Innovation, ENBIS and the Importance of Practice in the Development of Statistics.

NARCIS (Netherlands)

Bisgaard, S.

2005-01-01

The theme of this paper is innovation - in statistics and, more generally, in business and industry. Innovations in statistical theory have historically frequently occurred in direct response to demands for solutions to important practical problems. A major motivation for the establishment of the

Factors Affecting the Perception of Importance and Practice of Patient Safety Management among Hospital Employees in Korea.

Science.gov (United States)

Kim, In-Sook; Park, MiJeong; Park, Mi-Young; Yoo, Hana; Choi, Jihea

2013-03-01

The study was undertaken to identify factors affecting perception of the importance and practice of patient safety management (PSM) among hospital employees in Korea. This study was conducted using a descriptive design and a self-report questionnaire. Two hundred and eighty employees were recruited from three hospitals using a convenience sampling method. Measures were perception of the importance, practice, and characteristics of PSM. Data were analyzed using descriptive statistics including t test, one-way analysis of variance, Pearson's correlation analysis, and multiple regression. Factors affecting perception of the importance of PSM were whether hospital employees were in contact with patients while on duty, weekly working hours, education on PSM, and perceived adequacy of PSM system construction. Factors affecting the practice of PSM were perceived adequacy of work load, perceived adequacy of PSM system construction and perception of its importance. The findings of this study indicate a need for developing strategies to improve perception of the importance and practice of PSM among all hospital employees, and provide a reference for future experimental studies. Copyright © 2013. Published by Elsevier B.V.

Importance of including cultural practices in ecological restoration.

Science.gov (United States)

Wehi, Priscilla M; Lord, Janice M

2017-10-01

Ecosystems worldwide have a long history of use and management by indigenous cultures. However, environmental degradation can reduce the availability of culturally important resources. Ecological restoration aims to repair damage to ecosystems caused by human activity, but it is unclear how often restoration projects incorporate the return of harvesting or traditional life patterns for indigenous communities. We examined the incorporation of cultural use of natural resources into ecological restoration in the context of a culturally important but protected New Zealand bird; among award-winning restoration projects in Australasia and worldwide; and in the peer-reviewed restoration ecology literature. Among New Zealand's culturally important bird species, differences in threat status and availability for hunting were large. These differences indicate the values of a colonizing culture can inhibit harvesting by indigenous people. In Australasia among award-winning ecological restoration projects, restored areas beyond aesthetic or recreational use, despite many projects encouraging community participation. Globally, restoration goals differed among regions. For example, in North America, projects were primarily conservation oriented, whereas in Asia and Africa projects frequently focused on restoring cultural harvesting. From 1995 to 2014, the restoration ecology literature contained few references to cultural values or use. We argue that restoration practitioners are missing a vital component for reassembling functional ecosystems. Inclusion of sustainably harvestable areas within restored landscapes may allow for the continuation of traditional practices that shaped ecosystems for millennia, and also aid project success by ensuring community support. © 2017 Society for Conservation Biology.

Relative importance of Farmers’ Characteristics in Predicting their Knowledge about Indigenous Agricultural Practices

Directory of Open Access Journals (Sweden)

A. Sakeer Husain

2017-09-01

Full Text Available This study was conducted to identify the farmers’ characteristics that act as factors in influencing their knowledge on indigenous agricultural practices. The study was conducted in the state of Kerala among 40 farmers each of ten selected horticultural crops. Step wise regression analysis and multiple linear regression analysis were employed to identify the influencing factors. The study revealed that age, farm power status, innovativeness, rational orientation, communication status, and social participation status positively influence knowledge of farmers on indigenous agricultural practices whereas material status, educational status, and family status were the important characteristics of farmers negatively influencing the knowledge of indigenous practices.

The importance of good time management in supporting succesful dental practice

Directory of Open Access Journals (Sweden)

Mita Juliawati

2016-06-01

Full Text Available n the globalization and Asean Economic Community (MEA era, especially in the era of  competition and modern dentistry, dentists need increasing services in order to maintain and increase patient visits. Especially in patient’s complain about dental services that caused by unmanaged time, such as late dentist, long queue of patients and time inefficiency in dental practice. The objective of this review is to discuss the importance of good time management ’in supporting successful dental pratice. Time management is the act or process of planning and exercising conscious control over the amount of time spent on specific activities, especially to increase  effectiveness, efficiency or productivity. Implementation in dental practice are as follow: planning, scheduling and time organizing to avoid wasted time. Proper time management resulted in greater efficiency and productivity, professional reputation,reduces stress and improves the image of dental practices. Routine evaluation is needed to increase time management quality. Efficient time management in dental practice requires organizing  individual tasks, analizing daily task, scheduling main projects, establishing deadlines and organizing workflow. The implementation in dental practice like organizing patients, medical and non medical employee daily schedule, managing the patient’s queue to get the minimum waiting time and avoiding doctors being late in giving services to patient. Setting good time management will make the dentist's work 'smarter not harder' to get more results with limited time. In principle all medical and non-medical personnel should support the implementation of service excellence in the health care services especially dental practice. The final objective in realizing good time management in dental clinic is concerning in quality service and aims to achieve patient satisfaction (customer satisfaction that the end goal is a loyal patient, customer loyalty and

The importance of subsample preparation practices in the analysis of crude oils

Energy Technology Data Exchange (ETDEWEB)

Pereira, K.S.; Iorio, S.M.B.M. [Petroleo Brasileiro S.A. (CENPES/PETROBRAS), Rio de Janeiro, RJ (Brazil). Centro de Pesquisas], e-mail: katiapereira@petrobras.com.br; Marques, M.L.S.P. [Fundacao Gorceix, Ouro Preto, MG (Brazil)

2011-01-15

There have been many subsample preparation practices proposed to reduce sources of error in analyses of crude oils. Optimal subsample preparation allows keeping the degree of representativity of the final aliquot going into the laboratory analyzer. The objective of this work was to discuss some experiences in order to understand the importance of sampling practices to obtain representative subsamples of crude oils and petroleum products, and measurements with minimized uncertainty whenever possible. Specific practices, whose effectiveness was tested by experiments, are discussed in this work. The analysis of variance showed that the subsamples should not be used in vapor pressure tests unless in case of interlaboratory cross check, and have to be considered as the first test from the bottle subsample. Sometimes long periods of crude oils samples storage are necessary for a complete evaluation, but because of the effect of this storage time it was observed a trend in the reducing of acidity and sulfur content. (author)

The importance of good time management in supporting succesful dental practice

OpenAIRE

Mita Juliawati

2016-01-01

n the globalization and Asean Economic Community (MEA) era, especially in the era of  competition and modern dentistry, dentists need increasing services in order to maintain and increase patient visits. Especially in patient’s complain about dental services that caused by unmanaged time, such as late dentist, long queue of patients and time inefficiency in dental practice. The objective of this review is to discuss the importance of good time management ’in supporting successful dental prati...

High performance work practices, innovation and performance

DEFF Research Database (Denmark)

Jørgensen, Frances; Newton, Cameron; Johnston, Kim

2013-01-01

Research spanning nearly 20 years has provided considerable empirical evidence for relationships between High Performance Work Practices (HPWPs) and various measures of performance including increased productivity, improved customer service, and reduced turnover. What stands out from......, and Africa to examine these various questions relating to the HPWP-innovation-performance relationship. Each paper discusses a practice that has been identified in HPWP literature and potential variables that can facilitate or hinder the effects of these practices of innovation- and performance...

High-Performance Management Practices and Employee Outcomes in Denmark

DEFF Research Database (Denmark)

Cristini, Annalisa; Eriksson, Tor; Pozzoli, Dario

High-performance work practices are frequently considered to have positive effects on corporate performance, but what do they do for employees? After showing that organizational innovation is indeed positively associated with firm performance, we investigate whether high-involvement work practices...

Teacher Reflective Practice in Jesuit High Schools

Science.gov (United States)

Klug, Joseph H.

2010-01-01

Teachers who engage in reflective practice are more effective and may encourage higher student achievement. The purpose of this study is to explore and describe the methods that teachers use in order to engage in reflective practice. Further, it is essential to gain an understanding of how schools, including Jesuit high schools, promote reflective…

29 CFR 780.146 - Importance of relationship of the practice to farming generally.

Science.gov (United States)

2010-07-01

... to include typical factory workers or industrial operations, and the sponsors of the bill made it clear that the erection and operation on a farm by a farmer of a factory, even one using raw materials... in Conjunction Withâ the Farming Operations § 780.146 Importance of relationship of the practice to...

[The importance of symbolic interactionism in nursing practice].

Science.gov (United States)

Dupas, G; de Oliveira, I; Costa, T N

1997-08-01

The nurse should combine, in their daily practice, technical abilities with a profound comprehension of the main object oh their work, the human being. Symbolic Interactionism is an approach which enables the nursery professional to understand patients by the meaning they value their living experiences. The use of qualitative methods in nursery research is essential because it studies the humans beings and their relationship with the environment, allowing the understanding of the living experiences. These kind of approaches should be even more applied in nursery practice as they open new ways for professional knowledge and enrich practical skills.

In search of joy in practice: a report of 23 high-functioning primary care practices.

Science.gov (United States)

Sinsky, Christine A; Willard-Grace, Rachel; Schutzbank, Andrew M; Sinsky, Thomas A; Margolius, David; Bodenheimer, Thomas

2013-01-01

We highlight primary care innovations gathered from high-functioning primary care practices, innovations we believe can facilitate joy in practice and mitigate physician burnout. To do so, we made site visits to 23 high-performing primary care practices and focused on how these practices distribute functions among the team, use technology to their advantage, improve outcomes with data, and make the job of primary care feasible and enjoyable as a life's vocation. Innovations identified include (1) proactive planned care, with previsit planning and previsit laboratory tests; (2) sharing clinical care among a team, with expanded rooming protocols, standing orders, and panel management; (3) sharing clerical tasks with collaborative documentation (scribing), nonphysician order entry, and streamlined prescription management; (4) improving communication by verbal messaging and in-box management; and (5) improving team functioning through co-location, team meetings, and work flow mapping. Our observations suggest that a shift from a physician-centric model of work distribution and responsibility to a shared-care model, with a higher level of clinical support staff per physician and frequent forums for communication, can result in high-functioning teams, improved professional satisfaction, and greater joy in practice.

Food safety knowledge, attitudes and self-reported practices among Ontario high school students.

Science.gov (United States)

Majowicz, Shannon E; Diplock, Kenneth J; Leatherdale, Scott T; Bredin, Chad T; Rebellato, Steven; Hammond, David; Jones-Bitton, Andria; Dubin, Joel A

2016-03-16

To measure the food safety knowledge, attitudes and self-reported practices of high school students in Ontario. We administered a school-wide paper survey to the student body (n = 2,860) of four Ontario high schools. We developed the survey by selecting questions from existing, validated questionnaires, prioritizing questions that aligned with the Canadian Partnership for Consumer Food Safety Education's educational messages and the food safety objectives from the 2013 Ontario High School Curriculum. One in five students reported currently handling food in commercial or public-serving venues; of these, 45.1% had ever taken a course that taught them how to prepare food (e.g., food and nutrition classes, food handler certification). Food safety knowledge among respondents was low. For example, 17.3% knew that the best way to determine whether hamburgers were cooked enough to eat was to measure the temperature with a food thermometer. Despite low knowledge, most respondents (72.7%) reported being confident that they could cook safe, healthy meals for themselves and their families. Safe food handling practices were frequently self-reported. Most students (86.5%) agreed that being able to cook safe, healthy meals was an important life skill, although their interest in learning about safe food handling and concern about foodborne disease were less pronounced. Our findings suggest that food safety knowledge is low, yet confidence in preparing safe, healthy meals is high, among high school students. Because work and volunteer opportunities put students in contact with both the public and food, this group is important to target for increased education about safe food handling.

Importance of debriefing in high-fidelity simulations

Directory of Open Access Journals (Sweden)

Igor Karnjuš

2014-04-01

Full Text Available Debriefing has been identified as one of the most important parts of a high-fidelity simulation learning process. During debriefing, the mentor invites learners to critically assess the knowledge and skills used during the execution of a scenario. Regardless of the abundance of studies that have examined simulation-based education, debriefing is still poorly defined.The present article examines the essential features of debriefing, its phases, techniques and methods with a systematic review of recent publications. It emphasizes the mentor’s role, since the effectiveness of debriefing largely depends on the mentor’s skills to conduct it. The guidelines that allow the mentor to evaluate his performance in conducting debriefing are also presented. We underline the importance of debriefing in clinical settings as part of continuous learning process. Debriefing allows the medical teams to assess their performance and develop new strategies to achieve higher competencies.Although the debriefing is the cornerstone of high-fidelity simulation learning process, it also represents an important learning strategy in the clinical setting. Many important aspects of debriefing are still poorly explored and understood, therefore this part of the learning process should be given greater attention in the future.

Engaging Employees: The Importance of High-Performance Work Systems for Patient Safety.

Science.gov (United States)

Etchegaray, Jason M; Thomas, Eric J

2015-12-01

To develop and test survey items that measure high-performance work systems (HPWSs), report psychometric characteristics of the survey, and examine associations between HPWSs and teamwork culture, safety culture, and overall patient safety grade. We reviewed literature to determine dimensions of HPWSs and then asked executives to tell us which dimensions they viewed as most important for safety and quality. We then created a HPWSs survey to measure the most important HPWSs dimensions. We administered an anonymous, electronic survey to employees with direct patient care working at a large hospital system in the Southern United States and looked for linkages between HPWSs, culture, and outcomes. Similarities existed for the HPWS practices viewed as most important by previous researchers and health-care executives. The HPWSs survey was found to be reliable, distinct from safety culture and teamwork culture based on a confirmatory factor analysis, and was the strongest predictor of the extent to which employees felt comfortable speaking up about patient safety problems as well as patient safety grade. We used information from a literature review and executive input to create a reliable and valid HPWSs survey. Future research needs to examine whether HPWSs is associated with additional safety and quality outcomes.

Infant feeding practices in a high HIV prevalence rural district of ...

African Journals Online (AJOL)

Keywords: infant feeding practices; exclusive breast-feeding; mixed feeding; HIV. Infant feeding practices in ... HIV pandemic has fuelled further research and policy development ..... offer important nutritional benefits over breast milk. • Greater ...

International survey of veterinarians to assess the importance of competencies in professional practice and education

NARCIS (Netherlands)

Bok, H.G.; Teunissen, P.W.; Boerboom, T.B.; Rhind, S.M.; Baillie, S.; Tegzes, J.; Annandale, H.; Matthew, S.; Torgersen, A.; Hecker, K.G.; Hardi-Landerer, C.M.; Gomez-Lucia, E.; Ahmad, B.; Muijtjens, A.M.; Jaarsma, D.A.; Vleuten, C.P.M. van der; Beukelen, P. van

2014-01-01

OBJECTIVE: To determine the perceived importance of specific competencies in professional veterinary practice and education among veterinarians in several countries. DESIGN: Survey-based prospective study. SAMPLE: 1,137 veterinarians in 10 countries. PROCEDURES: Veterinarians were invited via email

Pragmatic characteristics of patient-reported outcome measures are important for use in clinical practice.

Science.gov (United States)

Kroenke, Kurt; Monahan, Patrick O; Kean, Jacob

2015-09-01

Measures for assessing patient-reported outcomes (PROs) that may have initially been developed for research are increasingly being recommended for use in clinical practice as well. Although psychometric rigor is essential, this article focuses on pragmatic characteristics of PROs that may enhance uptake into clinical practice. Three sources were drawn on in identifying pragmatic criteria for PROs: (1) selected literature review including recommendations by other expert groups; (2) key features of several model public domain PROs; and (3) the authors' experience in developing practical PROs. Eight characteristics of a practical PRO include: (1) actionability (i.e., scores guide diagnostic or therapeutic actions/decision making); (2) appropriateness for the relevant clinical setting; (3) universality (i.e., for screening, severity assessment, and monitoring across multiple conditions); (4) self-administration; (5) item features (number of items and bundling issues); (6) response options (option number and dimensions, uniform vs. varying options, time frame, intervals between options); (7) scoring (simplicity and interpretability); and (8) accessibility (nonproprietary, downloadable, available in different languages and for vulnerable groups, and incorporated into electronic health records). Balancing psychometric and pragmatic factors in the development of PROs is important for accelerating the incorporation of PROs into clinical practice. Published by Elsevier Inc.

International survey of veterinarians to assess the importance of competencies in professional practice and education

NARCIS (Netherlands)

Bok, Harold G. J.; Teunissen, Pim W.; Boerboom, Tobias B. B.; Rhind, Susan M.; Baillie, Sarah; Tegzes, John; Annandale, Henry; Matthew, Susan; Torgersen, Anne; Hecker, Kent G.; Härdi-Landerer, Christina M.; Gomez-Lucia, Esperanza; Ahmad, Bashir; Muijtjens, Arno M. M.; Jaarsma, Debbie A. D. C.; van der Vleuten, Cees P. M.; van Beukelen, Peter

2014-01-01

To determine the perceived importance of specific competencies in professional veterinary practice and education among veterinarians in several countries. Survey-based prospective study. 1,137 veterinarians in 10 countries. Veterinarians were invited via email to participate in the study. A

Best Practices During Hip Arthroscopy: Aggregate Recommendations of High-Volume Surgeons.

Science.gov (United States)

Gupta, Asheesh; Suarez-Ahedo, Carlos; Redmond, John M; Gerhardt, Michael B; Hanypsiak, Bryan; Stake, Christine E; Finch, Nathan A; Domb, Benjamin G

2015-09-01

To survey surgeons who perform a high volume of hip arthroscopy procedures regarding their operative technique, type of procedure, and postoperative management. We conducted a cross-sectional survey of 27 high-volume orthopaedic surgeons specializing in hip arthroscopy to report their preferences and practices related to their operative practice and postoperative rehabilitation protocol. All participants completed the survey in person in an anonymous fashion during a meeting of the American Hip Institute. All surgeons perform hip arthroscopy with the patient in the supine position, accessing the central compartment of the hip initially, using intraoperative fluoroscopy. All surgeons perform labral repair (100%), with the majority performing labral reconstructions (77.8%) and gluteus medius repairs (81.5%). There is variability in the type of anchors used during labral repair. Most surgeons perform capsular closure in most cases (88.9%), inject either intra-articular cortisone or platelet-rich plasma at the conclusion of the procedure (59%), and prescribe a postoperative hip brace for some or all patients (59%). There is considerable variability in rehabilitation protocols. All surgeons routinely prescribe postoperative heterotopic ossification prophylaxis to their patients, with most surgeons (88.9%) prescribing a nonsteroidal anti-inflammatory medication for 3 weeks. Forty percent of the respondents use the modified Harris Hip Score as the most important outcome measure. Consistent practices such as use of intraoperative fluoroscopy, heterotopic ossification prophylaxis, and labral repair skills were identified by surveying 27 hip arthroscopy surgeons at high-volume centers. Most of the surgeons performed routine capsular closure unless underlying conditions precluded capsular release or plication. The survey identified higher variability between surgeons regarding postoperative rehabilitation protocols and use of intra-articular pharmacologic injections at the

Importance of intrapreneurial practices prevalent among secondary school teachers in Kalungu District (Uganda

Directory of Open Access Journals (Sweden)

Genza Musoke Gyaviira

2016-02-01

Full Text Available The study examines teachers' business initiatives within school (intrapreneurial ventures and highlights the economic and educational importance of these initiatives. It first unveils the prevalence of different intrapreneurial ventures among teachers, before going on to state the meaning of these practices for both the economic and professional welfare of teachers in particular, and schools in general. The study concludes with several conclusions for the development of education on the African continent.

Importance of Practical Relevance and Design Modules in Electrical Circuits Education

Directory of Open Access Journals (Sweden)

Kalpathy Sundaram

2011-05-01

Full Text Available The interactive technical electronic book, TechEBook, currently under development at the University of Central Florida (UCF, provides a useful tool for engineers and scientists through unique features compared to the most used traditional electrical circuit textbooks available in the market. TechEBook has comprised the two worlds of classical circuit books and an interactive operating platform such as iPads, laptops and desktops utilizing Java Virtual Machine operator. The TechEBook provides an interactive applets screen that holds many modules, in which each had a specific application in the self learning process. This paper describes two of the interactive techniques in the TechEBook known as, Practical Relevance Modules (PRM and Design Modules (DM. The Practical Relevance Module will assist the readers to learn electrical circuit analysis and to understand the practical application of the electrical network theory through solving real world examples and problems. The Design Module will help students design real-life problems. These modules will be displayed after each section in the TechEBook for the user to relate his/her understanding with the outside world, which introduces the term me-applying and me-designing, as a comprehensive full experience for self or individualized education. The main emphasis of this paper is the PRM while the DM will be discussed in brief. A practical example of applying the PRM and DM features is discussed as part of a basic electrical engineering course currently given at UCF and results show improved student performances in learning materials in Electrical Circuits. In the future, such modules can be redesigned to become highly interactive with illustrated animations.

"Latte rural": the tangible and intangible factors important in the choice of a rural practice by recent GP graduates.

Science.gov (United States)

Laurence, Caroline O; Williamson, Victoria; Sumner, Karen E; Fleming, Jenny

2010-01-01

A large of amount of literature exists on the factors that influence the recruitment and retention of rural general practitioners (GPs) in Australia and other countries. The selection of a rural practice location is known to be influenced by professional, personal and family, community and economic factors. Most of this research has been undertaken on the either the baby boomer generation or their predecessors, and this is likely to have influenced the responses gained. Generation X and Y doctors are known to have a different perception regarding workload, lifestyle and the support required to practise. The aim of this study was to explore, from a Generation X perspective, factors deemed important by general practice graduates in selecting a rural practice at completion of their training. The study also aimed to identify the process general practice graduates use to identify a potential rural practice, and when they commence this process. Semi-structured interviews were held with 15 rural pathway general practice registrars in their final year of training with 2 regional training providers in South Australia. The interview topics included source of information on potential practices, their ideal rural practice and community, the process used to select a practice, and when they commenced this process. Phenomenological hermeneutic thematic analysis of interview transcripts was undertaken to identify themes and sub-themes. For an ideal rural practice, registrars wished to work in a practice with a friendly atmosphere, good business structure, support from senior GPs and in close proximity to a hospital. They also wanted reasonable on-call arrangements, the chance to develop further skills (such as anaesthetics or obstetrics) and the freedom to practise according to their interests. They also emphasised the importance of a good team and an ethical practice. In terms of community, registrars wanted a positive living place, access to amenities such as childcare, good

An Investigation of Literacy Practices in High School Science Classrooms

Science.gov (United States)

Wexler, Jade; Mitchell, Marisa A.; Clancy, Erin E.; Silverman, Rebecca D.

2017-01-01

This study reports findings from an exploration of the literacy practices of 10 high school science teachers. Based on observations of teachers' instruction, we report teachers' use of text, evidence-based vocabulary and comprehension practices, and grouping practices. Based on interviews with teachers, we also report teachers' perceptions…

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

Science.gov (United States)

Priest, Kerry L; Clegorne, Nicholas A

2015-01-01

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

Focus on the Finish Line: Does High-Impact Practice Participation Influence Career Plans and Early Job Attainment?

Science.gov (United States)

Miller, Angie L.; Rocconi, Louis M.; Dumford, Amber D.

2018-01-01

High-impact practices (HIPs) are important co-curricular educational experiences in post-secondary education, as they promote learning, development, and persistence among students. The goal of this study was to extend the research on HIPs to explore potential connections with HIP participation and career outcomes. Using data from the National…

Work Practice Characteristics

DEFF Research Database (Denmark)

Pors, Jens Kaaber; Simonsen, Jesper

2003-01-01

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

High Cholesterol and Complementary Health Practices: What the Science Says

Science.gov (United States)

... professionals High Cholesterol and Complementary Health Practices: What the Science Says Share: February 2013 Dietary Supplements Red Yeast ... to exploring complementary health products and practices in the context of rigorous ... health researchers, and disseminating authoritative information ...

Importance of nursing leadership in advancing evidence-based nursing practice.

Science.gov (United States)

Bradshaw, Wanda G

Our patients depend on us to do the best on their behalf. If we do not take accountability for our practice, continually examining what is the best way to deliver care, we are limiting our role to technical skills and not fully actualizing our professional role. [Evidence-based practice] is essential to practicing safely as nurses (p. 53).1.

Cognitive load theory: Practical implications and an important challenge

Directory of Open Access Journals (Sweden)

Jimmie Leppink, Ph.D.

2017-10-01

Full Text Available The field of medical education has adopted a wide variety of theories from other fields. A fairly recent example is cognitive load theory, which originated in educational psychology. Several empirical studies inspired by cognitive load theory and reviews of practical implications of cognitive load theory have contributed to guidelines for the design of medical education. Simultaneously, several research groups have developed instruments for the measurement of cognitive load in a medical education context. These developments notwithstanding, obtaining evidence for different types of cognitive load remains an important challenge. Therefore, the aim of this article is twofold: to provide medical educators with three key guidelines for the design of instruction and assessment and to discuss several fundamental issues in the remaining challenges presented by different types of cognitive load. The guidelines revolve around minimizing cognitive activity that does not contribute to learning, working with specific learning goals in mind, and appreciating the multifaceted relation between learning and assessment. Key issues around the types of cognitive load include the context in which learning occurs, the continued use of single-item mental effort ratings, and the timing of cognitive load and learning outcome measurements.

Key elements of high-quality practice organisation in primary health care: a systematic review.

Science.gov (United States)

Crossland, Lisa; Janamian, Tina; Jackson, Claire L

2014-08-04

To identify elements that are integral to high-quality practice and determine considerations relating to high-quality practice organisation in primary care. A narrative systematic review of published and grey literature. Electronic databases (PubMed, CINAHL, the Cochrane Library, Embase, Emerald Insight, PsycInfo, the Primary Health Care Research and Information Service website, Google Scholar) were searched in November 2013 and used to identify articles published in English from 2002 to 2013. Reference lists of included articles were searched for relevant unpublished articles and reports. Data were configured at the study level to allow for the inclusion of findings from a broad range of study types. Ten elements were most often included in the existing organisational assessment tools. A further three elements were identified from an inductive thematic analysis of descriptive articles, and were noted as important considerations in effective quality improvement in primary care settings. Although there are some validated tools available to primary care that identify and build quality, most are single-strategy approaches developed outside health care settings. There are currently no validated organisational improvement tools, designed specifically for primary health care, which combine all elements of practice improvement and whose use does not require extensive external facilitation.

Factors Affecting the Perception of Importance and Practice of Patient Safety Management among Hospital Employees in Korea

Directory of Open Access Journals (Sweden)

In-Sook Kim, RN, PhD

2013-03-01

Conclusion: The findings of this study indicate a need for developing strategies to improve perception of the importance and practice of PSM among all hospital employees, and provide a reference for future experimental studies.

Symbolic Meanings of High and Low Impact Daily Consumption Practices in Different Cultures

DEFF Research Database (Denmark)

Ger, Güliz; Wilhite, Harold; Halkier, Bente

1998-01-01

. They influence our choices and practices whether it is by motivating or impeding them. In this study we will look at the symbolic meanings of high and low environmental impact consumption practices. In order to create desirable social markers for environmentally-friendly practices and/or to change high impact...... practices, we need to understand emergent practices and their existing cultural meanings. Thus we have chosen three fields of daily consumption practices - food consumption, transport and hygiene - and sorted out the relatively environmentally friendly (low impact) and the relatively environmentally...

The perceived importance of anatomy and neuroanatomy in the practice of speech-language pathology.

Science.gov (United States)

Martin, Kate; Bessell, Nicola J; Scholten, Ingrid

2014-01-01

The purpose of this study was to examine the application of anatomy and neuroanatomy knowledge to current practice of speech-language pathology (SLP), based on the perceptions of practicing SLPs, and to elicit information on participants' experiences of learning these subjects in their primary SLP degree with a view to inform potential curriculum development. A qualitative approach was taken to the collection of data. Eight practicing SLPs from four settings were interviewed. The critical incident technique, together with further probing, was used to elicit information. Interviews were transcribed and later thematically analyzed. This study found that knowledge of anatomy and neuroanatomy was perceived to be important by SLPs across all settings, to varying degrees, with a greater application in acute hospital settings. Negative experiences in studying this material were reported across all settings regardless of country of study. Participants discussed ways to increase students' motivation to learn this challenging material. Relevance of material demanded by students may be enhanced if active learning methods were used to teach anatomy/neuroanatomy, including case-based learning and with vertical and horizontal integration of material to provide a cohesive, spiral curriculum. © 2013 American Association of Anatomists.

High school students' work engagement in practical teaching

Directory of Open Access Journals (Sweden)

Milanović-Dobrota Biljana Z.

2017-01-01

Full Text Available The current interest in introducing the dual education system into Serbian secondary education has drawn our attention to the question of students' self-perception in the process of practical teaching. The idea that underpins this paper is the supposition that students are affectively engaged with the work activities they perform. The Utrecht Work Engagement Scale (UWES (Schaufeli et al., 2002 has been used for assessing students' work engagement in practical teaching. A study was conducted to examine the differences between high school students with mild intellectual disabilities and those with typical development with regard to aspects of work engagement defined as Energy, Commitment and Absorption. The sample was comprised of 248 students of vocational high schools in Serbia of both genders, of whom 111 with intellectual disabilities and 137 with typical development. The findings indicate that students with mild intellectual disabilities tend to rate their engagement in practical teaching more positively (t=7,457; p=0,001 than students with typical development. The paper provides a detailed analysis of the pedagogical implications of these findings and also outlines the limitations of the study, thus pointing the way for future research on this or related issues.

High workload and job stress are associated with lower practice performance in general practice: an observational study in 239 general practices in the Netherlands

Directory of Open Access Journals (Sweden)

Grol Richard

2009-07-01

Full Text Available Abstract Background The impact of high physician workload and job stress on quality and outcomes of healthcare delivery is not clear. Our study explored whether high workload and job stress were associated with lower performance in general practices in the Netherlands. Methods Secondary analysis of data from 239 general practices, collected in practice visits between 2003 to 2006 in the Netherlands using a comprehensive set of measures of practice management. Data were collected by a practice visitor, a trained non-physician observer using patients questionnaires, doctors and staff. For this study we selected five measures of practice performance as outcomes and six measures of GP workload and job stress as predictors. A total of 79 indicators were used out of the 303 available indicators. Random coefficient regression models were applied to examine associations. Results and discussion Workload and job stress are associated with practice performance. Workload: Working more hours as a GP was associated with more positive patient experiences of accessibility and availability (b = 0.16. After list size adjustment, practices with more GP-time per patient scored higher on GP care (b = 0.45. When GPs provided more than 20 hours per week per 1000 patients, patients scored over 80% on the Europep questionnaire for quality of GP care. Job stress: High GP job stress was associated with lower accessibility and availability (b = 0.21 and insufficient practice management (b = 0.25. Higher GP commitment and more satisfaction with the job was associated with more prevention and disease management (b = 0.35. Conclusion Providing more time in the practice, and more time per patient and experiencing less job stress are all associated with perceptions by patients of better care and better practice performance. Workload and job stress should be assessed by using list size adjusted data in order to realise better quality of care. Organisational development using

High workload and job stress are associated with lower practice performance in general practice: an observational study in 239 general practices in the Netherlands.

Science.gov (United States)

van den Hombergh, Pieter; Künzi, Beat; Elwyn, Glyn; van Doremalen, Jan; Akkermans, Reinier; Grol, Richard; Wensing, Michel

2009-07-15

The impact of high physician workload and job stress on quality and outcomes of healthcare delivery is not clear. Our study explored whether high workload and job stress were associated with lower performance in general practices in the Netherlands. Secondary analysis of data from 239 general practices, collected in practice visits between 2003 to 2006 in the Netherlands using a comprehensive set of measures of practice management. Data were collected by a practice visitor, a trained non-physician observer using patients questionnaires, doctors and staff. For this study we selected five measures of practice performance as outcomes and six measures of GP workload and job stress as predictors. A total of 79 indicators were used out of the 303 available indicators. Random coefficient regression models were applied to examine associations. Workload and job stress are associated with practice performance.Workload: Working more hours as a GP was associated with more positive patient experiences of accessibility and availability (b = 0.16). After list size adjustment, practices with more GP-time per patient scored higher on GP care (b = 0.45). When GPs provided more than 20 hours per week per 1000 patients, patients scored over 80% on the Europep questionnaire for quality of GP care.Job stress: High GP job stress was associated with lower accessibility and availability (b = 0.21) and insufficient practice management (b = 0.25). Higher GP commitment and more satisfaction with the job was associated with more prevention and disease management (b = 0.35). Providing more time in the practice, and more time per patient and experiencing less job stress are all associated with perceptions by patients of better care and better practice performance. Workload and job stress should be assessed by using list size adjusted data in order to realise better quality of care. Organisational development using this kind of data feedback could benefit both patients and GP.

Aligning Responsible Business Practices

DEFF Research Database (Denmark)

Weller, Angeli E.

2017-01-01

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

Primary benign tumors in chiropractic practice and the importance of x-ray diagnosis: A report of two cases

Science.gov (United States)

Pelletier, Jacques C.

1987-01-01

Two cases of primary benign bone tumors were diagnosed radiographically in a chiropractic practice. Although primary osseous tumors are somewhat uncommon, their potential presence emphasizes the importance of x-ray diagnosis as an essential adjunct to chiropractic practice. This procedure may preclude underlying lesions before considering treatment of seemingly uncomplicated injuries. Two such cases are presented: unicameral bone cyst and osteochondroma. ImagesFigure 1Figure 2Figure 3

Making time for what's important: what elements should we value when planning practice-based professional training?

Science.gov (United States)

Williams, J C; Clements, S

2016-08-12

Newly qualified professional healthcare graduates, whether training to become doctors, dentists, veterinary surgeons or nurses, tend to need some support as they take their first steps along that bumpy road from university to confident, competent practice. We identify some key features of the UK programme of dental practice-based training to acknowledge its strengths - 12 months of clinical practice within a well-established dental team, one-to-one weekly meetings with the same dedicated mentor, regular peer learning with the same group of peers over 12 months and the opportunity to observe role models from the profession including training programme directors and other general dental practitioners (GDPs). This educational programme is unique to dentistry and this article outlines why we believe it is important to value these features when designing postgraduate professional training in healthcare sciences.

Practice and Perceived Importance of Advance Care Planning and Difficulties in Providing Palliative Care in Geriatric Health Service Facilities in Japan: A Nationwide Survey.

Science.gov (United States)

Yokoya, Shoji; Kizawa, Yoshiyuki; Maeno, Takami

2018-03-01

The provision of end-of-life (EOL) care by geriatric health service facilities (GHSFs) in Japan is increasing. Advance care planning (ACP) is one of the most important issues to provide quality EOL care. This study aimed to clarify the practice and perceived importance of ACP and the difficulties in providing palliative care in GHSFs. A self-report questionnaire was mailed to head nurses at 3437 GHSFs nationwide. We asked participants about their practices regarding ACP, their recognition of its importance, and their difficulties in providing palliative care. We also analyzed the relationship between these factors and EOL care education. Among 844 respondents (24.5% response rate), approximately 69% to 81% of head nurses confirmed that GHSF residents and their families understood disease conditions and goals of care. There was a large discrepancy between the actual practice of ACP components and the recognition of their importance (eg, asking residents about existing advance directive [AD; 27.5% practiced it, while 79.6% considered it important]; recommending completion of an AD [18.1% vs 68.4%], and asking for designation of a health-care proxy [30.4% vs 76.8%]). The EOL care education was provided at 517 facilities (61.3%). Head nurses working at EOL care education-providing GHSFs practiced ACP significantly more frequently and had significantly fewer difficulties in providing palliative care. A large discrepancy was found between GHSF nurses' practice of ACP and their recognition of its importance. Providing EOL care education in GHSFs may increase ACP practices and enhance respect for resident's preferences concerning EOL care.

Best Practices Guide for High-Performance Indian Office Buildings

Energy Technology Data Exchange (ETDEWEB)

Singh, Reshma [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Sartor, Dale [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Ghatikar, Girish [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2013-04-01

This document provides best practice guidance and energy- efficiency recommendations for the design, construction, and operation of high-­performance office buildings in India. Through a discussion of learnings from exemplary projects and inputs from experts, it provides recommendations that can potentially help achieve (1) enhanced working environments, (2) economic construction/faster payback, (3) reduced operating costs, and (4) reduced greenhouse gas (GHG) emissions. It also provides ambitious (but achievable) energy performance benchmarks, both as adopted targets during building modeling (design phase) and during measurement and verification (operations phase). These benchmarks have been derived from a set of representative best-in-class office buildings in India. The best practices strategies presented in this guide would ideally help in delivering high-­performance in terms of a triad—of energy efficiency, cost efficiency, and occupant comfort and well-­being. These best practices strategies and metrics should be normalized—that is, corrected to account for building characteristics, diversity of operations, weather, and materials and construction methods.

Republic Scientific-practical Conference 'The Youth Role in solving the most important issues of globalization process' Proceedings

International Nuclear Information System (INIS)

2015-01-01

Present collection comprises of materials of Republic Scientific-practical Conference 'The Youth Role in solving the most important issues of globalization process'. Present collection is intended for scientific and technical staff, postgraduates, and students of institutes of higher education.

PEDAGOGICAL PRACTICE WAY OF CONNECTING PEDAGOGICAL THEORY AND PRACTICE

OpenAIRE

Božo Obradović

2013-01-01

The issue of linking educational theory to educational practice (educational work with young people) is highly topical and important issue for the science of pedagogy. One way of achieving this task is a pedagogical practice (PP) students. In paper we deal with identifying, comparing, and analyzing the curricula of vocational (Curriculum for Preschool Teacher (2007) and academic (Curriculum for Educators (2007). Studies Teacher Training in Serbia, as well as educational disciplines and areas ...

National Best Practices Manual for Building High Performance Schools (Revised)

Energy Technology Data Exchange (ETDEWEB)

2007-10-01

The Best Practices Manual was written as a part of the promotional effort for EnergySmart Schools, provided by the US Department of Energy, to educate school districts around the country about energy efficiency and renewable energy. Written specifically for architects and engineers, The Best Practices Manual is designed to help those who are responsible for designing or retrofitting schools, as well as their project managers. This manual will help design staff make informed decisions about energy and environmental issues important to the school systems and communities.

Importance of public health nurses precepting students in clinical practice: a qualitative study.

Science.gov (United States)

Hjälmhult, Esther; Haaland, Gerd Unstad; Litland, Astrid Synnøve

2013-04-01

Preceptors' working environment, support and competence affect how they perform the preceptor role, are therefore important for developing students and can influence students' roles as students and future professionals. Previous research has focused on precepting student nurses and not so much on public health nurses or other postgraduate students. Knowledge in this field is therefore lacking. The article aims to present a grounded theory of the role of public health nurses as student preceptors in Norway. We conducted 20 interviews with public health nurses in addition to a focus group with four participants. We used classical grounded theory method to gather and analyze data. The preceptors were strongly concerned about invisibility and lack of recognition of the preceptor role. This main concern was resolved by the strategy of being obligated and included three patterns: optimistic, ambivalent and reluctant performance, all with differing motivation for being obligated. All stakeholders involved in clinical practice seem to contribute to making the preceptors' role invisible and thereby contribute to the lack of recognition, support and reward, which again seem to self-reinforce invisibility. The study highlights the obligation of public health nurses in precepting students and increases the understanding of the challenges of this role. Ensuring education of a high academic standard requires paying more attention to developing effective support for the people involved. Copyright © 2012 Elsevier Ltd. All rights reserved.

Assessment of knowledge and practice of menstrual hygiene among high school girls in Western Ethiopia.

Science.gov (United States)

Upashe, Shivaleela P; Tekelab, Tesfalidet; Mekonnen, Jalane

2015-10-14

The issue of menstrual hygiene is inadequately acknowledged and has not received proper attention. Use of sanitary pads and washing the genital area are essential practices to keep the menstrual hygiene. Unhygienic menstrual practices can affect the health of the girls and there is an increased vulnerability to reproductive tract infections and pelvic inflammatory diseases and other complications. Therefore, the objective of this study was to assess the knowledge and practice of menstrual hygiene among high school girls at Nekemte town, Oromia region, Western Ethiopia. A school based cross-sectional study design was employed in Nekemte Town, Western Ethiopia. A multi stage sampling technique was used to select 828 female high school students. Data collection was carried out from May 04 to May 30, 2014 using a pre- tested structured questionnaire. The data were entered into a computer using Epi-info version 3.5.1 and then exported to SPSS for Windows version 20.0 for analysis. Bivariate and multivariate logistic regression analysis was done at 95 % confidence interval. In this study, 504 (60.9 %) and 330 (39.9 %) respondents had good knowledge and practice of menstrual hygiene respectively. The findings of the study showed a significant positive association between good knowledge of menstruation and educational status of mothers (AOR = 1.51, 95 % CI = 1.02 - 2.22), having radio/TV (AOR = 2.42, 95 % CI: 1.64 - 3.56). Educational status of the mother (AOR = 2.03, 95 % CI = 1.38 - 2.97) and earning permanent pocket money from parents (AOR = 2.73, 95 % CI = 1.76 - 4.26) revealed significant positive association with good practice of menstrual hygiene. The findings showed that the knowledge and practice of menstrual hygiene is low. Awareness regarding the need for information about good menstrual practices is very important. So, health education program should be setup to create awareness and practice of good menstrual hygiene.

High-Frequency Technical Trading: The Importance of Speed

NARCIS (Netherlands)

M.L. Scholtus (Martin); D.J.C. van Dijk (Dick)

2012-01-01

textabstractThis paper investigates the importance of speed for technical trading rule performance for three highly liquid ETFs listed on NASDAQ over the period January 6, 2009 up to September 30, 2009. In addition we examine the characteristics of market activity over the day and within subperiods

Shared decision making in mental health: the importance for current clinical practice.

Science.gov (United States)

Alguera-Lara, Victoria; Dowsey, Michelle M; Ride, Jemimah; Kinder, Skye; Castle, David

2017-12-01

We reviewed the literature on shared decision making (regarding treatments in psychiatry), with a view to informing our understanding of the decision making process and the barriers that exist in clinical practice. Narrative review of published English-language articles. After culling, 18 relevant articles were included. Themes identified included models of psychiatric care, benefits for patients, and barriers. There is a paucity of published studies specifically related to antipsychotic medications. Shared decision making is a central part of the recovery paradigm and is of increasing importance in mental health service delivery. The field needs to better understand the basis on which decisions are reached regarding psychiatric treatments. Discrete choice experiments might be useful to inform the development of tools to assist shared decision making in psychiatry.

The Conditional Nature of High Impact/Good Practices on Student Learning Outcomes

Science.gov (United States)

Seifert, Tricia A.; Gillig, Benjamin; Hanson, Jana M.; Pascarella, Ernest T.; Blaich, Charles F.

2014-01-01

Using a multi-institutional sample of undergraduate students, this study found that the relationships between engaging in high impact/good practices and liberal arts outcomes differ based on students' precollege and background characteristics. Findings suggest that high impact/good practices are not a panacea and require a greater degree of…

Metabolic syndrome in family practice in Jordan: a study of high-risk groups.

Science.gov (United States)

Yasein, N; Masa'd, D

2011-12-01

This study assessed the prevalence of the metabolic syndrome, and its components, as defined by Adult Treatment Panel III criteria in Jordanian patients attending a family practice clinic for management of cardiovascular risk factors. The sample was 730 randomly selected patients aged > or = 25 years. The prevalence of metabolic syndrome was 37.4% (31.7% in men; 41.0% in women). The prevalence increased with age in the total sample and in both sexes. High waist circumference showed the highest prevalence in the total sample (61.6%). Among females it ranked as the first criterion (73.5%). High serum triglyceride level showed the highest prevalence in males (50.2%). Differences between the sexes were significant. Family practitioners should be alerted to the importance of multiple risk factors in the metabolic syndrome.

Transferring Aviation Practices into Clinical Medicine for the Promotion of High Reliability.

Science.gov (United States)

Powell-Dunford, Nicole; McPherson, Mark K; Pina, Joseph S; Gaydos, Steven J

2017-05-01

Aviation is a classic example of a high reliability organization (HRO)-an organization in which catastrophic events are expected to occur without control measures. As health care systems transition toward high reliability, aviation practices are increasingly transferred for clinical implementation. A PubMed search using the terms aviation, crew resource management, and patient safety was undertaken. Manuscripts authored by physician pilots and accident investigation regulations were analyzed. Subject matter experts involved in adoption of aviation practices into the medical field were interviewed. A PubMed search yielded 621 results with 22 relevant for inclusion. Improved clinical outcomes were noted in five research trials in which aviation practices were adopted, particularly with regard to checklist usage and crew resource-management training. Effectiveness of interventions was influenced by intensity of application, leadership involvement, and provision of staff training. The usefulness of incorporating mishap investigation techniques has not been established. Whereas aviation accident investigation is highly standardized, the investigation of medical error is characterized by variation. The adoption of aviation practices into clinical medicine facilitates an evolution toward high reliability. Evidence for the efficacy of the checklist and crew resource-management training is robust. Transference of aviation accident investigation practices is preliminary. A standardized, independent investigation process could facilitate the development of a safety culture commensurate with that achieved in the aviation industry.Powell-Dunford N, McPherson MK, Pina JS, Gaydos SJ. Transferring aviation practices into clinical medicine for the promotion of high reliability. Aerosp Med Hum Perform. 2017; 88(5):487-491.

