service. Major efforts are being directed towards frequency planning hardware and service development, service demonstration, and experimentation with new satellite and receiver technology.

  17. Directional spectrum of ocean waves

    Digital Repository Service at National Institute of Oceanography (India)

    Fernandes, A.A.; Gouveia, A.D.; Nagarajan, R.

    fields are described. For these sinusoidal wave fields, analysis of both linear and polygonal arrays consistently yielded accurate directions, in contrast with the limited success of Pawka (1974) in case of linear arrays and Esteva (1976, 1977) in case...

  18. Directional irradiances and fractional clouds (United States)

    Pagh Nielsen, Kristian; Andersen, Elsa; Dragsted, Janne; Furbo, Simon


    For large scale implementation of solar energy, better understanding of the directional and temporal variations in the solar resource is needed. This includes understanding the shading within a multiple row field of solar panels and how this affects the electricity or heat production. We have studied directional irradiances measured simultaneously from 16 downward directions at 1 minute temporal resolution. Also, we have performed measurements of the variations in the field of view across individual solar heating panels in the operational solar district heating plant in Hedehusene in Denmark. By combining a model of directional diffuse irradiances with the field of view variation across a solar panel in a solar panel field we can quantify the effect of shading of diffuse irradiances on the heat flow from the panel.

  19. Spillovers from Foreign Direct Investment

    DEFF Research Database (Denmark)

    Meyer, Klaus E.; Sinani, Evis


    The extensive empirical literature analyzing productivity spillovers from foreign direct investment to local firms provides inconclusive results. Some studies find that foreign presence has a positive impact on the productivity of domestic firms, while others find no evidence or a negative effect...... for industrialized countries in the 1990s. Transition economies may experience spillovers, but these have been declining in recent years. Keywords: developing countries, transition economies, spillovers, foreign direct investment, technology transfer, meta-analysis...

  20. Nuclear astrophysics from direct reactions

    Energy Technology Data Exchange (ETDEWEB)

    Bertulani, C. [Department of Physics, Texas A and M University, Commerce, TX 75429 (United States)]. e-mail:


    Accurate nuclear reaction rates are needed for primordial nucleosynthesis and hydrostatic burning in stars. The relevant reactions are extremely difficult to measure directly in the laboratory at the small astrophysical energies. In recent years direct reactions have been developed and applied to extract low-energy astrophysical S-factors. These methods require a combination of new experimental techniques and theoretical efforts, which are the subject of this presentation. (Author)