Importing low-density ideas to high-density revitalisation

DEFF Research Database (Denmark)

Arnholtz, Jens; Ibsen, Christian Lyhne; Ibsen, Flemming

2016-01-01

Why did union officials from a high-union-density country like Denmark choose to import an organising strategy from low-density countries such as the US and the UK? Drawing on in-depth interviews with key union officials and internal documents, the authors of this article argue two key points. Fi...

Importance of Multifaceted Approaches in Infection Control: A Practical Experience from an Outbreak Investigation.

Directory of Open Access Journals (Sweden)

Nina Katharina Stock

Full Text Available This study presents the results of a multidisciplinary, nosocomial MRSA outbreak investigation in an 8-bed medical intensive care unit (ICU. The identification of seven MRSA positive patients in the beginning of 2014 led to the closure of the ward for several weeks. A multidisciplinary, retrospective investigation was initiated in order to identify the reason and the source for the outbreak, describe MRSA transmission in the department and identify limitations in infection control.The investigation comprised an epidemiological description of MRSA cases from 2012 to 2014 and a characterization of MRSA isolates, including phage-, spa- and PFGE-typing. Additionally, MRSA screening was performed from the hospital staff and the environment. To identify the reason for the outbreak, work-related, psychological and behavioral factors were investigated by impartial audits and staff interviews.Thirty-one MRSA cases were registered during the study period, and 36 isolates were investigated. Molecular typing determined the outbreak strain (phage type 54/812, PFGE type A4, spa type t003 and identified the probable index case. Nasal carriage in one employee and a high environmental contamination with the outbreak strain was documented. Important gaps in nursing procedures and general management were identified. Elevated stress levels and communication problems preceded the outbreak. Compliance with hand hygiene and isolation procedures was evaluated as appropriate.This study demonstrates the complexity of controlling hospital-associated infections. The combined use of different typing methods is beneficial for outbreak investigations. Psychological, behavioral and other work-related factors have an important impact on the spread of nosocomial pathogens. These factors should be addressed and integrated in routine infection control practice.

Child-rearing practices toward children with hemophilia: The relative importance of clinical characteristics and parental emotional reactions

NARCIS (Netherlands)

Banis, Hendrika; Suurmeijer, Th.P.B.M.; van Peer, D.R.

This study addresses the relative importance of clinical characteristics of the child and parental emotional reactions, to child-rearing practices towards children who suffer from hemophilia. The variables were assessed in a Dutch sample of 108 zero-to-twelve-year-old boys with hemophilia and their

Caring for 'Very Important Patients'--Ethical Dilemmas and Suggestions for Practical Management.

Science.gov (United States)

Alfandre, David; Clever, Sarah; Farber, Neil J; Hughes, Mark T; Redstone, Paul; Lehmann, Lisa Soleymani

2016-02-01

The care of Very Important Patients (VIPs) is different from other patients because they may receive greater access, attention, and resources from health care staff. Although the term VIP is used regularly in the medical literature and is implicitly understood, in practice it constitutes a wide and heterogeneous group of patients that have a strong effect on health care providers. We define a VIP as a very influential patient whose individual attributes and characteristics (eg, social status, occupation, position), coupled with their behavior, have the potential to significantly influence a clinician's judgment or behavior. Physicians, celebrities, the politically powerful, and philanthropists, may all become VIPs in the appropriate context. The quality of care may be inferior because health care professionals may deviate from standard practices when caring for them. Understanding the common features among what may otherwise be very different groups of patients can help health care providers manage ethical concerns when they arise. We use a series of vignettes to demonstrate how VIPs behavior and status can influence a clinician's judgment or actions. Appreciating the ethical principles in these varied circumstances provides health care professionals with the tools to manage ethical conflicts that arise in the care of VIPs. We conclude each vignette with guidance for how health care providers and administrators can manage the ethical concern. Published by Elsevier Inc.

Exertional Heat Illnesses and Environmental Conditions During High School Football Practices.

Science.gov (United States)

Tripp, Brady L; Eberman, Lindsey E; Smith, Michael Seth

2015-10-01

Guidelines for preventing exertional heat illnesses (EHIs) during extreme heat stress should be specific to regional environments, age, and sport and should be based on evidence of reducing the risk. Each year in the United States, over 1 million high school football players practice in the August heat; however, no published data describe the incidence of EHIs in these athletes. To describe the environmental conditions and incidence of EHIs during high school football practices over a 3-month period. Descriptive epidemiology study. For a 3-month period (August-October), athletic trainers at 12 high schools in North Central Florida recorded the practice time and length, environmental conditions (wet-bulb globe temperature), and incidences of EHIs in varsity football athletes. Athletes suffered 57 total EHIs during 29,759 athlete-exposures (AEs) for the 3-month data collection period (rate = 1.92/1000 AEs). August accounted for the majority of all EHIs, with 82.5% (47/57) and the highest rate (4.35/1000 AEs). Of total heat illnesses, heat cramps accounted for 70.2% (40/57), heat exhaustion 22.8% (13/57), and heat syncope 7.0% (4/57). The odds ratio indicated that athletes in August practices that lasted longer than the recommended 3 hours were 9.84 times more likely to suffer a heat illness than those in practices lasting ≤3 hours. The highest rate of EHIs was during August. Practices in August that exceeded the recommended 3 hours were associated with a greater risk of heat illnesses. The overall rate of EHIs was lower for the high school football athletes observed in the study compared with that reported for collegiate football athletes in the region. The low rates of EHIs recorded suggest that the prevention guidelines employed by sports medicine teams are appropriate for the region and population. Team physicians and athletic trainers should employ evidence-based, region- and population-specific EHI prevention guidelines. Sports medicine teams, coaches, and

Context matters: the experience of 14 research teams in systematically reporting contextual factors important for practice change.

Science.gov (United States)

Tomoaia-Cotisel, Andrada; Scammon, Debra L; Waitzman, Norman J; Cronholm, Peter F; Halladay, Jacqueline R; Driscoll, David L; Solberg, Leif I; Hsu, Clarissa; Tai-Seale, Ming; Hiratsuka, Vanessa; Shih, Sarah C; Fetters, Michael D; Wise, Christopher G; Alexander, Jeffrey A; Hauser, Diane; McMullen, Carmit K; Scholle, Sarah Hudson; Tirodkar, Manasi A; Schmidt, Laura; Donahue, Katrina E; Parchman, Michael L; Stange, Kurt C

2013-01-01

We aimed to advance the internal and external validity of research by sharing our empirical experience and recommendations for systematically reporting contextual factors. Fourteen teams conducting research on primary care practice transformation retrospectively considered contextual factors important to interpreting their findings (internal validity) and transporting or reinventing their findings in other settings/situations (external validity). Each team provided a table or list of important contextual factors and interpretive text included as appendices to the articles in this supplement. Team members identified the most important contextual factors for their studies. We grouped the findings thematically and developed recommendations for reporting context. The most important contextual factors sorted into 5 domains: (1) the practice setting, (2) the larger organization, (3) the external environment, (4) implementation pathway, and (5) the motivation for implementation. To understand context, investigators recommend (1) engaging diverse perspectives and data sources, (2) considering multiple levels, (3) evaluating history and evolution over time, (4) looking at formal and informal systems and culture, and (5) assessing the (often nonlinear) interactions between contextual factors and both the process and outcome of studies. We include a template with tabular and interpretive elements to help study teams engage research participants in reporting relevant context. These findings demonstrate the feasibility and potential utility of identifying and reporting contextual factors. Involving diverse stakeholders in assessing context at multiple stages of the research process, examining their association with outcomes, and consistently reporting critical contextual factors are important challenges for a field interested in improving the internal and external validity and impact of health care research.

High-efficiency and low-cost permanent magnet guideway consideration for high-Tc superconducting Maglev vehicle practical application

International Nuclear Information System (INIS)

Deng, Z; Wang, J; Zheng, J; Jing, H; Lu, Y; Ma, G; Liu, L; Liu, W; Zhang, Y; Wang, S

2008-01-01

In order to improve the cost performance of the present high-T c superconducting (HTS) Maglev vehicle system for practical application, the multi-pole permanent magnet guideway (PMG) concept was introduced. A well-known double-pole Halbach PMG was chosen as a representative of multi-pole PMGs to compare with traditional monopole PMGs from the point of view of levitation efficiency and cost. Experimental results show that YBCO bulks above the double-pole Halbach PMG can exhibit better load capability and guidance performance as well as dynamics stability at the applied working height between the bulk HTSC and the PMG due to a more reasonable magnetic field distribution at the working range of bulk HTSC. Furthermore, the double-pole PMG configuration can play a more important role in improving guidance performance due to the potential-well field configuration. By comparing with former 'century' PMGs, the double-pole Halbach PMG shows another remarkable advantage in reducing the cost of levitation. As another necessary issue, magnetic field homogeneity and the corresponding magnetic drag force of a double-pole Halbach PMG has been considered by experiment in spite of the above highlights. Synthetically, the multi-pole Halbach PMG design is concluded to be one important choice for future HTS Maglev vehicle applications because of its high efficiency and low cost.

Knowledge, Attitude and Practice of Menstrual Hygiene among High Schools Students in Jatinangor

Directory of Open Access Journals (Sweden)

Maryam Balqis

2016-06-01

Full Text Available Background: Menstruation is a physiological process in female adolescents which usually started at age of 9–12 years. Menstrual hygiene is a hygienic practice during menstruation which can prevent women from the infection in reproductive and urinary tract. Lack of knowledge regarding menstruation and menstrual hygiene lead to poor attitude and practice. This study was conducted to assess the level of knowledge, attitude and practice of menstrual hygiene among high schools students in Jatinangor. Methods: This descriptive cross-sectional study was conducted from May until June 2013 in high schools around Jatinangor. This study population was taken from four schools selected through cluster random sampling from 17 junior and senior high schools available in Jatinangor. Total sampling from four schools was undertaken and a total of 238 female high school students’ data were established. The respondents aged between 13–19 years old. Results: The level of knowledge, attitude and practice among participants were 180 (75.63%, 186 (78.15% and 210 (88.24% respectively which were mostly good. Conclusions: Overall, most of the participants in this study have good knowledge, attitude and practice about menstrual hygiene, but a few of them still have poor and moderate knowledge and attitude, although there is no poor practice among them.

Importance of court practice review in Russian arbitration (commercial) court proceedings

OpenAIRE

Solovyev, A.

2013-01-01

The article concerns the matters of court practice review in terms of participation in arbitration (commercial) court proceedings. The author gives general description of the system of the arbitration courts administering business and economic justice in the Russian Federation, covered the key areas and worked out the practical recommendations concerning the focal points of arranging the appropriate work in respect of review of law enforcement practice of such courts.

An embedded longitudinal multi-faceted qualitative evaluation of a complex cluster randomized controlled trial aiming to reduce clinically important errors in medicines management in general practice

Directory of Open Access Journals (Sweden)

Cresswell Kathrin M

2012-06-01

. However, important concerns were identified about the likely sustainability of this new model of delivering care, in the absence of an appropriate support network for pharmacists and career development pathways. Conclusions This embedded qualitative inquiry has helped to understand the complex organizational and social environment in which the trial was undertaken and the PINCER intervention was delivered. The longitudinal element has given insight into the dynamic changes and developments over time. Medication errors and ways to address these are high on stakeholders’ agendas. Our results further indicate that pharmacists were, because of their professional standing and skill-set, able to engage with the complex general practice environment and able to identify and manage many clinically important errors in medicines management. The transferability of the PINCER intervention approach, both in relation to other prescribing errors and to other practices, is likely to be high.

Characteristics of primary care practices associated with high quality of care.

Science.gov (United States)

Beaulieu, Marie-Dominique; Haggerty, Jeannie; Tousignant, Pierre; Barnsley, Janet; Hogg, William; Geneau, Robert; Hudon, Éveline; Duplain, Réjean; Denis, Jean-Louis; Bonin, Lucie; Del Grande, Claudio; Dragieva, Natalyia

2013-09-03

No primary practice care model has been shown to be superior in achieving high-quality primary care. We aimed to identify the organizational characteristics of primary care practices that provide high-quality primary care. We performed a cross-sectional observational study involving a stratified random sample of 37 primary care practices from 3 regions of Quebec. We recruited 1457 patients who had 1 of 2 chronic care conditions or 1 of 6 episodic care conditions. The main outcome was the overall technical quality score. We measured organizational characteristics by use of a validated questionnaire and the Team Climate Inventory. Statistical analyses were based on multilevel regression modelling. The following characteristics were strongly associated with overall technical quality of care score: physician remuneration method (27.0; 95% confidence interval [CI] 19.0-35.0), extent of sharing of administrative resources (7.6; 95% CI 0.8-14.4), presence of allied health professionals (15.3; 95% CI 5.4-25.2) and/or specialist physicians (19.6; 95% CI 8.3-30.9), the presence of mechanisms for maintaining or evaluating competence (7.7; 95% CI 3.0-12.4) and average organizational access to the practice (4.9; 95% CI 2.6-7.2). The number of physicians (1.2; 95% CI 0.6-1.8) and the average Team Climate Inventory score (1.3; 95% CI 0.1-2.5) were modestly associated with high-quality care. We identified a common set of organizational characteristics associated with high-quality primary care. Many of these characteristics are amenable to change through practice-level organizational changes.

Different paths to high-quality care: three archetypes of top-performing practice sites.

Science.gov (United States)

Feifer, Chris; Nemeth, Lynne; Nietert, Paul J; Wessell, Andrea M; Jenkins, Ruth G; Roylance, Loraine; Ornstein, Steven M

2007-01-01

Primary care practices use different approaches in their quest for high-quality care. Previous work in the Practice Partner Research Network (PPRNet) found that improved outcomes are associated with strategies to prioritize performance, involve staff, redesign elements of the delivery system, make patients active partners in guideline adherence, and use tools embedded in the electronic medical record. The aim of this study was to examine variations in the adoption of improvements among sites achieving the best outcomes. This study used an observational case study design. A practice-level measure of adherence to clinical guidelines was used to identify the highest performing practices in a network of internal and family medicine practices participating in a national demonstration project. We analyzed qualitative and quantitative information derived from project documents, field notes, and evaluation questionnaires to develop and compare case studies. Nine cases are described. All use many of the same improvement strategies. Differences in the way improvements are organized define 3 distinct archetypes: the Technophiles, the Motivated Team, and the Care Enterprise. There is no single approach that explains the superior performance of high-performing practices, though each has adopted variations of PPRNet's improvement model. Practices will vary in their path to high-quality care. The archetypes could prove to be a useful guide to other practices selecting an overall quality improvement approach.

[IMPORTANCE OF SHEAR WAVE ELASTOGRAPHY OF LIVERS IN PRACTICALLY HEALTHY PREGNANT WOMEN].

Science.gov (United States)

Sariyeva, E; Salahova, S; Bayramov, N

2017-01-01

Pulse-wave elastography (SWE) that is one of the mostly used methods in the recent years holds important place in assessment of liver fibrosis. However there is no exact information on the results of liver elastography in healthy pregnant women in the world literature. The aim of the study was to investigate theSWE parameters of liver elastography in practically healthy pregnant women. The subject of the research was 50 practically healthy pregnant women within 18-45 years old (mean age 27.7±0.7). The pregnant women with genital and extragenital diseases were not included to the research. The research work was executed in the II Department of Obstetrics and Gynecology of Azerbaijan Medical University. SWE of liver in pregnant women was conducted in the I Department of Surgical Diseases of Azerbaijan Medical University through Supersonic Aixplorer Multi Wave device presented by the Scientific Development Foundation under the President of the Azerbaijan Republic. The obtained tissue hardness indicators are assessed under METAVIR scale. The results of the research showed that the measures of liver in practically healthy pregnant women are normal, edges flat, its echogenicity mainly normal, echostructure of its parenchyma homogenous, hardness was F0-F1 (normal) under METAVIR scale, fibrosis not observed. The obtained results were processed by variational (power average, percentile distribution) and correlation (ρ-Spearman) analyzes using the statistical package SPSS-20. A statistical study of the distribution of liver density in healthy women showed that the average density was 4,43±0,01 with 95% confidence interval (4,23 - 4,63). The histogram of distribution of liver density in practically healthy women belongs to the family of normal distributions with coefficients of variation coefficient (16.3%), asymmetry (-0.861±0.337) and excess (-0.068±0.662). Correlation analysis in healthy women did not reveal a reliable relationship between age and liver density (ρ=0

High schoolers masturbatory practices: their relationship to sexual intercourse and personal characteristics.

Science.gov (United States)

Smith, A M; Rosenthal, D A; Reichler, H

1996-10-01

This study examined the self-reported masturbatory experiences of high schooler and the relationships between masturbation and sexual intercourse and personal characteristics of these young people. A total of 436 suburban Australian adolescents between 15 and 18 years of age participated. Boys were more likely to report ever having masturbated (58.5%, versus 42.7%) and to have done so more frequently than girls (38.2% versus 8.7% reporting masturbating three or more times a week). While there was no significant sex difference in the age of initiation of masturbation there was some evidence that girls began masturbation earlier than boys. Whether sexual intercourse replaced or supplemented masturbation as a sexual practice could not be resolved, but there was evidence that masturbation was positively correlated with sexual self esteem. Young people whose parents provided a more open environment for the discussion of sexuality were more likely to report having masturbated, although the environment had a complex relationship with masturbatory practices as did young people's self rated physical maturity compared to their peers. A range of social and contextual factors must be explored to understand more fully this important component of young people's sexual experience.

Job satisfaction of practice assistants in general practice in Germany: an observational study.

Science.gov (United States)

Goetz, Katja; Campbell, Stephen; Broge, Bjoern; Brodowski, Marc; Steinhaeuser, Jost; Wensing, Michel; Szecsenyi, Joachim

2013-08-01

Job satisfaction of practice staff is important for optimal health care delivery and for minimizing the turnover of non-medical professions. To document the job satisfaction of practice assistants in German general practice and to explore associations between job satisfaction, staff characteristics and culture in general practice organizations. The study was based on data from the European Practice Assessment accreditation scheme for general practices and used an observational design. The study population consisted of 1158 practice assistants from 345 general practices across Germany. Job satisfaction was measured with the 10-item Warr-Cook-Wall questionnaire. Organizational culture was evaluated with four items. A linear regression analysis was performed in which each of the job satisfaction items was handled as dependent variable. Out of 1716 staff member questionnaires handed out to practice assistants, 1158 questionnaires were completed (response rate: 67.5%). Practice assistants were most satisfied with their colleagues and least satisfied with their income. Higher job satisfaction was associated with issues of organizational culture, particularly a good working atmosphere, opportunities to suggest and influence areas for improvement and clear responsibilities within the practice team. Prioritizing initiatives to maintain high levels of, or to improve the job satisfaction of practice assistants, is important for recruitment and retention. It will also help to improve working conditions for both practice assistants and GPs and create an environment to provide better quality care.

Outstanding High School Coaches: Philosophies, Views, and Practices

Science.gov (United States)

Miller, Glenn A.; Lutz, Rafer; Fredenburg, Karen

2012-01-01

The goal of this study was to examine the coaching philosophies, views, and practices of outstanding high school coaches of various male and female sports across the United States. The intention was to determine whether these coaches used unique or innovative techniques or strategies that contributed to their success and, if so, whether these…

Safety reloaded: lean operations and high involvement work practices for sustainable workplaces

OpenAIRE

Camuffo, Arnaldo; De Stefano, Federica; Paolino, Chiara

2017-01-01

Starting from the recent quest to investigate the human side of organizational sustainability, this study applies a variety of regression analyses to investigate the effects of Lean Operations, High Involvement Work Practices, and management behaviors on occupational safety. It tests and finds support for the hypotheses that Lean Production systems, High Involvement Work Practices, and two specific management behaviors—workers’ capability development (coaching and teaching of workers) and emp...

The Role of Goal Importance in Predicting University Students' High Academic Performance

Science.gov (United States)

Kyle, Vanessa A.; White, Katherine M.; Hyde, Melissa K.; Occhipinti, Stefano

2014-01-01

We examined goal importance, focusing on high, but not exclusive priority goals, in the theory of planned behaviour (TPB) to predict students' academic performance. At the beginning of semester, students in a psychology subject (N = 197) completed TPB and goal importance items for achieving a high grade. Regression analyses revealed partial…

What do prisoners eat? Nutrient intakes and food practices in a high-secure prison.

Science.gov (United States)

Hannan-Jones, Mary; Capra, Sandra

2016-04-01

There are limited studies on the adequacy of prisoner diet and food practices, yet understanding these are important to inform food provision and assure duty of care for this group. The aim of this study was to assess the dietary intakes of prisoners to inform food and nutrition policy in this setting. This research used a cross-sectional design with convenience sampling in a 945-bed male high-secure prison. Multiple methods were used to assess food available at the group level, including verification of food portion, quality and practices. A pictorial tool supported the diet history method. Of 276 eligible prisoners, 120 dietary interviews were conducted and verified against prison records, with 106 deemed plausible. The results showed the planned food to be nutritionally adequate, with the exception of vitamin D for older males and long-chain fatty acids, with Na above upper limits. The Australian dietary targets for chronic disease risk were not achieved. High energy intakes were reported with median 13·8 (se 0·3) MJ. Probability estimates of inadequate intake varied with age groups: Mg 8 % (>30 years), 2·9 % (70 years), 1·5 % (food provision in the prison environment and also poses questions for population-level dietary guidance in delivering appropriate nutrients within energy limits.

Insect pests of sweetpotato in Uganda: farmers' perceptions of their importance and control practices.

Science.gov (United States)

Okonya, Joshua Sikhu; Mwanga, Robert Om; Syndikus, Katja; Kroschel, Jürgen

2014-01-01

Insect pests are among the most important constraints limiting sweetpotato (Ipomoea batatas) production in Africa. However, there is inadequate information about farmers' knowledge, perceptions and practices in the management of key insect pests. This has hindered development of effective pest management approaches for smallholder farmers. A standard questionnaire was used to interview individual sweetpotato farmers (n = 192) about their perception and management practices regarding insect pests in six major sweetpotato producing districts of Uganda. The majority (93%) of farmers perceived insect pests to be a very serious problem. With the exception of Masindi and Wakiso districts where the sweetpotato butterfly (Acraea acerata) was the number one constraint, sweetpotato weevils (Cylas puncticollis and C. brunneus) were ranked as the most important insect pests. Insecticide use in sweetpotato fields was very low being highest (28-38% of households) in districts where A. acerata infestation is the biggest problem. On average, 65% and 87% of the farmers took no action to control A. acerata and Cylas spp., respectively. Farmers were more conversant with the presence of and damage by A. acerata than of Cylas spp. as they thought that Cylas spp. root damage was brought about by a prolonged dry season. Different levels of field resistance (ability of a variety to tolerate damage) of sweetpotato landraces to A. acerata (eight landraces) and Cylas spp. (six landraces) were reported by farmers in all the six districts. This perceived level of resistance to insect damage by landraces needs to be investigated. To improve farmers' capabilities for sweetpotato insect pest management, it is crucial to train them in the basic knowledge of insect pest biology and control.

Practical Statistics

CERN Document Server

Lyons, L.

2016-01-01

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.

How to Use the School Survey of Practices Associated with High Performance. REL 2016-162

Science.gov (United States)

Weinstock, Phyllis; Yumoto, Futoshi; Abe, Yasuyo; Meyers, Coby; Wan, Yinmei

2016-01-01

This report describes and explains how to use the School Survey of Practices Associated with High Performance, which measures the degree to which schools are engaging in practices associated with high performance. State education departments and school districts can use the survey results to identify and describe school practices associated with…

High-Performance Management Practices and Employee Outcomes in Denmark

DEFF Research Database (Denmark)

Cristini, Annalisa; Eriksson, Tor; Pozzoli, Dario

2013-01-01

affect workers in terms of wages, wage inequality and workforce composition. The analysis is based on a survey directed at Danish firms matched with linked employer–employee data and also examines whether the relationship between high-involvement work practices and employee outcomes is affected...

Science: from practice to teaching – The importance of research episodes in teacher formation

Directory of Open Access Journals (Sweden)

Deise Miranda Vianna

2001-05-01

Full Text Available Current researches into teacher formation show different aspects in their approaches. To teach science, a professional is required to have more than knowledge of the contents and possession of good didactic skills. Teacher formation (initial and continued is a broad problem, and a challenge, facing the innumerous questions already raised by experienced professionals in this field. Our research is directed at permanent teacher formation (initial and continued, giving priority to the relationship between DOING SCIENCE and TEACHING SCIENCE (VIANNA, 1998, while attempting to compare scientists practice at laboratories with teachers’ science. We analyzed a refresher course for High School teachers of Biology in Rio de Janeiro. We highlighted the parts of this course that took place in research laboratories, which we refer to as “research episodes,” showing what participants gained from this experience: knowledge about scientists’ practices, what they do, what they say, how they behave, how they interact, what they build, what they publish in their articles and why, that is: TO EXPERIENCE DAILY SCIENTIFIC PRACTICE. We looked at these “episodes” according to LATOUR and WOOLGAR (1988, 1989, 1994, 1995, 1997. The teachers who attended the course were queried about its influence on their teaching formation. They emphasized the perception they gained about how scientific knowledge is built, the passion researchers have for their activity, the new technologies and instruments used nowadays, and their desire to adopt a new approach in the classroom. Our work points out the need for a permanent teacher formation, establishing an analogy between scientific and pedagogic research with teaching practice.

Costing Practices in Healthcare

DEFF Research Database (Denmark)

Chapman, Christopher; Kern, Anja; Laguecir, Aziza

2014-01-01

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

High-performance workplace practices in nursing homes: an economic perspective.

Science.gov (United States)

Bishop, Christine E

2014-02-01

To develop implications for research, practice and policy, selected economics and human resources management research literature was reviewed to compare and contrast nursing home culture change work practices with high-performance human resource management systems in other industries. The organization of nursing home work under culture change has much in common with high-performance work systems, which are characterized by increased autonomy for front-line workers, self-managed teams, flattened supervisory hierarchy, and the aspiration that workers use specific knowledge gained on the job to enhance quality and customization. However, successful high-performance work systems also entail intensive recruitment, screening, and on-going training of workers, and compensation that supports selective hiring and worker commitment; these features are not usual in the nursing home sector. Thus despite many parallels with high-performance work systems, culture change work systems are missing essential elements: those that require higher compensation. If purchasers, including public payers, were willing to pay for customized, resident-centered care, productivity gains could be shared with workers, and the nursing home sector could move from a low-road to a high-road employment system.

The importance of least restrictive care: the clinical implications of a recent High Court decision on negligence.

Science.gov (United States)

Ryan, Christopher James; Callaghan, Sascha; Large, Matthew

2015-08-01

This paper aims to explain the meaning and implications for practice of the High Court of Australia's finding in the negligence case, Hunter and New England Local Health District v McKenna [2014] HCA 44. The facts of the case and the law of negligence are reviewed before reporting the Court's decision. The High Court found that the obligation upon doctors to provide the least restrictive option for care that was imposed by the, then applicable, Mental Health Act 1990 (NSW) was inconsistent with an obligation that might otherwise be imposed by a common law duty to have regard to the interests of those with whom a psychiatric patient may come into contact if not detained. The Court's finding underlines the importance of clinicians documenting their clinical reasoning around why their negotiated management plan was the option least restrictive of the patient's freedom and most protective of his or her human rights. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Connecting high-level principles and objectives with practical compliance criteria

International Nuclear Information System (INIS)

O'Sullivan, P.

2008-01-01

Designed as a Rapporteur if the session, on connecting high-level principles and objectives with practical compliance criteria, the author reports its observations and conclusions concerning the participants speeches. (A.L.B.)

Important interactional strategies for everyday public health nursing practice.

Science.gov (United States)

Porr, Caroline J

2015-01-01

This Clinical Concepts article concerns the relational tools required by public health nurses to establish relationships with single mothers living on public assistance, mothers who are vulnerable and often stigmatized. The implications of stigmatization for relationship building are highlighted based on previous research investigating how public health nurses working in Canadian jurisdictions establish professional caring relationships with this cohort of mothers. Public health nurses employed interactional strategies including engaging in a positive manner and offering verbal commendations which served as effective relational tools to break through mothers' walls of defensiveness and to resume the dynamic process of relationship building. Building Relationship is a key practice standard for public health nurses and is instrumental to their work at both individual and community levels to improve social determinants of health. The author concludes with recommendations to facilitate building relationships during everyday public health nursing practice. © 2013 Wiley Periodicals, Inc.

THE IMPORTANCE OF AFFECT TO BUILD CONSUMER TRUST IN HIGH-CONSEQUENCES EXCHANGES

Directory of Open Access Journals (Sweden)

Mellina da Silva Terres

2012-12-01

Full Text Available The present article investigates the importance of affect displayed by service provider to build consumer trust in high consequence exchanges. High-consequence exchanges are difficult situations in which the choices present a dilemma that can cause stress and severe emotional reactions (KAHN; LUCE, 2003. In this specific case, trust based on affect seems to become important; mainly because consumers may not have ability to evaluate the cognitive aspects of the situation, and moreover, a medical services failure can be highly problematic or even fatal (LEISEN; HYMAN, 2004. On the other hand, in low-consequence choices, we are predicting that cognition will be more important than affect in building trust. In this kind of situation, patients are more self-confident, less sensitive, and don’t perceive a high probability of loss (KUNREUTHER et al., 2002, and therefore focuses more on the rational outcomes.

Fluid dynamics practices as a scientific divulgation tool in high school education

Directory of Open Access Journals (Sweden)

Fabiano Tavares da Silva

2016-12-01

Full Text Available http://dx.doi.org/10.5007/1807-0221.2016v13n24p94 This extension project was designed to bring together students from high schools in Nova Friburgo-RJ region with the Instituto Politécnico IPRJ / UERJ, providing an experience within the university with scientific incentive practices to the area of sciences and earth. Introducing the universe and diversity in the mathematics and science area with a short course aimed to studies of particles analysis, viscosity and permeability, this initiative encompasses more than knowledge of these activities, but also restore the link between school and university, inserting the high school students in the university environment and scientific activities. The importance of providing a "north" for teens, due to the great difficulty of choosing their profession, makes this Extension Project a potential tool that will certainly contribute to the professional future of these young citizens. Therefore, the students had a laboratory experience and also it was possible to motivate them to go further in the superior education through the awareness that university is accessible to all of people.

High workload and job stress are associated with lower practice performance in general practice: an observational study in 239 general practices in the Netherlands.

NARCIS (Netherlands)

Hombergh, P. van den; Kunzi, B.; Elwyn, G.; Doremalen, J.H.M. van; Akkermans, R.P.; Grol, R.P.T.M.; Wensing, M.J.P.

2009-01-01

BACKGROUND: The impact of high physician workload and job stress on quality and outcomes of healthcare delivery is not clear. Our study explored whether high workload and job stress were associated with lower performance in general practices in the Netherlands. METHODS: Secondary analysis of data

Practical lubrication for industrial facilities

CERN Document Server

Bloch, Heinz

2016-01-01

Now completely revised and updated, this definitive, hands-on reference provides a comprehensive resource on the fundamental principles of lubricant application, what products are available, and which lubricants are most effective for specific applications. It also offers a detailed and highly practical discussion of lubrication delivery systems. You'll gain a clearer understanding of the "why" of relevant industrial lubrication practices, and, importantly, how these practices will facilitate optimized results. Lubricant applications covered include bearings and machine elements in earthbound

Relationships between Parenting Practices, Social Engagement, Academic Competency, and High School Dropout

Science.gov (United States)

Bedrossian, Alfred

2017-01-01

The purpose of this study was to investigate the relationships between parenting practices, social engagement, academic competency, and high school dropout. The study revealed students whose parents practiced Reactive Communication along with students that exhibited Truancy and Disciplinary Issues were more likely to drop out. Conversely, students…

Risk analysis methods: their importance for safety assessment of practices using radiation

International Nuclear Information System (INIS)

Dumenigo, C; Vilaragut, J.J.; Ferro, R.; Guillen, A.; Ramirez, M.L.; Ortiz Lopez, P.; Rodriguez, M.; McDonnell, J.D.; Papadopulos, S.; Pereira, P.P.; Goncalvez, M.; Morales, J.; Larrinaga, E.; Lopez Morones, R.; Sanchez, R.; Delgado, J.M.; Sanchez, C.; Somoano, F.

2008-01-01

Radiation safety has been based for many years on verification of compliance with regulatory requirements, codes of practice and international standards, which can be considered prescriptive methods. Accident analyses have been published, lessons have been learned and safety assessments have incorporated the need to check whether a facility is ready to avoid accidents similar to the reported ones. These approaches can be also called 'reactive methods'. They have in common the fundamental limitation of being restricted to reported experience, but do not take into account other potential events, which were never published or never happened, i.e. latent risks. Moreover, they focus on accident sequences with major consequences and low probability but may not pay enough attention to other sequences leading to lower, but still significant consequences with higher probability. More proactive approaches are, therefore, needed, to assess risk in radiation facilities. They aim at identifying all potential equipment faults and human error, which can lead to predefined unwanted consequences and are based on the general risk equation: Risk = Probability of occurrence of an accidental sequence * magnitude of the consequences. In this work, a review is given of the experience obtained by the countries of the Ibero American Forum of Nuclear and Radiation Safety Regulatory Organizations, by applying proactive methods to radiotherapy practice. In particular, probabilistic safety assessment (PSA) used for external beam treatments with linear electron accelerators and two studies, on cobalt 60 therapy and brachytherapy using the risk-matrix approach are presented. The work has identified event sequences, their likelihood of occurrence, the consequences, the efficiency of interlocks and control checks and the global importance in terms of overall risk, to facilitate decision making and implementation of preventive measures. A comparison is presented of advantages and limitations of

Underreporting of high-risk water and sanitation practices undermines progress on global targets.

Science.gov (United States)

Vedachalam, Sridhar; MacDonald, Luke H; Shiferaw, Solomon; Seme, Assefa; Schwab, Kellogg J

2017-01-01

Water and sanitation indicators under the Millennium Development Goals failed to capture high-risk practices undertaken on a regular basis. In conjunction with local partners, fourteen rounds of household surveys using mobile phones with a customized open-source application were conducted across nine study geographies in Asia and Africa. In addition to the main water and sanitation facilities, interviewees (n = 245,054) identified all water and sanitation options regularly used for at least one season of the year. Unimproved water consumption and open defecation were targeted as high-risk practices. We defined underreporting as the difference between the regular and main use of high-risk practices. Our estimates of high-risk practices as the main option matched the widely accepted Demographic and Health Surveys (DHS) estimates within the 95% confidence interval. However, estimates of these practices as a regular option was far higher than the DHS estimates. Across the nine geographies, median underreporting of unimproved water use was 5.5%, with a range of 0.5% to 13.9%. Median underreporting of open defecation was much higher at 9.9%, with a range of 2.7% to 11.5%. This resulted in an underreported population of 25 million regularly consuming unimproved water and 50 million regularly practicing open defecation. Further examination of data from Ethiopia suggested that location and socio-economic factors were significant drivers of underreporting. Current global monitoring relies on a framework that considers the availability and use of a single option to meet drinking water and sanitation needs. Our analysis demonstrates the use of multiple options and widespread underreporting of high-risk practices. Policies based on current monitoring data, therefore, fail to consider the range of challenges and solutions to meeting water and sanitation needs, and result in an inflated sense of progress. Mobile surveys offer a cost-effective and innovative platform to rapidly

Practical conditions in the neutron diffraction under high pressure

International Nuclear Information System (INIS)

Kamigaki, Kazuo; Ohashi, Masayoshi

1993-01-01

Practical analysis is made on some conditions in utilizing neutrons for the study of atomistic structure of materials under high pressure. Investigation is made on the geometrical conditions; size of the specimen, width of slits, and the rate of extra-scattering. Experiments are performed on the effects of absorption by high pressure cell and the disturbance due to an overlapping of diffraction peaks. An observation is presented on the pressure-induced transformation in RbBr. (author)

Women's participation in high performance work practices: a comparative analysis of Portugal and Spain

OpenAIRE

Ferreira, Pedro; Porto, Nelida; Portela, Marta

2010-01-01

High-performance work systems (HPWS) can be seen as a set of new forms of work organization combined with flexible human resources (HR) practices that enhance organizational performance through employee involvement and empowerment. Although in the past two decades much research has been conducted on the effects that high-performance work practices can have on organizations, there is still much to know about the ideal conditions for the adoption of such practices. According to some research, t...

The Undergraduate Leadership Teaching Assistant (ULTA): A High-Impact Practice for Undergraduates Studying Leadership

Science.gov (United States)

Odom, Summer F.; Ho, Sarah P.; Moore, Lori L.

2014-01-01

To meet the demands for effective leadership, leadership educators should integrate high-impact practices for students to develop, practice, and evaluate their leadership knowledge, skills, and abilities. The purpose of this application brief is to describe how undergraduate leadership teaching assistant (ULTA) experiences can be a high- impact…

Case Study of Leadership Practices and School-Community Interrelationships in High-Performing, High-Poverty, Rural California High Schools

Science.gov (United States)

Masumoto, Marcia; Brown-Welty, Sharon

2009-01-01

Many rural California high schools are impacted by the disadvantages of poverty, non-English speaking students, limited resources, changing demographics, and challenges of the rural context. Focusing on contemporary leadership theories and school-community interrelationships, this qualitative study examines the practices of educational leaders in…

A systematic review of medical practice variation in OECD countries.

Science.gov (United States)

Corallo, Ashley N; Croxford, Ruth; Goodman, David C; Bryan, Elisabeth L; Srivastava, Divya; Stukel, Therese A

2014-01-01

Major variations in medical practice have been documented internationally. Variations raise questions about the quality, equity, and efficiency of resource allocation and use, and have important implications for health care and health policy. To perform a systematic review of the peer-reviewed literature on medical practice variations in OECD countries. We searched MEDLINE to find publications on medical practice variations in OECD countries published between 2000 and 2011. We present an overview of the characteristics of published studies as well as the magnitude of variations for select high impact conditions. A total of 836 studies were included. Consistent with the gray literature, there were large variations across regions, hospitals and physician practices for almost every condition and procedure studied. Many studies focused on high-impact conditions, but very few looked at the causes or outcomes of medical practice variations. While there were an overwhelming number of publications on medical practice variations the coverage was broad and not often based on a theoretical construct. Future studies should focus on conditions and procedures that are clinically important, policy relevant, resource intensive, and have high levels of public awareness. Further study of the causes and consequences of variations is important. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

PEDAGOGICAL PRACTICE WAY OF CONNECTING PEDAGOGICAL THEORY AND PRACTICE

Directory of Open Access Journals (Sweden)

Božo Obradović

2013-12-01

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

The importance of work for highly educated refugees in Norway

OpenAIRE

Gobeti, Elina

2017-01-01

In 2016, the Ministry of Justice and Public Security highlighted the importance of refugee participation in labor in several reports. The ministry stresses the dependency of the Norwegian welfare model on high tax revenue, and argues that it is very important for adult refugees to work. In order to increase employment rates among the refugee population, and decrease number of dependents on social benefits, the Introduction Program was implemented in 2006. This was followed by the tightening o...

High-efficiency and low-cost permanent magnet guideway consideration for high-T{sub c} superconducting Maglev vehicle practical application

Energy Technology Data Exchange (ETDEWEB)

Deng, Z; Wang, J; Zheng, J; Jing, H; Lu, Y; Ma, G; Liu, L; Liu, W; Zhang, Y; Wang, S [Applied Superconductivity Laboratory, Southwest Jiaotong University, Chengdu 610031 (China)], E-mail: asclab@asclab.cn

2008-11-15

In order to improve the cost performance of the present high-T{sub c} superconducting (HTS) Maglev vehicle system for practical application, the multi-pole permanent magnet guideway (PMG) concept was introduced. A well-known double-pole Halbach PMG was chosen as a representative of multi-pole PMGs to compare with traditional monopole PMGs from the point of view of levitation efficiency and cost. Experimental results show that YBCO bulks above the double-pole Halbach PMG can exhibit better load capability and guidance performance as well as dynamics stability at the applied working height between the bulk HTSC and the PMG due to a more reasonable magnetic field distribution at the working range of bulk HTSC. Furthermore, the double-pole PMG configuration can play a more important role in improving guidance performance due to the potential-well field configuration. By comparing with former 'century' PMGs, the double-pole Halbach PMG shows another remarkable advantage in reducing the cost of levitation. As another necessary issue, magnetic field homogeneity and the corresponding magnetic drag force of a double-pole Halbach PMG has been considered by experiment in spite of the above highlights. Synthetically, the multi-pole Halbach PMG design is concluded to be one important choice for future HTS Maglev vehicle applications because of its high efficiency and low cost.

All about High/Scope: Practical Summaries of High/Scope's History, Educational Approach, and Curriculum. Numbers 1-10.

Science.gov (United States)

Epstein, Ann S.

This document is comprised of 10 High/Scope fact sheets for parents, detailing the history of the High/Scope educational approach and describing its educational practice and curriculum. The major topic for each four-page fact sheet follows: (1) educational approach, including goals for young children and features of the High/Scope approach to…

Kata practice and concepts according to highly experienced judo teachers and referees

Directory of Open Access Journals (Sweden)

Mario Luiz Miranda

2012-07-01

Full Text Available The objective of the present study was to characterize the kata practice among judo teachers, responsible by São Paulo State Federation’s kata competition and grade examinations. A closed questionnaire was applied to 20 teachers (male = 18; female = 2. The sample was 46 ± 10 years-old, with judo practice time of 34 ± 9 years, and graduation 5 ± 1 dan. Practice often varied from 2 (50% to 4 (30% sessions per month. Nage no kata was identified as the most performed (78% and preferred (31% kata, followed by katame no kata (25%, ju no kata (21% and kime no kata (12%. Initiation of kata study usually started at the teacher’s dojo (79% and through courses offered by state federation (21%. Practice is directed to techniques improvement (46%, complementation for judo training (29%, spiritualized/mental practice (14% and for competition preparation (11%. The following attributes are the most important meanings given for kata: foundation (45%, essence (25%, origin (15%, form (10% and principle (5%.

Action to Support Practices Implement Research Evidence (ASPIRE): protocol for a cluster-randomised evaluation of adaptable implementation packages targeting 'high impact' clinical practice recommendations in general practice.

Science.gov (United States)

Willis, Thomas A; Hartley, Suzanne; Glidewell, Liz; Farrin, Amanda J; Lawton, Rebecca; McEachan, Rosemary R C; Ingleson, Emma; Heudtlass, Peter; Collinson, Michelle; Clamp, Susan; Hunter, Cheryl; Ward, Vicky; Hulme, Claire; Meads, David; Bregantini, Daniele; Carder, Paul; Foy, Robbie

2016-02-29

There are recognised gaps between evidence and practice in general practice, a setting which provides particular challenges for implementation. We earlier screened clinical guideline recommendations to derive a set of 'high impact' indicators based upon criteria including potential for significant patient benefit, scope for improved practice and amenability to measurement using routinely collected data. We aim to evaluate the effectiveness and cost-effectiveness of a multifaceted, adaptable intervention package to implement four targeted, high impact recommendations in general practice. The research programme Action to Support Practice Implement Research Evidence (ASPIRE) includes a pair of pragmatic cluster-randomised trials which use a balanced incomplete block design. Clusters are general practices in West Yorkshire, United Kingdom (UK), recruited using an 'opt-out' recruitment process. The intervention package adapted to each recommendation includes combinations of audit and feedback, educational outreach visits and computerised prompts with embedded behaviour change techniques selected on the basis of identified needs and barriers to change. In trial 1, practices are randomised to adapted interventions targeting either diabetes control or risky prescribing and those in trial 2 to adapted interventions targeting either blood pressure control in patients at risk of cardiovascular events or anticoagulation in atrial fibrillation. The respective primary endpoints comprise achievement of all recommended target levels of haemoglobin A1c (HbA1c), blood pressure and cholesterol in patients with type 2 diabetes, a composite indicator of risky prescribing, achievement of recommended blood pressure targets for specific patient groups and anticoagulation prescribing in patients with atrial fibrillation. We are also randomising practices to a fifth, non-intervention control group to further assess Hawthorne effects. Outcomes will be assessed using routinely collected data

Reconsidering the Study of Mathematics Instructional Practices: The Importance of Curricular Context in Understanding Local and Global Teacher Change

Science.gov (United States)

Herbel-Eisenmann, Beth A.; Lubienski, Sarah Theule; Id-Deen, Lateefah

2006-01-01

This paper discusses the case of one teacher, Jackie, whose instructional practices illuminate the importance of textbooks and student/parent expectations in shaping pedagogy. Jackie teaches in the Plainview district, which offers parents and students a choice between a reform-oriented, integrated curriculum ("Core Plus") and a more…

Experimenting with practice

DEFF Research Database (Denmark)

Knudsen, Hanne; Adriansen, Hanne Kirstine

2016-01-01

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

Heavy episodic drinking and soccer practice among high school students in Brazil: the contextual aspects of this relationship.

Science.gov (United States)

Bedendo, André; Opaleye, Emérita S; Andrade, André Luiz Monezi; Noto, Ana Regina

2013-03-20

Heavy episodic drinking (HED) (consumption of five or more drinks on the same occasion) among adolescents is related to several problems and partaking in sport or physical activities has been suggested as an option to prevent or reduce alcohol consumption among this population. The aim of this study was to investigate the relationship between soccer practice and heavy episodic drinking among high school students from Brazil. Data were obtained from a cross-sectional study among a representative sample of public and private high school students from all Brazilian state capitals (N=19,132). Only students aged from 14 to 18 who reported having taken part in soccer practice, other team sports or non-practicing sports in the last month were included. Characteristics of sport practice (frequency and motivation) and HED in the last month (type of drink; where and with whom they drank; frequency of HED) were also considered. Regression models were controlled for sociodemographic variables. For all groups studied most of the students reported drinking beer, with friends and at nightclubs or bars. Soccer practice was associated to HED when compared to non-practicing sports and to other team sports. Compared to other team sports, playing soccer for pleasure or profession, but not for keep fit or health reasons, were more associated to HED. Frequency of soccer practice from 1 to 5 days per month and 20 or more days per month, but not from 6 to 19 days per month, were also more associated to HED. The relationship between soccer and HED appears to be particularly stronger than in other team sports among adolescents in Brazil. Induced sociability of team sports practice cannot be assumed as the main reason for HED among soccer players. Possibly these results reflect the importance of a strong cultural association between soccer and beer in Brazil and these findings should be integrated to future prevention or intervention programs.

Participative leadership practice in junior high schools and actions to improve the practice : a case study of Sekyere south district, Ghana

OpenAIRE

Gyasi, Kwame

2015-01-01

Gyasi, Kwame. 2015. Participative leadership practice in junior high schools and actions to improve the practice: a case study of Sekyere south district, Ghana Master's Thesis in Education. University of Jyväskylä. Department of Education Participative leadership practice is seen as the kind of school leadership which recognizes parents’ contribution and teachers’ ability and talents in leadership by sharing with them roles and responsibilities in the school administrative process. Th...

Imported tropical neuroinfections: practice skills and knowledge among nurses and nursing students.

Science.gov (United States)

Rajoo, Maheswaari; Sulicova, Andrea; Mroskova, Slavka; Supinova, Maria; Plackova, Anna; Bystra, Martina; Baranova, Lenka; Grezdova, Iveta; Santova, Tatiana; Janakova, Maria; Simova, Zuzana; Cinova, Jana; Cibrikova, Silvia; Decsiova, Zuzana; Lengyelova, Anna; Hlinovska, Jana; Rovna, Silvia; Igazova, Maria; Nadova, Monika; Rakova, Jana; Lehotska, Maria; Moraucikova, Eva; Mizenkova, Ludmila; Novotna, Zuzana; Paukova, Luba; Semjonova, Alexandra; Schlosserova, Alena; Vicanova, Michaela; Balkova, Hilda; Banasova, Vlasta; Horanska, Valeria; Hudakova, Pavlina; Hudakova, Anna; Majernikova, Ludmila; Poliakova, Nikoleta; Suchanova, Renata; Tirpakova, Libusa; Perinova, Nadezda; Vatehova, Drahormira; Komanicky, Dusan; Koudelkova, Vlasta; Capska, Jana; Maskalikova, Tatiana; Hulkova, Vlasta; Treslova, Marie

2013-09-01

Tropical neuroinfections are still cause of substantial mortality in travelers. Therefore, good knowledge of early symptoms is very important for nurses acting as first contact persons. Nurse's practical skills and knowledge of signs and early recognition of tropical neuroinfections, providing first aid and quick action has been studied among graduates of two Tropical Nursing PhD programs (in EU-Countries vs. tropical country) using a standardized questionnaire. Statistical package EPI info was used to determine potential differences between both groups of graduates. Acceptable knowledge on early symptoms and signs of cerebral malaria and meningococcal meningitis in returning travelers was found among 121 graduates of two PhD programs who were included in the study. Of these, 99 questionnaires were filled in Slovakia, Czech Republic and Germany and another 22 were filled in Malaysia, as a part of the Tropical Nursing PhD Study Programs. Nursing students and recent graduates in two PhD programs demonstrated acceptable, although not large-scaled, knowledge of early signs and symptoms of tropical neuroinfections.

Choosing High-Yield Tasks for the Mathematical Development of Practicing Secondary Teachers

Science.gov (United States)

Epperson, James A. Mendoza; Rhoads, Kathryn

2015-01-01

Many mathematics teacher educators encounter the challenge of creating or choosing mathematical tasks that evoke important mathematical insights and connections yet remain firmly grounded in school mathematics. This challenge increases substantially when trying to meet the needs of practicing secondary mathematics teachers pursuing graduate work…

The occurrence and prevention of Infectious Pancreatic Necrosis Virus (IPNV) in rainbow trout fish farms: the importance of improved sanitary practices

OpenAIRE

AGIM REXHEPI; KURTESH SHERIFI; PETER SCHEINERT; LINDA GRAPCI-KOTORRI

2014-01-01

The viral diseases of rainbow trout are of worldwide concern including infectious pancreatic necrosis (IPN). On this study good sanitary practices are applied to prevent outbreaks and minimize losses caused from IPN disease. To highlight importance of improvements on sanitary practices in IPN prevention were compared results from two studies, first conducted in year 2006-2009 with results from one year later study conducted in 2010. In year 2010, samples of organs are collected from 260 fish ...

The High Field Path to Practical Fusion Energy

Science.gov (United States)

Mumgaard, Robert; Whyte, D.; Greenwald, M.; Hartwig, Z.; Brunner, D.; Sorbom, B.; Marmar, E.; Minervini, J.; Bonoli, P.; Irby, J.; Labombard, B.; Terry, J.; Vieira, R.; Wukitch, S.

2017-10-01

We propose a faster, lower cost development path for fusion energy enabled by high temperature superconductors, devices at high magnetic field, innovative technologies and modern approaches to technology development. Timeliness, scale, and economic-viability are the drivers for fusion energy to combat climate change and aid economic development. The opportunities provided by high-temperature superconductors, innovative engineering and physics, and new organizational structures identified over the last few years open new possibilities for realizing practical fusion energy that could meet mid-century de-carbonization needs. We discuss re-factoring the fusion energy development path with an emphasis on concrete risk retirement strategies utilizing a modular approach based on the high-field tokamak that leverages the broader tokamak physics understanding of confinement, stability, and operational limits. Elements of this plan include development of high-temperature superconductor magnets, simplified immersion blankets, advanced long-leg divertors, a compact divertor test tokamak, efficient current drive, modular construction, and demountable magnet joints. An R&D plan culminating in the construction of an integrated pilot plant and test facility modeled on the ARC concept is presented.

Supporting successful inclusive practices for learners with disabilities in high schools: a multisite, mixed method collective case study.

Science.gov (United States)

Maciver, Donald; Hunter, Cathleen; Adamson, Amanda; Grayson, Zoe; Forsyth, Kirsty; McLeod, Iona

2018-07-01

The increase in the number of individuals with disabilities in general education has led to an increased interest in how to best provide support. Despite an emphasis on inclusion and participation in policy and practice, defining and describing the support provided for these learners is still an important task. This multisite, mixed method collective case study reports on 125 education and other staff from seven schools who took part in interviews and focus groups to reflect on a range of topics related to learners with disabilities in high schools. We focused on what the participants did, what they considered to be successful and what their "best" practices were. Descriptions of practices were rich, nuanced and complex. The analysis identified over 200 "strategies" which were synthesized into two meta-themes and eight subthemes. We discuss the results in the context of an ecological perspective, and the importance of focusing on the full range of influences and outcomes for young people in designing supports. We have drawn on evidence from this study as a basis for professional development activities and identified that focusing on the environment and the role of practitioners has a potential to improve the inclusion outcomes for older learners with disabilities. Implications for Rehabilitation Inclusion is influenced by the physical environment, attitudes, expectations and opportunities, in addition to a learner's skills and abilities. Schools should focus on the environment and teachers' practices, rather than on what an individual learner can or cannot do. The practices discussed in this study reflect those that a range of educators and related services personnel agree are realistic, appropriate and effective. Change may be led by the school management team; however, there are many ways in which all staff can contribute; indeed, approaches will not work effectively unless they are understood and implemented by everyone.

Current issues in dental practice management. Part 1. The importance of shared values.

Science.gov (United States)

Newsome, Philip R H

2003-04-01

/1997 when NHS fees stood at 1.6 billion Pounds (71%) and private fees at 0.6 billion Pounds (29%) and it can be seen that while the size of the whole market has grown NHS fees have risen by around 18% while private sector fees have gone up by 64% during the same period. It cannot be said therefore that NHS dentistry has disappeared although it is clear that access to NHS dentistry has been and may still be difficult in some parts of the country. The Department of Health in England has responded by developing 'access centres' and in the recently published Options for Change sets out sweeping proposals to revitalise NHS dentistry and delegate decisions over funding to a local level. It is far from clear what the consequences of these changes will be. However, one possible scenario is that in many parts of the UK, although relief of pain, prevention and restoration of function will be funded by the NHS, other than in 'special circumstances' such as after trauma and inherited conditions 'cosmetic embellishment' will not be funded. In which case, ever increasing public interest in personal appearance may well lead to further growth in private dentistry. Against a background of change and uncertainty, this series of articles explores some of the issues facing dentists coming to terms with working in this brave new world. This first part examines an aspect of dental practice that is seldom discussed openly and yet is of such fundamental importance that it is the cornerstone of all successful practices and the main fault line in unsuccessful ones, namely the nature and strength of practice values.

The importance of academic literacy for undergraduate nursing students and its relationship to future professional clinical practice: A systematic review.

Science.gov (United States)

Jefferies, Diana; McNally, Stephen; Roberts, Katriona; Wallace, Anna; Stunden, Annette; D'Souza, Suzanne; Glew, Paul

2018-01-01

This systematic review was designed to assess the importance of academic literacy for undergraduate nursing students and its relationship to future professional clinical practice. It aimed to explore the link between academic literacy and writing in an undergraduate nursing degree and the development of critical thinking skills for their future professional clinical practice. A systematic review of qualitative studies and expert opinion publications. A systematic literature search was undertaken of the following databases: ERIC, PubMed, CINAHL, MEDLINE and Scopus. All papers reviewed were from 2000 to 2016 and were written in English. We identified 981 studies and expert opinion papers from the selected databases. After reviewing key words and abstracts for the inclusion and exclusion criteria, 48 papers were selected for review. These were read and reread, with 22 papers, including one thesis, selected for quality appraisal. One paper was discarded due to the exclusion criteria. Three major themes were evident from this study. First, students need assistance to develop tertiary level academic literacy skills when they commence their undergraduate nursing degree. Second, that teaching practices need to be consistent in both designing assessments and in giving feedback to students, in order to assist improvement of academic literacy skills. And finally, academic literacy can facilitate critical thinking when students are assessed using discipline specific genres that relate to their future professional nursing practice. This review highlights the importance of critical thinking in clinical nursing practice and its strong relationship with academic writing skills. It has shown critical thinking is discipline specific and nursing students need to be taught discipline specific literacy genres in undergraduate nursing degrees. Nursing has a diverse educational and cultural mix of students, and educators should not assume academic literacy skills upon commencement of an

The use of plane parallel ionization chambers in high energy electron and photon beams. An international code of practice for dosimetry

International Nuclear Information System (INIS)

1997-01-01

Research on plane-parallel ionization chambers since the IAEA code of practice (TRS-277) was published in 1987 has explained our knowledge on perturbation and other correction factors in ionization chamber, and also constructional details of these chambers have been shown to be important. Different countries have published, or are in the process of publishing, dosimetry recommendations which include specific procedures for the use of plan parallel ionization chambers. An international working group was formed under the auspieces of the IAEA, first to review the status and the actual validity of the code of practice and second to develop an international code of practice of the use of plane parallel ionization chambers in high energy electron and photon beams used in radiotherapy. This document fulfills the second taste. 153 refs, 21 figs, 18 tabs

What diversity management practices do hotel managers and employees view as important for retaining employees?

OpenAIRE

Twum, Sophia Araba

2015-01-01

Master's thesis in International hotel and tourism management Abstract Research shows that the hotel industry is noted for high rate of turnover. Again, diversity management practices have been found to be a good human resource tool helping to manage and retain diverse workforce. A lot of studies have been done on employee retention and diversity management separately but the two concepts are related therefore there is the need to look at them together. This thesis aims...

Tillage practices and identity formation in High Plains farming

DEFF Research Database (Denmark)

Strand, Katherine; Arnould, Eric; Press, Melea

2014-01-01

farming, recognition and denunciation of other farmers’ practices, and recognition and justification of their own contribute to identity formation. This research contributes to the ongoing discussion of how identity is formed through day-to-day activities in the material world. The plow creates divisions...... landscape. Specifically, they compare conservation tillage wedded to ‘modern’ ideologies of scientific farming with conventional tillage newly linked to beliefs about both organic and traditional farming, and examine how farmers use these different forms of tillage to create their identities. Roadside...... in the High Plains community between organic farmers who continue to rely on this implement in their material engagement with the land and the chemical farmers who distance their practices from the plow as they distinguish themselves as stewards of the soil....

Exploring the Principles and Practices of One Teacher of L2 Speaking: The Importance of Reflecting on Practice

Directory of Open Access Journals (Sweden)

Thomas S. C. Farrell

2018-01-01

Full Text Available Teacher principles encompass a teacher’s stated assumptions, beliefs, and conceptions about acquiring and teaching a second language (L2. Due to the complex and diversified nature of how principles take form, an individual teacher’s principles will influence their judgements, perceptions and instructional decisions, thus affecting the outcome of classroom practices. Exploring teacher principles and their impact on classroom practices and vice versa is an invaluable and necessary component to research in L2 teaching and learning since it plays an influential role in instructional outcomes.This paper explores the nature of the principles/practice relationship through an investigative case study with an ESL teacher of L2 speaking. Additionally, the results of research on principles and practices related to L2 teaching when conducted by academics rarely gets back to teachers in the front lines. Thus the researchers shared their findings with the teacher who as a result of reflecting on the analysis came up with a set of principles she says guides her teaching of L2 speaking.

Coaching Teachers: An Important Principal Role. Research into Practice

Science.gov (United States)

Williamson, Ronald

2012-01-01

A principal's most important role is instructional leader. There is a growing recognition of the importance of working with teachers, serving as a mentor and coach. Coaching has emerged as one of the more effective professional development options for adult learners. It is an important tool because it is an investment in human capital and in the…

Mastitis prevention and control practices and mastitis treatment strategies associated with the consumption of (critically important) antimicrobials on dairy herds in Flanders, Belgium.

Science.gov (United States)

Stevens, M; Piepers, S; De Vliegher, S

2016-04-01

The main objectives of this study were to evaluate to what extent variations in herd-level antimicrobial consumption (AMC) can be explained by differences in management practices that are consistently effective in the prevention of (sub)clinical mastitis, on the one hand, and by differences in mastitis treatment strategies, on the other hand. Antimicrobial consumption data were obtained during 2012 and 2013 by "garbage can audits" and expressed as antimicrobial treatment incidences (ATI) for all compounds combined (total ATI) and for the critically important antimicrobials for human health separately. Data on mastitis prevention and control practices were obtained via face-to-face interviews performed during herd visits in March 2013. Some management practices and treatment strategies related to udder health were associated with the total AMC. However, the results demonstrated that implementing effective udder health management practices does not necessarily imply a low AMC and vice versa. Herds participating in a veterinary herd health management program and herds selectively drying off cows used fewer antimicrobials compared with herds not participating in such a program or applying blanket dry-cow therapy. Moreover, herds treating (some) (sub)clinical mastitis cases with intramammary homeopathic substances consumed fewer antimicrobials than herds not applying such homeopathic treatments. Besides these factors, no other direct association was found between effective udder health management practices on the one hand and AMC on the other hand. Also, the use of critically important antimicrobials was only associated with the way in which subclinical mastitis cases were treated. The latter indicates that the AMC of critically important antimicrobials is potentially driven by factors other than those included in this study such as those related to the "mindset" of the veterinarians and their farmers. Future research should therefore aim to unravel the reasoning of

High School Instrumental Music Students' Attitudes and Beliefs regarding Practice: An Application of Attribution Theory

Science.gov (United States)

Schatt, Matthew D.

2011-01-01

The purpose of this study was to explore high school band students' perspectives of instrumental music practice from within the attribution theory paradigm and to attempt to elucidate the secondary student's attitudes toward practice. High school band students from three Midwestern school districts (N = 218) completed a survey that was used to…

The Main Anatomic Variations of the Hepatic Artery and Their Importance in Surgical Practice: Review of the Literature.

Science.gov (United States)

Noussios, George; Dimitriou, Ioannis; Chatzis, Iosif; Katsourakis, Anastasios

2017-04-01

Anatomical variations of the hepatic artery are important in the planning and performance of abdominal surgical procedures. Normal hepatic anatomy occurs in approximately 80% of cases, for the remaining 20% multiple variations have been described. The purpose of this study was to review the existing literature on the hepatic anatomy and to stress out its importance in surgical practice. Two main databases were searched for eligible articles during the period 2000 - 2015, and results concerning more than 19,000 patients were included in the study. The most common variation was the replaced right hepatic artery (type III according to Michels classification) which is the chief source of blood supply to the bile duct.

Using cytology to increase small animal practice revenue.

Science.gov (United States)

Hodges, Joanne

2013-11-01

Diagnostic cytology is a useful, noninvasive test with practical foundations in high-quality medicine and applications to practice building. Cytology will generate practice revenue whether assessed in-house or sent to a clinical pathologist. Thorough in-house evaluation is adequate in some cases, but expert opinion is important in many cases. Specimen slides should at least be reviewed in-house for assessment of cellularity and potential artifacts before submission to a reference laboratory. Reference laboratories also provide special stains and advanced molecular diagnostics to help further characterize many neoplastic processes, search for organisms, identify pigments, and address other important aspects of the lesion. Copyright © 2013 Elsevier Inc. All rights reserved.

The Effects of Practice-Based Training on Graduate Teaching Assistants’ Classroom Practices

Science.gov (United States)

Becker, Erin A.; Easlon, Erin J.; Potter, Sarah C.; Guzman-Alvarez, Alberto; Spear, Jensen M.; Facciotti, Marc T.; Igo, Michele M.; Singer, Mitchell; Pagliarulo, Christopher

2017-01-01

Evidence-based teaching is a highly complex skill, requiring repeated cycles of deliberate practice and feedback to master. Despite existing well-characterized frameworks for practice-based training in K–12 teacher education, the major principles of these frameworks have not yet been transferred to instructor development in higher educational contexts, including training of graduate teaching assistants (GTAs). We sought to determine whether a practice-based training program could help GTAs learn and use evidence-based teaching methods in their classrooms. We implemented a weekly training program for introductory biology GTAs that included structured drills of techniques selected to enhance student practice, logic development, and accountability and reduce apprehension. These elements were selected based on their previous characterization as dimensions of active learning. GTAs received regular performance feedback based on classroom observations. To quantify use of target techniques and levels of student participation, we collected and coded 160 h of video footage. We investigated the relationship between frequency of GTA implementation of target techniques and student exam scores; however, we observed no significant relationship. Although GTAs adopted and used many of the target techniques with high frequency, techniques that enforced student participation were not stably adopted, and their use was unresponsive to formal feedback. We also found that techniques discussed in training, but not practiced, were not used at quantifiable frequencies, further supporting the importance of practice-based training for influencing instructional practices. PMID:29146664

Equity crowdfunding in China : Current practice and important legal issues

NARCIS (Netherlands)

Li, Jing

2017-01-01

By studying two leading Chinese equity crowdfunding portals, namely, Renrentou and Zhongou8, this paper provides the very first empirical evidence on the practice and regulation of equity crowdfunding in China. In the case of Renrentou, I examine a hand-collected sample consisting of the investment

Substance use and dietary practices among students attending alternative high schools: results from a pilot study

OpenAIRE

Arcan, Chrisa; Kubik, Martha Y; Fulkerson, Jayne A; Hannan, Peter J; Story, Mary

2011-01-01

Abstract Background Substance use and poor dietary practices are prevalent among adolescents. The purpose of this study was to examine frequency of substance use and associations between cigarette, alcohol and marijuana use and selected dietary practices, such as sugar-sweetened beverages, high-fat foods, fruits and vegetables, and frequency of fast food restaurant use among alternative high school students. Associations between multi-substance use and the same dietary practices were also exa...

Teacher Support, Instructional Practices, Student Motivation, and Mathematics Achievement in High School

Science.gov (United States)

Yu, Rongrong; Singh, Kusum

2018-01-01

The authors examined the relationships among teacher classroom practices, student motivation, and mathematics achievement in high school. The data for this study was drawn from the base-year data of High School Longitudinal Study of 2009. Structural equation modeling method was used to estimate the relationships among variables. The results…

Transforming High School Counseling: Counselors' Roles, Practices, and Expectations for Students' Success

Science.gov (United States)

Mau, Wei-Cheng J.; Li, Jiaqi; Hoetmer, Kimberly

2016-01-01

This study examined the current roles and practices of American high school counselors in relation to the ASCA [American School Counselor Association] National Model. Expectations for student success by high school counselors were also examined and compared to those of teachers' and school administrators'. A nationally representative sample of 852…

High Performance Activity Practices in Small Firms in Romania

Directory of Open Access Journals (Sweden)

Gabriela ŢUŢUEANU

2014-12-01

Full Text Available High Performance Activity Practices in Small Firms in Romania Abstract: High performance activity practices (HPAPs are human resource management activities aimed at stimulating employee and organisational performance. The application of HPAPs is not widespread in small organisations. We examine whether the implementation of coherent bundles of HPAPs (aimed at employee ability, employee motivation or at the opportunity to perform depends on the scarcity of resources, as reflected in the size of the company, and on strategic decision-making in small firms related to the owner’s expertise and attitudes. In our research, a total of 224 employees from 50 small organisations were asked to rate the presence of HPAPs in their organisation. These averaged perceptions were linked to information provided by the owner–managers on the size of their firm and their own expertise and attitudes. The findings support that smaller but coherent bundles of HPAPs can be found in small organisations and that the implementation of these bundles depends on available resources, strategic decision-making and the combination of the two. These findings highlight the need to integrate the notions of resource poverty and strategic decision-making to understand the uptake of bundles of HPAPs within small firms.

Import Substitution in Regional Industrial Production: Theoretical and Practical Aspects

Directory of Open Access Journals (Sweden)

Yevgeniy Georgievich Animitsa

2015-09-01

Full Text Available The article proves the important role of import substitution in the economic security protection of state and its regions, especially in times of crisis, geopolitical and economical instability. The authors argue that the problem of import substitution is not modern, trendy scientific stream. The issue of displacement of import goods by domestic ones was brought up in famous classic theories of mercantilists. The particular emphasis is placed on the analysis and systematization of different scientific approaches, which are utilized by native and foreign scientists to bring out the matter of “import substitution,” to determine its essential characteristics. The authors suggest their own interpretation of the import substitution notion. In the article, the most significant pro and contra arguments in import substitution policy are defined. The regional aspects in the import substitution are approved: case study — organization of industrial import substitution in the Sverdlovsk region. In the article, the authors analyze the subject matter of the Program “Development of Intraregional Industrial Cooperation and Implementation of an Import Substitution in Branches of Industry in the Sverdlovsk Region.” It is resumed, that active policy of import substitution in the industry may become the driver of regional economic development.

Greenhouse Schools in Boston: School Leadership Practices across a High-Performing Charter Sector

Science.gov (United States)

McGovern, Kate

2014-01-01

TNTP has been investigating the importance of school environment and leadership practices using a survey tool called "Instructional Culture Insight," which measures teachers' perceptions of their school environments. In "Greenhouse Schools: How Schools Can Build Cultures Where Teachers and Students Thrive (2012)," TNTP found…

Best practices and better protocols : guidance for a comprehensive community emissions inventory system from a high level review of international best practices

International Nuclear Information System (INIS)

Boston, A.

2007-11-01

A community greenhouse gas emission and energy inventory is an important tool to help local governments plan, implement and monitor climate change mitigation strategies and sustainable energy systems. Inventories can also facilitate a number of other local priorities such as air quality management; integrated land-use and transportation planning; infrastructure optimization and planning; and community economic development planning. The British Columbia government's community energy and emissions inventory initiative (CEEI) intends to collect and centralize high-quality geocoded data to generate high-value community inventories for the province's 185 local governments. This report presented strategic guidance for a comprehensive community emissions inventory system based on a high level review of international best practices. The report described the project objective and scope; guiding principles; research methodology; and inventory limitations. The report provided observations, findings and recommendations according to the following four areas: protocols and standards recommendations; data management systems recommendations; community inventory parameters recommendations; and reporting formats and capacity building recommendations. It was recommended that as CEEI progresses, consideration should be given to developing provincial level reports and online reporting of local government activity in order to strengthen awareness, recognize leadership and build support.17 refs., 2 tabs., 11 figs., 2 appendices

Fundamentals of modern mathematics a practical review

CERN Document Server

MacNeil, David B

2013-01-01

Students and others wishing to know more about the practical side of mathematics will find this volume a highly informative resource. Accessible explanations of important concepts feature worked examples and diagrams. 1963 edition.

The ethics and practical importance of defining, distinguishing and disclosing nursing errors: a discussion paper.

Science.gov (United States)

Johnstone, Megan-Jane; Kanitsaki, Olga

2006-03-01

Nurses globally are required and expected to report nursing errors. As is clearly demonstrated in the international literature, fulfilling this requirement is not, however, without risks. In this discussion paper, the notion of 'nursing error', the practical and moral importance of defining, distinguishing and disclosing nursing errors and how a distinct definition of 'nursing error' fits with the new 'system approach' to human-error management in health care are critiqued. Drawing on international literature and two key case exemplars from the USA and Australia, arguments are advanced to support the view that although it is 'right' for nurses to report nursing errors, it will be very difficult for them to do so unless a non-punitive approach to nursing-error management is adopted.

High-performance HR practices, positive affect and employee outcomes

OpenAIRE

Mostafa, Ahmed

2017-01-01

Purpose – The purpose of this paper is to provide insight into the affective or emotional mechanisms that underlie the relationship between high-performance HR practices (HPHRP) and employee attitudes and behaviours. Drawing on affective events theory (AET), this paper examines a mediation model in which HPHRP influence positive affect which in turn affects job satisfaction and organizational citizenship behaviours (OCBs). Design/methodology/approach – Two-wave data was collected from a sampl...

Demystifying the Biochemistry: Theoretical Concepts and Practical Activities for High School

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C.S. Bard

2013-05-01

Full Text Available INTRODUCTION: The education goes through a crisis in their teaching-learning process, due to the fact that their contents are developed out of context, merely theoretical activities. Several scholars warn about the importance of working with experiential activities to enhance and stimulate student learning, seeking a more meaningful than we have seen in recent times. The objectives of this work are installation of a laboratory for teaching science in public school, ISEPAM, at North of Rio de Janeiro, formation of multipliers agents and promoting a Scientific Week/Exhibition involving all school community. MATERIALS AND METHODS:First, we perform the spatial organization of the laboratory, including purchase of materials/equipment. In a second step, experimental activities involving identification of Macromolecules in foods were prepared and tested. From this, we promote short courses in biochemistry for teachers to forming multiplier agents. As a conclusion of the activities of this project a Scientific Week/Exhibition was promoted in school. RESULTS AND DISCUSSION: Practical classes on fermentation, identification of lipids, proteins and carbohydrates were performed by teachers and students from ISEPAM. We observed in the biochemistry course which the participants have established relationships between theory and practice and also they showed interest in the insertion of experiments in their work routine.. Regarding the Scientific Week/Exhibition, students of elementary and high school participated. They were encouraged and integrated with experiment activities and thereby new talents for scientific and technological interest were identified. CONCLUSION: It was observed that the experimental activities become more attractive and challenging the search for knowledge.

Principals' Leadership Practices and Mathematics Pass Rate in Jamaican High Schools

Science.gov (United States)

Palmer, David; Hermond, Douglas; Gardiner, Carl

2014-01-01

This research was intended to explore the degree to which leadership practices impacted Jamaican schools' mathematics achievement. More specifically, the researchers examined Jamaica's high school students' CSEC mathematics performance in relation to principals' instructional leadership behaviors as measured by teachers' perceptions, using Kouzes…

Development of a Causal Framework linking High Perofrmance HRM Practices, Positive Psychological Capital, Creative Behaviours

OpenAIRE

Gupta, Vishal

2013-01-01

Synthesizing the ideas of high-performance Human Resource Management (HRM), positive psychological capital, and componential theory of creativity, the present study develops a multi-level causal framework linking high-performance work practices (HPWP), positive psychological capital, employee creative performance behaviors and creative performance. The paper argues that to provide a convincing explanation of the association between HRM practices and creativity, we need to improve our theoreti...

Consumption of highly processed snacks, sugar-sweetened beverages and child feeding practices in a rural area of Nicaragua.

Science.gov (United States)

Contreras, Mariela; Zelaya Blandón, Elmer; Persson, Lars-Åke; Ekström, Eva-Charlotte

2016-01-01

Appropriate feeding behaviours are important for child growth and development. In societies undergoing nutrition transition, new food items are introduced that may be unfavourable for child health. Set in rural Nicaragua, the aim of this study was to describe the infant and young child feeding (IYCF) practices as well as the consumption of highly processed snack foods (HP snacks) and sugar-sweetened beverages (SSBs). All households with at least one child 0- to 35-month-old (n = 1371) were visited to collect information on current IYCF practices in the youngest child as well as consumption of SSBs and HP snacks. Breastfeeding was dominant (98%) among 0- to 1-month-olds and continued to be prevalent (60%) in the second year, while only 34% of the 0- to 5-month-olds were exclusively breastfed. Complementary feeding practices were deemed acceptable for only 59% of the 6- to 11-month-old infants, with low dietary diversity reported for 50% and inadequate meal frequency reported for 30%. Consumption of HP snacks and SSBs was frequent and started early; among 6- to 8-month-olds, 42% and 32% had consumed HP snacks and SSBs, respectively. The difference between the observed IYCF behaviours and World Health Organization recommendations raises concern of increased risk of infections and insufficient intake of micronutrients that may impair linear growth. The concurrent high consumption of SSBs and HP snacks may increase the risk of displacing the recommended feeding behaviours. To promote immediate and long-term health, growth and development, there is a need to both promote recommended IYCF practices as well as discourage unfavourable feeding behaviours. © 2014 John Wiley & Sons Ltd.

Defining High-Quality Palliative Care in Oncology Practice: An American Society of Clinical Oncology/American Academy of Hospice and Palliative Medicine Guidance Statement.

Science.gov (United States)

Bickel, Kathleen E; McNiff, Kristen; Buss, Mary K; Kamal, Arif; Lupu, Dale; Abernethy, Amy P; Broder, Michael S; Shapiro, Charles L; Acheson, Anupama Kurup; Malin, Jennifer; Evans, Tracey; Krzyzanowska, Monika K

2016-09-01

Integrated into routine oncology care, palliative care can improve symptom burden, quality of life, and patient and caregiver satisfaction. However, not all oncology practices have access to specialist palliative medicine. This project endeavored to define what constitutes high-quality primary palliative care as delivered by medical oncology practices. An expert steering committee outlined 966 palliative care service items, in nine domains, each describing a candidate element of primary palliative care delivery for patients with advanced cancer or high symptom burden. Using modified Delphi methodology, 31 multidisciplinary panelists rated each service item on three constructs: importance, feasibility, and scope within medical oncology practice. Panelists endorsed the highest proportion of palliative care service items in the domains of End-of-Life Care (81%); Communication and Shared Decision Making (79%); and Advance Care Planning (78%). The lowest proportions were in Spiritual and Cultural Assessment and Management (35%) and Psychosocial Assessment and Management (39%). In the largest domain, Symptom Assessment and Management, there was consensus that all symptoms should be assessed and managed at a basic level, with more comprehensive management for common symptoms such as nausea, vomiting, diarrhea, dyspnea, and pain. Within the Appropriate Palliative Care and Hospice Referral domain, there was consensus that oncology practices should be able to describe the difference between palliative care and hospice to patients and refer patients appropriately. This statement describes the elements comprising high-quality primary palliative care for patients with advanced cancer or high symptom burden, as delivered by oncology practices. Oncology providers wishing to enhance palliative care delivery may find this information useful to inform operational changes and quality improvement efforts. Copyright © 2016 by American Society of Clinical Oncology.

Characteristics of an ideal practice educator: Perspectives from practice educators in diagnostic radiography, nuclear medicine, nutrition and dietetics, occupational therapy and physiotherapy and radiation therapy

International Nuclear Information System (INIS)

Francis, A.; Hills, C.; MacDonald-Wicks, L.; Johnston, C.; James, D.; Surjan, Y.; Warren-Forward, H.

2016-01-01

Background: Practice education is a compulsory component of health programs with practice educators playing a critical role in the education of students. Practice educator characteristics may positively or negatively affect student learning in practice settings. This study aimed to identify characteristics of the ideal practice educator that lead to successful practical experiences as perceived by current practice educators working in the Australian context of diagnostic radiography, nuclear medicine, nutrition and dietetics, occupational therapy, physiotherapy and radiation therapy. Methods: All practice educators (n = 1063) on the University of Newcastle Practice Educator Database were invited to participate in this prospective, cross-sectional, descriptive study via online link or paper format. Results: There was a 52% response rate. The five most valued characteristics were feedback skills, non-judgemental, professionalism, clarity and listening skills. The five least valued characteristics were scholarly activity, respect for students' autonomy, well-prepared, availability and being a role model. Comparisons between disciplines, genders, ages, years in practice and levels of supervisory experience indicated some statistically significant differences, though actual differences were small. Discussion: Overall there was a high degree of agreement within and between disciplines on the characteristics of the ideal practice educator. The top five skills could be classed as generic skills and not specific clinical and practice skills, thus formal training and certification schemes may enhance practice educator competence. - Highlights: • The most important characteristics were feedback skills and non-judgmental. • The least important characteristics were scholarly activity and respects student autonomy. • Female educators valued all characteristics except scholarly activities as being more important. • Older participants valued availability, and

The problem of modernization of the high-pressure pipelines clampers - Practice

International Nuclear Information System (INIS)

Komorowski, J.; Zajaczkowski, P.; Szteke, W.

2008-01-01

In the paper the problems connected with the modernization and repair of the clampers of high-pressure pipelines joining the boiler with the turbine, on the basis of authors experiences are presented. The basic scope of requirements and practice recommendation are also done. (author)

I Bought my Car, What’s Next? Perception and Importance Analysis Attributed by Costumers to After Sales Services

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Francisco Dimitrius Comiotto

2014-12-01

Full Text Available The objective of this research is analyzing the consumer perception and importance gave to after-sales service strategies at the car dealers market, in Florianópolis, SC. The study arose from a curiosity to discover if after-sales practices would be associated to a product/service or to a consumer, as well as how do consumers evaluate those practices. In order to, an exploratory descriptive and quantitative was made, by applying a survey with 400 vehicles owners of brands JAC, GM, Fiat and Toyota. Results points that consumers firstly associate after-sales practices to services/product aspects (31,4% associate to maintenance review and then to consumer relationship (9,8% associate to complaining channels. Besides, some practices are perceived as high importance, although demonstrate low satisfaction – for example the “quick response to complaining” (high importance issue to 66%, but low satisfaction to 62% and “equal treatment during all consumption process” (high importance issue to 62%, but low satisfaction to equals 62%. The study also shows that consumers perceive differently after-sales treatment from those made on purchase moment. This statement is based on 2,15 media, the lowest among the analyzed variables, with standard deviation of 0,759 and negative asymmetry of -0,249. The present research rises questioning about after-sales importance on both relationship to consumer and loyalty. Besides, incite a deep look to aftersales theme, both on academicals and managerial environment. 

Practical examples and discussion in junior high school biological delivery classes

OpenAIRE

石井, 照久; ISHII, Teruhisa

2013-01-01

Practical examples of the delivery class in junior high school biological education were reported. In 2006-2012, author did 13 times of delivery class in 5 junior high schools in Akita Prefecture. The contents of the delivery classes were‘‘Observation of animals in river’’, ‘‘Marine ecology’’, ‘‘Ecological problems’’ and ‘‘cells and DNA’’. In this report, these contents were discussed in regard to new course of education in Japan. Also, better delivery class in junior high school biological e...

Identifying organisational principles and management practices important to the quality of health care services for chronic conditions.

Science.gov (United States)

Frølich, Anne

2012-02-01

The quality of health care services offered to people suffering from chronic diseases often fails to meet standards in Denmark or internationally. The population consisting of people with chronic diseases is large and accounts for about 70% of total health care expenses. Given that resources are limited, it is necessary to identify efficient methods to improve the quality of care. Comparing health care systems is a well-known method for identifying new knowledge regarding, for instance, organisational methods and principles. Kaiser Permanente (KP), an integrated health care delivery system in the U.S., is recognized as providing high-quality chronic care; to some extent, this is due to KP's implementation of the chronic care model (CCM). This model recommends a range of evidence-based management practices that support the implementation of evidence-based medicine. However, it is not clear which management practices in the CCM are most efficient and in what combinations. In addition, financial incentives and public reporting of performance are often considered effective at improving the quality of health care services, but this has not yet been definitively proved. The aim of this dissertation is to describe the effect of determinants, such as organisational structures and management practices including two selected incentives, on the quality of care in chronic diseases. The dissertation is based on four studies with the following purposes: 1) macro- or healthcare system-level identification of organisational structures and principles that affect the quality of health care services, based on a comparison of KP and the Danish health care system; 2) meso- or organisation-level identification of management practices with positive effects on screening rates for hemoglobin A1c and lipid profile in diabetes; 3) evaluation of the effect of the CCM on quality of health care services and continuity of care in a Danish setting; 4) micro- or practice-level evaluation of the

Can we import quality tools? a feasibility study of European practice assessment in a country with less organised general practice

Directory of Open Access Journals (Sweden)

Pestiaux Dominique

2009-10-01

Full Text Available Abstract Background Quality is on the agenda of European general practice (GP. European researchers have, in collaboration, developed tools to assess quality of GPs. In this feasibility study, we tested the European Practice Assessment (EPA in a one-off project in Belgium, where general practice has a low level of GP organisation. Methods A framework for feasibility analysis included describing the recruiting of participants, a brief telephone study survey among non-responders, organisational and logistic problems. Using field notes and focus groups, we studied the participants' opinions. Results In this study, only 36 of 1000 invited practices agreed to participate. Co-ordination, administrative work, practice visits and organisational problems required several days per practice. The researchers further encountered technical problems, for instance when entering the data and uploading to the web-based server. In subsequent qualitative analysis using two focus groups, most participant GPs expressed a positive feeling after the EPA procedure. In the short period of follow-up, only a few GPs reported improvements after the visit. The participant GPs suggested that follow-up and coaching would probably facilitate the implementation of changes. Conclusion This feasibility study shows that prior interest in EPA is low in the GP community. We encountered a number of logistic and organisational problems. It proved attractive to participants, but it can be augmented by coaching of participants in more than a one-off project to identify and achieve targets for quality improvement. In the absence of commitment of the government, a network of universities and one scientific organisation will offer EPA as a service to training practices.

Practice for characterization and performance of a high-dose radiation dosimetry calibration laboratory

International Nuclear Information System (INIS)

2003-01-01

This practice addresses the specific requirements for laboratories engaged in dosimetry calibrations involving ionizing radiation, namely, gamma-radiation, electron beams or X-radiation (bremsstrahlung) beams. It specifically describes the requirements for the characterization and performance criteria to be met by a high-dose radiation dosimetry calibration laboratory. The absorbed-dose range is typically between 10 and 10 5 Gy. This practice addresses criteria for laboratories seeking accreditation for performing high-dose dosimetry calibrations, and is a supplement to the general requirements described in ISO/IEC 17025. By meeting these criteria and those in ISO/IEC 17025, the laboratory may be accredited by a recognized accreditation organization. Adherence to these criteria will help to ensure high standards of performance and instill confidence regarding the competency of the accredited laboratory with respect to the services it offers

The importance of integumentary knowledge and skill in physical therapist entry-level education: are they prepared for practice?

Science.gov (United States)

Gibbs, Karen A; Furney, Steven R

2013-01-01

Physical therapist practice is grounded in patient management principles encompassing all body systems and focuses on prevention, education, and functional outcomes. As such, management of the integumentary system crosses all practice settings, emphasizing the importance that basic integumentary content be adequately addressed during entry-level education. The purpose of this qualitative study was to compare the self-reported integumentary knowledge and skill of recent graduates to profession-determined expectations for education. Participants were 7 licensed physical therapists experienced in wound management. Semi-structured interview data were recorded, transcribed, and coded. A matrix compiling professional expectations for integumentary education was utilized to identify topics as absent, covered only briefly, or covered only during clinical rotations. Compression, vascular screening, infection, factors impacting healing, modalities, dressings, wound measurements, topicals, and sutures/staples were among the most commonly reported areas of deficiency. While integumentary care makes up a small percentage of physical therapy practice, it is a significant part of a comprehensively educated therapist. This study found participants did not perceive themselves to have received the minimum entry-level integumentary knowledge and skill deemed necessary by the profession. Study results are supported by current literature and demonstrate the need for integumentary curriculum review in entry-level programs.

Risk activities and pre-travel health seeking practices of notified cases of imported infectious diseases in Australia.

Science.gov (United States)

Paudel, Prakash; Raina, C; Zwar, Nicholas; Seale, Holly; Worth, Heather; Sheikh, Mohamud; Heywood, Anita E

2017-09-01

Travellers are at risk of acquiring infectious diseases during travel, with risks differing by destination, travel and traveller characteristics. A pre-travel health consultation may minimize this risk. However, uptake of pre-travel health advice remains low. We investigated pre-travel health preparations and disease-specific risk behaviours among notified cases of selected travel-associated infectious diseases imported into Australia. Prospective enhanced surveillance of notified cases of typhoid, paratyphoid, measles, hepatitis A, hepatitis E, malaria and chikungunya was conducted in two Australian states between February 2013 and January 2014. Details of pre-travel health preparation and disease-specific risk behaviours were collected. Among 180 cases associated with international travel, 28% were travellers and 22% were frequent travellers, having travelled ≥5 times in the past 5 years. 25% had sought pre-travel advice from a healthcare provider, and 16% reported a pre-travel vaccine. Seeking pre-travel health advice did not differ by immigrant status ( P  = 0.22) or by reason for travel ( P  = 0.13) but was more commonly sought by first time travellers ( P  = 0.03). Travellers visiting friends and relatives were more likely to report at-risk activities of brushing teeth with tap water ( P  food ( P  = 0.03) during travel compared to other travellers. Pre-travel health advice seeking practices and vaccine uptake was suboptimal among cases of notified disease. The results of this study highlight the need for a better understanding of barriers to pre-travel health seeking, particularly among high risk travellers, to reduce the importation of infectious diseases into Australia. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

Promoting High-Value Practice by Reducing Unnecessary Transfusions With a Patient Blood Management Program.

Science.gov (United States)

Sadana, Divyajot; Pratzer, Ariella; Scher, Lauren J; Saag, Harry S; Adler, Nicole; Volpicelli, Frank M; Auron, Moises; Frank, Steven M

2018-01-01

Although blood transfusion is a lifesaving therapy for some patients, transfusion has been named 1 of the top 5 overused procedures in US hospitals. As unnecessary transfusions only increase risk and cost without providing benefit, improving transfusion practice is an effective way of promoting high-value care. Most high-quality clinical trials supporting a restrictive transfusion strategy have been published in the past 5 to 10 years, so the value of a successful patient blood management program has only recently been recognized. We review the most recent transfusion practice guidelines and the evidence supporting these guidelines. We also discuss several medical societies' Choosing Wisely campaigns to reduce or eliminate overuse of transfusions. A blueprint is presented for developing a patient blood management program, which includes discussion of specific methods for optimizing transfusion practice.

Financial management practices in successful Small and Medium Enterprises (SMEs

Directory of Open Access Journals (Sweden)

Hendrik Petrus Wolmarans

2015-07-01

Full Text Available Although the success of small, medium and micro enterprises (SMEs is extremely important for the South African economy, their failure rate is amongst the highest in the world; some researchers estimate as high as 90 percent. Research has shown that the lack of financial management skills and application of financial management practices are some of the biggest factors contributing to SME failure. However, it is not clear from the literature which of these skills and practices are more important than others. This study aims to fill this gap by determining which financial management skills are relevant for successful SMEs. A survey was done on a sample of owner-managers of successful SMEs who had been asked, firstly, whether they performed different financial management practices and, secondly, how frequently they performed these in their companies. The study concludes that practices regarding working capital as well as profitability are much more relevant than those regarding a balance sheet or strategic finance. Similarly, financial practices related to cash flow and decision making are more relevant than those related to planning or analysing. It may be true, due to the high risk and volatile environment of SMEs, as well as the challenges that are often underestimated, that financial practices which academics regard as important are not always implemented by these companies.  This study contributes to the existing body of knowledge as it determines the relative relevance and frequency of use of financial management practices by successful SMEs. KEY WORDS Small and medium enterprises, Financial management practices, Successful SMEs, Entrepreneurship education

Iterative Design toward Equity: Youth Repertoires of Practice in a High School Maker Space

Science.gov (United States)

Martin, Lee; Dixon, Colin; Betser, Sagit

2018-01-01

Despite their potential, maker activities do not always support equitable engagement. The authors report on a design research study where they worked to support equitable engagement of youth repertoires of practice in a high school makerspace. Their orientation toward equity is grounded in the construct of repertoires of practice, and they focus…

Fiber optics principles and practices

CERN Document Server

Al-Azzawi, Abdul

2007-01-01

Since the invention of the laser, our fascination with the photon has led to one of the most dynamic and rapidly growing fields of technology. New advances in fiber optic devices, components, and materials make it more important than ever to stay current. Comprising chapters drawn from the author's highly anticipated book Photonics: Principles and Practices, Fiber Optics: Principles and Practices offers a detailed and focused treatment for anyone in need of authoritative information on this critical area underlying photonics.Using a consistent approach, the author leads you step-by-step throug

The Main Anatomical Variations of the Pancreatic Duct System: Review of the Literature and Its Importance in Surgical Practice.

Science.gov (United States)

Dimitriou, Ioannis; Katsourakis, Anastasios; Nikolaidou, Eirini; Noussios, George

2018-05-01

Anatomical variations or anomalies of the pancreatic ducts are important in the planning and performance of endoscopic retrograde cholangiopancreatography (ERCP) and surgical procedures of the pancreas. Normal pancreatic duct anatomy occurs in approximately 94.3% of cases, and multiple variations have been described for the remaining 5.7%. The purpose of this study was to review the literature on the pancreatic duct anatomy and to underline its importance in daily invasive endoscopic and surgical practice. Two main databases were searched for suitable articles published from 2000 to 2017, and results concerning more than 8,200 patients were included in the review. The most common anatomical variation was that of pancreas divisum, which appeared in approximately 4.5% of cases.

The Ethics of Ambiguity: Rethinking the Role and Importance of Uncertainty in Medical Education and Practice.

Science.gov (United States)

Domen, Ronald E

2016-01-01

Understanding and embracing uncertainty are critical for effective teacher-learner relationships as well as for shared decision-making in the physician-patient relationship. However, ambiguity has not been given serious consideration in either the undergraduate or graduate medical curricula or in the role it plays in patient-centered care. In this article, the author examines the ethics of ambiguity and argues for a pedagogy that includes education in the importance of, and tolerance of, ambiguity that is inherent in medical education and practice. Common threads running through the ethics of ambiguity are the virtue of respect, and the development of a culture of respect is required for the successful understanding and implementation of a pedagogy of ambiguity.

High performance work practices in small firms : A resource-poverty and strategic decision-making perspective

NARCIS (Netherlands)

Kroon, B.; van de Voorde, F.C.; Timmers, J.

2013-01-01

High performance work practices (HPWPs) are human resource management practices aimed at stimulating employee and organisational performance. The application of HPWPs is not widespread in small organisations. We examine whether the implementation of coherent bundles of HPWPs (aimed at employee

High performance work practices in small firms: a resource-poverty and strategic decision-making perspective

NARCIS (Netherlands)

Kroon, B.; Voorde, F.C. van de; Timmers, J.

2013-01-01

High performance work practices (HPWPs) are human resource management practices aimed at stimulating employee and organisational performance. The application of HPWPs is not widespread in small organisations. We examine whether the implementation of coherent bundles of HPWPs (aimed at employee

[Medical professionals on the subject of their core values: the importance of practice-based stories and intrinsic motivation].

Science.gov (United States)

Witman, Yolande; van den Kerkhof, Peter C M; Braat, Didi D M

2013-01-01

In the current system for guaranteeing quality of care, emphasis is placed firmly on external control of professionals. We looked for a way to appeal to the intrinsic motivation of medical professionals and to discover what they mean by 'good work'. This was achieved with the aid of reflective sessions using the toolkit 'Good Work': in four sessions three different groups of medical professionals (medical department chairs, residents and interns) from a Dutch university hospital reflected on the topics 'excellence', 'moral responsibility' and 'personal engagement'. The participants exchanged practice-based stories during the sessions. The most important theme was moral responsibility, with its accompanying dilemmas. The sessions gave rise to feelings of mutual acknowledgement, recognition, inspiration and motivation. Sharing meaningful practice-based stories can be considered as a 'moment of learning', strengthening professional identity and stimulating intrinsic motivation. More space for this form of reflection might restore the balance with external control systems.

Identifying organisational principles and management practices important to the quality of health care services for chronic conditions

DEFF Research Database (Denmark)

Frølich, Anne

2012-01-01

are limited, it is necessary to identify efficient methods to improve the quality of care. Comparing health care systems is a well-known method for identifying new knowledge regarding, for instance, organisational methods and principles. Kaiser Permanente (KP), an integrated health care delivery system...... in the U.S., is recognized as providing high-quality chronic care; to some extent, this is due to KP's implementation of the chronic care model (CCM). This model recommends a range of evidence-based management practices that support the implementation of evidence-based medicine. However, it is not clear...... which management practices in the CCM are most efficient and in what combinations. In addition, financial incentives and public reporting of performance are often considered effective at improving the quality of health care services, but this has not yet been definitively proved....

High Performance Human Resource Practices, Identification with Organizational Values and Goals, and Service-Oriented Organizational Citizenship Behavior: A Review of Literature and Proposed Model

Directory of Open Access Journals (Sweden)

Nasurdin Aizzat Mohd.

2015-01-01

Full Text Available Increasing competition within the hospitality industry has recognized the importance of service quality as a key business differentiation strategy. Proactive involvement of employees is a vital component of the service delivery, which in turn, enhances customer satisfaction and loyalty. Hence, hospitality organizations, particularly hotels, need to encourage their employees to perform voluntary behaviors that go “beyond their call of duty”. These behaviors are referred to as service-oriented organizational citizenship behaviors (hereafter labeled as SO-OCBs. A review of the literature indicates that an organization’s human resource management (henceforth labeled as HRM practices are instrumental in establishing the tone of the employee-employer relationship, which subsequently affects employees’ display of discretionary functional service-related behaviors. Specifically, high-performance HRM practices can nurture a relational employment relationship, leading to internalization of organizational values and goals. This, in turn, would induce employees to engage in greater SO-OCBs. However, conceptual and empirical work explaining the mechanism by which high-performance HRM practices relate to SO-OCBs remains scarce. Therefore, this paper aims to construct a model linking a set of high-performance HRM practices (selective hiring, communication, appraisal, and reward and SO-OCBs. Identification with organizational values and goals is posited as a mediator in the proposed relationship. A discussion of the literature to support the proposed framework is furnished.

The business of dental practice

Directory of Open Access Journals (Sweden)

Niken Widyanti Sriyono

2006-06-01

Full Text Available Globalization including General Agreement on Trade in Services (GATS and Asia Fair Trade Agreement (AFTA are a new free trade system. In globalization era, there will be an intense and free competition in looking for jobs throughout the world. This new system will affect the health services system in which health services tend to follow an industrial model. Meaning that dentistry or dental health services tend to be part of a business system, and this system has caused controversy among the community and the profession itself. The results of the discussion revealed that professional and business of dentistry is compatible and complementary. The tendency of increasing number of legal form of practice (group and a professional corporation and the worldwide advertisement of these practices supported the premise that delivering dental practice tends to follow the industrial model. Dentists should not only more focus on achieving financial success in running the business of practice but profession should have the most concern for the people who seek their services. Delivering quality of dental care depends on the high skill of the dentist and on the satisfactory income for the survival of the practice in the long run, and this make the practice will be viewed by the public and profession as being appropriate and of high quality. Facing the globalization, besides possessing high clinical skill, dentists must have a firm understanding of management concepts and apply them in their practice. In conclusion: The profession and the business of dentistry are compatible and complementary. The delivery of the dental services tends to follow the industrial model, which is a current reality. Dentist should concern more on the delivering high quality of dental services, not only focus on the business of the practice, although the satisfactory income is important for the survival growth of the practice in the long run. It is suggested for dentists to follow as

What can scientific practice look like in a classroom? Insights from scientists' critique of high school students' climate change argumentation practice

Science.gov (United States)

Walsh, E.; McGowan, V. C.

2015-12-01

The Next Generation Science Standards promote a vision in which learners engage in authentic knowledge in practice to tackle personally consequential science problems in the classroom. However, there is not yet a clear understanding amongst researchers and educators of what authentic practice looks like in a classroom and how this can be accomplished. This study explores these questions by examining interactions between scientists and students on a social media platform during two pilot enactments of a project-based curriculum focusing on the ecological impacts of climate change. During this unit, scientists provided feedback to students on infographics, visual representations of scientific information meant to communicate to an audience about climate change. We conceptualize the feedback and student work as boundary objects co-created by students and scientists moving between the school and scientific contexts, and analyze the structure and content of the scientists' feedback. We find that when giving feedback on a particular practice (e.g. argumentation), scientists would provide avenues, critiques and questions that incorporated many other practices (e.g. data analysis, visual communication); thus, scientists encouraged students to participate systemically in practices instead of isolating one particular practice. In addition, scientists drew attention to particular habits of mind that are valued in the scientific community and noted when students' work aligned with scientific values. In this way, scientists positioned students as capable of participating "scientifically." While traditionally, incorporating scientific inquiry in a classroom has emphasized student experimentation and data generation, in this work, we found that engaging with scientists around established scientific texts and data sets provided students with a platform for developing expertise in other important scientific practices during argment construction.

Role and importance of workshops in the development of heritage protection

Directory of Open Access Journals (Sweden)

Živa Deu

2013-07-01

Full Text Available This contribution presents a detailed account of the role and importance of urbanist-architecture and architecture workshops. The analysis of the chosen sample of twenty-five workshops tied to the developmental protection of the heritage of built structures and the preservation of immobile cultural heritage as a whole illuminates the pedagogic importance and examines the transmission of workshop products into practice. It has been established that in addition to raising new architects the workshops posses a wider educational importance. Apart from the client the workshop process includes the local inhabitants who, through the process, familiarize themselves with less well known expert and practical knowledge. Without it any expectation of a quality settlement of vital building heritage would not be merited. An overview of the results stemming from the workshops demonstrates that practical applications do not achieve desired results. Many products remained locked in the clients’ desk drawers with less than half ever put into practice. All the workshops, including the ones not, or not yet realised in their intended form, produced material of lasting value, specifically in the work of the regional Institutes for the Protection of Cultural Heritage. The materials handed over to institutes playing an important role in the productive efforts of the high grade of protection and development of heritage include multi-layered analyses of valuable built structures and architectural recordings. From the point of view of developmental protection of Slovenian cultural heritage and due to the demonstrated use of important analytic material and especially due to their proven educational value the exercise of workshops in various settlements of Slovenian space is indispensable.

Practical reasons for investigating ion transport in high temperature insulating materials

International Nuclear Information System (INIS)

Sonder, E.

1976-01-01

Practical problems encountered in a number of advanced technology appliations, particularly those related to energy conversion, are discussed. Refractory ionic compounds which are abundant and of high melting point are listed, and technological problems are discussed in terms of specific materials problems. The argument is made that basic information concerning transport properties in refractory compounds is lacking to such an extent that it is difficult to design and assess advanced energy generation systems. Technology applications include: a) ceramic nuclear fuels for high temperature fission reactors, b) high temperature gas turbine blades, c) insulators in controlled thermonuclear reactors, and d) magnetohydrodynamic generators. Some of the difficulties inherent in making transport property measurements at high temperatures are also listed

Knowledge, attitude, and practice on emergency contraceptives ...

African Journals Online (AJOL)

Background: Unwanted pregnancy followed by unsafe abortion can be avoided by using different contraceptive methods, including emergency contraceptives. Information on knowledge, attitude and practice of emergency contraceptives among women is particularly important because of high rates of teenage and ...

Standard practice for evaluation of disbonding of bimetallic stainless alloy/steel plate for use in high-pressure, high-temperature refinery hydrogen service

CERN Document Server

American Society for Testing and Materials. Philadelphia

2001-01-01

1.1 This practice covers a procedure for the evaluation of disbonding of bimetallic stainless alloy/steel plate for use in refinery high-pressure/high-temperature (HP/HT) gaseous hydrogen service. It includes procedures to (1) produce suitable laboratory test specimens, (2) obtain hydrogen charging conditions in the laboratory that are similar to those found in refinery HP/HT hydrogen gas service for evaluation of bimetallic specimens exposed to these environments, and (3) perform analysis of the test data. The purpose of this practice is to allow for comparison of data among test laboratories on the resistance of bimetallic stainless alloy/steels to hydrogen-induced disbonding (HID). 1.2 This practice applies primarily to bimetallic products fabricated by weld overlay of stainless alloy onto a steel substrate. Most of the information developed using this practice has been obtained for such materials. The procedures described herein, may also be appropriate for evaluation of hot roll bonded, explosive bonded...

The importance of community building for establishing data management and curation practices for physical samples

Science.gov (United States)

Ramdeen, S.; Hangsterfer, A.; Stanley, V. L.

2017-12-01

There is growing enthusiasm for curation of physical samples in the Earth Science community (see sessions at AGU, GSA, ESIP). Multiple federally funded efforts aim to develop best practices for curation of physical samples; however, these efforts have not yet been consolidated. Harmonizing these concurrent efforts would enable the community as a whole to build the necessary tools and community standards to move forward together. Preliminary research indicate the various groups focused on this topic are working in isolation, and the development of standards needs to come from the broadest view of `community'. We will investigate the gaps between communities by collecting information about preservation policies and practices from curators, who can provide a diverse cross-section of the grand challenges to the overall community. We will look at existing reports and study results to identify example cases, then develop a survey to gather large scale data to reinforce or clarify the example cases. We will be targeting the various community groups which are working on similar issues, and use the survey to improve the visibility of developed best practices. Given that preservation and digital collection management for physical samples are both important and difficult at present (GMRWG, 2015; NRC, 2002), barriers to both need to be addressed in order to achieve open science goals for the entire community. To address these challenges, EarthCube's iSamples, a research coordination network established to advance discoverability, access, and curation of physical samples using cyberinfrastructure, has formed a working group to collect use cases to examine the breadth of earth scientists' work with physical samples. This research team includes curators of state survey and oceanographic geological collections, and a researcher from information science. In our presentation, we will share our research and the design of the proposed survey. Our goal is to engage the audience in a

Is it possible to estimate the minimal clinically important treatment effect needed to change practice in preterm birth prevention? Results of an obstetrician survey used to support the design of a trial

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Ross Sue

2012-03-01

Full Text Available Abstract Background Sample sizes for obstetrical trials are often based on the opinion of investigators about clinically important effect size. We surveyed Canadian obstetricians to investigate clinically important effect sizes required before introducing new treatments into practice to prevent preterm birth. Methods Questionnaires were mailed to practicing obstetricians, asking the magnitude of pregnancy prolongation required to introduce treatments into practice. The three prophylactic treatments were of increasing invasiveness: vaginal progesterone, intramuscular progesterone, and cervical cerclage. We also asked about the perceived most relevant outcome measures for obstetrical trials and current obstetrical practice in preterm birth prevention. Results 544/1293(42.1% completed questionnaires were received. The majority of respondents required one or two weeks' increase in length of gestation before introducing vaginal (372,77.1%, and intramuscular progesterone(354,67.9%. At least three weeks increase was required before introducing prophylactic cervical cerclage(326,62.8%. Clinicians who already used a treatment required a smaller difference before introducing it into practice. Decreasing neonatal morbidity was cited as the most important outcome for obstetrical trials (349,72.2%. Conclusion Obstetricians would require a larger increase in treatment effect before introducing more invasive treatments into practice. Although infant morbidity was perceived as a more important outcome, clinicians appeared willing to change practice on the basis of prolongation of pregnancy, a surrogate outcome. We found that there is not a single minimum clinically important treatment effect that will influence all practising clinicians: rather the effect size that will influence physicians is affected by the nature of the treatment, the reported outcome measure and the clinician's own current clinical practice.

Oral and anal sex practices among high school youth in Addis Ababa, Ethiopia

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Cherie Amsale

2012-01-01

Full Text Available Abstract Background Understanding the full range of sexual behaviors of young people is crucial in developing appropriate interventions to prevent and control sexually transmitted infections including HIV. However, such information is meager in developing countries. The objective of this study was to describe oral and anal sex practices and identify associated factors among high school youth. Methods A cross-sectional study was conducted among high school youth in Addis Ababa, Ethiopia. A multi-stage sampling procedure was followed to select a representative sample of school youth. The total sample size for this study was 3840. Data were collected using a self-administered questionnaire. Data analysis was guided by the ecological framework. Results The overall proportion of people who reported ever having oral sex was 5.4% (190 and that of anal sex was 4.3% (154. Of these 51.6% (98 had oral sex and 57.1% (87 had anal sex in the past 12 months. Multiple partnerships were reported by 61.2% of the respondents who had oral sex and 51.1% of students practicing anal sex. Consistent condom use was reported by 12.2% of those practicing oral sex and 26.1% of anal sex. Reasons for oral and anal sex included prevention of pregnancy, preserving virginity, and reduction of HIV and STIs transmission. Oral sex practice was strongly and significantly associated with perception of best friends engagement in oral sex (AOR = 5.7; 95% CI 3.6-11.2 and having illiterate mothers (AOR = 11.5; 95%CI 6.4-18.5. Similarly, anal sex practice was strongly and significantly associated with favorable attitude towards anal sex (AOR = 6.2; 95%CI 3.8-12.4, and perceived best friends engagement in anal sex (AOR = 9.7; 95%CI 5.4-17.7. Conclusion Considerable proportion of adolescents had engaged in oral and anal sex practices. Multiple sexual partnerships were common while consistent condom use was low. Sexual health education and behavior change communication strategies need to

Prospective High School Physics Teachers' Beliefs about Teaching Practices: From Traditionalist to Constructivist

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Demirci, Neset

2015-01-01

The main aim of this study was to determine the teaching practices of prospective high school physics teachers with respect to their preference for teaching as a traditionalist or as a constructivist. To study the beliefs of prospective high school physics teachers on this subject, firstly, the Teacher Belief Survey was administered to 135…

The Importance of Simulation in Nursing Education

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Eyikara, Evrim; Baykara, Zehra Gocmen

2017-01-01

Nursing education involves a practice-oriented curriculum in which emphasis is placed on both theoretical knowledge and psychomotor skills. In skill-based education, where learning through practice occupies a central role, it is important to ensure the integration of theoretical knowledge into practice. In this context, simulations represent an…

Fasting practices in Tamil Nadu and their importance for patients with diabetes.

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Kannan, Subramanian; Mahadevan, Shriraam; Seshadri, Krishna; Sadacharan, Dhalapathy; Velayutham, Kumaravel

2016-01-01

Religious practices and cultural customs related to eating habits have a significant impact on lifestyle and health of the community. The Ramadan fasting in Muslims and its influence on various metabolic parameters such as diabetes have been reasonably studied. However, literature related to Hindu religious customs related to fasting and food patterns during various festivals and its effect on diabetes are scarce. This article is an attempt to describe the Hindu religious customs related to fasting and food practices from the State of Tamil Nadu (South India) and to raise the awareness among physicians about its relationship with diabetes which may help in managing their diabetic patients in a better way.

Why quality of life measurement is important in dermatology clinical practice

DEFF Research Database (Denmark)

Finlay, A Y; Salek, M S; Abeni, D

2017-01-01

The aim of this study was to describe the many ways in which quality of life (QoL) measurement may potentially be advantageous in routine clinical dermatology practice. Thirteen members of the EADV Task Force on Quality of Life, eight dermatologists, three health psychologists, one epidemiologist...

Implementing differentiated practice: personal values and work satisfaction among hospital staff nurses.

Science.gov (United States)

Prothero, M M; Marshall, E S; Fosbinder, D M

1999-01-01

This project was part of a collaborative model for nursing staff development and student education. Personal values and work satisfaction of 49 staff nurses working on three hospital units were compared. One of the units employed differentiated practice. Results revealed high similarity in personal values among all nurses. Work satisfaction was significantly higher among nurses working on the unit employing differentiated practice. The importance of assessing personal values of nurses emerged as an important aspect of staff development, and differentiated practice appeared to be related to staff nurse satisfaction.

Small hydroelectric engineering practice

CERN Document Server

Leyland, Bryan

2014-01-01

Small Hydroelectric Engineering Practice is a comprehensive reference book covering all aspects of identifying, building, and operating hydroelectric schemes between 500 kW and 50 MW. In this range of outputs there are many options for all aspects of the scheme and it is very important that the best options are chosen.As small hydroelectric schemes are usually built against a limited budget it is extremely important that the concept design is optimum and every component is designed to maximise the benefi t and minimise the cost. As operating costs are often a high proportion of the income it i

[Practice marketing. Data analysis of a urological group practice].

Science.gov (United States)

Schneider, T; Schneider, B; Eisenhardt, A; Sperling, H

2009-07-01

The urological practice setting in Germany has changed tremendously over the last years. Group practices with two or more urologists working together are becoming more and more popular. At the same time, marketing has become essential even for urologists. To evaluate the patient flow to our group practice, we asked all new patients to fill out a questionnaire (n=2112). We also evaluated the efficacy of our recall system. The analysis showed that patients were 18-93 years old (mean 57 years), 68% being male and 32% female. The largest age group consisted of 41-50-year-olds. The most important reasons for choosing our practice were recommendations by general practitioners in 38%, recommendations by specialists in 11%, and recommendations by friends and relatives in 27%. Five percent of the patients chose the practice because of the Internet home page and 10% because of entries in various phone books. Three percent of the patients came because of newspaper articles about the practice owners, and advertising for a urological practice. Phone books are increasingly becoming less important, and the Internet is increasingly attractive to the younger population. Recall systems can also be useful for urological practices.

Practical aspects of spherical near-field antenna measurements using a high-order probe

DEFF Research Database (Denmark)

Laitinen, Tommi; Pivnenko, Sergey; Nielsen, Jeppe Majlund

2006-01-01

Two practical aspects related to accurate antenna pattern characterization by probe-corrected spherical near-field antenna measurements with a high-order probe are examined. First, the requirements set by an arbitrary high-order probe on the scanning technique are pointed out. Secondly, a channel...... balance calibration procedure for a high-order dual-port probe with non-identical ports is presented, and the requirements set by this procedure for the probe are discussed....

The use of high impact practices (HIPs) on chemistry lesson design and implementation by pre-service teachers

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Chamrat, Suthida; Apichatyotin, Nattaya; Puakanokhirun, Kittaporn

2018-01-01

The quality of lesson design is essential to learning effectiveness. Research shows some characteristics of lessons have strong effect on learning which were grouped into "High Impact Practices or HIPs. This research aims to examine the use of HIPs on chemistry lesson design as a part of Teaching Science Strand in Chemistry Concepts course. At the first round of lesson design and implementing in classroom, 14 chemistry pre-services teachers freely selected topics, designed and implemented on their own ideas. The lessons have been reflected by instructors and their peers. High Impact Practices were overtly used as the conceptual framework along with the After-Action Review and Reflection (AARR). The selected High Impact practice in this study consisted of 6 elements: well-designed lesson, vary cognitive demand/academic challenge, students center approach, opportunity of students to reflect by discussion or writing, the assignment of project based learning or task, and the lesson reflects pre-service teachers' Technological Pedagogical Content Knowledge (TPACK). The second round, pre-service teachers were encouraged to explicitly used 6 High Impact Practices in cooperated with literature review specified on focused concepts for bettering designed and implemented lessons. The data were collected from 28 lesson plans and 28 classroom observations to compare and discuss between the first and second lesson and implementation. The results indicated that High Impact Practices effect on the quality of delivered lesson. However, there are some elements that vary on changes which were detailed and discussed in this research article.

Substance use and dietary practices among students attending alternative high schools: results from a pilot study

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Hannan Peter J

2011-04-01

Full Text Available Abstract Background Substance use and poor dietary practices are prevalent among adolescents. The purpose of this study was to examine frequency of substance use and associations between cigarette, alcohol and marijuana use and selected dietary practices, such as sugar-sweetened beverages, high-fat foods, fruits and vegetables, and frequency of fast food restaurant use among alternative high school students. Associations between multi-substance use and the same dietary practices were also examined. Methods A convenience sample of adolescents (n = 145; 61% minority, 52% male attending six alternative high schools in the St Paul/Minneapolis metropolitan area completed baseline surveys. Students were participants in the Team COOL (Controlling Overweight and Obesity for Life pilot study, a group randomized obesity prevention pilot trial. Mixed model multivariate analyses procedures were used to assess associations of interest. Results Daily cigarette smoking was reported by 36% of students. Cigarette smoking was positively associated with consumption of regular soda (p = 0.019, high-fat foods (p = 0.037, and fast food restaurant use (p = 0.002. Alcohol (p = 0.005 and marijuana use (p = 0.035 were positively associated with high-fat food intake. With increasing numbers of substances, a positive trend was observed in high-fat food intake (p = 0.0003. There were no significant associations between substance use and fruit and vegetable intake. Conclusions Alternative high school students who use individual substances as well as multiple substances may be at high risk of unhealthful dietary practices. Comprehensive health interventions in alternative high schools have the potential of reducing health-compromising behaviors that are prevalent among this group of students. This study adds to the limited research examining substance use and diet among at-risk youth. Trial registration number ClinicalTrials.gov: NCT01315743

Perceptions of Future Employees toward CSR Environmental Practices in Tourism

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Diana Corina Gligor-Cimpoieru

2017-09-01

Full Text Available Corporate social responsibility (CSR in tourism, with its central evironmental dimension, represents an important component for the sustainable growth of the tourism industry. The related CSR education could prove a major factor for future professional performance in this field of activity. Thus, this article is aimed at identifying the perceptions of current business students about CSR (students from study programs dedicated to business administration in tourism and the importance they attribute to CSR environmental practices, mainly from their perspective as future employees in the tourism industry. We elaborated a research methodology based on the Ecolabelling principles, designed by the European Union in 2009. Our findings revealed that business tourism students assign more importance to several specific CSR environmental practices and that the importance of these CSR practices is statistically significant (we determined this significance by using the Friedman, Paired-Samples t-, ANOVA, Kruskal-Wallis and Bartlett sphericity statistical tests. The elaborated research methodology proved to be statistically highly reliable. Results also show the differences regarding the CSR practices preferred by various categories of students according to their study levels and gender. Our results pointed out that our third-year bachelor students showed a higher interest in CSR practices related to their professional training, while students from the master level degree attached more importance to CSR practices related to the environment. We also confirmed conclusions of previous studies that female respondents attach more importance to environmental issues than male respondents. Thus, we can state that a higher level of education is a key factor that supports CSR development in practice. Also, a significant conclusion of our research is related to the academic curricula for business faculties which must incorporate solid CSR and business ethics

Using a Mixed Methods Approach to Examine Practice Characteristics Associated With Implementation of an Adult Immunization Intervention Using the 4 Pillars Practice Transformation Program.

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Hawk, Mary; Nowalk, Mary Patricia; Moehling, Krissy K; Pavlik, Valory; Raviotta, Jonathan M; Brown, Anthony E; Zimmerman, Richard K; Ricci, Edmund M

Adult immunization rates are consistently suboptimal, exacting significant human and financial burden of preventable disease. Practice-level interventions to improve immunization rates have produced mixed results. The context of change critically affects implementation of evidence-based interventions. We conducted a randomized controlled cluster trial of the 4 Pillars Practice Transformation Program to increase adult vaccination rates in primary care practices and used qualitative methods to test intervention effects and understand practice characteristics associated with implementation success. We conducted qualitative interviews with staff from 14 practices to assess implementation experiences. Thematic analysis of data pointed to the importance of quality improvement history, communication and practice leadership, Immunization Champion leadership effectiveness, and organizational flexibility. Practices were scored on these characteristics and grouped into four types: Low Implementers, Medium Implementers, High Implementers, and Public/University Practices. Intervention uptake and immunization rate changes were compared, and a significant increase in influenza vaccination rates (3.9 percentage points [PPs]; p = .038) was observed for High Implementers only. Significant increases in Tdap vaccination rates were observed for High Implementers (9.3 PP; p = 0.006) and the Public/University groups (6.5 PP; p = 0.012), but not other groups. Practice characteristics may be critical factors in predicting intervention success.

Social Practices

DEFF Research Database (Denmark)

Schmidt, Kirsten

2013-01-01

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

Important Poisonous Plants in Tibetan Ethnomedicine

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Lijuan Ma

2015-01-01

Full Text Available Tibetan ethnomedicine is famous worldwide, both for its high effectiveness and unique cultural background. Many poisonous plants have been widely used to treat disorders in the Tibetan medicinal system. In the present review article, some representative poisonous plant species are introduced in terms of their significance in traditional Tibetan medicinal practices. They are Aconitum pendulum, Strychnos nux-vomica, Datura stramonium and Anisodus tanguticus, for which the toxic chemical constituents, bioactivities and pharmacological functions are reviewed herein. The most important toxins include aconitine, strychnine, scopolamine, and anisodamine. These toxic plants are still currently in use for pain-reduction and other purposes by Tibetan healers after processing.

Importance measures and resource allocation

International Nuclear Information System (INIS)

Guey, C.N.; Morgan, T.; Hughes, E.A.

1987-01-01

This paper discusses various importance measures and their practical relevance to allocating resources. The characteristics of importance measures are illustrated through simple examples. Important factors associated with effectively allocating resources to improve plant system performance or to prevent system degradation are discussed. It is concluded that importance measures are only indicative of and not equal to the risk significance of a component, system, or event. A decision framework is suggested to provide a comprehensive basis for resource allocation

LATENT CLUSTER ANALYSIS OF INSTRUCTIONAL PRACTICES REPORTED BY HIGH- AND LOW-PERFORMING MATHEMATICS TEACHERS IN FOUR COUNTRIES

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Qiang Cheng

2017-06-01

Full Text Available Using Trends in International Mathematics and Science Study (TIMSS 2011 eighth-grade international dataset, this study explored the profiles of instructional practices reported by high- and low-performing mathematics teachers across the US, Finland, Korea, and Russia. Concepts of conceptual teaching and procedural teaching were used to frame the design of the current study. Latent cluster analysis was applied in the investigation of the profiles of mathematics teachers’ instructional practices across the four education systems. It was found that all mathematics teachers in the high- and low-performing groups used procedurally as well as conceptually oriented practices in their teaching. However, one group of high-performing mathematics teachers from the U.S. sample and all the high-performing teachers from Finland, Korea, and Russia showed more frequent use of conceptually oriented practices than their corresponding low-performing teachers. Another group of U.S. high-performing mathematics teachers showed a distinctive procedurally oriented pattern, which presented a rather different picture. Such results provide useful suggestions for practitioners and policy makers in their effort to improve mathematics teaching and learning in the US and in other countries as well.DOI: http://dx.doi.org/10.22342/jme.8.2.4066.115-132

Telemedicine: Its Importance in Cardiology Practice. Experience in Chile

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Edgardo Escobar, MD, FACC, FAHA

2017-05-01

Full Text Available There is a growing need worldwide to take medical care to distant locations far from the main urban centers, particularly to rural areas. Furthermore, there is the ethical imperative to provide equal access to medical care to all patients, regardless of their place of residence, so as to satisfy an increasingly demanding population. A widespread problem, from which cardiology is not excepted, is the insufficient number of specialists and their uneven distribution. The upsurge in information and communications technology has made available a large collection of tools, mainly computers, smartphones, e-mail, and the Internet, to name just a few, to meet the needs of communication between individuals and organizations. This article defines telemedicine and describes its application in the practice of cardiology and its impact in Chile.

Combining clinical practice and academic work in nursing: A qualitative study about perceived importance, facilitators and barriers regarding clinical academic careers for nurses in university hospitals.

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van Oostveen, Catharina J; Goedhart, Nicole S; Francke, Anneke L; Vermeulen, Hester

2017-12-01

To obtain in-depth insight into the perceptions of nurse academics and other stakeholders regarding the importance, facilitators and barriers for nurses combining clinical and academic work in university hospitals. Combining clinical practice and academic work facilitates the use of research findings for high-quality patient care. However, nurse academics move away from the bedside because clinical academic careers for nurses have not yet been established in the Netherlands. This qualitative study was conducted in two Dutch university hospitals and their affiliated medical faculties and universities of applied sciences. Data were collected between May 2015 and August 2016. We used purposive sampling for 24 interviews. We asked 14 participants in two focus groups for their perceptions of importance, facilitators and barriers in nurses' combined clinical and academic work in education and research. We audiotaped, transcribed and thematically analysed the interviews and focus groups. Three themes related to perceived importance, facilitators and barriers: culture, leadership and infrastructure. These themes represent deficiencies in facilitating clinical academic careers for nurses. The current nursing culture emphasises direct patient care, which is perceived as an academic misfit. Leadership is lacking at all levels, resulting in the underuse of nurse academics and the absence of supporting structures for nurses who combine clinical and academic work. The present nursing culture appears to be the root cause of the dearth of academic positions and established clinical academic posts. A culture change would require a show of leadership that would promote and enable combined research, teaching and clinical practice and that would introduce clinical academic career pathways for nurses. Meanwhile, nurse academics should collaborate with established medical academics for whom combined roles are mainstream, and they should take advantage of their established infrastructure

How to define 'best practice' for use in Knowledge Translation research: a practical, stepped and interactive process.

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Bosch, Marije; Tavender, Emma; Bragge, Peter; Gruen, Russell; Green, Sally

2013-10-01

Defining 'best practice' is one of the first and crucial steps in any Knowledge Translation (KT) research project. Without a sound understanding of what exactly should happen in practice, it is impossible to measure the extent of existing gaps between 'desired' and 'actual' care, set implementation goals, and monitor performance. The aim of this paper is to present a practical, stepped and interactive process to develop best practice recommendations that are actionable, locally applicable and in line with the best available research-based evidence, with a view to adapt these into process measures (quality indicators) for KT research purposes. Our process encompasses the following steps: (1) identify current, high-quality clinical practice guidelines (CPGs) and extract recommendations; (2) select strong recommendations in key clinical management areas; (3) update evidence and create evidence overviews; (4) discuss evidence and produce agreed 'evidence statements'; (5) discuss the relevance of the evidence with local stakeholders; and (6) develop locally applicable actionable best practice recommendations, suitable for use as the basis of quality indicators. Actionable definitions of local best practice are a prerequisite for doing KT research. As substantial resources go into rigorously synthesizing evidence and developing CPGs, it is important to make best use of such available resources. We developed a process for efficiently developing locally applicable actionable best practice recommendations from existing high-quality CPGs that are in line with current research evidence. © 2012 John Wiley & Sons Ltd.

16 CFR 1211.25 - Product certification and labeling by importers.

Science.gov (United States)

2010-01-01

... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Product certification and labeling by importers. 1211.25 Section 1211.25 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT... § 1211.25 Product certification and labeling by importers. (a) General. The importer of any automatic...

How will practices cope with information for the new GMS contract? Coronary heart disease data recording in five Scottish practices

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Libby Morris

2003-11-01

Conclusions We have shown that in Scotland there is a high level of testing and recording of all the important information regarding patients with recorded CHD, irrespective of whether practices have fully electronic records, paper-based records, or a mixture of the two. If practices have fully electronic patient records, the information can be extracted easily, but unless there is a standard template, the information can only be viewed in isolation and is of little value for comparative purposes.

Exploring geographic distributions of high-risk water, sanitation, and hygiene practices and their association with child diarrhea in Uganda

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Mitsuaki Hirai

2016-10-01

Full Text Available Background: High-risk water, sanitation, and hygiene (WASH practices are still prevalent in most low-income countries. Because of limited access to WASH, children may be put at an increased risk of diarrheal diseases. Objectives: This study aims to 1 develop a new measure of WASH-induced burden, the WASH Resource Index (WRI, and estimate its correlation with child diarrhea and an additive index of high-risk WASH practices; 2 explore the geographic distribution of high-risk WASH practices, child diarrhea, and summary indices at the cluster level; and 3 examine the association between the WRI and child diarrhea at the individual level. Design: A sample of 7,019 children from the Uganda Demographic and Health Survey 2011 were included in this study. Principal component analysis was used to develop a WRI, and households were classified as WASH poorest, poorer, middle, richer, and richest. A hot spot analysis was conducted to assess whether and how high-risk WASH practices and child diarrhea were geographically clustered. A potential association between the WRI and child diarrhea was examined through a nested regression analysis. Results: High-risk WASH practices were clustered at geographically distant regions from Kampala. The 2-week prevalence of child diarrhea, however, was concentrated in Eastern and East Central regions where high-risk WASH practices were not prevalent. At the individual level, none of the high-risk WASH practices were significantly associated with child diarrhea. Being in the highest WASH quintile was, however, significantly associated with 24.9% lower prevalence of child diarrhea compared to being in the lowest quintile (p<0.05. Conclusions: Only a weak association was found between the WRI and child diarrhea in this study. Future research should explore the potential utility of the WRI to examine WASH-induced burden.

Dentists' dietary perception and practice patterns in a dental practice-based research network.

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Yoko Yokoyama

Full Text Available Dental caries are largely preventable, and epidemiological evidence for a relationship between diet and oral health is abundant. To date, however, dentists' perceptions about the role of diet and dentists' practice patterns regarding diet counseling have not been clarified.THE PURPOSES OF THIS STUDY WERE TO: (1 examine discordance between dentists' perception of the importance of diet in caries treatment planning and their actual provision of diet counseling to patients, and (2 identify dentists' characteristics associated with their provision of diet counseling.The study used a cross-sectional study design consisting of a questionnaire survey in Japan.The study queried dentists working in outpatient dental practices who were affiliated with the Dental Practice-Based Research Network Japan (JDPBRN, which aims to allow dentists to investigate research questions and share experiences and expertise (n = 282.Dentists were asked about their perceptions on the importance of diet and their practice patterns regarding diet counseling, as well as patient, practice, and dentist background data.The majority of participants (n = 116, 63% recognized that diet is "more important" to oral health. However, among participants who think diet is "more important" (n = 116, only 48% (n = 56 provide diet counseling to more than 20% of their patients. Multiple logistic regression analysis suggested that several variables were associated with providing diet counseling; dentist gender, practice busyness, percentage of patients interested in caries prevention, caries risk assessment, and percentage of patients who receive blood pressure screening.Some discordance exists between dentists' perception of the importance of diet in caries treatment planning and their actual practice pattern regarding diet counseling to patients. Reducing this discordance may require additional dentist education, including nutritional and systemic disease concepts; patient

High School Teacher Perspectives and Practices: Second Language Writing and Language Development

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Gilliland, Betsy

2015-01-01

Teachers' understandings of second language learning influence their practices in the classroom. This paper analyzes interview and classroom data collected during a year-long ethnographic study of two high school English language development classes to identify (1) what the teachers understood about second language (L2) development and L2 academic…

High School Spanish Teachers' Attitudes and Practices toward Spanish Heritage Language Learners

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Russell, Brittany D.; Kuriscak, Lisa M.

2015-01-01

This case study uses survey data to examine the attitudes and pedagogical practices of preservice and current high school Spanish teachers toward Spanish heritage language learners (HLLs). The research questions addressed were (1) the extent to which participants were aware of the challenges facing Spanish HLLs who are enrolled in traditional…

Predictors of Summer Sun Safety Practice Intentions among Rural High School Students

Science.gov (United States)

Cho, Hyunyi; Sands, Laura P.; Wilson, Kari M.

2010-01-01

To investigate the association between theoretically grounded psychosocial motivators and the sun safety practice intentions of rural youth. Method: A survey was given to 219 members of FFA (Future Farmers of America) at high schools in the rural Midwest (average age = 16). Results: Perceived self-efficacy, peer norms, response efficacy, and…

High Bar Swing Performance in Novice Adults: Effects of Practice and Talent

Science.gov (United States)

Busquets, Albert; Marina, Michel; Irurtia, Alfredo; Ranz, Daniel; Angulo-Barroso, Rosa M.

2011-01-01

An individual's a priori talent can affect movement performance during learning. Also, task requirements and motor-perceptual factors are critical to the learning process. This study describes changes in high bar swing performance after a 2-month practice period. Twenty-five novice participants were divided by a priori talent level…

The Perceived Importance of Anatomy and Neuroanatomy in the Practice of Speech-Language Pathology

Science.gov (United States)

Martin, Kate; Bessell, Nicola J.; Scholten, Ingrid

2013-01-01

The purpose of this study was to examine the application of anatomy and neuroanatomy knowledge to current practice of speech-language pathology (SLP), based on the perceptions of practicing SLPs, and to elicit information on participants' experiences of learning these subjects in their primary SLP degree with a view to inform potential…

The Non-sexual Needs of Men that Motivate them to Engage in High-Risk Sexual Practices with Other Men

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Percy Fernández-Dávila

2009-05-01

Full Text Available Currently there is a growing trend toward high-risk sexual practices with casual partners in the group of men who have sex with men (MSM in many industrialized countries. This study offers some understanding of why a group of men had unprotected anal intercourse (UAI. A grounded approach was used to analyze 20 interviews with MSM from Barcelona between 18 and 40 years of age who had at least one episode of UAI in the past three months. The results reveal that many respondents had UAI practices with casual sexual partners because they were in search of experiences that were not directly tied to sexual relations: reaffirmation of a sense of personal worth and of their own physical attractiveness, offset shortcomings and feelings of emotional loneliness, the search for connection and intimacy, being in love, conversion of the risk into pleasure for the forbidden and a desire to rebel against established rules. In these cases, concerns about sexual and health care seemed to overwhelm and were not taken into account when having UAI. It is important that HIV prevention programs include in their messages the power of these motivations that lead to practices of UAI. URN: urn:nbn:de:0114-fqs0902219

Does high antibiotic consumption still reflect bad practices?

Science.gov (United States)

Levent, T; Delfosse, F; Lambiotte, F; Dezorzi, S; Gosteau, L; Vasseur, M

2012-07-01

The authors had for aim to assess the quality of antibiotic prescription in an intensive care unit because of their high rate of consumption. A prospective 5-month study was made of the first 50 prescriptions of ciprofloxacin, levofloxacin, teicoplanin, vancomycin, and imipenem. Treatment was considered adequate at day 5 if the indication was relevant, with the right doses, and if the prescription was adapted to the antibiogram. Fifty treatments were evaluated (38 patients included). Eighty-four percent (42/50) was adequate at day 5. Glycopeptides and fluoroquinolones accounted for 2/3 of prescriptions. The absence of de-escalation was the most common mistake. The severity of presentations was evident with a mean SSI at 68 (22-113), and a mean BMI at 28 (18.5 - 50). Eighty-four percent (32/38) of patients were exposed to invasive devices, 47% died in the ICU. Most prescriptions were adequate. The patient profile could explain the high rate of antibiotic consumption. Bacteriological monitoring revealed an increased prevalence of resistant bacteria, which could explain a high rate of consumption along with adaptation of the dose to overweight. De-escalation, using aminosides more frequently, and shorter prescribed courses of fluoroquinolones should improve consumption rates does not always reflect bad practices, but may be adequate when considering bacterial ecology and patient profile. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Incidence of Concussion During Practice and Games in Youth, High School, and Collegiate American Football Players.

Science.gov (United States)

Dompier, Thomas P; Kerr, Zachary Y; Marshall, Stephen W; Hainline, Brian; Snook, Erin M; Hayden, Ross; Simon, Janet E

2015-07-01

A report by the Institute of Medicine called for comprehensive nationwide concussion incidence data across the spectrum of athletes aged 5 to 23 years. To describe the incidence of concussion in athletes participating in youth, high school, and collegiate American football. Data were collected by athletic trainers at youth, high school, and collegiate football practices and games to create multiple prospective observational cohorts during the 2012 and 2013 football seasons. Data were collected from July 1, 2012, through January 31, 2013, for the 2012 season and from July 1, 2013, through January 31, 2014, for the 2013 season. The Youth Football Surveillance System included 118 youth football teams, providing 4092 athlete-seasons. The National Athletic Treatment, Injury and Outcomes Network program included 96 secondary school football programs, providing 11 957 athlete-seasons. The National Collegiate Athletic Association Injury Surveillance Program included 24 member institutions, providing 4305 athlete-seasons. All injuries regardless of severity, including concussions, and athlete exposure information were documented by athletic trainers during practices and games. Injury rates, injury rate ratios, risks, risk ratios, and 95% CIs were calculated. Concussions comprised 9.6%, 4.0%, and 8.0% of all injuries reported in the Youth Football Surveillance System; National Athletic Treatment, Injury and Outcomes Network; and National Collegiate Athletic Association Injury Surveillance Program, respectively. The game concussion rate was higher than the practice concussion rate across all 3 competitive levels. The game concussion rate for college athletes (3.74 per 1000 athlete exposures) was higher than those for high school athletes (injury rate ratio, 1.86; 95% CI, 1.50-2.31) and youth athletes (injury rate ratio, 1.57; 95% CI, 1.17-2.10). The practice concussion rate in college (0.53 per 1000 athlete exposures) was lower than that in high school (injury rate ratio, 0

Enhancing High Value Care in Gastroenterology Practice.

Science.gov (United States)

Camilleri, Michael; Katzka, David A

2016-10-01

The objective of this review is to identify common areas in gastroenterology practice where studies performed provide an opportunity for enhancing value or lowering costs. We provide examples of topics in gastroenterology where clinicians could enhance value by either using less invasive testing, choosing a single best test, or by using patient symptoms to guide additional testing. The topics selected for review are selected in esophageal, pancreatic, and colorectal cancer; functional gastrointestinal diseases (irritable bowel syndrome, bacterial overgrowth, constipation); immune-mediated gastrointestinal diseases; and pancreaticobiliary pathology. We propose guidance to alter practice based on current evidence. These studies support the need to review current practice and to continue performing research to further validate the proposed guidance to enhance value of care in gastroenterology and hepatology. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

The importance of high vehicle power for passenger car emissions

Science.gov (United States)

Carslaw, David C.; Williams, Martin L.; Tate, James E.; Beevers, Sean D.

2013-04-01

In this paper we use a quantile regression technique to explore the emissions characteristics of petrol and diesel passenger cars to reveal the importance of high vehicle power on exhaust emissions. A large database of ≈67,000 passenger cars from vehicle emission remote sensing data was used from surveys from several campaigns around the UK. Most previous remote sensing studies have focused on presenting mean emission estimates by vehicle type over time. However, as shown in the current work, considerably more insight can be gained into vehicle emission characteristics if techniques are used that can describe and model the full distribution of vehicle emissions as a function of important explanatory variables. For post-2000 model year (Euro 3-5) diesel cars it is shown that there is a strong dependence of vehicle specific power for emissions of NOx that was absent in earlier models and is absent for other pollutants such as CO, hydrocarbons and 'smoke'. Furthermore, we also find a stronger dependence on vehicle specific power for older catalyst-equipped petrol vehicles (Euro 1/2) on emissions of NOx that is less important for other emissions such as CO and hydrocarbons. Moreover, it is shown that while the rated maximum power output of petrol cars has remained almost constant over the past 15-20 years, the power output from diesel cars has increased markedly by about 50%. These results suggest that changes to vehicle technology, driving conditions and driver behaviour have become more important determinants of passenger car NOx emissions in recent years and may help explain why urban ambient concentrations of NOx have not decreased as much as anticipated.

Organisational culture: an important concept for pharmacy practice research.

Science.gov (United States)

Scahill, Shane; Harrison, Jeff; Carswell, Peter; Babar, Zaheer-Ud-Din

2009-10-01

Throughout the developed world, community pharmacy is under considerable pressure to play a greater part in delivering effective primary health care. The requirement to adopt new roles continues to challenge community pharmacy and drive change. The factors that determine the ability of community pharmacy to effectively deliver services for health gain are complex and include; policy, professional, financial and structural elements. There is also evidence to suggest that organisational culture may influence the effectiveness of an organisation. In order to address this there is a need to understand the dimensions of organisational culture that lead to successful implementation of the change necessary for community pharmacy to become a more effective primary health care organisation. In this commentary, we introduce the concept of organisational culture, outline two frameworks for studying culture, and argue the benefits of pursuing an organisational culture research agenda for the evolution of pharmacy practice and research.

Heritage Language Learners in Mixed Spanish Classes: Subtractive Practices and Perceptions of High School Spanish Teachers

Science.gov (United States)

Randolph, Linwood J., Jr.

2017-01-01

This qualitative study investigated the language ideologies and instructional practices of an entire Spanish language faculty at a high school in a new gateway state for immigration. The study examined additive and subtractive practices of teachers as they strived to teach Spanish to heritage language learners (HLLs) enrolled in mixed…

Perceptions of UK medical graduates' preparedness for practice: a multi-centre qualitative study reflecting the importance of learning on the job.

Science.gov (United States)

Illing, Jan C; Morrow, Gill M; Rothwell nee Kergon, Charlotte R; Burford, Bryan C; Baldauf, Beate K; Davies, Carol L; Peile, Ed B; Spencer, John A; Johnson, Neil; Allen, Maggie; Morrison, Jill

2013-02-28

There is evidence that graduates of different medical schools vary in their preparedness for their first post. In 2003 Goldacre et al. reported that over 40% of UK medical graduates did not feel prepared and found large differences between graduates of different schools. A follow-up survey showed that levels of preparedness had increased yet there was still wide variation. This study aimed to examine whether medical graduates from three diverse UK medical schools were prepared for practice. This was a qualitative study using a constructivist grounded theory approach. Prospective and cross-sectional data were collected from the three medical schools.A sample of 60 medical graduates (20 from each school) was targeted. They were interviewed three times: at the end of medical school (n = 65) and after four (n = 55) and 12 months (n = 46) as a Year 1 Foundation Programme doctor. Triangulated data were collected from clinicians via interviews across the three sites (n = 92). In addition three focus groups were conducted with senior clinicians who assess learning portfolios. The focus was on identifying areas of preparedness for practice and any areas of lack of preparedness. Although selected for being diverse, we did not find substantial differences between the schools. The same themes were identified at each site. Junior doctors felt prepared in terms of communication skills, clinical and practical skills and team working. They felt less prepared for areas of practice that are based on experiential learning in clinical practice: ward work, being on call, management of acute clinical situations, prescribing, clinical prioritisation and time management and dealing with paperwork. Our data highlighted the importance of students learning on the job, having a role in the team in supervised practice to enable them to learn about the duties and responsibilities of a new doctor in advance of starting work.

Validity And Practicality of Experiment Integrated Guided Inquiry-Based Module on Topic of Colloidal Chemistry for Senior High School Learning

Science.gov (United States)

Andromeda, A.; Lufri; Festiyed; Ellizar, E.; Iryani, I.; Guspatni, G.; Fitri, L.

2018-04-01

This Research & Development study aims to produce a valid and practical experiment integrated guided inquiry based module on topic of colloidal chemistry. 4D instructional design model was selected in this study. Limited trial of the product was conducted at SMAN 7 Padang. Instruments used were validity and practicality questionnaires. Validity and practicality data were analyzed using Kappa moment. Analysis of the data shows that Kappa moment for validity was 0.88 indicating a very high degree of validity. Kappa moments for the practicality from students and teachers were 0.89 and 0.95 respectively indicating high degree of practicality. Analysis on the module filled in by students shows that 91.37% students could correctly answer critical thinking, exercise, prelab, postlab and worksheet questions asked in the module. These findings indicate that the integrated guided inquiry based module on topic of colloidal chemistry was valid and practical for chemistry learning in senior high school.

Instructional Strategies and Practices Used to Enhance Student Success in the High School Algebra I Inclusive Classroom

OpenAIRE

Lowery, Lillian Margretta

2003-01-01

Instructional Strategies and Practices Used to Enhance Student Success in the High School Algebra I Inclusive Classroom Lillian M. Lowery Dr. Jean B. Crockett, Chair (ABSTRACT) The purpose of this qualitative study was to examine the instructional conditions and practices described as successful for teachers in the Algebra I inclusive classroom. In the southeastern suburban school district used for this study, students who began their freshman year of high school in fiscal y...

Practical Modeling of aluminum species in high-pH waste

International Nuclear Information System (INIS)

Reynolds, D.A.

1995-10-01

One of the main components of the nuclear waste stored at the Hanford Site is aluminum. As efforts are made to dispose of the waste, the need to predict the various phases of the aluminum becomes important for modeling of the disposal processes. Current databases of the aluminum species are not adequate as they stand. This study is not an attempt to present a rigorous discussion of aluminum chemistry, but to approach aluminum solubility as a practical application. The approach considers two different forms of aluminate; Al(OH) 4 - and AlO 2 - . By taking both of these forms of aluminate into consideration, a workable system of aluminium chemistry is formed that can be used to model the various waste disposal processes

Total Quality Management (TQM) Practices and School Climate amongst High, Average and Low Performance Secondary Schools

Science.gov (United States)

Ismail, Siti Noor

2014-01-01

Purpose: This study attempted to determine whether the dimensions of TQM practices are predictors of school climate. It aimed to identify the level of TQM practices and school climate in three different categories of schools, namely high, average and low performance schools. The study also sought to examine which dimensions of TQM practices…

Labour productivity and innovation performance: the importance of internal labour flexibility practices

NARCIS (Netherlands)

Preenen, P.T.Y.; Vergeer, R.; Kraan, K.O.; Dhondt, S.

2017-01-01

This article develops and examines the idea that internal labour flexibility practices are beneficial for labour productivity and innovation performance of companies. This is tested in two studies using unique company level datasets. In Study 1, results obtained from 377 independent companies

PHARMACOKINETIC RESEARCHES AND PRACTICAL MEDICINE

Directory of Open Access Journals (Sweden)

V. G. Belolipetskaya

2015-12-01

Full Text Available An article gives in a comprehensive manner the main idea of pharmacokinetics, as the science about rules of substances behavior in the internal environment of the organism, as well as of main parameters of pharmacokinetic researches. The article provides vivid and very  persuasive examples of high practical importance of this science both for creating new medical forms of drugs and for choosing the optimal of therapy regime.

PHARMACOKINETIC RESEARCHES AND PRACTICAL MEDICINE

Directory of Open Access Journals (Sweden)

V. G. Belolipetskaya

2005-01-01

Full Text Available An article gives in a comprehensive manner the main idea of pharmacokinetics, as the science about rules of substances behavior in the internal environment of the organism, as well as of main parameters of pharmacokinetic researches. The article provides vivid and very  persuasive examples of high practical importance of this science both for creating new medical forms of drugs and for choosing the optimal of therapy regime.

What attributions do Australian high-performing general practices make for their success? Applying the clinical microsystems framework: a qualitative study.

Science.gov (United States)

Dunham, Annette H; Dunbar, James A; Johnson, Julie K; Fuller, Jeff; Morgan, Mark; Ford, Dale

2018-04-10

To identify the success attributions of high-performing Australian general practices and the enablers and barriers they envisage for practices wishing to emulate them. Qualitative study using semi-structured interviews and content analysis of the data. Responses were recorded, transcribed verbatim and coded according to success characteristics of high-performing clinical microsystems. Primary healthcare with the participating general practices representing all Australian states and territories, and representing metropolitan and rural locations. Twenty-two general practices identified as high performing via a number of success criteria. The 52 participants were 19 general practitioners, 18 practice managers and 15 practice nurses. Participants most frequently attributed success to the interdependence of the team members, patient-focused care and leadership of the practice. They most often signalled practice leadership, team interdependence and staff focus as enablers that other organisations would need to emulate their success. They most frequently identified barriers that might be encountered in the form of potential deficits or limitations in practice leadership, staff focus and mesosystem support. Practice leaders need to empower their teams to take action through providing inclusive leadership that facilitates team interdependence. Mesosystem support for quality improvement in general practice should focus on enabling this leadership and team building, thereby ensuring improvement efforts are converted into effective healthcare provision. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Practices and Attitudes of Missouri School Nurses Regarding Immunization Records and Select Immunizations of Graduating High School Seniors.

Science.gov (United States)

Rhodes, Darson L; Draper, Michele; Woolman, Kendra; Cox, Carol

2017-10-01

School nurses play a key role in maintaining a healthy student population, and one of their roles includes maintaining vaccination records. Further, they can play an important role in advocating for human papillomavirus (HPV) and meningococcal vaccination for students. All Missouri public high school nurses were sent an electronic survey addressing the knowledge, attitudes, and practices regarding immunization records and HPV and meningococcal vaccination of high school seniors. Approximately 75% of nurses reported their schools did not have or they did not know if the school had a written policy regarding the release of vaccination records. Approximately 1/2 and 1/3 of nurses do not communicate with parents/students about HPV or meningococcal vaccines, respectively. Although most favorable toward meningococcal, nurses had positive attitudes toward both vaccines. Recommendations include establishment of written policies regarding vaccination record release, and future research should focus on evaluating school nurses' communication methods regarding HPV and meningococcal vaccination.

Medical Assistant-based care management for high risk patients in small primary care practices

DEFF Research Database (Denmark)

Freund, Tobias; Peters-Klimm, Frank; Boyd, Cynthia M.

2016-01-01

Background: Patients with multiple chronic conditions are at high risk of potentially avoidable hospital admissions, which may be reduced by care coordination and self-management support. Medical assistants are an increasingly available resource for patient care in primary care practices. Objective......: To determine whether protocol-based care management delivered by medical assistants improves patient care in patients at high risk of future hospitalization in primary care. Design: Two-year cluster randomized clinical trial. Setting: 115 primary care practices in Germany. Patients: 2,076 patients with type 2......, and monitoring delivered by medical assistants with usual care. Measurements: All-cause hospitalizations at 12 months (primary outcome) and quality of life scores (Short Form 12 Health Questionnaire [SF-12] and the Euroqol instrument [EQ-5D]). Results: Included patients had, on average, four co-occurring chronic...

Designing for Engagement: Using the ADDIE Model to Integrate High-Impact Practices into an Online Information Literacy Course

Directory of Open Access Journals (Sweden)

Amanda Nichols Hess

2016-12-01

Full Text Available In this article, the authors share how a team of librarians used the ADDIE instructional design model to incorporate best practices in teaching and learning into an online, four-credit information literacy course. In this redesign process, the Association of American Colleges and Universities’ high-impact practices and e-learning best practices were integrated as scaffolds for course content. The authors' experience with this systematic process and the concepts of instructional design suggest that the ADDIE model can be used to achieve several different ends in information literacy instruction. First, it can provide a structure around which librarians can develop a variety of instructional interactions. Second, it can help librarians consider student engagement, learning, and assessment more intentionally. And third, it can help to marry information literacy-specific standards and other learning guidelines, such as high-impact practices and e-learning best practices. From the authors' experience, other academic librarians may find applications for instructional design constructs into their own teaching practices, both in online and face-to-face learning environments.

Integration of professional judgement and decision-making in high-level adventure sports coaching practice.

Science.gov (United States)

Collins, Loel; Collins, Dave

2015-01-01

This study examined the integration of professional judgement and decision-making processes in adventure sports coaching. The study utilised a thematic analysis approach to investigate the decision-making practices of a sample of high-level adventure sports coaches over a series of sessions. Results revealed that, in order to make judgements and decisions in practice, expert coaches employ a range of practical and pedagogic management strategies to create and opportunistically use time for decision-making. These approaches include span of control and time management strategies to facilitate the decision-making process regarding risk management, venue selection, aims, objectives, session content, and differentiation of the coaching process. The implication for coaches, coach education, and accreditation is the recognition and training of the approaches that "create time" for the judgements in practice, namely "creating space to think". The paper concludes by offering a template for a more expertise-focused progression in adventure sports coaching.

Referrals and relationships: in-practice referrals meetings in a general practice.

Science.gov (United States)

Rowlands, G; Willis, S; Singleton, A

2001-08-01

GP referrals to secondary care are an important factor in the cost of running the NHS. The known variation in referral rates between doctors has the potential to cause tension within primary care which will be exacerbated by the latest reorganization of primary care and the trend towards capitation-based budgets. The importance of postgraduate learning for GPs has been recognized; continuing professional development is moving towards self-directed practice-based learning programmes. Educational interventions have been shown to alter doctors' prescribing behaviour. This, together with the pressure on accounting for referral activity, makes the prospect of improving, and possibly reducing, referral activity through educational interventions very attractive. This study complemented a randomized controlled trial (RCT) which investigated whether an intervention of the type which had reduced prescribing costs would have a similar effect on referral activity. The context of the study, description of the characteristics of the practice and the issues seen as important by the doctors and practice manager were identified through preliminary semi-structured interviews. The practice then held a series of educational in-practice meetings to discuss referrals and issues arising from referrals. The audio- and videotaped transcripts were interpreted using content and group dynamic analysis. Participants commented upon our preliminary findings. In addition, we used dimensional analysis to induce a preliminary theory describing the effect of the intervention on this general practice which enabled us to review the findings of the parallel RCT. The educational value of the meetings and the learning needs of the participants were also assessed. Our complementary study showed no alteration of practice referral rates following the educational intervention. The qualitative study, unencumbered by the assumptions inherent in the development of the hypothesis tested in the RCT, highlighted

Practices and Processes of Leading High Performance Home Builders in the Upper Midwest

Energy Technology Data Exchange (ETDEWEB)

Von Thoma, Ed [Univ. of Minnesota, St. Paul, MN (United States). NorthernSTAR Building America Partnership; Ojzcyk, Cindy [Univ. of Minnesota, St. Paul, MN (United States). NorthernSTAR Building America Partnership

2012-12-01

The NorthernSTAR Building America Partnership team proposed this study to gain insight into the business, sales, and construction processes of successful high performance builders. The knowledge gained by understanding the high performance strategies used by individual builders, as well as the process each followed to move from traditional builder to high performance builder, will be beneficial in proposing more in-depth research to yield specific action items to assist the industry at large transform to high performance new home construction. This investigation identified the best practices of three successful high performance builders in the upper Midwest. In-depth field analysis of the performance levels of their homes, their business models, and their strategies for market acceptance were explored.

Certifying leaders? high-quality management practices and healthy organisations: an ISO-9000 based standardisation approach.

Science.gov (United States)

Montano, Diego

2016-08-05

The present study proposes a set of quality requirements to management practices by taking into account the empirical evidence on their potential effects on health, the systemic nature of social organisations, and the current conceptualisations of management functions within the framework of comprehensive quality management systems. Systematic reviews and meta-analyses focusing on the associations between leadership and/or supervision and health in occupational settings are evaluated, and the core elements of an ISO 9001 standardisation approach are presented. Six major occupational health requirements to high-quality management practices are identified pertaining to communication processes, organisational justice, role clarity, decision making, social influence processes and management support. It is concluded that the quality of management practices may be improved by developing a quality management system of management practices that ensures not only conformity to product but also to occupational safety and health requirements. Further research may evaluate the practicability of the proposed approach.

Seismic design practices for power systems

International Nuclear Information System (INIS)

Schiff, A.J.

1991-01-01

In this paper, the evolution of seismic design practices in electric power systems is reviewed. In California the evolution had led to many installation practices that are directed at improving the seismic ruggedness of power system facilities, particularly high voltage substation equipment. The primary means for substantiating the seismic ruggedness of important, hard to analyze substation equipment is through vibration testing. Current activities include system evaluations, development of emergency response plans and their exercise, and review elements that impact the entire system, such as energy control centers and communication systems. From a national perspective there is a need to standardize seismic specifications, identify a seismic specialist within each utility and enhance communications among these specialists. There is a general need to incorporate good seismic design practices on a national basis emphasizing new construction

Varied Rates of Implementation of Patient-Centered Medical Home Features and Residents' Perceptions of Their Importance Based on Practice Experience.

Science.gov (United States)

Eiff, M Patrice; Green, Larry A; Jones, Geoff; Devlaeminck, Alex Verdieck; Waller, Elaine; Dexter, Eve; Marino, Miguel; Carney, Patricia A

2017-03-01

Little is known about how the patient-centered medical home (PCMH) is being implemented in residency practices. We describe both the trends in implementation of PCMH features and the influence that working with PCMH features has on resident attitudes toward their importance in 14 family medicine residencies associated with the P4 Project. We assessed 24 residency continuity clinics annually between 2007-2011 on presence or absence of PCMH features. Annual resident surveys (n=690) assessed perceptions of importance of PCMH features using a 4-point scale (not at all important to very important). We used generalized estimating equations logistic regression to assess trends and ordinal-response proportional odds regression models to determine if resident ratings of importance were associated with working with those features during training. Implementation of electronic health record (EHR) features increased significantly from 2007-2011, such as email communication with patients (33% to 67%), preventive services registries (23% to 64%), chronic disease registries (63% to 82%), and population-based quality assurance (46% to 79%). Team-based care was the only process of care feature to change significantly (54% to 93%). Residents with any exposure to EHR-based features had higher odds of rating the features more important compared to those with no exposure. We observed consistently lower odds of the resident rating process of care features as more important with any exposure compared to no exposure. Residencies engaged in educational transformation were more successful in implementing EHR-based PCMH features, and exposure during training appears to positively influence resident ratings of importance, while exposure to process of care features are slower to implement with less influence on importance ratings.

Can High-involvement Innovation Practices improve Productivity and the Quality of Working-life simultaneously? Management and Employee Views on Comparison

Directory of Open Access Journals (Sweden)

Elise Ramstad

2015-01-01

Full Text Available This paper examines the association of high-involvement innovation practices (HIIPs and simultaneous improvement of productivity and the quality of working life (QWL. HIIPs refer to work, managerial, and organizational practices that are intended for supporting continuous improvement and broad participation. The data are based on the evaluation surveys carried out by the Finnish Workplace Development Programme TYKES (2004–2010. TYKES was a governmental programme for promoting simultaneous improvements in productivity and the QWL in workplaces through changes in work, managerial, and organizational practices. Information obtained via two different surveys has been combined for the purposes of this article: a survey on HIIPs within a work organization (HIIP and a self-assessment survey of project outcomes (SA. The survey material comprises altogether 253 responses from 163 different workplaces. The analysis provides evidence in favor of a view that publicly funded workplace development projects constitute appropriate means to support productivity and the QWL simultaneously. The results provide evidence that HIIPs, including decentralized decision making, competence development, internal cooperation, and external cooperation, are of importance when trying to gain better results in both productivity and the QWL from both management and employees’ point of view. In addition, the development process itself, that is, how the practices are implemented and good skills in project management, is highlighted. Concerning the supervisor’s supportive role in employees’ innovation activities, the picture is more mixed and surprising.

Presenting practice financial information.

Science.gov (United States)

Webster, Lee Ann H

2007-01-01

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

On the counterintuitive consequences of high-performance work practices in cross-border post-merger human integration

DEFF Research Database (Denmark)

Vasilaki, A.; Smith, Pernille; Giangreco, A.

2012-01-01

, such as communication, employee involvement, and team building, may not always produce the expected effects on human integration; rather, it can have the opposite effects if top management does not closely monitor the immediate results of deploying such practices. Implications for managers dealing with post......, this article investigates the impact of systemic and integrated human resource practices [i.e., high-performance work practices (HPWPs)] on human integration and how their implementation affects employees' behaviours and attitudes towards post-merger human integration. We find that the implementation of HPWPs...

General practice registrars' intentions for future practice: implications for rural medical workforce planning.

Science.gov (United States)

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

2016-11-01

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, Pmedical graduates intend to own their own practice compared with 52% of international medical graduates (χ 2 (1)=8.498, P=0.004). Future general practitioners (GPs) intend to work fewer hours than current GPs. Assumptions about lifestyle factors, practice models and possible professional roles should be carefully evaluated when developing strategies to recruit GPs and GPRs into rural practice.

Entrepreneurial leadership practices and school innovativeness

Directory of Open Access Journals (Sweden)

Zaidatol Akmaliah Lope Pihie

2014-01-01

Full Text Available Entrepreneurial leadership, as a distinctive type of leadership required for dealing with challenges and crises of current organizational settings, has increasingly been applied to improve school performance. However, there is limited research on the impact ofschool leaders' entrepreneurial leadership practices on school innovativeness. The main purpose of this study is to identify the relationship between principals' entrepreneurial leadership practices and school innovativeness through the teachers' perspectives. The participants included 294 Malaysian secondary school teachers in Selangor, Malaysia. A questionnaire containing 64 items (50 items on school principals' entrepreneurial leadership practices and 14 items on school innovativeness was utilized. An analysis of the data indicates that teachers perceive entrepreneurial leadership as highly important for school principals. However, the principals practise it moderately. Furthermore, this study found a significant correlation between teachers' perceptions of school principals' entrepreneurial leadership practices and school in-novativeness. Implications of the findings for developing school principals' entrepreneurial leadership and school innovativeness are discussed.

High performance work practices in the health care sector: A dutch case study

NARCIS (Netherlands)

Boselie, J.P.P.E.F.

2010-01-01

Purpose – This paper aims to present an empirical study of the effect of high performance work practices on commitment and citizenship behaviour in the health care sector. The theory suggests that individual employees are willing “to go the extra mile” when they are given the opportunity to develop

Defining neuromarketing: practices and professional challenges.

Science.gov (United States)

Fisher, Carl Erik; Chin, Lisa; Klitzman, Robert

2010-01-01

Neuromarketing has recently generated controversies concerning the involvement of medical professionals, and many key questions remain-ones that have potentially important implications for the field of psychiatry. Conflicting definitions of neuromarketing have been proposed, and little is known about the actual practices of companies, physicians, and scientists involved in its practice. This article reviews the history of neuromarketing and uses an exploratory survey of neuromarketing Web sites to illustrate ethical issues raised by this new field. Neuromarketing, as currently practiced, is heterogeneous, as companies are offering a variety of technologies. Many companies employ academicians and professionals, but few list their clients or fees. Media coverage of neuromarketing appears disproportionately high compared to the paucity of peer-reviewed reports in the field. Companies may be making premature claims about the power of neuroscience to predict consumer behavior. Overall, neuromarketing has important implications for academic-industrial partnerships, the responsible conduct of research, and the public understanding of the brain. We explore these themes to uncover issues relevant to professional ethics, research, and policy. Of particular relevance to psychiatry, neuromarketing may be seen as an extension of the search for quantification and certainty in previously indefinite aspects of human behavior.

Open lung high frequency ventilation in preterm infants with respiratory distress syndrome: practical considerations and recommendations

NARCIS (Netherlands)

De Jaegere, A.P.M.C.

2012-01-01

In premature infants ventilated because of RDS the favorable effect of HFV OLV compared to conventional mechanical ventilation on the incidence of BPD remains a matter of debate. An important lack in published human studies is the clinical practice surrounding the thorough application of OLV with

Uses of risk importance measures

International Nuclear Information System (INIS)

Mankamo, T.; Poern, K.; Holmberg, J.

1991-05-01

Risk importance measures provide an understandable and practical way of presenting probabilistic safety analysis results which too often tend to remain abstract numbers without real insight into the content. The report clarifies the definitions, relationships and interpretations of the three most basic measures: Risk increase factor, risk decrease factor, and fractional contribution. The above three measures already cover the main types of risk importance measures. Many other importance measures presented in literature are close variants to some of these three measures. They are related in many cases so that, for a technical system considered, the two other measures can be derived from the one calculated first. However, the practical interpretations are different, and hence each three measures have their own uses and rights to existence. The fundamental aspect of importance measures is, that they express some specific influence of a basic event on the total risk. The basic failure or error events are the elements from which the reliability and risk models are constituted. The importance measures are relative, which is an advantage compared to absolute risk numbers, due to insensitivity with respect to quantification uncertainties. Therefore they are particularly adapted to give first hand guidance where to focus main interest from the system's risk and reliability point of view and wherefrom to continue the analysis with more sophisticated methods requiring more effort

Exploring the relationships between high involvement work system practices, work demands and emotional exhaustion : A multi-level study.

NARCIS (Netherlands)

Oppenauer, V.; van de Voorde, F.C.

2018-01-01

This study explores the impact of enacted high involvement work systems (HIWS) practices on employee emotional exhaustion. This study hypothesized that work overload and job responsibility mediate the relationship between HIWS practices (ability, motivation, opportunity and work design HIWS

Integrating advanced practice providers into medical critical care teams.

Science.gov (United States)

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

2013-03-01

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

Ambulatory surgery centers best practices for the 90s.

Science.gov (United States)

Hoover, J A

1994-05-01

Outpatient surgery will be the driving force in the continued growth of ambulatory care in the 1990s. Providing efficient, high-quality ambulatory surgical services should therefore be a priority among healthcare providers. Arthur Andersen conducted a survey to discover best practices in ambulatory surgical service. General success characteristics of best performers were business-focused relationships with physicians, the use of clinical protocols, patient convenience, cost management, strong leadership, teamwork, streamlined processes and efficient design. Other important factors included scheduling to maximize OR room use; achieving surgical efficiencies through reduced case pack assembly errors and equipment availability; a focus on cost capture rather than charge capture; sound materiel management practices, such as standardization and vendor teaming; and the appropriate use of automated systems. It is important to evaluate whether the best practices are applicable to your environment and what specific changes to your current processes would be necessary to adopt them.

High Resolution Melting (HRM for High-Throughput Genotyping—Limitations and Caveats in Practical Case Studies

Directory of Open Access Journals (Sweden)

Marcin Słomka

2017-11-01

Full Text Available High resolution melting (HRM is a convenient method for gene scanning as well as genotyping of individual and multiple single nucleotide polymorphisms (SNPs. This rapid, simple, closed-tube, homogenous, and cost-efficient approach has the capacity for high specificity and sensitivity, while allowing easy transition to high-throughput scale. In this paper, we provide examples from our laboratory practice of some problematic issues which can affect the performance and data analysis of HRM results, especially with regard to reference curve-based targeted genotyping. We present those examples in order of the typical experimental workflow, and discuss the crucial significance of the respective experimental errors and limitations for the quality and analysis of results. The experimental details which have a decisive impact on correct execution of a HRM genotyping experiment include type and quality of DNA source material, reproducibility of isolation method and template DNA preparation, primer and amplicon design, automation-derived preparation and pipetting inconsistencies, as well as physical limitations in melting curve distinction for alternative variants and careful selection of samples for validation by sequencing. We provide a case-by-case analysis and discussion of actual problems we encountered and solutions that should be taken into account by researchers newly attempting HRM genotyping, especially in a high-throughput setup.

High Resolution Melting (HRM) for High-Throughput Genotyping—Limitations and Caveats in Practical Case Studies

Science.gov (United States)

Słomka, Marcin; Sobalska-Kwapis, Marta; Wachulec, Monika; Bartosz, Grzegorz

2017-01-01

High resolution melting (HRM) is a convenient method for gene scanning as well as genotyping of individual and multiple single nucleotide polymorphisms (SNPs). This rapid, simple, closed-tube, homogenous, and cost-efficient approach has the capacity for high specificity and sensitivity, while allowing easy transition to high-throughput scale. In this paper, we provide examples from our laboratory practice of some problematic issues which can affect the performance and data analysis of HRM results, especially with regard to reference curve-based targeted genotyping. We present those examples in order of the typical experimental workflow, and discuss the crucial significance of the respective experimental errors and limitations for the quality and analysis of results. The experimental details which have a decisive impact on correct execution of a HRM genotyping experiment include type and quality of DNA source material, reproducibility of isolation method and template DNA preparation, primer and amplicon design, automation-derived preparation and pipetting inconsistencies, as well as physical limitations in melting curve distinction for alternative variants and careful selection of samples for validation by sequencing. We provide a case-by-case analysis and discussion of actual problems we encountered and solutions that should be taken into account by researchers newly attempting HRM genotyping, especially in a high-throughput setup. PMID:29099791

High Resolution Melting (HRM) for High-Throughput Genotyping-Limitations and Caveats in Practical Case Studies.

Science.gov (United States)

Słomka, Marcin; Sobalska-Kwapis, Marta; Wachulec, Monika; Bartosz, Grzegorz; Strapagiel, Dominik

2017-11-03

High resolution melting (HRM) is a convenient method for gene scanning as well as genotyping of individual and multiple single nucleotide polymorphisms (SNPs). This rapid, simple, closed-tube, homogenous, and cost-efficient approach has the capacity for high specificity and sensitivity, while allowing easy transition to high-throughput scale. In this paper, we provide examples from our laboratory practice of some problematic issues which can affect the performance and data analysis of HRM results, especially with regard to reference curve-based targeted genotyping. We present those examples in order of the typical experimental workflow, and discuss the crucial significance of the respective experimental errors and limitations for the quality and analysis of results. The experimental details which have a decisive impact on correct execution of a HRM genotyping experiment include type and quality of DNA source material, reproducibility of isolation method and template DNA preparation, primer and amplicon design, automation-derived preparation and pipetting inconsistencies, as well as physical limitations in melting curve distinction for alternative variants and careful selection of samples for validation by sequencing. We provide a case-by-case analysis and discussion of actual problems we encountered and solutions that should be taken into account by researchers newly attempting HRM genotyping, especially in a high-throughput setup.

Supporting Implementation of Evidence-Based Practices through Practice-Based Coaching

Science.gov (United States)

Snyder, Patricia A.; Hemmeter, Mary Louise; Fox, Lise

2015-01-01

In active implementation science frameworks, coaching has been described as an important competency "driver" to ensure evidence-based practices are implemented as intended. Empirical evidence also has identified coaching as a promising job-embedded professional development strategy to support implementation of quality teaching practices.…

Communities of practice: Participation patterns and professional impact for high school mathematics and science teachers

Science.gov (United States)

Printy, Susan M.

Improving the quality of teachers in schools is a keystone to educational improvement. New and veteran teachers alike need to enhance their content knowledge and pedagogical skills, but they must also examine, and often change, their underlying attitudes, beliefs, and values about the nature of knowledge and the abilities of students. Best accomplished collectively rather than individually, the interactions between teachers as they undertake the process of collaborative inquiry create "communities of practice." This dissertation investigates the importance of science and mathematics teachers' participation in communities of practice to their professional capabilities. The study tests the hypothesis that the social learning inherent in community of practice participation encourages teachers to learn from others with expertise, enhances teachers' sense of competence, and increases the likelihood that teachers' will use student-centered, problem-based instructional techniques aligned with national disciplinary standards. The researcher conceptualizes communities of practice along two dimensions that affect social learning: legitimate participation in activities and span of engagement with school members. Differences in teachers' subject area and the curricular track of their teaching assignment contribute to variation in teachers' participation in communities of practice along those dimensions. Using data from the National Educational Longitudinal Study, first and second follow-up, the study has two stages of multi-level analysis. The first stage examines factors that contribute to teachers' participation in communities of practice, including teachers' social and professional characteristics and school demographic and organizational characteristics. The second stage investigates the professional impact of such participation on the three outcome variables: teacher learning, teacher competence, and use of standards-based pedagogy. Hierarchical linear models provide

Job satisfaction of practice assistants in general practice in Germany: an observational study

NARCIS (Netherlands)

Goetz, K.; Campbell, S.; Broge, B.; Brodowski, M.; Steinhaeuser, J.; Wensing, M.; Szecsenyi, J.

2013-01-01

BACKGROUND: Job satisfaction of practice staff is important for optimal health care delivery and for minimizing the turnover of non-medical professions. OBJECTIVE: To document the job satisfaction of practice assistants in German general practice and to explore associations between job satisfaction,

Practical Radiobiology for Proton Therapy Planning

Science.gov (United States)

Jones, Bleddyn

2017-12-01

Practical Radiobiology for Proton Therapy Planning covers the principles, advantages and potential pitfalls that occur in proton therapy, especially its radiobiological modelling applications. This book is intended to educate, inform and to stimulate further research questions. Additionally, it will help proton therapy centres when designing new treatments or when unintended errors or delays occur. The clear descriptions of useful equations for high LET particle beam applications, worked examples of many important clinical situations, and discussion of how proton therapy may be optimized are all important features of the text. This important book blends the relevant physics, biology and medical aspects of this multidisciplinary subject. Part of Series in Physics and Engineering in Medicine and Biology.

Unusual and highly tunable missing-linker defects in zirconium metal-organic framework UiO-66 and their important effects on gas adsorption.

Science.gov (United States)

Wu, Hui; Chua, Yong Shen; Krungleviciute, Vaiva; Tyagi, Madhusudan; Chen, Ping; Yildirim, Taner; Zhou, Wei

2013-07-17

UiO-66 is a highly important prototypical zirconium metal-organic framework (MOF) compound because of its excellent stabilities not typically found in common porous MOFs. In its perfect crystal structure, each Zr metal center is fully coordinated by 12 organic linkers to form a highly connected framework. Using high-resolution neutron power diffraction technique, we found the first direct structural evidence showing that real UiO-66 material contains significant amount of missing-linker defects, an unusual phenomenon for MOFs. The concentration of the missing-linker defects is surprisingly high, ∼10% in our sample, effectively reducing the framework connection from 12 to ∼11. We show that by varying the concentration of the acetic acid modulator and the synthesis time, the linker vacancies can be tuned systematically, leading to dramatically enhanced porosity. We obtained samples with pore volumes ranging from 0.44 to 1.0 cm(3)/g and Brunauer-Emmett-Teller surface areas ranging from 1000 to 1600 m(2)/g, the largest values of which are ∼150% and ∼60% higher than the theoretical values of defect-free UiO-66 crystal, respectively. The linker vacancies also have profound effects on the gas adsorption behaviors of UiO-66, in particular CO2. Finally, comparing the gas adsorption of hydroxylated and dehydroxylated UiO-66, we found that the former performs systematically better than the latter (particularly for CO2) suggesting the beneficial effect of the -OH groups. This finding is of great importance because hydroxylated UiO-66 is the practically more relevant, non-air-sensitive form of this MOF. The preferred gas adsorption on the metal center was confirmed by neutron diffraction measurements, and the gas binding strength enhancement by the -OH group was further supported by our first-principles calculations.

Knowledge and practice of junior and senior high school students regarding violent behaviors in Isfahan province

Directory of Open Access Journals (Sweden)

Razieh Omidi

2014-01-01

Full Text Available Background: Considering the importance of anger, aggression, violence and other misbehaviours in schoolchildren education, the present study was conducted to evaluate the knowledge and practice of students in Isfahan province regarding violence, in order to figure out the required interventions for violence-reduction. Methods: In a survey during 2008-2009, 5500 junior and senior high school students of Isfahan province were assessed in a multistage sampling process to determine their level of knowledge about various types of violent behaviors, causes of violence, its consequences, and preventive behaviors. Validity and reliability of the data collection tool (questionnaire were assessed. Results: The study revealed that the mean scores of violent behaviors knowledge, knowledge of violent behavior outcomes, and knowledge of violence preventive behaviors, were 6.6 ± 2.1, 5.5 ± 1.9, and 4.7 ± 1.3, respectively. Sources of violent behaviors in 92% of urban students and 89% of rural students were personal reasons and family behaviors, and 85% of urban and 88% of rural students considered mass media and computer games blameworthy, and the differences were statistically significant in all cases (P < 0.0001. In terms of practice, overall, 69.7% of girls and 84.2% of boys had violent behaviors. Physical and verbal violence were 31.3% and 40.7%in girls, and 66% and 52.8% in boys, respectively (intersexes P values were P < 0.001 and P = 0.7 respectively, and intra-sex P value was P < 0.0001. Conclusions: Results showed that girls and city dwellers were more aware of recognizing violent behaviors, outcomes, and causes, compared with boys and villagers, and in terms of general practice, violence was observed among boys more than girls. Further complementary studies in this area seem required.

Reducing the Risks of Firearm Violence in High Schools: Principals' Perceptions and Practices.

Science.gov (United States)

Price, James H; Khubchandani, Jagdish; Payton, Erica; Thompson, Amy

2016-04-01

This study assessed the perceptions and practices of a national sample of secondary school principals regarding reducing firearm violence in high schools. Data were collected via three-wave postal mailings. A 59-item valid and reliable questionnaire was mailed to a national random sample of 800 secondary school principals. Of the 349 principals (46 %) that responded, 17 % reported a firearm incident at their school in the past 5 years. Principals perceived inadequate parental monitoring (70 %), inadequate mental health services (64 %), peer harassment/bullying (59 %), and easy access to firearms (50 %) as the main causes of firearm violence in schools. The three barriers to implementing firearm violence prevention practices were: lack of expertise as to which practices to implement (33 %), lack of time (30 %), and lack of research as to which practices are most effective (30 %). Less than half of schools trained school personnel regarding firearm violence issues. The findings indicate that firearm incidents at schools may be more common than previously thought. A significant portion of principals are at a loss as to what to implement because of a lack of empirical evidence on what is effective. More research is needed to find the most effective school interventions for reducing firearm violence.

Hypothyroidism in clinical practice

Directory of Open Access Journals (Sweden)

Faiza Qari

2014-01-01

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.

Combining clinical practice and academic work in nursing: a qualitative study about perceived importance, facilitators and barriers regarding clinical academic careers for nurses in university hospitals.

NARCIS (Netherlands)

Oostveen, C.J. van; Goedhart, N.S.; Francke, A.L.; Vermeulen, H.

2017-01-01

Aims and objectives: To obtain in-depth insight into the perceptions of nurse aca- demics and other stakeholders regarding the importance, facilitators and barriers for nurses combining clinical and academic work in university hospitals. Background: Combining clinical practice and academic work

Pengaruh High Performance Work Practice (Hpwp) Terhadap Job Performance Pada Frontliner Bank

OpenAIRE

Ihdaryanti, Monica Amani; Panggabean, Mutiara S

2014-01-01

Generally High Performance Work Practice (HPWP) is a part of management human resources. The objectives of this research are getting and analyzing the effect of HPWPs with Job Satisfaction; HPWPs with Organizational Commitment; Job Satisfaction with Organizational Commitment; Job Satisfaction with Job Performance; and Organizational Commitment with Job Performance. The total of sample in this research is 100 respondents which are as Front liner BNI and Mandiri. The result of th...

The importance of gender of patients and general practitioners in relation to treatment practices for overweight

DEFF Research Database (Denmark)

Rohde, Jeanett Friis; Hessner, Marie Vik; Lous, Jørgen

2014-01-01

BACKGROUND: Several studies suggest that men and women are treated differently for similar disease including diabetes and cardiovascular disease. Differences in attitudes and treatment practices towards men and women with obesity are not well recognized. OBJECTIVE: To investigate the attitudes...... and treatment practices among Danish general practitioners (GPs), in relation to treatment of overweight, while taking gender of both the patients and practitioners into account. DESIGN: Questionnaire inventory covertly examining attitudes and practices among Danish general practitioners towards treatment......: Among general practitioners in Denmark, treatment for weight loss is more often practiced for overweight male than overweight female patients presenting with same symptoms. In addition, hyperlipidemia among overweight males is also more often treated with lipid lowering medicine than hyperlipidemia...

Practical guidebook of the petroleum regulation (import-distribution); Guide pratique de la reglementation petroliere (importation-distribution)

Energy Technology Data Exchange (ETDEWEB)

NONE

2002-02-01

This yearly guidebook is issued at the beginning of each year. It brings together, with some relevant comments, the overall regulation related to the import and distribution of petroleum products in France. It includes some models of declaration files, the organisation of the French general direction of energy and raw materials (DGEMP) and of the direction of customs. It includes the most recent texts and is intended for jurists and non-jurists petroleum operators. It comprises three parts dealing with: 1 - general regulation (import rules, product characteristics, stockpiles, creation and extension of depots, regulation of sale points, pricing regulation and competition, advertising in the domain of energy); custom and fiscal regulation (custom rights, taxes, preferential fiscal regimes, depot regulations, powers of attorney, tax exemption, return to stocks); statistical declarations (declarations for the administration and for the French professional committee of petroleum (CPDP)). (J.S.)

Effective Practices for Training and Inspiring High School Physics Teachers

Science.gov (United States)

Magee-Sauer, Karen

It is well-documented that there is a nationwide shortage of highly qualified high school physics teachers. Not surprising, institutions of higher education report that the most common number of physics teacher graduates is zero with the majority of institutions graduating less than two physics teachers per year. With these statistics in mind, it is critical that institutions take a careful look at how they recruit, train, and contribute to the retention of high school physics teachers. PhysTEC is a partnership between the APS and AAPT that is dedicated to improving and promoting the education of high school physics teachers. Primarily funded by the NSF and its partnering organizations, PhysTEC has identified key components that are common to successful physics teacher preparation programs. While creating a successful training program in physics, it is also important that students have the opportunity for a ``do-able'' path to certification that does not add further financial debt. This talk will present an overview of ``what works'' in creating a path for physics majors to a high school physics teaching career, actions and activities that help train and inspire pre-service physics teachers, and frameworks that provide the support for in-service teachers. Obstacles to certification and the importance of a strong partnership with colleges of education will be discussed. Several examples of successful physics high school teacher preparation programs will be presented. This material is part of the Physics Teacher Education Coalition project, which is based upon work supported by the National Science Foundation under Grant Nos. 0808790, 0108787, and 0833210.

Hospital and Community Pharmacists’ Perceptions of Which Competences Are Important for Their Practice

Directory of Open Access Journals (Sweden)

Jeffrey Atkinson

2016-06-01

Full Text Available The objective of the PHAR-QA (Quality assurance in European pharmacy education and training project was to investigate how competence-based learning could be applied to a healthcare, sectoral profession such as pharmacy. This is the first study on evaluation of competences from the pharmacists’ perspective using an improved Delphi method with a large number of respondents from all over Europe. This paper looks at the way in which hospital pharmacists rank the fundamental competences for pharmacy practice. European hospital pharmacists (n = 152 ranked 68 competences for pharmacy practice of two types (personal and patient care, arranged into 13 clusters. Results were compared to those obtained from community pharmacists (n = 258. Generally, hospital and community pharmacists rank competences in a similar way. Nevertheless, differences can be detected. The higher focus of hospital pharmacists on knowledge of the different areas of science as well as on laboratory tests reflects the idea of a hospital pharmacy specialisation. The difference is also visible in the field of drug production. This is a necessary competence in hospitals with requests for drugs for rare diseases, as well as paediatric and oncologic drugs. Hospital pharmacists give entrepreneurship a lower score, but cost-effectiveness a higher one than community pharmacists. This reflects the reality of pharmacy practice where community pharmacists have to act as entrepreneurs, and hospital pharmacists are managers staying within drug budgets. The results are discussed in the light of a “hospital pharmacy” specialisation.

Hospital and Community Pharmacists’ Perceptions of Which Competences Are Important for Their Practice

Science.gov (United States)

Atkinson, Jeffrey; Sánchez Pozo, Antonio; Rekkas, Dimitrios; Volmer, Daisy; Hirvonen, Jouni; Bozic, Borut; Skowron, Agnieska; Mircioiu, Constantin; Sandulovici, Roxana; Marcincal, Annie; Koster, Andries; Wilson, Keith A.; van Schravendijk, Chris; Frontini, Roberto; Price, Richard; Bates, Ian; De Paepe, Kristien

2016-01-01

The objective of the PHAR-QA (Quality assurance in European pharmacy education and training) project was to investigate how competence-based learning could be applied to a healthcare, sectoral profession such as pharmacy. This is the first study on evaluation of competences from the pharmacists’ perspective using an improved Delphi method with a large number of respondents from all over Europe. This paper looks at the way in which hospital pharmacists rank the fundamental competences for pharmacy practice. European hospital pharmacists (n = 152) ranked 68 competences for pharmacy practice of two types (personal and patient care), arranged into 13 clusters. Results were compared to those obtained from community pharmacists (n = 258). Generally, hospital and community pharmacists rank competences in a similar way. Nevertheless, differences can be detected. The higher focus of hospital pharmacists on knowledge of the different areas of science as well as on laboratory tests reflects the idea of a hospital pharmacy specialisation. The difference is also visible in the field of drug production. This is a necessary competence in hospitals with requests for drugs for rare diseases, as well as paediatric and oncologic drugs. Hospital pharmacists give entrepreneurship a lower score, but cost-effectiveness a higher one than community pharmacists. This reflects the reality of pharmacy practice where community pharmacists have to act as entrepreneurs, and hospital pharmacists are managers staying within drug budgets. The results are discussed in the light of a “hospital pharmacy” specialisation. PMID:28970394

A Cluster-Randomized Trial of Restorative Practices: An Illustration to Spur High-Quality Research and Evaluation.

Science.gov (United States)

Acosta, Joie D; Chinman, Matthew; Ebener, Patricia; Phillips, Andrea; Xenakis, Lea; Malone, Patrick S

2016-01-01

Restorative Practices in schools lack rigorous evaluation studies. As an example of rigorous school-based research, this paper describes the first randomized control trial of restorative practices to date, the Study of Restorative Practices. It is a 5-year, cluster-randomized controlled trial (RCT) of the Restorative Practices Intervention (RPI) in 14 middle schools in Maine to assess whether RPI impacts both positive developmental outcomes and problem behaviors and whether the effects persist during the transition from middle to high school. The two-year RPI intervention began in the 2014-2015 school year. The study's rationale and theoretical concerns are discussed along with methodological concerns including teacher professional development. The theoretical rationale and description of the methods from this study may be useful to others conducting rigorous research and evaluation in this area.

The importance of the GHQ in general practice.

NARCIS (Netherlands)

Verhaak, P.F.M.; Wennink, H.J.; Tijhuis, M.A.R.

1990-01-01

The relationship between General Health Questionnaire (GHQ) score and complaints presented at the general practitioners office was examined, and showed that the correlation between them is not as high as might be expected. Many patients who present psychosocial problems to their GP appear to have a

Importance of riparian remnants for frog species diversity in a highly fragmented rainforest.

Science.gov (United States)

Rodríguez-Mendoza, Clara; Pineda, Eduardo

2010-12-23

Tropical forests undergo continuous transformation to other land uses, resulting in landscapes typified by forest fragments surrounded by anthropogenic habitats. Small forest fragments, specifically strip-shaped remnants flanking streams (referred to as riparian remnants), can be particularly important for the maintenance and conservation of biodiversity within highly fragmented forests. We compared frog species diversity between riparian remnants, other forest fragments and cattle pastures in a tropical landscape in Los Tuxtlas, Mexico. We found similar species richness in the three habitats studied and a similar assemblage structure between riparian remnants and forest fragments, although species composition differed by 50 per cent. Frog abundance was halved in riparian remnants compared with forest fragments, but was twice that found in pastures. Our results suggest that riparian remnants play an important role in maintaining a portion of frog species diversity in a highly fragmented forest, particularly during environmentally stressful (hot and dry) periods. In this regard, however, the role of riparian remnants is complementary, rather than substitutive, with respect to the function of other forest fragments within the fragmented forest.

The impact of high-stakes, state-mandated student performance assessment on 10th grade English, mathematics, and science teachers' instructional practices

Science.gov (United States)

Vogler, Kenneth E.

The purpose of this study was to determine if the public release of student results on high-stakes, state-mandated performance assessments influence instructional practices, and if so in what manner. The research focused on changes in teachers' instructional practices and factors that may have influenced such changes since the public release of high-stakes, state-mandated student performance assessment scores. The data for this study were obtained from a 54-question survey instrument given to a stratified random sample of teachers teaching at least one section of 10th grade English, mathematics, or science in an academic public high school within Massachusetts. Two hundred and fifty-seven (257) teachers, or 62% of the total sample, completed the survey instrument. An analysis of the data found that teachers are making changes in their instructional practices. The data show notable increases in the use of open-response questions, creative/critical thinking questions, problem-solving activities, use of rubrics or scoring guides, writing assignments, and inquiry/investigation. Teachers also have decreased the use of multiple-choice and true-false questions, textbook-based assignments, and lecturing. Also, the data show that teachers felt that changes made in their instructional practices were most influenced by an "interest in helping my students attain MCAS assessment scores that will allow them to graduate high school" and by an "interest in helping my school improve student (MCAS) assessment scores," Finally, mathematics teachers and teachers with 13--19 years of experience report making significantly more changes than did others. It may be interpreted from the data that the use of state-mandated student performance assessments and the high-stakes attached to this type of testing program contributed to changes in teachers' instructional practices. The changes in teachers' instructional practices have included increases in the use of instructional practices deemed

High school students' work engagement in practical teaching

OpenAIRE

Milanović-Dobrota Biljana Z.; Radić-Šestić Marina N.

2017-01-01

The current interest in introducing the dual education system into Serbian secondary education has drawn our attention to the question of students' self-perception in the process of practical teaching. The idea that underpins this paper is the supposition that students are affectively engaged with the work activities they perform. The Utrecht Work Engagement Scale (UWES) (Schaufeli et al., 2002) has been used for assessing students' work engagement in practical teaching. A study was conducted...

Transforming Principles into Practice: Using Cognitive Active Learning Strategies in the High School Classroom

Science.gov (United States)

Swiderski, Suzanne M.

2011-01-01

High school teachers who engage students through active learning in their classrooms can more fully understand this instructional practice by examining the theories and strategies underlying the cognitive perspective of educational psychology, which addresses the development of knowledge in the individual mind. Two theoretical explanations,…

Designing for Engagement: Using the ADDIE Model to Integrate High-Impact Practices into an Online Information Literacy Course

OpenAIRE

Amanda Nichols Hess; Katie Greer

2016-01-01

In this article, the authors share how a team of librarians used the ADDIE instructional design model to incorporate best practices in teaching and learning into an online, four-credit information literacy course. In this redesign process, the Association of American Colleges and Universities’ high-impact practices and e-learning best practices were integrated as scaffolds for course content. The authors' experience with this systematic process and the concepts of instructional design suggest...

High Power High Efficiency Diode Laser Stack for Processing

Science.gov (United States)

Gu, Yuanyuan; Lu, Hui; Fu, Yueming; Cui, Yan

2018-03-01

High-power diode lasers based on GaAs semiconductor bars are well established as reliable and highly efficient laser sources. As diode laser is simple in structure, small size, longer life expectancy with the advantages of low prices, it is widely used in the industry processing, such as heat treating, welding, hardening, cladding and so on. Respectively, diode laser could make it possible to establish the practical application because of rectangular beam patterns which are suitable to make fine bead with less power. At this power level, it can have many important applications, such as surgery, welding of polymers, soldering, coatings and surface treatment of metals. But there are some applications, which require much higher power and brightness, e.g. hardening, key hole welding, cutting and metal welding. In addition, High power diode lasers in the military field also have important applications. So all developed countries have attached great importance to high-power diode laser system and its applications. This is mainly due their low performance. In this paper we will introduce the structure and the principle of the high power diode stack.

Terminology, the importance of defining.

Science.gov (United States)

van Mil, J W Foppe; Henman, Martin

2016-06-01

Multiple terms and definitions exist to describe specific aspects of pharmacy practice and service provision. This commentary explores the reasons for different interpretations of words and concepts in pharmaceutical care and pharmacy practice research. Reasons for this variation can be found in language, culture, profession and may also depend on developments over time. A list of words is provided where the authors think that currently multiple interpretations are possible. To make sure that the reader understands the essence, it seems imperative that authors include a definition of the topics that they actually study in their papers, and that they clearly cite existing definitions or refer to collections of definitions such as existing glossaries. It is important that presenters, authors and reviewers of pharmacy practice papers pay more attention to this aspect of describing studies.

High Performance and the Transformation of Work? The Implications of Alternative Work Practices for the Experience and Outcomes of Work.

Science.gov (United States)

Godard, John

2001-01-01

A survey of 508 Canadian workers showed that moderate levels of high-performance work practices were associated with increased belonging, empowerment, job satisfaction, and organizational citizenship behavior. At higher levels, the association became negative. Work was more stressful with these practices. Team autonomy, just-in-time practices, and…

High speed network sampling

OpenAIRE

Rindalsholt, Ole Arild

2005-01-01

Master i nettverks- og systemadministrasjon Classical Sampling methods play an important role in the current practice of Internet measurement. With today’s high speed networks, routers cannot manage to generate complete Netflow data for every packet. They have to perform restricted sampling. This thesis summarizes some of the most important sampling schemes and their applications before diving into an analysis on the effect of sampling Netflow records.

Impact of Euro-Canadian agrarian practices: in search of sustainable import-substitution strategies to enhance food security in subarctic Ontario, Canada.

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Spiegelaar, Nicole F; Tsuji, Leonard J S

2013-01-01

In Canada, food insecurity exists among Aboriginal (Inuit, Metis and First Nations) people living in remote northern communities, in part, because of their reliance on the industrialized, import-based food system. Local food production as a substitute to imports would be an adaptive response, but enhancement of food security via food localization requires reflection on previous failings of conventional agricultural strategies so that informed decisions can be made. In light of potential reintroduction of local food production in remote First Nations communities, we investigated the cultural, social and ecological effects of a 20th century, Euro-Canadian agrarian settlement on the food system of a subarctic First Nation; this will act as the first step in developing a more sustainable local food program and enhancing food security in this community. To investigate the socio-cultural impacts of the Euro-Canadian agrarian initiative on the food system of Fort Albany First Nation, purposive, semi-directive interviews were conducted with elders and other knowledgeable community members. Interview data were placed into themes using inductive analyses. To determine the biophysical impact of the agrarian initiative, soil samples were taken from one site within the cultivated area and from one site in an undisturbed forest area. Soil properties associated with agricultural use and productivity were assessed. To compare the means of a given soil property between the sites, one-tailed t-tests were employed. Vegetative analysis was conducted in both sites to assess disturbance. According to the interviewees, prior to the agrarian initiative, First Nation families harvested wild game and fish, and gathered berries as well as other forms of vegetation for sustenance. With the introduction of the residential school and agrarian initiative, traditional food practices were deemed inadequate, families were forced to work and live in the settlement (becoming less reliant on

Practices for Identifying and Rejecting Hemolyzed Specimens Are Highly Variable in Clinical Laboratories.

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Howanitz, Peter J; Lehman, Christopher M; Jones, Bruce A; Meier, Frederick A; Horowitz, Gary L

2015-08-01

Hemolysis is an important clinical laboratory quality attribute that influences result reliability. To determine hemolysis identification and rejection practices occurring in clinical laboratories. We used the College of American Pathologists Survey program to distribute a Q-Probes-type questionnaire about hemolysis practices to Chemistry Survey participants. Of 3495 participants sent the questionnaire, 846 (24%) responded. In 71% of 772 laboratories, the hemolysis rate was less than 3.0%, whereas in 5%, it was 6.0% or greater. A visual scale, an instrument scale, and combination of visual and instrument scales were used to identify hemolysis in 48%, 11%, and 41% of laboratories, respectively. A picture of the hemolysis level was used as an aid to technologists' visual interpretation of hemolysis levels in 40% of laboratories. In 7.0% of laboratories, all hemolyzed specimens were rejected; in 4% of laboratories, no hemolyzed specimens were rejected; and in 88% of laboratories, some specimens were rejected depending on hemolysis levels. Participants used 69 different terms to describe hemolysis scales, with 21 terms used in more than 10 laboratories. Slight and moderate were the terms used most commonly. Of 16 different cutoffs used to reject hemolyzed specimens, moderate was the most common, occurring in 30% of laboratories. For whole blood electrolyte measurements performed in 86 laboratories, 57% did not evaluate the presence of hemolysis, but for those that did, the most common practice in 21 laboratories (24%) was centrifuging and visually determining the presence of hemolysis in all specimens. Hemolysis practices vary widely. Standard assessment and consistent reporting are the first steps in reducing interlaboratory variability among results.

Practices and preferences: Exploring the relationships between food-related parenting practices and child food preferences for high fat and/or sugar foods, fruits, and vegetables.

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Vollmer, Rachel L; Baietto, Jamey

2017-06-01

The purpose of this study was to determine the relationship between food-related parenting practices and child fruit, vegetable, and high fat/sugar food preferences. Parents (n = 148) of children (3-7 years old) completed the Comprehensive Feeding Practices Questionnaire (CFPQ), the Preschool Adapted Food Liking Scale (PALS), and answered demographic questions. Separate linear regressions were conducted to test relationships between the different food categories on PALS (fruits, vegetables, and high fat/sugar foods) and each food-related parenting practice using race, ethnicity, and income level, and child age and gender as covariates. It was found that when a parent allows a child to control eating, it was negatively associated with a child's preference for fruit (β = -0.15, p = 0.032) and parent encouragement of child involvement in meal preparation was positively related to child preference for vegetables (β = 0.14, p = 0.048). Children preferred high fat and sugar foods more if parents used food to regulate child emotions (β = 0.24, p = 0.007), used food as a reward (β = 0.32, p food (β = 0.16, p = 0.045), and restricted unhealthy food (β = 0.20, p = 0.024). Conversely, children preferred high fat and sugar foods less if parents made healthy food available in the home (β = -0.13, p = 0.05), modeled healthy eating in front of the child (β = -0.21, p = 0.021), and if parents explained why healthy foods should be consumed (β = -0.24, p = 0.011). Although it cannot be determined if the parent is influencing the child or vice versa, this study provides some evidence that coercive feeding practices are detrimental to a child's food preferences. Copyright © 2017 Elsevier Ltd. All rights reserved.

Why Macro Practice Matters

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Reisch, Michael

2016-01-01

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

Reflections in the clinical practice.

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Borrell-Carrió, F; Hernández-Clemente, J C

2014-03-01

The purpose of this article is to analyze some models of expert decision and their impact on the clinical practice. We have analyzed decision-making considering the cognitive aspects (explanatory models, perceptual skills, analysis of the variability of a phenomenon, creating habits and inertia of reasoning and declarative models based on criteria). We have added the importance of emotions in decision making within highly complex situations, such as those occurring within the clinical practice. The quality of the reflective act depends, among other factors, on the ability of metacognition (thinking about what we think). Finally, we propose an educational strategy based on having a task supervisor and rectification scenarios to improve the quality of medical decision making. Copyright © 2013 Elsevier España, S.L. All rights reserved.

The information sources and journals consulted or read by UK paediatricians to inform their clinical practice and those which they consider important: a questionnaire survey.

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

2007-01-15

Implementation of health research findings is important for medicine to be evidence-based. Previous studies have found variation in the information sources thought to be of greatest importance to clinicians but publication in peer-reviewed journals is the traditional route for dissemination of research findings. There is debate about whether the impact made on clinicians should be considered as part of the evaluation of research outputs. We aimed to determine first which information sources are generally most consulted by paediatricians to inform their clinical practice, and which sources they considered most important, and second, how many and which peer-reviewed journals they read. We inquired, by questionnaire survey, about the information sources and academic journals that UK medical paediatric specialists generally consulted, attended or read and considered important to their clinical practice. The same three information sources--professional meetings & conferences, peer-reviewed journals and medical colleagues--were, overall, the most consulted or attended and ranked the most important. No one information source was found to be of greatest importance to all groups of paediatricians. Journals were widely read by all groups, but the proportion ranking them first in importance as an information source ranged from 10% to 46%. The number of journals read varied between the groups, but Archives of Disease in Childhood and BMJ were the most read journals in all groups. Six out of the seven journals previously identified as containing best paediatric evidence are the most widely read overall by UK paediatricians, however, only the two most prominent are widely read by those based in the community. No one information source is dominant, therefore a variety of approaches to Continuing Professional Development and the dissemination of research findings to paediatricians should be used. Journals are an important information source. A small number of key ones can be

Consumerism: forcing medical practices toward patient-centered care.

Science.gov (United States)

Ozmon, Jeff

2007-01-01

Consumerism has been apart of many industries over the years; now consumerism may change the way many medical practices deliver healthcare. With the advent of consumer-driven healthcare, employers are shifting the decision-making power to their employees. Benefits strategies like health savings accounts and high-deductible insurance plans now allow the patients to control how and where they spend their money on medical care. Practices that seek to attract the more affluent and informed consumers are beginning to institute patient-centered systems designs that invite patients to actively participate in their healthcare. This article will outline the changes in the healthcare delivery system facing medical practices, the importance of patient-centered care, and six strategies to implement to change toward more patient-centered care.

Dental students' beliefs about culture in patient care: self-reported knowledge and importance.

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Wagner, Julie A; Redford-Badwal, Deborah

2008-05-01

In order to decrease the well-documented disparities in oral health and oral health care, the next generation of dentists must be prepared to serve a diverse patient population. This article describes dental students' self-reported knowledge of culture and importance of using culturally sensitive dental practices. Three consecutive graduating classes (n=111) were surveyed anonymously in their sophomore years. Students indicated their self-rated knowledge of oral health and oral health care for their own culture and the cultures of patients they are likely to see in dental practice. Students also rated their perceived importance of culturally sensitive dental practice. Overall, students reported low knowledge of the cultures of the patients they will see in practice. Few students could identify any cultural group that they knew well. However, students as a group indicated that using culturally sensitive practices in dentistry is important. Students who could identify at least one cultural group they knew well perceived cultural sensitivity in dental practice as more important than students who could not. These results suggest that students need cross-cultural training and believe that such training is important. The results also suggest that a specific curriculum that increases knowledge of other cultures may have the potential to ultimately increase the use of culturally sensitive practices.

Cardiac troponins--Translational biomarkers in cardiology: Theory and practice of cardiac troponin high-sensitivity assays.

Science.gov (United States)

Adamcova, Michaela; Popelova-Lencova, Olga; Jirkovsky, Eduard; Simko, Fedor; Gersl, Vladimir; Sterba, Martin

2016-01-01

Tn is a unique translational biomarker in cardiology whose potential has not been diminished in the new era of high sensitive assays. cTns can be valuable markers in cardiac diseases as well as in infectious diseases and respiratory diseases. Furthermore, the role of cTns is growing in the routine evaluation of cardioxicity and in determining the efficacy/safety ratio of novel cardioprotective strategies in clinical settings. cTns can detect myocardial injury not only in a wide spectrum of laboratory animals in experimental studies in vivo, but also in isolated heart models or cardiomyocytes in vitro. The crucial issue regarding the cross-species usage of cardiac troponin investigation remains the choice of cardiac troponin testing. This review summarizes the recent proteomic data on aminoacid sequences of cTnT and cTnI in various species, as well as selected analytical characteristics of human cardiac troponin high-sensitivity assays. Due to the highly phylogenetically conserved structure of troponins, the same bioindicator can be investigated using the same method in both clinical and experimental cardiology, thus contributing to a better understanding of the pathogenesis of cardiac diseases as well as to increased effectiveness of troponin use in clinical practice. Measuring cardiac troponins using commercially available human high-sensitivity cardiac troponin tests with convenient antibodies selected on the basis of adequate proteomic knowledge can solve many issues which would otherwise be difficult to address in clinical settings for various ethical and practical reasons. Our survey could help elaborate the practical guidelines for optimizing the choice of cTns assay in cardiology. © 2016 International Union of Biochemistry and Molecular Biology.

Importance of the High-Expression of Proline Transporter PutP to the Adaptation of Escherichia coli to High Salinity.

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Sasaki, Hideaki; Sato, Daichi; Oshima, Akinobu

2017-01-01

　The effect of the amount of the proline transporter PutP expression on the mechanism of adaptation of E. coli cells to high salinity was analyzed. The PutP gene derived from the E. coli expression plasmid was introduced into the E. coli cell, and a high PutP expression strain was developed. At 1.2 M NaCl culture condition, the growth of normal E. coli cells was inhibited, whereas high ProP expression cells showed growth under 2.5 M NaCl conditions. The uptake of proline by E. coli as a compatible solute and substrate for metabolization was in good accordance with those seen in cell growth. These data suggested that the amount of the proline transporter PutP expression played an important role in the adaptation of E. coli cells to high saline conditions.

An Examination of the Outcomes of the Undergraduate Leadership Teaching Assistant (ULTA) Experience as a High-Impact Practice in Leadership Education

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Odom, Summer F.; Ho, Sarah P.; Moore, Lori L.

2015-01-01

The Undergraduate Leadership Teaching Assistant (ULTA) experience offers students a high-impact opportunity to develop, practice, and evaluate their leadership knowledge, skills, and abilities. The purpose of this qualitative study was to examine outcomes of the ULTA experience as a high-impact practice for students studying leadership. Weekly…

The Importance of Justice Restorative to Combat Drug Trafficking

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Henrique Ribeiro Cardoso

2016-12-01

Full Text Available Over the last few decades, the criminal model of retributive justice has been challenged for not being suitable for the prevention and repression of criminality in Brazil. The high incarceration rate has increased with the number of drug trafficking prisoners which leads to, consequently, a formulation of criminal policy on the standard punitive model rather effective alternative forms, or less harmful for solving the problem. Its commercial nature at the same time reveals the importance for the consummation of the crime opening the possibilities for insertion of the extensive restorative practices, which exceeds the legally allowed.

High School Teachers' Openness to Adopting New Practices: The Role of Personal Resources and Organizational Climate.

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Johnson, Stacy R; Pas, Elise T; Loh, Deanna; Debnam, Katrina J; Bradshaw, Catherine P

2017-03-01

Although evidence-based practices for students' social, emotional, and behavioral health are readily available, their adoption and quality implementation in schools are of increasing concern. Teachers are vital to implementation; yet, there is limited research on teachers' openness to adopting new practices, which may be essential to successful program adoption and implementation. The current study explored how perceptions of principal support, teacher affiliation, teacher efficacy, and burnout relate to teachers' openness to new practices. Data came from 2,133 teachers across 51 high schools. Structural equation modeling assessed how organizational climate (i.e., principal support and teacher affiliation) related to teachers' openness directly and indirectly via teacher resources (i.e., efficacy and burnout). Teachers with more favorable perceptions of both principal support and teacher affiliation reported greater efficacy, and, in turn, more openness; however, burnout was not significantly associated with openness. Post hoc analyses indicated that among teachers with high levels of burnout, only principal support related to greater efficacy, and in turn, higher openness. Implications for promoting teachers' openness to new program adoption are discussed.

Are family practice trainers and their host practices any better? comparing practice trainers and non-trainers and their practices

NARCIS (Netherlands)

Hombergh, P. van den; Schalk-Soekar, S.; Kramer, A.; Bottema, B.J.; Campbell, S.M.; Braspenning, J.C.

2013-01-01

BACKGROUND: Family Physician (FP) trainees are expected to be provided with high quality training in well organized practice settings. This study examines differences between FP trainers and non-trainers and their practices to see whether there are differences in trainers and non-trainers and in how

Practical Approaches to Mitigation of Specimen Charging in High-Resolution Transmission Electron Microscopy

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Young-Min Kim

2010-09-01

Full Text Available Specimen charging that is associated with the electron bombardment on the sample is a practical hindrance to high-resolution transmission electron microscopy (HRTEM analysis because it causes a severe loss of resolution in either diffraction or image data. Conductive thin film deposition on an insulating specimen has been proposed as an effective approach to the mitigation of the specimen charging; however, this method is generally not useful in HRTEM imaging of materials because the deposited film induces another artifact in the HRTEM image contrast. In this study, we propose practical methods to mitigate the specimen charging that takes place during the HRTEM of materials. For bulk-type specimens prepared by either an ion-thinning or focused-ion beam (FIB process, a plasma cleaning treatment is significantly effective in eliminating the charging phenomenon. In the case of low-dimensional nanomaterials such as nanowires and nanoparticles, the plasma cleaning is not feasible; however, the charging effect can be effectively eliminated by adjusting the electron illumination condition. The proposed methods facilitate a decrease in the buildup of specimen charging, thereby enhancing the quality of high-resolution images significantly.

Modeling self on others: An import theory of subjectivity and selfhood.

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Prinz, Wolfgang

2017-03-01

This paper outlines an Import Theory of subjectivity and selfhood. Import theory claims that subjectivity is initially perceived as a key feature of other minds before it then becomes imported from other minds to own minds whereby it lays the ground for mental selfhood. Import theory builds on perception-production matching, which in turn draws on both representational mechanisms and social practices. Representational mechanisms rely on common coding of perception and production. Social practices rely on action mirroring in dyadic interactions. The interplay between mechanisms and practices gives rise to model self on others. Individuals become intentional agents in virtue of perceiving others mirroring themselves. The outline of the theory is preceded by an introductory section that locates import theory in the broader context of competing approaches, and it is followed by a concluding section that assesses import theory in terms of empirical evidence and explanatory power. Copyright © 2017 Elsevier Inc. All rights reserved.

Parenting practices among Dominican and Puerto Rican mothers.

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Guilamo-Ramos, Vincent; Dittus, Patricia; Jaccard, James; Johansson, Margaret; Bouris, Alida; Acosta, Neifi

2007-01-01

This study presents descriptive qualitative data about Latino parenting practices in an urban context. Focus groups were conducted with Dominican and Puerto Rican mother-adolescent pairs in the Bronx borough of NewYork City. When parenting style typologies are integrated with the Latino cultural components familismo, respeto, personalismo, and simpatía, Latino parenting practices and their underlying styles are better understood. Content analysis of parents' focus groups revealed five essential Latino parenting practices: (1) ensuring close monitoring of adolescents; (2) maintaining warm and supportive relationships characterized by high levels of parent-adolescent interaction and sharing; (3) explaining parental decisions and actions; (4) making an effort to build and improve relationships; and (5) differential parenting practices based on adolescents' gender. Mothers reported concerns related to the risks associated with living in an urban area, exposure to different cultural values, and opportunities for engaging in risky behaviors. Adolescents' recommendations for effective parenting strategies were similar to the practices reported by their mothers. The study has important applied implications for culturally competent social work practice with Latino adolescents and their families.

Designing for Engagement: Using the ADDIE Model to Integrate High-Impact Practices into an Online Information Literacy Course

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Nichols Hess, Amanda Kathryn; Greer, Katie

2016-01-01

In this article, the authors share how a team of librarians used the ADDIE instructional design model to incorporate best practices in teaching and learning into an online, four-credit information literacy course. In this redesign process, the Association of American Colleges and Universities' high-impact practices and e-learning best practices…

Organizational Learning from Experience in High-Hazard Industries: Problem Investigation as Off-Line Reflective Practice

OpenAIRE

Rudolph, Jenny; Hatakenaka, Sachi; Carroll, John S.

2002-01-01

Learning from experience, the cyclical interplay of thinking and doing, is increasingly important as organizations struggle to cope with rapidly changing environments and more complex and interdependent sets of knowledge. This paper confronts two central issues for organizational learning: (1) how is local learning (by individuals or small groups) integrated into collective learning by organizations? and (2) what are the differences between learning practices that focus on control, eliminatio...

Toward practical SERS sensing

Science.gov (United States)

Zhao, Yiping

2012-06-01

Since its discovery more than 30 years ago, surface-enhanced Raman scattering (SERS) has been recognized as a highly sensitive detection technique for chemical and biological sensing and medical diagnostics. However, the practical application of this remarkably sensitive technique has not been widely accepted as a viable diagnostic method due to the difficulty in preparing robust and reproducible substrates that provide maximum SERS enhancement. Here, we demonstrate that the aligned silver nanorod (AgNR) array substrates engineered by the oblique angle deposition method are capable of providing extremely high SERS enhancement factors (>108). The substrates are large area, uniform, reproducible, and compatible with general microfabrication process. The enhancement factor depends strongly on the length and shape of the Ag nanorods and the underlying substrate coating. By optimizing AgNR SERS substrates, we show that SERS is able to detect trace amount of toxins, virus, bacteria, or other chemical and biological molecules, and distinguish different viruses/bacteria and virus/bacteria strains. The substrate can be tailored into a multi-well chip for high throughput screening, integrated into fiber tip for portable sensing, incorporated into fluid/microfluidic devices for in situ real-time monitoring, fabricated onto a flexible substrate for tracking and identification, or used as on-chip separation device for ultra-thin layer chromatography and diagnostics. By combining the unique SERS substrates with a handheld Raman system, it can become a practical and portable sensor system for field applications. All these developments have demonstrated that AgNR SERS substrates could play an important role in the future for practical clinical, industrial, defense, and security sensing applications.

A simple high-performance liquid chromatographic practical approach for determination of flurbiprofen

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Muhammad Akhlaq

2011-01-01

Full Text Available A simple, rapid, sensitive, and specific high-performance liquid chromatography (HPLC assay for flurbiprofen has been developed and validated practically. The chromatography was conducted using Gemini C18 column (5 μm; 4.6 mm × 250 mm, Phenomenex, California, USA. The mobile phase containing disodium hydrogen phosphate solution (30 mM pH 7.0 and acetonitrile (50:50; and the isocratic flow rate of 1.0 ml/min were used in the current study. Detection was made at 247 nm. The calibration curve was linear (r ≥ 0.9996 over the concentration range of 5-50 mm/ml. Mean percentage (% recovery ± % relative standard deviation (RSD ranged from 97.07 ± 0.008 to 103.66 ± 0.013. Within-day and between-day precision were also in acceptable range of 98.83 ± 0.004 to 104.56 ± 0.009. In order to confirm the practical applicability of the method developed, flurbiprofen controlled release matrix tablets were subjected to the dissolution studies and the release rate was analyzed. The reported HPLC for flurbiprofen provides several advantages of simplicity, high specificity, accuracy, and very short run-cycle time. It is suggested that the method should be used for the routine quality control analysis of flurbiprofen pure drug and its dosage forms.

A Comparative Study of Teachers' Attitudes and Practices regarding Homework in the Elementary, Middle, and High School Grades

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Peltier, Courtney Pisarich

2011-01-01

The purpose of this study was to examine the attitudes and practices of elementary, middle, and high school teachers regarding homework. In addition, the study sought to find if there was a relationship between the teachers' attitudes and practices of homework, as well as finding the differences between the grade levels. The questionnaire used…

Sleep: important considerations for the prevention of cardiovascular disease.

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Grandner, Michael A; Alfonso-Miller, Pamela; Fernandez-Mendoza, Julio; Shetty, Safal; Shenoy, Sundeep; Combs, Daniel

2016-09-01

Sleep plays many roles in maintenance of cardiovascular health. This review summarizes the literature across several areas of sleep and sleep disorders in relation to cardiometabolic disease risk factors. Insufficient sleep duration is prevalent in the population and is associated with weight gain and obesity, inflammation, cardiovascular disease, diabetes, and mortality. Insomnia is also highly present and represents an important risk factor for cardiovascular disease, especially when accompanied by short sleep duration. Sleep apnea is a well-characterized risk factor for cardiometabolic disease and cardiovascular mortality. Other issues are relevant as well. For example, sleep disorders in pediatric populations may convey cardiovascular risks. Also, sleep may play an important role in cardiovascular health disparities. Sleep and sleep disorders are implicated in cardiometabolic disease risk. This review addresses these and other issues, concluding with recommendations for research and clinical practice.

Fluid dynamics practices as a scientific divulgation tool in high school education

OpenAIRE

Fabiano Tavares da Silva; Lamon Benevides de Souza; Leôncio Diógenes Tavares Câmara

2016-01-01

http://dx.doi.org/10.5007/1807-0221.2016v13n24p94 This extension project was designed to bring together students from high schools in Nova Friburgo-RJ region with the Instituto Politécnico IPRJ / UERJ, providing an experience within the university with scientific incentive practices to the area of sciences and earth. Introducing the universe and diversity in the mathematics and science area with a short course aimed to studies of particles analysis, viscosity and permeability, this initia...

The Importance of Serum Cytokine Levels in Febrile Neutropenia

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Nuray Buyukberber

2003-02-01

Full Text Available The most important evaluation of the neutropenic patients is to determine the risk group. The desired approach to patients with low risks should be either not to hospitalize or to hospitalize for a short period of time which both decreases the cost and exposure to the resistant flora. The early diagnosis of sepsis in patients with high risk may be life saving. Recently, the determination of low and high-risk groups only by the clinical variables is not found to be a reliable method. The laboratory parameters supported by the clinical variables may be more practical. The determination of serum cytokines levels in febrile neutropenia may be helpful for the early risk diagnosis, new treatment approaches, and prognosis. [Archives Medical Review Journal 2003; 12(1.000: 12-19

Environmental certification for more sustainable imports

International Nuclear Information System (INIS)

Henry, Lucile; Monnoyer-Smith, Laurence; Demeulenaere, Laurence

2017-12-01

As France imports high quantities of products which have environmental impacts abroad due to extraction, transformations, and transports of used materials, and which are not visible for consumers, environmental certification could be a mean to reduce these impacts as it would allow consumers to identify the less polluting products, and incite producers to put such products on the market. After having discussed these issues, the author outlines key factors of success for such a certification, briefly identifies required adjustments at the technical level (requirement level, cost anticipation), and at the social and political level. She also evokes accompanying measures, and outlines that environmental certification is only a tool among others such as partnership agreements currently being negotiated between the European Union and other countries, or a combination of certification and cooperation with extracting countries (as practiced by Germany)

Professional knowledge and interprofessional practice

International Nuclear Information System (INIS)

Milburn, Peter C.; Colyer, Hazel

2008-01-01

Interprofessional education (IPE) is well-established in the professional discipline of radiography and other health and social care professions, driven by central government policies promoting interprofessional, collaborative working. The development of an appropriate knowledge base for interprofessional work is therefore important and, as a starting point, the article investigates the concept and significance of professional knowledge as a means to unravel and shed light on the potential emergence of a new body of knowledge, 'interprofessional knowledge'. The paper discusses whether the term 'interprofessional knowledge' (IPK) is meaningful and its utility for interprofessional practice, arguing that such knowledge is located within the discourse of interprofessional learning and practice. As such it is fluid and contextualised. The implications of this for all health and social care professionals, including radiographers, are elaborated to assist in future curriculum development and enhance understanding of the knowledge that underpins effective, collaborative, interprofessional practice. The paper concludes by suggesting there are a number of key implications for professional practice namely, IPE cannot teach interprofessional knowledge, rather it should facilitate interprofessional practice, through which such knowledge is construed, and person-centred care can be more effectively achieved. Second, interprofessional practice is highly contextualised by practice setting and point of service delivery. Any attempt to decontextualise it for the purpose of curriculum development would be illogical; interprofessional knowledge is in a symbiotic relationship with its prior professional knowledge. Third, the organisation of IPE would be better driven by alliances of complementary professions in order to maximise its potential effectiveness and credibility with practitioners

Sampling high-altitude and stratified mating flights of red imported fire ant.

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Fritz, Gary N; Fritz, Ann H; Vander Meer, Robert K

2011-05-01

With the exception of an airplane equipped with nets, no method has been developed that successfully samples red imported fire ant, Solenopsis invicta Buren, sexuals in mating/dispersal flights throughout their potential altitudinal trajectories. We developed and tested a method for sampling queens and males during mating flights at altitudinal intervals reaching as high as "140 m. Our trapping system uses an electric winch and a 1.2-m spindle bolted to a swiveling platform. The winch dispenses up to 183 m of Kevlar-core, nylon rope and the spindle stores 10 panels (0.9 by 4.6 m each) of nylon tulle impregnated with Tangle-Trap. The panels can be attached to the rope at various intervals and hoisted into the air by using a 3-m-diameter, helium-filled balloon. Raising or lowering all 10 panels takes approximately 15-20 min. This trap also should be useful for altitudinal sampling of other insects of medical importance.

Latent Cluster Analysis of Instructional Practices Reported by High- and Low-performing Mathematics Teachers in Four Countries

OpenAIRE

Cheng, Qiang; Hsu, Hsien-Yuan

2017-01-01

Using Trends in International Mathematics and Science Study (TIMSS) 2011 eighth-grade international dataset, this study explored the profiles of instructional practices reported by high- and low-performing mathematics teachers across the US, Finland, Korea, and Russia. Concepts of conceptual teaching and procedural teaching were used to frame the design of the current study. Latent cluster analysis was applied in the investigation of the profiles of mathematics teachers’ instructional practic...

Clinical Outcome of Degenerative Mitral Regurgitation: Critical Importance of Echocardiographic Quantitative Assessment in Routine Practice.

Science.gov (United States)

Antoine, Clemence; Benfari, Giovanni; Michelena, Hector I; Malouf, Joseph F; Nkomo, Vuyisile T; Thapa, Prabin; Enriquez-Sarano, Maurice

2018-05-31

Background -Echocardiographic quantitation of degenerative mitral regurgitation (DMR) is recommended whenever possible in clinical guidelines but is criticized and its scalability to routine clinical practice doubted. We hypothesized that echocardiographic DMR quantitation, performed in routine clinical practice by multiple practitioners predicts independently long-term survival, and thus is essential to DMR management. Methods -We included patients diagnosed with isolated mitral-valve-prolapse 2003-2011 and any degree of MR quantified by any physician/sonographer in routine clinical practice. Clinical/echocardiographic data acquired at diagnosis were retrieved electronically. Endpoint was mortality under medical treatment analyzed by Kaplan-Meir method and Proportional-Hazard models. Results -The cohort included 3914 patients (55% male) aged 62±17 years, with left ventricular ejection fraction (LVEF) 63±8% and routinely measured effective regurgitant orifice area (EROA) 19[0-40] mm 2 During follow-up (6.7±3.1 years) 696 patients died under medical management and 1263 underwent mitral surgery. In multivariate analysis, routinely measured EROA was associated with mortality (adjusted-hazard-ratio 1.19[1.13-1.24] p 40 mm 2 threshold. Conclusions -Echocardiographic DMR quantitation is scalable to routine practice and is independently associated with clinical outcome. Routinely measured EROA is strongly associated with long-term survival under medical treatment. Excess mortality vs. the general population appears in the "moderate" DMR range and steadily increases with higher EROA. Hence, individual EROA values should be integrated into therapeutic considerations, additionally to categorical DMR grading.

Cultivating Mathematical Skills: From Drill-and-Practice to Deliberate Practice

Science.gov (United States)

Lehtinen, Erno; Hannula-Sormunen, Minna; McMullen, Jake; Gruber, Hans

2017-01-01

Contemporary theories of expertise development highlight the crucial role of deliberate practice in the development of high level performance. Deliberate practice is practice that intentionally aims at improving one's skills and competencies. It is not a mechanical or repetitive process of making performance more fluid. Instead, it involves a…

Best practices in road transport: An exploratory study

Directory of Open Access Journals (Sweden)

Mar Fernández Vázquez-Noguerol

2018-04-01

Full Text Available Purpose: Road transport aspects are becoming increasingly important due to their high impact on economic, environmental and social sustainability. Considering the triple bottom line approach, best practices play a fundamental role within organisations. The purpose of this paper is to analyse several sustainable initiatives in road transport adopted by companies. Design/methodology/approach: The findings were developed and evaluated based on empirical data captured through a survey of 98 professionals involved in logistics and transport activities. Additionally, key literature on transport initiatives was reviewed to supplement the framework for the implementation of best practices in road transport. Findings: The exploratory study shows the importance of each best practice and determines the level of implementation of each initiative, comparing the results among different dealers (retailers, wholesalers, carriers and manufacturers, type of transport fleet and companies’ revenues. Research limitations/implications: The sample of 98 companies was based on simple search filters and the group is not wholly representative of all sectors. Respondents were mainly managers from Spain involved in logistics and transport activities. Surveyed companies included manufacturing, retailers, wholesalers and third-party logistics providers. Practical implications: The most common best practices in road transport are identified, including initiatives related to: efficiency, reusability, safety, optimization, emissions, waste and recycling. Initiatives that influence road transport are ranked by their degree of implementation in the companies analysed.  Social implications: Implementation of some of these best practices may help lessen negative impacts of road transport on society and the environment. Originality/value: The study results indicate which practices are most frequently used and their level of implementation depending on companies’ roles in the

High School Health-Education Teachers' Perceptions and Practices Related to Teaching HIV Prevention

Science.gov (United States)

Herr, Scott W.; Telljohann, Susan K.; Price, James H.; Dake, Joseph A.; Stone, Gregory E.

2012-01-01

Background: HIV/AIDS is one of the leading causes of illness and death in the United States with individuals between the ages of 13 and 19 years being especially vulnerable for infection. The purpose of this study was to examine the attitudes, perceptions, and instructional practices of high school health teachers toward teaching HIV prevention.…

Communication's Role in Safety Management and Performance for the Road Safety Practices

OpenAIRE

Salim Keffane (s)

2014-01-01

Communication among organizations could play an important role in increasing road safety. To get in-depth knowledge of its role, this study measured managers' and employees' perceptions of the communication's role on six safety management and performance criteria for road safety practices by conducting a survey using a questionnaire among 165 employees and 135 managers. Path analysis using AMOS-19 software shows that some of the safety management road safety practices have high correlation wi...

The Importance of High School Physics Teachers for Female Students' Physics Identity and Persistence

Science.gov (United States)

Hazari, Zahra; Brewe, Eric; Goertzen, Renee Michelle; Hodapp, Theodore

2017-01-01

Given the historic and continued underrepresentation of women in physics, it is important to understand the role that high school physics might play in attracting female students to physics careers. Drawing on data from over 900 female undergraduates in physics, we examine when these women became interested in physics careers and different sources…

IMPORTANCE OF KNOWLEDGE MANAGEMENT FOR COMPANIES

OpenAIRE

Vivian Toledo Santos Gambarato; Pâmela Gimenez Mateus; Renato Luiz Gambarato

2015-01-01

This work addressed the importance of knowledge management as a strategy for the survival of companies in the market. It have been shown the talent retention concepts, people management, intellectual capital and technologies related to knowledge management, in the view of several authors, in order to prove the importance of these issues can provide organizations. A survey of companies was performed, which showed part of your reality with respect to talent retention practice and...

Perceived cultural importance and actual self-importance of values in cultural identification.

Science.gov (United States)

Wan, Ching; Chiu, Chi-yue; Tam, Kim-pong; Lee, Sau-lai; Lau, Ivy Yee-man; Peng, Siqing

2007-02-01

Cross-cultural psychologists assume that core cultural values define to a large extent what a culture is. Typically, core values are identified through an actual self-importance approach, in which core values are those that members of the culture as a group strongly endorse. In this article, the authors propose a perceived cultural importance approach to identifying core values, in which core values are values that members of the culture as a group generally believe to be important in the culture. In 5 studies, the authors examine the utility of the perceived cultural importance approach. Results consistently showed that, compared with values of high actual self-importance, values of high perceived cultural importance play a more important role in cultural identification. These findings have important implications for conceptualizing and measuring cultures. ((c) 2007 APA, all rights reserved).

The role of informal dimensions of safety in high-volume organisational routines: an ethnographic study of test results handling in UK general practice.

Science.gov (United States)

Grant, Suzanne; Checkland, Katherine; Bowie, Paul; Guthrie, Bruce

2017-04-27

The handling of laboratory, imaging and other test results in UK general practice is a high-volume organisational routine that is both complex and high risk. Previous research in this area has focused on errors and harm, but a complementary approach is to better understand how safety is achieved in everyday practice. This paper ethnographically examines the role of informal dimensions of test results handling routines in the achievement of safety in UK general practice and how these findings can best be developed for wider application by policymakers and practitioners. Non-participant observation was conducted of high-volume organisational routines across eight UK general practices with diverse organisational characteristics. Sixty-two semi-structured interviews were also conducted with the key practice staff alongside the analysis of relevant documents. While formal results handling routines were described similarly across the eight study practices, the everyday structure of how the routine should be enacted in practice was informally understood. Results handling safety took a range of local forms depending on how different aspects of safety were prioritised, with practices varying in terms of how they balanced thoroughness (i.e. ensuring the high-quality management of results by the most appropriate clinician) and efficiency (i.e. timely management of results) depending on a range of factors (e.g. practice history, team composition). Each approach adopted created its own potential risks, with demands for thoroughness reducing productivity and demands for efficiency reducing handling quality. Irrespective of the practice-level approach adopted, staff also regularly varied what they did for individual patients depending on the specific context (e.g. type of result, patient circumstances). General practices variably prioritised a legitimate range of results handling safety processes and outcomes, each with differing strengths and trade-offs. Future safety

Perceptions about the Influence of Instructional Leadership Practices of Elementary Principals on Teachers' ELA Pedagogical Changes in High-Poverty NYC Elementary Schools

Science.gov (United States)

Green, Linda D.

2017-01-01

This quantitative study examined the relationships between instructional leadership practices of elementary school principals in high-poverty schools and changes in teachers' ELA instructional practices. This research sought to identify principals' perceptions about their use of instructional leadership practices and the teaching practices used in…

Eurogin 2016 Roadmap: how HPV knowledge is changing screening practice.

Science.gov (United States)

Wentzensen, Nicolas; Arbyn, Marc; Berkhof, Johannes; Bower, Mark; Canfell, Karen; Einstein, Mark; Farley, Christopher; Monsonego, Joseph; Franceschi, Silvia

2017-05-15

Human papillomaviruses (HPVs) are the necessary cause of most cervical cancers, a large proportion of other anogenital cancers, and a subset of oropharyngeal cancers. The knowledge about HPV has led to development of novel HPV-based prevention strategies with important impact on clinical and public health practice. Two complementary reviews have been prepared following the 2015 Eurogin Conference to evaluate how knowledge about HPV is changing practice in HPV infection and disease control through vaccination and screening. This review focuses on screening for cervical and anal cancers in increasingly vaccinated populations. The introduction of HPV vaccines a decade ago has led to reductions in HPV infections and early cancer precursors in countries with wide vaccination coverage. Despite the high efficacy of HPV vaccines, cervical cancer screening will remain important for many decades. Many healthcare systems are considering switching to primary HPV screening, which has higher sensitivity for cervical precancers and allows extending screening intervals. We describe different approaches to implementing HPV-based screening efforts in different healthcare systems with a focus in high-income countries. While the population prevalence for other anogenital cancers is too low for population-based screening, anal cancer incidence is very high in HIV-infected men who have sex with men, warranting consideration of early detection approaches. We summarize the current evidence on HPV-based prevention of anal cancers and highlight important evidence gaps. © 2016 UICC.

Imprecise system reliability and component importance based on survival signature

International Nuclear Information System (INIS)

Feng, Geng; Patelli, Edoardo; Beer, Michael; Coolen, Frank P.A.

2016-01-01

The concept of the survival signature has recently attracted increasing attention for performing reliability analysis on systems with multiple types of components. It opens a new pathway for a structured approach with high computational efficiency based on a complete probabilistic description of the system. In practical applications, however, some of the parameters of the system might not be defined completely due to limited data, which implies the need to take imprecisions of component specifications into account. This paper presents a methodology to include explicitly the imprecision, which leads to upper and lower bounds of the survival function of the system. In addition, the approach introduces novel and efficient component importance measures. By implementing relative importance index of each component without or with imprecision, the most critical component in the system can be identified depending on the service time of the system. Simulation method based on survival signature is introduced to deal with imprecision within components, which is precise and efficient. Numerical example is presented to show the applicability of the approach for systems. - Highlights: • Survival signature is a novel way for system reliability and component importance • High computational efficiency based on a complete description of system. • Include explicitly the imprecision, which leads to bounds of the survival function. • A novel relative importance index is proposed as importance measure. • Allows to identify critical components depending on the service time of the system.

Integrated and isolated impact of high-performance work practices on employee health and well-being : A comparative studie

NARCIS (Netherlands)

Ogbonnaya, C.; Daniels, K.; Connolly, S.; van Veldhoven, M.J.P.M.

2017-01-01

We investigate the positive relationships between high-performance work practices (HPWP) and employee health and well-being and examine the conflicting assumption that high work intensification arising from HPWP might offset these positive relationships. We present new insights on whether the

Importance of Pharmaceutical Training and Clinical Research at Medical Facilities.

Science.gov (United States)

Myotoku, Michiaki

2017-01-01

To respond to advancements in medical techniques, and to address the separation of medical and dispensary practices, clinical professors are required to educate human resource staff to become highly-skilled pharmacists. For this purpose, it is extremely important for these professors to learn about cutting-edge practical skills and knowledge, as well as to advance their expertise. In addition, they need to conduct clinical research in cooperation with relevant facilities. As our university does not have its own hospital or pharmacy, it is important to provide training for clinical professors in clinical facilities. Such training mainly involves medical teams' in-hospital rounds and participation in conferences (nutrition support team; NST), operation of the pharmacy department, and intervention targeting improvement in the department's duties. We have conducted collaborative studies, provided research instructions, implemented studies aimed at improving the department's work (pharmacists appointed on wards at all times to ensure medical safety) as well as studies regarding team medical care (nutritional evaluation during outpatient chemotherapy), and resolved issues regarding this work (drug solution mixability in a hand-held constant infusion pump, and a safe pump-filling methods). Thus, it has become possible to keep track of the current state of a pharmacists' work within team medical care, to access information about novel drugs, to view clinical and prescription-claim data, to cooperate with other professionals (e.g., doctors and nurses), to promote pharmacists' self-awareness of their roles in cooperative medical practice, and to effectively maintain the hospital's clinical settings.

Important atomic physics issues for ion beam fusion

International Nuclear Information System (INIS)

Bangerter, Roger.

1986-01-01

The nearly endless variety of interesting and challenging problems makes physics research enjoyable. Most of us would choose to be physicists even if physics had no practical applications. However, physics does have practical applications. This workshop deals with one of those applications, namely ion beam fusion. Not all interesting and challenging atomic physics questions are important for ion beam fusion. This paper suggests some questions that may be important for ion beam fusion. It also suggests some criteria for determining if a question is only interesting, or both interesting and important. Importance is time dependent and, because of some restrictions on the flow of information, also country dependent. In the early days of ion beam fusion, it was important to determine if ion beam fusion made sense. Approximate answers and bounds on various parameters were required. Accurate, detailed answers were not needed. Because of the efforts of many people attending this workshop, we now know that ion beam fusion does make some sense. We must still determine if ion beam fusion truly makes good sense. If it does make good sense, we must determine how to make it work. Accurate detailed answers are becoming increasingly important. (author)

Intravenous high-dose immunotherapy: practical recommendations for use in the treatment of neurological disimmune diseases

Directory of Open Access Journals (Sweden)

N. A. Suponeva

2015-01-01

Full Text Available Current publication summarizes main indications and benefits of intravenous high-dose immunotherapy (IHI in the treatment of various autoimmune diseases of the peripheral nervous system. Available products of intravenous immunoglobulin (IVIG on the Russian market are reviewed. Tactics for choosing optimal medication for IHI based on its effectiveness and safety are analyzed. Dosage calculation and way of administration of IVIG are described, beeing of a high practical value in neurologist’s daily work.

Enhancing Important Fluctuations: Rare Events and Metadynamics from a Conceptual Viewpoint

Science.gov (United States)

Valsson, Omar; Tiwary, Pratyush; Parrinello, Michele

2016-05-01

Atomistic simulations play a central role in many fields of science. However, their usefulness is often limited by the fact that many systems are characterized by several metastable states separated by high barriers, leading to kinetic bottlenecks. Transitions between metastable states are thus rare events that occur on significantly longer timescales than one can simulate in practice. Numerous enhanced sampling methods have been introduced to alleviate this timescale problem, including methods based on identifying a few crucial order parameters or collective variables and enhancing the sampling of these variables. Metadynamics is one such method that has proven successful in a great variety of fields. Here we review the conceptual and theoretical foundations of metadynamics. As demonstrated, metadynamics is not just a practical tool but can also be considered an important development in the theory of statistical mechanics.

Temperature profile evolution in quenching high-Tc ...

Indian Academy of Sciences (India)

Abstract. Irreversible normal zones leading to quench is an important aspect of high-temperature superconductors (HTS) in all practical applications. As a consequence of quench, transport current gets diverted to the matrix stabilizer material of the high-Tc composite and causes Joule heating till the original conditions are ...

The Relative Importance of Low Significance Level and High Power in Multiple Tests of Significance.

Science.gov (United States)

Westermann, Rainer; Hager, Willi

1983-01-01

Two psychological experiments--Anderson and Shanteau (1970), Berkowitz and LePage (1967)--are reanalyzed to present the problem of the relative importance of low Type 1 error probability and high power when answering a research question by testing several statistical hypotheses. (Author/PN)

Management and non-supervisory perceptions surrounding the implementation and significance of high-performance work practices in a nuclear power plant

Science.gov (United States)

Ashbridge, Gayle Ann

Change management has become an imperative for organizations as they move into the 21st century; up to 75 percent of change initiatives fail. Nuclear power plants face the same challenges as industrial firms with the added challenge of deregulation. Faced with this challenge, restructuring the electric utility has raised a number of complex issues. Under traditional cost-of-service regulation, electric utilities were able to pass on their costs to consumers who absorbed them. In the new competitive environment, customers will now choose their suppliers based on the most competitive price. The purpose of this study is to determine the degree of congruence between non-supervisory and supervisory personnel regarding the perceived implementation of high performance workplace practices at a nuclear power plant. This study used as its foundation the practices identified in the Road to High Performance Workplaces: A Guide to Better Jobs and Better Business Results by the U.S. Department of Labor's Office of the American Workplace (1994). The population for this study consisted of organizational members at one nuclear power plant. Over 300 individuals completed surveys on high performance workplace practices. Two surveys were administered, one to non-supervisory personnel and one to first line supervisors and above. The determination of implementation levels was accomplished through descriptive statistical analysis. Results of the study revealed 32 areas of noncongruence between non-supervisory and supervisory personnel in regard to the perceived implementation level of the high performance workplace practices. Factor analysis further revealed that the order in which the respondents place emphasis on the variables varies between the two groups. This study provides recommendations that may improve the nuclear power plants alignment of activities. Recommendations are also provided for additional research on high-performance work practices.

SiC-C Composite as A Highly Stable and Easily Regenerable Photothermal Material for Practical Water Evaporation

KAUST Repository

Shi, Le

2018-05-26

Solar-driven water distillation by photothermal materials is emerging as a promising way of renewable energy-driven clean water production. In designing photothermal materials, light absorption, photo-to-thermal conversion efficiency, and ability to localize thermal energy at the water-air interface are three important considerations. However, one additional consideration, regenerability, has so far slipped out of the photothermal material designs at status quo. This work reveals that there is a fouling layer formed during photothermal evaporation of real seawater (Red Sea water) and domestic wastewater, which once formed, would be difficult to remove. Herein, we synthesize a SiC-C composite monolith as an effective photothermal material where carbon acts as photothermal component and SiC serves as a heat conductor and strong structural support. The high mechanical strength of the monolithic composite makes it able to withstand repeatedly high strength physical cleaning by brush scrubbing and sonication and the anti-carbon-loss mechanism generates zero carbon loss during the physical cleaning. In the case of the domestic wastewater evaporation, the bio- and organic foulants on the SiC-C composite monolith can be totally removed by annealing at 1000 oC in N2 atmosphere. We believe that the SiC-C composite monoliths are promising photothermal materials in practical solar-driven water evaporation applications thanks to their highly stable and easily regenerable properties and therefore more research efforts are warranted to further improve their performances.

Job Satisfaction among Practicing School Psychologists: The Impact of SLD Identification

Science.gov (United States)

Cottrell, Joseph M.; Barrett, Courtenay A.

2016-01-01

Research has documented high levels of job satisfaction among school psychologists. Given that school psychologists spend much of their time in special education decision making and identifying students with specific learning disabilities (SLDs), it is important to understand how assessment practices relate to job satisfaction. This study surveyed…

Mining High-Dimensional Data

Science.gov (United States)

Wang, Wei; Yang, Jiong

With the rapid growth of computational biology and e-commerce applications, high-dimensional data becomes very common. Thus, mining high-dimensional data is an urgent problem of great practical importance. However, there are some unique challenges for mining data of high dimensions, including (1) the curse of dimensionality and more crucial (2) the meaningfulness of the similarity measure in the high dimension space. In this chapter, we present several state-of-art techniques for analyzing high-dimensional data, e.g., frequent pattern mining, clustering, and classification. We will discuss how these methods deal with the challenges of high dimensionality.

Technical attainment, practical success and practical knowledge: hermeneutical bases for child nursing care.

Science.gov (United States)

de Mello, Débora Falleiros; de Lima, Regina Aparecida Garcia

2009-01-01

This reflective study aimed to present some aspects of the concepts technical attainment, practical success and practical knowledge, with a view to a broader understanding of child nursing care. Health care is considered in the perspective of reconstructive practices, characterized as contingencies, highlighting the importance of the connection between technical attainment and practical success and the valuation of practical knowledge, based on philosophical hermeneutics, in the context of practical philosophy. Child health nursing can deal with technical attainment and practical success jointly, and also understand practical knowledge in the longitudinality of care. Health promotion, disease prevention, recovery and rehabilitation of child health should be indissociably associated with contextualized realities, shared between professionals and families, aiming to follow the child's growth and development, produce narratives, identify experiences, choices and decision making to broaden health care.

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

Science.gov (United States)

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

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

Identifying and Understanding Effective High School Practices

Science.gov (United States)

Rutledge, Stacey A.; Cannata, Marisa

2016-01-01

The authors report on a yearlong investigation into similar schools that performed well and less well in the same district. They found that the higher-performing schools engaged in an intentional set of systemic practices that encourage Personalization for Academic and Social Learning (PASL) in one district and integrated structures of academic…

The challenges and opportunities of translating best practice immunisation strategies among low performing general practices to reduce equity gaps in childhood immunisation coverage in New Zealand.

Science.gov (United States)

Turner, Nikki M; Charania, Nadia A; Chong, Angela; Stewart, Joanna; Taylor, Lynn

2017-01-01

Immunisation coverage rates vary considerably at the local level across New Zealand and challenges remain with effectively translating best available research evidence into public health practice. This study aimed to translate best practices from high performing general practices into strategies to improve childhood immunisation coverage among low performing practices. An intervention study was undertaken of general practices with low immunisation coverage rates and a high percentage of the enrolled population being of Māori ethnicity. Intervention groups received customised action plans and support for a 12 month period while control groups received 'business as usual' support. Structured interviews were conducted with key informants from all participating practices to understand current aspects related to childhood immunisation delivery and surveys were conducted to understand how the intervention worked. Collected data were thematically analysed. Ten sites were randomised to either intervention ( n  = 6) or control group ( n  = 4). Positive aspects of childhood immunisation delivery included high prioritisation at the practice and staff being pro-immunisation and knowledgeable. Key challenges experienced included inaccurate family contact information and discrepancies with referral processes to other providers. Other challenges noted were building rapport with families and vaccine hesitancy. The action plans included various strategies aimed to improve processes at the practice, contact and engagement with parents, and partnership development with local service providers. Creating customised action plans and providing support to providers were considered as helpful approaches when attempting to improve childhood immunisation coverage rates. Our study supports the notion that one strategy will not solely by itself improve childhood immunisation rates and highlights the importance of having a toolkit of strategies from which to draw from.

Parasites of importance for human health in Nigerian dogs: high prevalence and limited knowledge of pet owners.

Science.gov (United States)

Ugbomoiko, Uade Samuel; Ariza, Liana; Heukelbach, Jorg

2008-12-09

Dogs are the most common pet animals worldwide. They may harbour a wide range of parasites with zoonotic potential, thus causing a health risk to humans. In Nigeria, epidemiological knowledge on these parasites is limited. In a community-based study, we examined 396 dogs in urban and rural areas of Ilorin (Kwara State, Central Nigeria) for ectoparasites and intestinal helminths. In addition, a questionnaire regarding knowledge and practices was applied to pet owners. Nine ectoparasite species belonging to four taxa and six intestinal helminth species were identified: fleas (Ctenocephalides canis, Pulex irritans, Tunga penetrans), mites (Demodex canis, Otodectes sp., Sarcoptes scabiei var. canis), ticks (Rhipicephalus sanguineus, Ixodes sp.), and lice (Trichodectes canis); and Toxocara canis, Ancylostoma sp., Trichuris vulpis, Dipylidium caninum, Taenidae and Strongyloides sp. Overall prevalence of ectoparasites was 60.4% and of intestinal helminths 68.4%. The occurrence of C. canis, R. sanguineus, T. canis, Ancylostoma sp. and T. vulpis was most common (prevalence 14.4% to 41.7%). Prevalence patterns in helminths were age-dependent, with T. canis showing a decreasing prevalence with age of host, and a reverse trend in other parasite species. Knowledge regarding zoonoses was very limited and the diseases not considered a major health problem. Treatment with antiparasitic drugs was more frequent in urban areas. Parasites of importance for human health were highly prevalent in Nigerian dogs. Interventions should include health education provided to dog owners and the establishment of a program focusing on zoonotic diseases.

The Synergy of and Readiness for High-Impact Practices during the First Year of College

Science.gov (United States)

Hansen, Michele JoAnn; Schmidt, Lauren

2017-01-01

Students often participate in a myriad of academic support programs offered during the first year of college. This study is an investigation of the effects of participation in multiple high-impact educational practices on academic success outcomes (cumulative GPAs and persistence rates) among 2,028 first-year students. Results suggest that the…

Patient satisfaction is a best practice.

Science.gov (United States)

2009-10-01

There are several best practices ED physicians and nurses can adopt to minimize the likelihood of a lawsuit, but perhaps none is more important than ensuring high patient satisfaction scores. Research shows a definite correlation between increasing patient satisfaction and decreasing the medical malpractice frequency. Bad outcomes are more likely to lead to lawsuits if the patient doesn't like their doctor or nurse. Being attuned to patients and their perspective is one of the best ways to prevent complaints, which eventually can lead to lawsuits.

Effective communication skills in nursing practice.

Science.gov (United States)

Bramhall, Elaine

2014-12-09

This article highlights the importance of effective communication skills for nurses. It focuses on core communication skills, their definitions and the positive outcomes that result when applied to practice. Effective communication is central to the provision of compassionate, high-quality nursing care. The article aims to refresh and develop existing knowledge and understanding of effective communication skills. Nurses reading this article will be encouraged to develop a more conscious style of communicating with patients and carers, with the aim of improving health outcomes and patient satisfaction.

Theoretical perspectives for the Environmental Education in high school. Theory and practice

Directory of Open Access Journals (Sweden)

Liliana Haydé Gutiérrez Sabogal

2017-03-01

Full Text Available This article exposes the background and conclusions of an Environmental Education purpose —EE— supported by theoretical models able to frame processes of teaching and learning applied to EE in the high school. All of this come from strict revision and analysis of complemented educational didactics, through the professional teaching experience. To reveal this conceptual framework, the activities are posed and developed within the Environmental School Project —ESP— of the District Education Institute —DEI— Ignacio Pescador as a mode to put into practice the analyzed theory. Thus, the results obtained validate the referential framework proposed to produce knowledge about the instructive theory — which is aimed to professional teachers who will be added to the teaching process of EE into the high school institutes— and the process of knowledge creation in the student body.

High School Physics Students' Personal Epistemologies and School Science Practice

Science.gov (United States)

Alpaslan, Muhammet Mustafa; Yalvac, Bugrahan; Loving, Cathleen

2017-11-01

This case study explores students' physics-related personal epistemologies in school science practices. The school science practices of nine eleventh grade students in a physics class were audio-taped over 6 weeks. The students were also interviewed to find out their ideas on the nature of scientific knowledge after each activity. Analysis of transcripts yielded several epistemological resources that students activated in their school science practice. The findings show that there is inconsistency between students' definitions of scientific theories and their epistemological judgments. Analysis revealed that students used several epistemological resources to decide on the accuracy of their data including accuracy via following the right procedure and accuracy via what the others find. Traditional, formulation-based, physics instruction might have led students to activate naive epistemological resources that prevent them to participate in the practice of science in ways that are more meaningful. Implications for future studies are presented.

Are family practice trainers and their host practices any better? Comparing practice trainers and non-trainers and their practices.

Science.gov (United States)

van den Hombergh, Pieter; Schalk-Soekar, Saskia; Kramer, Anneke; Bottema, Ben; Campbell, Stephen; Braspenning, Jozé

2013-02-21

Family Physician (FP) trainees are expected to be provided with high quality training in well organized practice settings. This study examines differences between FP trainers and non-trainers and their practices to see whether there are differences in trainers and non-trainers and in how their practices are organized and their services are delivered. 203 practices (88 non-training and 115 training) with 512 FPs (335 non-trainers and 177 trainers) were assessed using the "Visit Instrument Practice organization (VIP)" on 369 items (142 FP-level; 227 Practice level). Analyses (ANOVA, ANCOVA) were conducted for each level by calculating differences between FP trainees and non-trainees and their host practices. Trainers scored higher on all but one of the items, and significantly higher on 47 items, of which 13 remained significant after correcting for covariates. Training practices scored higher on all items and significantly higher on 61 items, of which 23 remained significant after correcting for covariates. Trainers (and training practices) provided more diagnostic and therapeutic services, made better use of team skills and scored higher on practice organization, chronic care services and quality management than non-training practices. Trainers reported more job satisfaction and commitment and less job stress than non-trainers. There are positive differences between FP trainers and non-trainers in both the level and the quality of services provided by their host practices. Training institutions can use this information to promote the advantages of becoming a FP trainer and training practice as well as to improve the quality of training settings for FPs.

Changing Practice.

Science.gov (United States)

Benson, Chris, Ed.

1999-01-01

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

Child care hygiene practices of women migrating from rural to urban areas of bangladesh.

Science.gov (United States)

Begum, Housne Ara; Moneesha, Shanta Shyamolee; Sayem, Amir Mohammad

2013-07-01

Children's hygiene is very important for better health but there is a paucity of studies in this area. This questionnaire study examined the child care hygiene practices of mothers of young children. A total of 354 women from slum areas of Dhaka city, Bangladesh, who migrated from rural to urban areas were selected for this study. The mean score on hygiene practice was 6.21 of 10 items (SD = 2.113). Low (score = 3) and high hygiene practice (score = 7-10) were practiced by 12.4% and 45.8% of participants, respectively. Multivariate regression analysis indicated that independent variables explained 39.9% of variance in hygiene practices. Eight variables have significant effect: participant's education (0.108; P hygiene practice indicates the necessity of awareness building initiatives.

Data analysis in high energy physics. A practical guide to statistical methods

International Nuclear Information System (INIS)

Behnke, Olaf; Schoerner-Sadenius, Thomas; Kroeninger, Kevin; Schott, Gregory

2013-01-01

This practical guide covers the essential tasks in statistical data analysis encountered in high energy physics and provides comprehensive advice for typical questions and problems. The basic methods for inferring results from data are presented as well as tools for advanced tasks such as improving the signal-to-background ratio, correcting detector effects, determining systematics and many others. Concrete applications are discussed in analysis walkthroughs. Each chapter is supplemented by numerous examples and exercises and by a list of literature and relevant links. The book targets a broad readership at all career levels - from students to senior researchers.

Detection of previously undiagnosed cases of COPD in a high-risk population identified in general practice

DEFF Research Database (Denmark)

Løkke, Anders; Ulrik, Charlotte Suppli; Dahl, Ronald

2012-01-01

Background and Aim: Under-diagnosis of COPD is a widespread problem. This study aimed to identify previously undiagnosed cases of COPD in a high-risk population identified through general practice. Methods: Participating GPs (n = 241) recruited subjects with no previous diagnosis of lung disease,...

Practical impact of group communication theory

OpenAIRE

Schiper, A.

2003-01-01

Practical impact of group communication theory Andre Schiper Group communication is an important topic in fault-tolerant distributed applications. The paper summarizes the main contributions of practical importance that contributed to our current understanding of group communication. These contributions are classified into ''abstractions'' and ''specifications'', ''paradigms'', ''system models'', ''algorithms'', and ''theoretical results''. Some open issues are discussed at the end of the ...

CSR practices of Palestinian Islamic banks: contribution to socio-economic development

Directory of Open Access Journals (Sweden)

Abdalrahman Mohamed Migdad

2017-07-01

Full Text Available Purpose - Corporate social responsibility (CSR is an important corporate activity that affirms the importance of giving back to the community. This research aims to examine the CSR practices of Palestinian Islamic banks and their contribution to socio-economic development. There is an ongoing debate regarding Islamic financial institutions’ profit motive versus their motivation to achieve human welfare. The Palestinian Islamic banks are not disconnected from this debate, and this paper aims to discuss this issue. Design/methodology/approach - For the purpose of assessing the CSR practices of Palestinian Islamic banks, a secondary analysis of the banks’ annual reports was carried out. In addition, 11 structured interviews were conducted with Islamic banks’ practitioners at the decision-making level and with some of the banks’ Sharīʿah board members to gather their views on CSR. These have been analyzed in light of the actual CSR practices disclosed in each bank’s annual reports. Findings - The main research findings suggest that the CSR practice is highly valued by the Palestinian Islamic banks, but it is small and has marginal effects on the community’s socio-economic development. Another important observation from report analysis is that Islamic banks have great potential for expansion, given that the demand for Islamic financial transactions is double of what Islamic banks currently offer. If Islamic banks live up to that opportunity, they could deliver more in CSR practices, which is their ultimate goal according to the majority of the interviewees. Originality/value - Existing literature has presented findings on the CSR of Palestinian corporations in general, but there is no available literature on the CSR practices of Palestinian Islamic banks. This research attempts to fill in the gap by presenting preliminary findings on Palestinian Islamic banks’ CSR practices.

The importance of traditional fire use and management practices for contemporary land managers in the American Southwest

Science.gov (United States)

Carol Raish; Armando Gonzalez-Caban; Carol J. Condie

2005-01-01

Indigenous and traditional peoples worldwide have used fire to manipulate their environment for thousands of years. These longstanding practices still continue and have considerable relevance for today’s land managers. This discussion explores the value of documenting and understanding historic and contemporary fire use attitudes and practices of the varied cultural/...

Does a Nutrition Education Programme Change the Knowledge and Practice of Healthy Diets among High School Adolescents in Chennai, India?

Science.gov (United States)

Rani, M. Anitha; Shriraam, Vanishree; Zachariah, Rony; Harries, Anthony D.; Satyanarayana, Srinath; Tetali, Shailaja; Anchala, Raghupathy; Muthukumar, Diviya; Sathiyasekaran, B. W. C.

2013-01-01

Background: Nutrition education is used as a way of promoting lifelong healthy eating practices among school adolescents. There is limited published information on the impact of nutrition education programmes in India. Objectives: To assess the knowledge and practices of high school students with respect to healthy diets before and after a…

The Quechua manta pouch: a caretaking practice for buffering the Peruvian infant against the multiple stressors of high altitude.

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Tronick, E Z; Thomas, R B; Daltabuit, M

1994-08-01

The manta pouch--a caretaking practice of tightly swaddling and enclosing the infant in a set of cloths and blankets--and other caretaking practices are described for high-altitude resident (> 4,000 m) Quechua mother-infant pairs (N = 14). The manta pouch modifies the microenvironment inside the pouch so that, compared to the ambient environment, the temperature is higher and more stable, the humidity is higher, the partial pressure of O2 is lower, and stimulation levels are reduced. As the infant gets older, the characteristics of the pouch are modified such that the infant is increasingly exposed to ambient conditions. These caretaking practices may benefit the infant by buffering the infant from the multiple ecological stressors of high altitude, but they may also incur costs by exposing the infant to additional microenvironmental stressors (e.g., higher CO2 levels) and by reducing stimulation and limiting infant movement.

Development of Australian clinical practice outcome standards for graduates of critical care nurse education.

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Gill, Fenella J; Leslie, Gavin D; Grech, Carol; Boldy, Duncan; Latour, Jos M

2015-02-01

To develop critical care nurse education practice standards. Critical care specialist education for registered nurses in Australia is provided at graduate level. Considerable variation exists across courses with no framework to guide practice outcomes or evidence supporting the level of qualification. An eDelphi technique involved the iterative process of a national expert panel responding to three survey rounds. For the first round, 84 statements, organised within six domains, were developed from earlier phases of the study that included a literature review, analysis of critical care courses and input from health consumers. The panel, which represented the perspectives of four stakeholder groups, responded to two rating scales: level of importance and level of practice. Of 105 experts who agreed to participate, 92 (88%) completed survey round I; 85 (92%) round II; and 73 (86%) round III. Of the 98 statements, 75 were rated as having a high level of importance - median 7 (IQR 6-7); 14 were rated as having a moderate level of importance - median 6 (IQR 5-7); and nine were rated as having a low level of importance - median 4 (IQR 4-6)-6 (IQR 4-6). The majority of the panel rated graduate level of practice as 'demonstrates independently' or 'teaches or supervises others' for 80 statements. For 18 statements, there was no category selected by 50% or more of the panel. The process resulted in the development of 98 practice standards, categorised into three levels, indicating a practice outcome level by the practitioner who can independently provide nursing care for a variety of critically ill patients in most contexts, using a patient- and family-focused approach. The graduate practice outcomes provide a critical care qualification definition for nursing workforce standards and can be used by course providers to achieve consistent practice outcomes. © 2014 John Wiley & Sons Ltd.

16 CFR 1205.36 - Product certification and labeling by importers.

Science.gov (United States)

2010-01-01

... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Product certification and labeling by importers. 1205.36 Section 1205.36 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS SAFETY STANDARD FOR WALK-BEHIND POWER LAWN MOWERS Certification § 1205.36 Product...

High-stakes conflicts and the link between theory and practice : celebrating the work of Ellen Giebels

NARCIS (Netherlands)

Oostinga, Miriam S.D.; Rispens, Sonja; Taylor, Paul J.; Ufkes, Elze G.

2018-01-01

In this tribute to the 2012 recipient of the IACM's Jeffrey Rubin's Theory-to-Practice Award, we celebrate the work of Ellen Giebels. We highlight her groundbreaking research on influence tactics in crisis negotiations and other high-stakes conflict situations, showing how her focus on theoretical

High-Stakes Conflicts and the Link between Theory and Practice : Celebrating the Work of Ellen Giebels

NARCIS (Netherlands)

Oostinga, Miriam S.D.; Rispens, Sonja; Taylor, Paul J.; Ufkes, Elze G.

2018-01-01

In this tribute to the 2012 recipient of the IACM's Jeffrey Rubin's Theory-to-Practice Award, we celebrate the work of Ellen Giebels. We highlight her groundbreaking research on influence tactics in crisis negotiations and other high-stakes conflict situations, showing how her focus on theoretical

High-Functioning Autism/Asperger Syndrome in Schools: Assessment and Intervention. Practical Intervention in the Schools Series

Science.gov (United States)

Sansosti, Frank J.; Powell-Smith, Kelly A.; Cowan, Richard J.

2010-01-01

Meeting a growing need for school-based practitioners, this book provides vital tools for improving the academic, behavioral, and social outcomes of students with high-functioning autism or Asperger syndrome (HFA/AS). Research-based best practices are presented for conducting meaningful assessments; collaborating with teachers, students, and…

The Effective Practices and Beliefs of School Principals in High Achieving Hispanic Majority Mid-Level Schools

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Briseno, Johnny

2010-01-01

This qualitative phenomenological research study used narrative inquiry to investigate the effective practices and beliefs of 10 Texas principals in high achieving majority Hispanic mid-level schools. Participant interviews were analyzed using the Creswell (2007) six step method for analyzing phenomenological studies. Findings from this study…

Is the bulk mode conversion important in high density helicon plasma?

Energy Technology Data Exchange (ETDEWEB)

Isayama, Shogo; Hada, Tohru [Interdisciplinary Graduate School of Engineering Sciences, Kyushu University, 6-1 Kasuga-Kohen, Kasuga, Fukuoka 816-8580 (Japan); Shinohara, Shunjiro [Institute of Engineering, Tokyo University of Agriculture and Technology, 2-24-16, Naka-cho, Koganei, Tokyo 184-8588 (Japan); Tanikawa, Takao [Research Institute of Science and Technology, Tokai University 4-1-1 Kitakaname, Hiratsuka, Kanagawa 259-1292 (Japan)

2016-06-15

In a high-density helicon plasma production process, a contribution of Trivelpiece-Gould (TG) wave for surface power deposition is widely accepted. The TG wave can be excited either due to an abrupt density gradient near the plasma edge (surface conversion) or due to linear mode conversion from the helicon wave in a density gradient in the bulk region (bulk mode conversion). By numerically solving the boundary value problem of linear coupling between the helicon and the TG waves in a background with density gradient, we show that the efficiency of the bulk mode conversion strongly depends on the dissipation included in the plasma, and the bulk mode conversion is important when the dissipation is small. Also, by performing FDTD simulation, we show the time evolution of energy flux associated with the helicon and the TG waves.

Star formation at high redshift and the importance of dust obscuration

DEFF Research Database (Denmark)

Michalowski, Michal

One of the aspects of the understanding of the Universe evolution is its star formation history. In order to gain a complete picture of the Universe evolution it is important to know when the stars we see today were formed. One of the method to study this problem is to use far-infrared and radio...... emission of galaxies. In this way it is possible to investigate the sites of star formation that are totally obscured by dust and therefore invisible at the optical wavelengths. It is because the energy absorbed by dust in the optical is re-emitted in the infrared, whereas radio emission is unaffected...... and/or radio, namely their enhanced submillimeter / radio emission combined with optical faintness and blue colors. I find that these four galaxies are young, highly star-forming, low-mass and dusty....

Self-handicapping status, claimed self-handicaps and reduced practice effort following success and failure feedback.

Science.gov (United States)

Thompson, T; Richardson, A

2001-03-01

Self-handicapping involves the strategic establishment of an impediment or obstacle to success prior to a performance situation which thereby provides a convenient excuse for poor performance. The study sought to establish that relative to low trait self-handicappers, high trait self-handicappers exposed to failure in an intellectually evaluative situation will (a) pre-emptively claim more handicaps, and (b) behaviourally self-handicap through reduced practice effort, and (c) report greater anxiety and negative affect relative to low trait self-handicappers. Participants were 72 undergraduate students, divided equally between high and low self-handicapping groups. This study utilised a 2 (self-handicapping status: high, low) x 3 (performance feedback: fail, low task importance; fail, high task importance; success) between-subjects factorial design to investigate claimed and behavioural self-handicapping through reduced practice effort. This was done by manipulating performance outcome and perceived task importance. Relative to low trait self-handicappers, high trait high self-handicappers claimed more handicaps and engaged in greater behavioural self-handicapping following failure when working on tasks that were described as potentially diagnostic of low ability. While low self-handicappers internalised their success more than their failure in the high task importance condition, high self-handicappers were undifferentiated in their attributions across performance conditions. Greater anxiety and greater negative affect were also characteristic of high self-handicappers. The study highlights the self-protective benefit of self-handicapping in sparing the individual from conclusions of low ability, and the failure of high self-handicappers to fully internalise their success. These elements and the role of uncertain estimates of ability are discussed in considering implications for intervention.

Reference Management Practices of Postgraduate Students and Academic Researchers are Highly Individualized

Directory of Open Access Journals (Sweden)

Kimberly Miller

2016-09-01

Full Text Available A Review of: Melles, A., & Unsworth, K. (2015. Examining the reference management practices of humanities and social science postgraduate students and academics. Australian Academic & Research Libraries, 46(4, 250-276. http://dx.doi.org/10.1080/00048623.2015.1104790 Objective – To understand patterns in reference management practices of postgraduate students and faculty members at one institution. Design – Mixed methods online survey and semi-structured interviews. Setting – Public research university in Australia. Subjects – The survey included responses from 81 postgraduate students. Semi-structured interviews were conducted with 8 postgraduate students and 13 faculty members. Methods – The researchers distributed an 18-item survey via email to approximately 800 people who previously registered for EndNote training sessions. Survey participants were also recruited via a website advertisement. The researchers recruited postgraduate student interview participants from the list of survey respondents. Librarians invited faculty members to participate in the semi-structured interviews. Interview audio recordings were transcribed and coded for data analysis. Main Results – The survey found that 71.4% (n=55 of respondents used reference management software (RMS and 29% (n=22 did not. Over half of the students who did not use an RMS described other ad hoc or “manual” (p. 255 methods for organizing and tracking references. The majority of participants reported using EndNote (67.53%, n=52, while few respondents reported using other RMS tools like Zotero (1.3%, n=1 or Mendeley (1.3%, n = 1. Software awareness (49.32%, n=36, recommendations from faculty members (30.14%, n=22, and University support (47.95%, n=35 were the primary motivations for choosing a specific RMS. Other important factors included ease of use (32.88%, n=24 and integration with Microsoft Word (46.58%, n=34. Students preferred RMS features that support the process of

High sodium intake is associated with important risk factors in a large cohort of chronic kidney disease patients.

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Nerbass, F B; Pecoits-Filho, R; McIntyre, N J; McIntyre, C W; Taal, M W

2015-07-01

An increased risk of mortality and cardiovascular disease (CVD) is observed in people with chronic kidney disease (CKD) even in early stages. Dietary sodium intake has been associated with important CVD and CKD progression risk factors such as hypertension and proteinuria in this population. We aimed to investigate the relationship between sodium intake and CVD or CKD progression risk factors in a large cohort of patients with CKD stage 3 recruited from primary care. A total of 1733 patients with previous estimated glomerular filtration rate (eGFR) of 30-59 ml/min/1.73m(2), with a mean age 72.9±9.0 years, were recruited from 32 general practices in primary care in England. Medical history was obtained and participants underwent clinical assessment, urine and serum biochemistry testing. Sodium intake was estimated from three early-morning urine specimens using an equation validated for this study population. Sixty percent of participants who had estimated sodium intake above recommendation (>100 mmol/day or 6 g salt/day) also had higher diastolic blood pressure, mean arterial pressure (MAP), urinary albumin-to-creatinine ratio, high-sensitive C-reactive protein and uric acid and used a greater number of anti-hypertensive drugs. In multivariable regression analysis, excessive sodium intake was an independent predictor of MAP (B=1.57, 95% confidence interval (CI) 0.41-2.72; P=0.008) and albuminuria (B=1.35, 95% CI 1.02-1.79; P=0.03). High sodium intake was associated with CVD and CKD progression risk factors in patients with predominantly early stages of CKD followed up in primary care. This suggests that dietary sodium intake could afffect CVD risk even in early or mild CKD. Intervention studies are warranted to investigate the potential benefit of dietary advice to reduce sodium intake in this population.

Can practical ALARA be taught?

International Nuclear Information System (INIS)

Guest, R. Monty

2008-01-01

Full text: Purpose: Outside of the nuclear industry, many users of sources of ionising radiation may be characterised as 'High Frequency/Low Dose' users. It is argued here that they have special training requirements in order to understand the ICRP concept ALARA, indeed all the fundamental concepts of radiological protection and their relevance to the workplace. It is not practicable to practise dose avoidance in many situations so dose reduction becomes even more important. For example, laboratory life sciences researchers often have to use very small quantities and activities of beta emitting radioisotopes which give small or minuscule external doses to well trained workers but can give extremely serious high doses if mishandled Similarly, dentists routinely use 60- 100 kV X-ray generators to diagnose abnormalities and disease which other techniques would fail to detect. By practising simple and effective dose reduction methods, they can reduce the dose to themselves and their patients to arguably trivial levels. Method: The paper will use examples from Radiation Protection Supervisors courses run over the past 6 years for UK pharmaceutical companies and research into courses for general dental practitioners run over the past 8 years in East Anglia, England. The latter courses must meet the requirements laid down in the Ionising Radiation (Medical Exposure) Regulations 2000 and the requirements of the professional dental association, the British Dental Council, and the continuing professional development requirements of the dental registration body, the General Dental Council. Major Findings and Conclusions: The research findings show an urgent need to train dental practitioners in the concepts and practical aspects of dose avoidance and dose minimisation, social and economic factors being considered. Pharmaceutical company research Radiation Protection Supervisors are generally well trained but also need to know the practical implications of the ALARA principle

Importance of mitochondrial calcium uniporter in high glucose-induced endothelial cell dysfunction.

Science.gov (United States)

Chen, Wei; Yang, Jie; Chen, Shuhua; Xiang, Hong; Liu, Hengdao; Lin, Dan; Zhao, Shaoli; Peng, Hui; Chen, Pan; Chen, Alex F; Lu, Hongwei

2017-11-01

Mitochondrial Ca 2+ overload is implicated in hyperglycaemia-induced endothelial cell dysfunction, but the key molecular events responsible remain unclear. We examined the involvement of mitochondrial calcium uniporter, which mediates mitochondrial Ca 2+ uptake, in endothelial cell dysfunction resulting from high-glucose treatment. Human umbilical vein endothelial cells were exposed to various glucose concentrations and to high glucose (30 mM) following mitochondrial calcium uniporter inhibition or activation with ruthenium red and spermine, respectively. Subsequently, mitochondrial calcium uniporter and mitochondrial calcium uniporter regulator 1 messenger RNA and protein expression was measured by real-time polymerase chain reaction and western blotting. Ca 2+ concentrations were analysed by laser confocal microscopy, and cytoplasmic and mitochondrial oxidative stress was detected using 2',7'-dichlorofluorescein diacetate and MitoSOX Red, respectively. Apoptosis was assessed by annexin V-fluorescein isothiocyanate/propidium iodide staining, and a wound-healing assay was performed using an in vitro model. High glucose markedly upregulated mitochondrial calcium uniporter and mitochondrial calcium uniporter regulator 1 messenger RNA expression, as well as protein production, in a dose- and time-dependent manner with a maximum effect demonstrated at 72 h and 30 mM glucose concentration. Moreover, high-glucose treatment significantly raised both mitochondrial and cytoplasmic Ca 2+ and reactive oxygen species levels, increased apoptosis and compromised wound healing (all p calcium uniporter, respectively. Mitochondrial calcium uniporter plays an important role in hyperglycaemia-induced endothelial cell dysfunction and may constitute a therapeutic target to reduce vascular complications in diabetes.

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

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

2017-04-26

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

Target Inquiry: Changing Chemistry High School Teachers' Classroom Practices and Knowledge and Beliefs about Inquiry Instruction

Science.gov (United States)

Herrington, Deborah G.; Yezierski, Ellen J.; Luxford, Karen M.; Luxford, Cynthia J.

2011-01-01

Inquiry-based instruction requires a deep, conceptual understanding of the process of science combined with a sophisticated knowledge of teaching and learning. This study examines the changes in classroom instructional practices and corresponding changes to knowledge and beliefs about inquiry instruction for eight high school chemistry teachers.…

The development of professional practice standards for Australian general practice nurses.

Science.gov (United States)

Halcomb, Elizabeth; Stephens, Moira; Bryce, Julianne; Foley, Elizabeth; Ashley, Christine

2017-08-01

The aim of this study was to explore the current role of general practice nurses and the scope of nursing practice to inform the development of national professional practice standards for Australian general practice nurses. Increasing numbers of nurses have been employed in Australian general practice to meet the growing demand for primary care services. This has brought significant changes to the nursing role. Competency standards for nurses working in general practice were first developed in Australia in 2005, but limited attention has been placed on articulating the contemporary scope of practice for nurses in this setting. Concurrent mixed methods design. Data collection was conducted during 2013-2014 and involved two online surveys of Registered and Enrolled Nurses currently working in general practice, a series of 14 focus groups across Australia and a series of consultations with key experts. Data collection enabled the development of 22 Practice Standards separated into four domains: (i) Professional Practice; (ii) Nursing Care; (iii) General Practice Environment and (iv) Collaborative Practice. To differentiate the variations in enacting these Standards, performance indicators for the Enrolled Nurse, Registered Nurse and Registered Nurse Advanced Practice are provided under each Standard. The development of national professional practice standards for nurses working in Australian general practice will support ongoing workforce development. These Standards are also an important means of articulating the role and scope of the nurses' practice for both consumers and other health professionals, as well as being a guide for curriculum development and measurement of performance. © 2017 John Wiley & Sons Ltd.

Positive Correlation Between Academic Library Services and High-Impact Practices for

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Saori Wendy Herman, MLIS, AHIP

2016-03-01

Full Text Available Objective – To investigate the perceived alignment between academic library services and high-impact practices (HIPs that affect student retention. Design – Survey questionnaire. Setting – Public comprehensive universities in the United States of America with a Carnegie classification of master’s level as of January 2013. Subjects – 68 library deans or directors out of the 271 who were originally contacted. Methods – The author used Qualtrics software to create a survey based on the HIPs, tested the survey for reliability, and then distributed it to 271 universities. Library services were grouped into 1 of 3 library scales: library collection, library instruction, or library facilities. The survey consisted of a matrix of 10 Likert-style questions addressing the perceived level of alignment between the library scales and the HIPs. Each question provided an opportunity for the respondent to enter a “brief description of support practices” (p 477. Additional demographic questions addressed the years of experience of the respondent, undergraduate student enrollment of the university, and whether librarians held faculty rank. Main Results – The author measured Pearson correlation coefficients and found a positive correlation between the library scales and the HIPs. All three library scales displayed a moderately strong positive correlation between first-year seminars and experiences (HIP 1, common intellectual experiences (HIP 2, writing-intensive courses (HIP 4, undergraduate research (HIP 6, diversity and global learning (HIP 7, service learning and community-based learning (HIP 8, internships (HIP 9, and capstone courses and projects (HIP 10. The library collections scale and library facilities scale displayed a moderately strong correlation with learning communities (HIP 3 and collaborative assignments and projects (HIP 5. The library instruction scale displayed a strong positive correlation with HIP 3 and a very strong

Practical approach for the study of metabolic regulation

Directory of Open Access Journals (Sweden)

D.V. Macedo

2004-05-01

Full Text Available First year students in Physical Education must understand metabolic regulation to comprehend thewhole integration of biochemical pathways in attempt to establish the relation with exercise. Thiswhole view is not easy to learn and the task becomes even harder with the lack of time at theend of course, when normally the students think about metabolic integration. Trying to get thestudents attention to this important issue, we developed practical works beginning in the middle ofthe course, in parallel with theory classes. Blood and urine were collected for metabolite analysis ineach practice. The students were divided in groups (10 students and they created the protocols in formthat they only have been guided and directed by the teacher and monitors. The practical activitiesand biochemical analysis were: six 30m sprints with dierent recovery times (blood lactate and meanvelocities, lactate removal from muscle to blood after high intensity exercise (blood lactate, anaerobicthreshold (blood lactate and heart rate, the eect of glycogen depletion after high and moderateintensity exercises (plasma glucose and urea concentrations and low carbohydrate diet vs. normaldiet (plasma glucose and urine ketone bodies. After data collection, discussion and interpretation, thestudents presented orally each work in the same order above. Each presentation had the focus on themetabolic pathways involved in each practice. Group 1: phosphocreatine utilization and resynthesis.Group 2: anaerobic glycolysis, lactate production and removal. Group 3: transition between anaerobicglycolysis and oxidative metabolism. In attempt to promote the integration between muscle and liver-Group 4: protein catabolism after high intensity exercise with low muscular glycogen concentration(transamination, Cori Cycle and gluconeogenesis. Group 5: liver ketogenesis in low carbohydratediet. This sequence was intended to promote the comprehension of integrated metabolism. As a nalactivity, the

Practical ultrasonic transducers for high-temperature applications using bismuth titanate and Ceramabind 830

Science.gov (United States)

Xu, Janet L.; Batista, Caio F. G.; Tittmann, Bernhard R.

2018-04-01

Structural health monitoring of large valve bodies in high-temperature environments such as power plants faces several limitations: commercial transducers are not rated for such high temperatures, gel couplants will evaporate, and measurements cannot be made in-situ. To solve this, we have furthered the work of Ledford in applying a practical transducer in liquid form which hardens and air dries directly onto the substrate. The transducer material is a piezoceramic film composed of bismuth titanate and a high-temperature binding agent, Ceramabind 830. The effects of several fabrication conditions were studied to optimize transducer performance and ensure repeatability. These fabrication conditions include humidity, binder ratio, water ratio, substrate roughness, and film thickness. The final product is stable for both reactive and non-reactive substrates, has a quick fabrication time, and has an operating temperature up to the Curie temperature of BIT, 650°C, well beyond the safe operating temperature of PZT (150°C).

Noise exposure and hearing conservation practices in an industry with high incidence of workers' compensation claims for hearing loss.

Science.gov (United States)

Daniell, William E; Swan, Susan S; McDaniel, Mary M; Stebbins, John G; Seixas, Noah S; Morgan, Michael S

2002-10-01

Washington State has experienced a striking increase in workers' compensation claims for hearing loss. This cross-sectional study examined noise exposures and hearing conservation practices in one industry with a high rate of hearing loss claims. We evaluated 10 representative foundries with personal noise dosimetry, management interviews, employee interviews, and existing audiometry. Noise levels routinely exceeded 85 dBA. All companies were out of compliance with hearing conservation regulations. Most employees with important findings on audiograms were not aware of their findings. There was a significant positive correlation between management-interview scores and worksite-average employee-interview scores (r = 0.70, P = 0.02). Companies where more effort is put into hearing conservation program activities can achieve a greater positive impact on employee awareness. However, there were broad deficiencies even in the better programs in this sample, suggesting that workers in this industry probably face a continuing substantial risk of occupational hearing loss. Copyright 2002 Wiley-Liss, Inc.

Effect of task-oriented training and high-variability practice on gross motor performance and activities of daily living in children with spastic diplegia.

Science.gov (United States)

Kwon, Hae-Yeon; Ahn, So-Yoon

2016-10-01

[Purpose] This study investigates how a task-oriented training and high-variability practice program can affect the gross motor performance and activities of daily living for children with spastic diplegia and provides an effective and reliable clinical database for future improvement of motor performances skills. [Subjects and Methods] This study randomly assigned seven children with spastic diplegia to each intervention group including that of a control group, task-oriented training group, and a high-variability practice group. The control group only received neurodevelopmental treatment for 40 minutes, while the other two intervention groups additionally implemented a task-oriented training and high-variability practice program for 8 weeks (twice a week, 60 min per session). To compare intra and inter-relationships of the three intervention groups, this study measured gross motor performance measure (GMPM) and functional independence measure for children (WeeFIM) before and after 8 weeks of training. [Results] There were statistically significant differences in the amount of change before and after the training among the three intervention groups for the gross motor performance measure and functional independence measure. [Conclusion] Applying high-variability practice in a task-oriented training course may be considered an efficient intervention method to improve motor performance skills that can tune to movement necessary for daily livelihood through motor experience and learning of new skills as well as change of tasks learned in a complex environment or similar situations to high-variability practice.

Practices and Processes of Leading High Performance Home Builders in the Upper Midwest

Energy Technology Data Exchange (ETDEWEB)

Von Thoma, E.; Ojczyk, C.

2012-12-01

The NorthernSTAR Building America Partnership team proposed this study to gain insight into the business, sales, and construction processes of successful high performance builders. The knowledge gained by understanding the high performance strategies used by individual builders, as well as the process each followed to move from traditional builder to high performance builder, will be beneficial in proposing more in-depth research to yield specific action items to assist the industry at large transform to high performance new home construction. This investigation identified the best practices of three successful high performance builders in the upper Midwest. In-depth field analysis of the performance levels of their homes, their business models, and their strategies for market acceptance were explored. All three builders commonly seek ENERGY STAR certification on their homes and implement strategies that would allow them to meet the requirements for the Building America Builders Challenge program. Their desire for continuous improvement, willingness to seek outside assistance, and ambition to be leaders in their field are common themes. Problem solving to overcome challenges was accepted as part of doing business. It was concluded that crossing the gap from code-based building to high performance based building was a natural evolution for these leading builders.

Parasites of importance for human health in Nigerian dogs: high prevalence and limited knowledge of pet owners

Directory of Open Access Journals (Sweden)

Heukelbach Jorg

2008-12-01

Full Text Available Abstract Background Dogs are the most common pet animals worldwide. They may harbour a wide range of parasites with zoonotic potential, thus causing a health risk to humans. In Nigeria, epidemiological knowledge on these parasites is limited. Methods In a community-based study, we examined 396 dogs in urban and rural areas of Ilorin (Kwara State, Central Nigeria for ectoparasites and intestinal helminths. In addition, a questionnaire regarding knowledge and practices was applied to pet owners. Results Nine ectoparasite species belonging to four taxa and six intestinal helminth species were identified: fleas (Ctenocephalides canis, Pulex irritans, Tunga penetrans, mites (Demodex canis, Otodectes sp., Sarcoptes scabiei var. canis, ticks (Rhipicephalus sanguineus, Ixodes sp., and lice (Trichodectes canis; and Toxocara canis, Ancylostoma sp., Trichuris vulpis, Dipylidium caninum, Taenidae and Strongyloides sp. Overall prevalence of ectoparasites was 60.4% and of intestinal helminths 68.4%. The occurrence of C. canis, R. sanguineus, T. canis, Ancylostoma sp. and T. vulpis was most common (prevalence 14.4% to 41.7%. Prevalence patterns in helminths were age-dependent, with T. canis showing a decreasing prevalence with age of host, and a reverse trend in other parasite species. Knowledge regarding zoonoses was very limited and the diseases not considered a major health problem. Treatment with antiparasitic drugs was more frequent in urban areas. Conclusion Parasites of importance for human health were highly prevalent in Nigerian dogs. Interventions should include health education provided to dog owners and the establishment of a program focusing on zoonotic diseases.

Theory and Practice - Measuring High-Pressure Electronic and Magnetic Properties

International Nuclear Information System (INIS)

Hemley, R.J.; Struzhkin, V.V.; Cohen, R.E.

2008-01-01

Measurements of the electronic and magnetic properties of Earth and planetary materials at high pressure play a crucial role in modern geoscience. There have been numerous advances in the field, primarily as a result of developments in diamond-anvil cell methods. In particular, synchrotron radiation techniques play an especially important role. The chapter begins with a short review of fundamental properties of the relevant materials, with emphasis on how these are altered under very high pressures and temperatures of the Earth's deep interior, followed by a discussion of different classes of electronic and magnetic excitations. Various techniques currently used for high-pressure studies are then described, beginning with optical spectroscopies, Moessbauer spectroscopy, elastic X-ray and neutron scattering, many new X-ray spectroscopy and inelastic scattering methods, transport techniques, and finally resonance methods. Selected examples of the techniques are given, with a common theme being the high P-T behavior of iron-containing oxides, silicates, and metals at conditions found throughout the Earth's interior. Applications to upper-mantle phases, 'simple' oxides, silicate perovskite and post-perovskite, volatiles, and iron and iron alloys are discussed, with an emphasis given to integrated studies utilizing a combination of different techniques to understand high P-T electronic and magnetic phenomena.

The importance of professional skills alongside scientific and technical excellence to underpin ethical geoscience practice

Science.gov (United States)

Allington, Ruth; Fernandez-Fuentes, Isabel

2013-04-01

There is consensus that reliable ground models, based on a sound understanding of the geology and surface processes are vital as a basis for natural hazard identification and risk assessment, and there is a great deal of skill and experience in the geoscience community with mapping, modelling and predicting natural hazards and their likely impacts. This presentation will highlight the contributions of geology and geomorphology in the identification of natural hazards and mitigation of their impacts. It will then consider a range of "professional skills" that are needed by geoscientists working with other specialists and non-specialists (e.g. engineers, emergency services, land-use planners, architects responsible for building codes, politicians, regulators, the public etc) alongside technical and scientific excellence. It will argue that development and application of both scientific/technical and professional skills is essential to ensure that the maps, models and other data relevant to natural hazards and environmental change are used to provide effective public protection through communication, land-use planning and planning for resilience. The professional skills of particular importance include interdisciplinary collaboration; project management; cost-benefit analysis; effective communication with specialists and non specialists (especially the public); and facilitative skills. All the technical, scientific and professional skills need to be applied competently and with the highest standards of ethical underpinning. The contribution will consider how this can be achieved (or at least facilitated) through professional training, award of professional titles, licensure etc, drawing on international examples of best practice in professional codes of conduct and regulation directed to the protection of the public.

Developing a practice guideline for the occupational health services by using a community of practice approach: a process evaluation of the development process

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Lydia Kwak

2017-01-01

Full Text Available Abstract Background One way to facilitate the translation of research into the occupational health service practice is through clinical practice guidelines. To increase the implementability of guidelines it is important to include the end-users in the development, for example by a community of practice approach. This paper describes the development of an occupational health practice guideline aimed at the management of non-specific low back pain (LBP by using a community of practice approach. The paper also includes a process evaluation of the development providing insight into the feasibility of the process. Methods A multidisciplinary community of practice group (n = 16 consisting of occupational nurses, occupational physicians, ergonomists/physical therapists, health and safety engineers, health educators, psychologists and researchers from different types of occupational health services and geographical regions within Sweden met eleven times (June 2012–December 2013 to develop the practice guideline following recommendations of guideline development handbooks. Process-outcomes recruitment, reach, context, satisfaction, feasibility and fidelity were assessed by questionnaire, observations and administrative data. Results Group members attended on average 7.5 out of 11 meetings. Half experienced support from their workplace for their involvement. Feasibility was rated as good, except for time-scheduling. Most group members were satisfied with the structure of the process (e.g. presentations, multidisciplinary group. Fidelity was rated as fairly high. Conclusions The described development process is a feasible process for guideline development. For future guideline development expectations of the work involved should be more clearly communicated, as well as the purpose and tasks of the CoP-group. Moreover, possibilities to improve support from managers and colleagues should be explored. This paper has important implications for future

A highly redundant BAC library of Atlantic salmon (Salmo salar: an important tool for salmon projects

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Koop Ben F

2005-04-01

Full Text Available Abstract Background As farming of Atlantic salmon is growing as an aquaculture enterprise, the need to identify the genomic mechanisms for specific traits is becoming more important in breeding and management of the animal. Traits of importance might be related to growth, disease resistance, food conversion efficiency, color or taste. To identify genomic regions responsible for specific traits, genomic large insert libraries have previously proven to be of crucial importance. These large insert libraries can be screened using gene or genetic markers in order to identify and map regions of interest. Furthermore, large-scale mapping can utilize highly redundant libraries in genome projects, and hence provide valuable data on the genome structure. Results Here we report the construction and characterization of a highly redundant bacterial artificial chromosome (BAC library constructed from a Norwegian aquaculture strain male of Atlantic salmon (Salmo salar. The library consists of a total number of 305 557 clones, in which approximately 299 000 are recombinants. The average insert size of the library is 188 kbp, representing 18-fold genome coverage. High-density filters each consisting of 18 432 clones spotted in duplicates have been produced for hybridization screening, and are publicly available 1. To characterize the library, 15 expressed sequence tags (ESTs derived overgos and 12 oligo sequences derived from microsatellite markers were used in hybridization screening of the complete BAC library. Secondary hybridizations with individual probes were performed for the clones detected. The BACs positive for the EST probes were fingerprinted and mapped into contigs, yielding an average of 3 contigs for each probe. Clones identified using genomic probes were PCR verified using microsatellite specific primers. Conclusion Identification of genes and genomic regions of interest is greatly aided by the availability of the CHORI-214 Atlantic salmon BAC

Teachers' Views about Multiple Strategies in Middle and High School Mathematics

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Lynch, Kathleen; Star, Jon R.

2014-01-01

Despite extensive scholarship about the importance of teaching mathematics with multiple strategies in the elementary grades, there has been relatively little discussion of this practice in the middle and high school levels or in the context of introductory algebra. This article begins our exploration of this practice by addressing the following…

The minimally important difference for the health assessment questionnaire in rheumatoid arthritis clinical practice is smaller than in randomized controlled trials.

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Pope, Janet E; Khanna, Dinesh; Norrie, Deborah; Ouimet, Janine M

2009-02-01

Patient-reported outcomes are used in clinical practice and trials. We studied a large clinical practice to determine the minimally important difference (MID) estimates for (1) the Health Assessment Questionnaire-Damage Index (HAQ-DI): improvement and worsening using patient global assessment anchor; and (2) pain using a patient-reported pain anchor. Patients with rheumatoid arthritis (RA; N = 225) had clinic visits at 2 timepoints within 1 year, completed the HAQ-DI and pain visual analog scale (VAS; 0-100 mm), and answered the question, "How would you describe your overall status/overall pain since the last visit?", as much worsened, somewhat worsened, the same, somewhat improved, or much improved. If rated as somewhat improved or worsened, they were defined as the minimally changed subgroups. Eighty-three percent were women, mean age 60 years, with disease duration 11.7 +/- 10.7 years. The baseline HAQ-DI was 0.97 +/- SD 0.76, and at followup 1.0 +/- 0.77 (mean change +0.03 +/- 0.40). The baseline pain VAS was 42.3 +/- 28.8, and at followup 38.5 +/- 27.9 (mean change -2.8 +/- 25.9). The mean (SD) HAQ-DI change score was -0.09 (0.42) for somewhat improved and 0.15 (0.33) for somewhat worsened. The HAQ-DI change for somewhat/much better was -0.20 +/- 0.52, and for somewhat/much worse +0.21 +/- 0.33. For pain, somewhat improved changed by -11.9 mm on the VAS, and somewhat worsened by 6.8 mm. Estimates for HAQ-DI and pain were larger than the for no-change group, 0.03 (0.32) and -3.2 (20.9). The MID for HAQ-DI in clinical practice is smaller than it is in trials. This may have implications for observational studies and clinical care.

High temperature vapors science and technology

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Hastie, John

2012-01-01

High Temperature Vapors: Science and Technology focuses on the relationship of the basic science of high-temperature vapors to some areas of discernible practical importance in modern science and technology. The major high-temperature problem areas selected for discussion include chemical vapor transport and deposition; the vapor phase aspects of corrosion, combustion, and energy systems; and extraterrestrial high-temperature species. This book is comprised of seven chapters and begins with an introduction to the nature of the high-temperature vapor state, the scope and literature of high-temp

The development of a concise questionnaire designed to measure perceived outcomes on the issues of greatest importance to patients.

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Busby, M; Burke, F J T; Matthews, R; Cyrta, J; Mullins, A

2012-04-01

To develop a concise patient feedback audit instrument designed to inform practice development on those issues of greatest importance to patients. A literature review was used to establish the issues which were of greatest importance to patients. Ten core questions were then designed with the help of an experienced survey and polling organisation. A challenging grading of patient responses was utilised in an attempt to differentiate perceived performance within a practice on the different aspects and between practices. A feasibility study was conducted using the interactive voice response mode with seven volunteer practices in 2009. The instrument was then used in the later part of 2010 by 61 practices mostly in paper-based format. Practices received feedback which is primarily based on a bar chart plotting their percentage of top grades received against a national reference sample (NRS) compiled from the results of other participating practices. A statistical analysis was conducted to establish the level at which an individual practice result becomes statistically significant against the NRS. The 61 participating practices each received an average of 121 responses (total 7,381 responses). Seventy-four percent of responses across all ten questions received the top grade, 'ideal'. Statistical analysis indicated that at the level of 121 responses, a score of around 4-9% difference to the National Reference Sample, depending on the specific question, was statistically significant. In keeping with international experience with dental patient feedback surveys this audit suggests high levels of patient satisfaction with their dental service. Nevertheless, by focusing results on the proportion of highest grades received, this instrument is capable of indicating when perceived performance falls significantly below the average. It can therefore inform practice development.

Learning Curves of Virtual Mastoidectomy in Distributed and Massed Practice

DEFF Research Database (Denmark)

Andersen, Steven Arild Wuyts; Konge, Lars; Cayé-Thomasen, Per

2015-01-01

IMPORTANCE: Repeated and deliberate practice is crucial in surgical skills training, and virtual reality (VR) simulation can provide self-directed training of basic surgical skills to meet the individual needs of the trainee. Assessment of the learning curves of surgical procedures is pivotal...... in understanding skills acquisition and best-practice implementation and organization of training. OBJECTIVE: To explore the learning curves of VR simulation training of mastoidectomy and the effects of different practice sequences with the aim of proposing the optimal organization of training. DESIGN, SETTING...... plateaued on a score of 16.0 (15.3-16.7) at approximately the ninth repetition, but the individual learning curves were highly variable. CONCLUSIONS AND RELEVANCE: Novices can acquire basic mastoidectomy competencies with self-directed VR simulation training. Training should be organized with distributed...

Global importation and population risk factors for measles in New Zealand: a case study for highly immunized populations.

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Hayman, D T S; Marshall, J C; French, N P; Carpenter, T E; Roberts, M G; Kiedrzynski, T

2017-07-01

As endemic measles is eliminated through immunization, countries must determine the risk factors for the importation of measles into highly immunized populations to target control measures. Despite eliminating endemic measles, New Zealand suffers from outbreaks after introductions from abroad, enabling us to use it as a model for measles introduction risk. We used a generalized linear model to analyze risk factors for 1137 measles cases from 2007 to June 2014, provide estimates of national immunity levels, and model measles importation risk. People of European ethnicity made up the majority of measles cases. Age is a positive risk factor, particularly 0-2-year-olds and 5-17-year-old Europeans, along with increased wealth. Pacific islanders were also at greater risk, but due to 0-2-year-old cases. Despite recent high measles, mumps, and rubella vaccine immunization coverage, overall population immunity against measles remains ~90% and is lower in people born between 1982 and 2005. Greatest measles importation risk is during December, and countries predicted to be sources have historical connections and highest travel rates (Australia and UK), followed by Asian countries with high travel rates and higher measles incidences. Our results suggest measles importation due to travel is seeding measles outbreaks, and immunization levels are insufficient to continue to prevent outbreaks because of heterogeneous immunity in the population, leaving particular age groups at risk.

Highly Adoptable Improvement: A Practical Model and Toolkit to Address Adoptability and Sustainability of Quality Improvement Initiatives.

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Hayes, Christopher William; Goldmann, Don

2018-03-01

Failure to consider the impact of change on health care providers is a barrier to success. Initiatives that increase workload and have low perceived value are less likely to be adopted. A practical model and supporting tools were developed on the basis of existing theories to help quality improvement (QI) programs design more adoptable approaches. Models and theories from the diffusion of innovation and work stress literature were reviewed, and key-informant interviews and site visits were conducted to develop a draft Highly Adoptable Improvement (HAI) Model. A list of candidate factors considered for inclusion in the draft model was presented to an expert panel. A modified Delphi process was used to narrow the list of factors into main themes and refine the model. The resulting model and supporting tools were pilot tested by 16 improvement advisors for face validity and usability. The HAI Model depicts how workload and perceived value influence adoptability of QI initiatives. The supporting tools include an assessment guide and suggested actions that QI programs can use to help design interventions that are likely to be adopted. Improvement advisors reported good face validity and usability and found that the model and the supporting tools helped address key issues related to adoption and reported that they would continue to use them. The HAI Model addresses important issues regarding workload and perceived value of improvement initiatives. Pilot testing suggests that the model and supporting tools are helpful and practical in guiding design and implementation of adoptable and sustainable QI interventions. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

Implementation of evidence-based knowledge in general practice.

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Le, Jette Videbæk

2017-12-01

Background Keeping up with the evidence and implementing it into the daily care for patients are fundamental prerequisites for delivering a high quality of care in general practice. However, despite many years of research into dissemination and implementation of evidence-based recommendations, significant challenges remain. In recent years, organisational factors have become widely acknowledged as vitally important for ensuring successful implementation. Further knowledge is needed to understand more about which factors affect the seeking and implementation of evidence-based knowledge in general practice. Aim The overall aim was to investigate how evidence-based knowledge is sought and implemented in general practice and to analyse associations with GP characteristics and quality of care. Three separate studies, each covering a specific part of the overall aim, were undertaken: I. To examine how GPs implement clinical practice guidelines in everyday clinical practice, and how implementation approaches differ between practices. II. To assess GPs’ information seeking behaviour with regard to the use and perceived importance of scientific medical information sources and to investigate associations with GP characteristics. III. To investigate if there are associations between specific formalised implementation activities within general practice and quality of care – exemplified by the use of spirometry testing among first-time users of medication against obstructive lung diseases. Methods The study was designed as a mixed methods study combining qualitative interviews, questionnaire and register data. Study I was a qualitative interview study that involved purposefully selected GPs representing seven different practices. The interviews were analysed using systematic text condensation, and results were used to qualify the development of a national survey of general practitioners regarding their seeking and implementation of evidence-based knowledge. This survey was

Practice management companies improve practices' financial position.

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Dupell, T

1997-11-01

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

Inspiring science achievement: a mixed methods examination of the practices and characteristics of successful science programs in diverse high schools

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Scogin, Stephen C.; Cavlazoglu, Baki; LeBlanc, Jennifer; Stuessy, Carol L.

2017-08-01

While the achievement gap in science exists in the US, research associated with our investigation reveals some high school science programs serving diverse student bodies are successfully closing the gap. Using a mixed methods approach, we identified and investigated ten high schools in a large Southwestern state that fit the definition of "highly successful, highly diverse". By conducting interviews with science liaisons associated with each school and reviewing the literature, we developed a rubric identifying specific characteristics associated with successful science programs. These characteristics and practices included setting high expectations for students, providing extensive teacher support for student learning, and utilizing student-centered pedagogy. We used the rubric to assess the successful high school science programs and compare them to other high school science programs in the state (i.e., less successful and less diverse high school science programs). Highly successful, highly diverse schools were very different in their approach to science education when compared to the other programs. The findings from this study will help schools with diverse students to strengthen hiring practices, enhance teacher support mechanisms, and develop student-focused strategies in the classroom that increase science achievement.

Highly Reliable Organizations in the Onshore Natural Gas Sector: An Assessment of Current Practices, Regulatory Frameworks, and Select Case Studies

Energy Technology Data Exchange (ETDEWEB)

Logan, Jeffrey S. [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Paranhos, Elizabeth [Energy Innovation Partners, Seattle, WA (United States); Kozak, Tracy G. [Energy Innovation Partners, Seattle, WA (United States); Boyd, William [Univ. of Colorado, Boulder, CO (United States)

2017-07-31

This study focuses on onshore natural gas operations and examines the extent to which oil and gas firms have embraced certain organizational characteristics that lead to 'high reliability' - understood here as strong safety and reliability records over extended periods of operation. The key questions that motivated this study include whether onshore oil and gas firms engaged in exploration and production (E&P) and midstream (i.e., natural gas transmission and storage) are implementing practices characteristic of high reliability organizations (HROs) and the extent to which any such practices are being driven by industry innovations and standards and/or regulatory requirements.

The role of high-involvement work practices and professional self-image in nursing recruits' turnover: A three-year prospective study.

Science.gov (United States)

Chênevert, Denis; Jourdain, Geneviève; Vandenberghe, Christian

2016-01-01

The retention of young graduate nurses has become a major management challenge among hospitals in Western countries, which is amplified in a context of aging of populations and an increasing demand for services from patients. Moreover, as it has been reported that 50% of experienced nurses do not recommend a career in nursing, it is likely that retention problems occur not only at the level of the organization, but also at the level of the nursing profession. Although research has identified some predictors of nurse turnover, it is unclear which factors influence nurses' turnover from the organization and from the profession and how these factors interrelate with one another over time. The present study extends previous research on nurse turnover by looking at the combined effects of nurses' pre-entry expectations, perceived high-involvement work practices, and professional self-image, on intended and actual turnover from the organization and the profession. A prospective, longitudinal study of a sample of 160 graduated nurses affiliated with the Quebec Nurses' Association, Canada, was conducted. Participants were surveyed at three points in time, spread over a 3-year period. Graduated nurses' pre-entry expectations and professional self-image were surveyed at graduation (Time 1), while perceived high-involvement work practices, professional self-image, and intention to leave the organization and the profession were captured six months following nurses' entry into the labor market (Time 2). Finally, participants were surveyed with respect to organizational and professional turnover three years after the Time 2 survey (Time 3). Structural equations modeling was used to examine the structure of the measures and the relationships among the constructs. Although pre-entry expectations had no effect, perceived high-involvement work practices were positively related to Time 2, professional self-image (controlling for pre-entry professional self-image). Moreover, high

The International Employment Protection Practices

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Otenko Pavlo V.

2017-09-01

Full Text Available The article discusses the need for corporate protection of staff in accordance with both the European and the International labor law. The author defines the essence of the category of «protection of staff», its constituent elements and the importance of function of this mechanism in terms of corporate security. The main methods used in the international practice to achieve a high degree of protection of staff have been systematized and presented. The main stages of development and tendencies concerning the formation of instruments for protection of staff have been analyzed, and the principal indices to assess the degree of protection of staff have been determined.

THE IMPORTANCE OF ELECTROENCEPHALOGRAPHIC ACTIVATING METHODS IN CLINICAL PRACTICE OF NEUROLOGIST

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L. Yu. Glukhova

2013-01-01

Full Text Available The electroencephalographic activating methods are widely used during the EEG investigation to detect the reactivity of normal electric activity of the brain and for provocation of pathological (especially epileptiform activity. The most common activating procedures are intermittent photic stimulation, hyperventilation, the probe "opening – closing" of the eyes, sleep deprivation and sleep. The more different activation methods are used during EEG investigation the more information EEG-method can propose in diagnostics of various pathological conditions , especially epilepsy, since epileptiform activity typically occur under certain conditions. In practice it is desirable to apply the activating procedures that are easily achievable with the available equipment and without possible adverse effects for the patients. The use of activating methods during EEG helps to establish correct diagnosis and to improve the efficacy of the treatment. The authors proposed a detailed review, devoted to the clinical aspects of these activating methods, combined with their own illustrations of EEG- responses to a variety of activating procedures.

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

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Howard, Patricia B; Williams, Tracy E

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

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

Science.gov (United States)

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

2016-01-01

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

Understanding the importance of teachers in facilitating student success: Contemporary science, practice, and policy.

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Jimerson, Shane R; Haddock, Aaron D

2015-12-01

Teacher quality has a vital influence on student success or failure. Thus, further research regarding teacher effectiveness, teacher evaluation, teacher well-being, and teacher contributions is essential to inform school psychologists and allied educational professionals who collaborate and consult with teachers to facilitate student success. In this special topic section of School Psychology Quarterly, a series of 6 articles further elucidate teachers' powerful contributions to student outcomes along with concrete, research-based ways for school psychologists to support and collaborate with teachers. The studies included in the special section describe how teacher support facilitates students' positive academic and social-emotional outcomes and how students' attitudes toward learning moderate the association between the classroom environment and students' academic achievement. Studies also report on the development and validation of self-report measures focused on both teacher subjective well-being and teachers' use of evidence-based practices. Finally, the articles included in the special topic section offer insights and ideas for refining teacher evaluation practices, understanding the factors contributing to program implementation fidelity, and improving prevention, early identification, and intervention efforts aimed at fostering school completion and positive youth development. (c) 2015 APA, all rights reserved).

Living with Invasive Plants in the Anthropocene: The Importance of Understanding Practice and Experience

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Lesley Head

2015-01-01

Full Text Available The role of humans in facilitating the rapid spread of plants at a scale that is considered invasive is one manifestation of the Anthropocene, now framed as a geological period in which humans are the dominant force in landscape transformation. Invasive plant management faces intensified challenges, and can no longer be viewed in terms of ′eradication′ or ′restoration of original landscapes′. In this perspectives piece, we focus on the practice and experience of people engaged in invasive plant management, using examples from Australia and Canada. We show how managers 1 face several pragmatic trade-offs; 2 must reconcile diverse views, even within stakeholder groups; 3 must balance competing temporal scales; 4 encounter tensions with policy; and 5 face critical and under-acknowledged labour challenges. These themes show the variety of considerations based on which invasive plant managers make complex decisions about when, where, and how to intervene. Their widespread pragmatic acceptance of small, situated gains (as well as losses combines with impressive long-term commitments to the task of invasives management. We suggest that the actual practice of weed management challenges those academic perspectives that still aspire to attain pristine nature.

STAR*D: helping to close the gap between science and practice.

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Shern, David L; Moran, Hazel

2009-11-01

Practical clinical trials, such as STAR*D (Sequenced Treatment Alternatives to Relieve Depression), extend the traditional randomized controlled trial to real-world settings. Consumers and clinicians should be encouraged by STAR*D's 70% remission rate and should realize that for many participants remission required medication switching and augmentation. Policy makers should recognize the importance of easy access to a full range of treatments. Researchers should be sobered by the high attrition rate and the 30% of participants who did not achieve remission. Although more such practical trials are needed, future work must more meaningfully involve consumers in design, analysis, and interpretation.

The Value of Literacy Practices

Science.gov (United States)

Esposito, Lucio; Kebede, Bereket; Maddox, Bryan

2015-01-01

The concepts of literacy events and practices have received considerable attention in educational research and policy. In comparison, the question of value, that is, "which literacy practices do people most value?" has been neglected. With the current trend of cross-cultural adult literacy assessment, it is increasingly important to…

Selecting information technology for physicians' practices: a cross-sectional study

Directory of Open Access Journals (Sweden)

Eden Karen

2002-04-01

Full Text Available Abstract Background Many physicians are transitioning from paper to electronic formats for billing, scheduling, medical charts, communications, etc. The primary objective of this research was to identify the relationship (if any between the software selection process and the office staff's perceptions of the software's impact on practice activities. Methods A telephone survey was conducted with office representatives of 407 physician practices in Oregon who had purchased information technology. The respondents, usually office managers, answered scripted questions about their selection process and their perceptions of the software after implementation. Results Multiple logistic regression revealed that software type, selection steps, and certain factors influencing the purchase were related to whether the respondents felt the software improved the scheduling and financial analysis practice activities. Specifically, practices that selected electronic medical record or practice management software, that made software comparisons, or that considered prior user testimony as important were more likely to have perceived improvements in the scheduling process than were other practices. Practices that considered value important, that did not consider compatibility important, that selected managed care software, that spent less than $10,000, or that provided learning time (most dramatic increase in odds ratio, 8.2 during implementation were more likely to perceive that the software had improved the financial analysis process than were other practices. Conclusion Perhaps one of the most important predictors of improvement was providing learning time during implementation, particularly when the software involves several practice activities. Despite this importance, less than half of the practices reported performing this step.

Embedding Microethical Dilemmas in High-Fidelity Simulation Scenarios: Preparing Nursing Students for Ethical Practice.

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Krautscheid, Lorretta C

2017-01-01

Despite the inclusion of ethics education in the formal curriculum, students felt ill-prepared to manage ethical issues and protect patients' health and well-being. Nursing students reported knowing what should be done to promote optimal patient care; however, they also reported an inability to act on their convictions due to fear of reprisal, powerlessness, and low confidence. Bloom's Taxonomy guided the development and implementation of experiential-applied ethics education via microethical dilemmas embedded in existing high-fidelity simulation (HFS) scenarios. Students were unaware that ethical dilemmas would be presented, replicating complex and spontaneous practice environments. Students reported that the educational strategy was powerful, increasing ethical decision-making confidence, empowering effective advocacy, and building courage to overcome fears and defend ethical practice. Simulation extends ethics education beyond the cognitive domain, ensuring the purposeful integration of affective and psychomotor learning, which promotes congruence between knowing what to do and acting on one's convictions. [J Nurs Educ. 2017;56(1):55-58.]. Copyright 2017, SLACK Incorporated.

Transformation in Interdisciplinary Research Methodology: The Importance of Shared Experiences in Landscapes of Practice

Science.gov (United States)

Clark, Jill; Laing, Karen; Leat, David; Lofthouse, Rachel; Thomas, Ulrike; Tiplady, Lucy; Woolner, Pamela

2017-01-01

Current debates around the concept of boundary crossing stress the importance of boundary objects in bringing people together to share understandings. We argue that the boundary object is of secondary importance, and that what is important for the transformational potential of interdisciplinary understanding is opportunities for "boundary…

Predictors of perceived importance and acceptance of digital delivery modes in higher education

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Anne Mertens

2014-04-01

Full Text Available Teaching and assessment in higher education institutions are increasingly supported by digital tools and services. Students, however, perceive and value the importance of such e-learning offerings in very diverse ways. The goal of this article is to examine which predictors significantly influence students’ perceptions of the value of digital learning formats. Based on Küpper's acceptance model, we generate hypotheses that are subsequently tested using data from a German student survey. The results show that individual-related characteristics, especially motivation and orientation patterns of students, have a high impact on the perceived importance of digital learning formats. Our analyses indicate that besides individual performance and motivation, the practical orientation of a student is also a key predictor for a high rating of the importance of digital learning formats. An analysis of characteristics regarding the field of study shows that students who major in economic sciences, especially those who frequently work with digital learning formats in their classes, find them significantly more important than students who major in social science. Regarding innovation-based characteristics, students who express a need for flexible course offerings rate the use of digital learning formats as particularly important. The discussion provides an evaluation of the results of the student study based on the hypotheses and presents further implications.

Relationships of demographic background and practice setting among practicing physician assistants in the United States.

Science.gov (United States)

Muma, Richard D; Kelley, Justin; Lies, Shawn

2010-01-01

it is assumed that minority health care providers continue to work in primary care and in underserved areas in higher proportions than their nonminority counterparts, regardless of changing workforce practice patterns. The primary purpose of this study was to determine whether this assumption still holds true among US physician assistants (PAs) in light of recent PA specialization. This assumption is important as there is continuing evidence that a similar background between providers and patients can be beneficial to the provider-patient relationship and to patient outcomes. A secondary purpose was to determine the relationships between various demographic variables (eg, race) and current practice specialty and population served among all PAs. this cross-sectional study measured demographic and practice setting survey data. A random sample of 10,500 PAs was surveyed. the main finding was that minority PAs were more likely to care for the underserved (31.9% vs. 19.3%) and to work in primary care practices (38.8% vs. 29.3%) than were nonminorities. A significant relationship was also found between serving underserved populations and nonmarried status, as well as age over 39 (these groups were more likely to serve this population, p time of high school graduation was significantly related to caring for underserved individuals (p Minority PAs were more likely to care for the underserved and work in primary care settings. Certain other demographic variables among all respondents were also significantly related to service to the underserved and work in primary care settings.

Good practices in collecting umbilical cord and placental blood

Directory of Open Access Journals (Sweden)

Lauren Auer Lopes

Full Text Available Abstract Objective: to identify the factors related to the quality of umbilical cord and placental blood specimens, and define best practices for their collection in a government bank of umbilical cord and placental blood. Method: this was a descriptive study, quantitative approach, performed at a government umbilical cord and placental blood bank, in two steps: 1 verification of the obstetric, neonatal and operational factors, using a specific tool for gathering data as non-participant observers; 2 definition of best practices by grouping non-conformities observed before, during and after blood collection. The data was analyzed using descriptive statistics and the following statistical software: Statistica(r and R(r. Results: while there was a correlation with obstetrical and neonatal factors, there was a larger correlation with operational factors, resulting in the need to adjust the professional practices of the nursing staff and obstetrical team involved in collecting this type of blood. Based on these non-conformities we defined best practices for nurses before, during and after blood collection. Conclusion: the best practices defined in this study are an important management tool for the work of nurses in obtaining blood specimens of high cell quality.

The importance of longitudinal studies in family medicine: experiences of two practice-based research networks.

NARCIS (Netherlands)

Weel, C. van; Weel-Baumgarten, E.M. van; Mold, J.

2006-01-01

BACKGROUND: For evidence-based decision making in family practice, it is essential to know the long-term (natural) course of common diseases and their outcomes under care and treatment. This article, based on a research methodology workshop, aims to raise awareness and interest in longitudinal

Important aspects for consideration in minimizing plant outage times. Swiss experience in achieving high availability

International Nuclear Information System (INIS)

Malcotsis, G.

1984-01-01

Operation of Swiss nuclear power plants has not been entirely free of trouble. They have experienced defective fuel elements, steam generator tube damage, excessive vibration of the core components, leakages in the recirculation pump seals and excessive corrosion and erosion in the steam-feedwater plant. Despite these technical problems in the early life of the plants, on overall balance the plants can be considered to have performed exceedingly well. The safety records from more than 40 reactor-years of operation are excellent and, individually and collectively, the capacity factors obtained are among the highest in the world. The problems mentioned have been solved and the plants continue operation with high availabilities. This success can be attributed to the good practices of the utilities with regard to the choice of special design criteria, plant organization, plant operation and plant maintenance, and also to the pragmatic approach of the licensing authorities and their consultants to quality assurance and quality control. The early technical problems encountered, the corresponding solutions adopted and the factors that contributed towards achieving high availabilities in Swiss nuclear power plants are briefly described. (author)

HIGHLY IMPORTANT OBJECTIVES FOR INNOVATION IN ROMANIA WITHIN THE EUROPEAN CONTEXT

Directory of Open Access Journals (Sweden)

Popa Ion

2013-07-01

Full Text Available Romania, as a country with a low R&D level, in order to converge to the living standards of western economies, is doomed to foster private investments in applied research and experimental development. Thus, it is critical to study what are the main objectives for innovation at organizational level. This paper investigates the most important objectives for innovation in Romania and in the European Union, aiming to find out what are the main challenges innovative enterprises have to face. The general approach is focused on the analysis of the frequency with which these objectives occur, both at general and structural levels. Therefore we have extracted the most important three highly important objectives for innovation, both in Romania and EU: improving the quality of goods or services, the need to increase the range of goods or services and the entering new markets or increase the market share. All these three are positively correlated with the size (number of employees of the organization. One of our findings underlines that there are fewer objectives in EU then in Romania, both at general and structural levels. Such a situation suggesting that the differences derive from two main sources: Romania has more needs, thus the enterprises target more goals, and there is a lack of managerial know-how that leads to non-prioritized objectives for innovation. Also, we identified an asymmetry, consisting in the fact that in EU, medium sized enterprises are more likely to act as the small ones, as opposed to the Romanian context. R&D and innovation component should be in the center of the Romanian strategy for convergence and competitiveness strengthening, treating differently the SMEs in order to foster innovation in a sustainable manner, through the encouragement of private enterprises to engage in partnerships for R&D an innovation. Also there is a critical need for governmental intervention in building facilities for the modern business infrastructures

Balance of trade: export-import in family medicine.

Science.gov (United States)

Pust, Ronald E

2007-01-01

North American family physicians leaving for less-developed countries (LDCs) may not be aware of internationally validated diagnostic and treatment technologies originating in LDCs. Thus they may bring with them inappropriate models and methods of medical care. More useful "exports" are based in sharing our collaborative vocational perspective with dedicated indigenous generalist clinicians who serve their communities. More specifically, Western doctors abroad can promote local reanalyses of international evidence-based medicine (EBM) studies, efficient deployment of scarce clinical resources, and a family medicine/generalist career ladder, ultimately reversing the "brain drain" from LDCs. Balancing these exports, we should import the growing number of EBM best practices originated in World Health Organization and other LDCs research that are applicable in developed nations. Many generalist colleagues, expatriate and indigenous, with long-term LDC experience stand ready to help us import these practices and perspectives.

TESOL, A Profession That Eats its Young: The Importance of Reflective Practice in Language Teacher Education

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Thomas SC Farrell

2016-10-01

Full Text Available The field of teaching English to speakers of other languages (TESOL is similar to other fields in that we must not take it for granted that novice teachers will survive their first year without some kind of support. This paper outlines how three novice ESL teachers in Canada survived their first year without any support from the school they were placed. Specifically, the paper outlines how they, with the aid of a facilitator, engaged in reflective practice by using a framework for reflecting on practice to help them navigate complex issues and challenges they faced during their first year of teaching. Had they not engaged in such structured reflection during their first year, they would have probably become another statistic of those who quit the profession and contribute to the growing perception that TESOL is a profession that eats its young. The paper suggests that language teacher educators and novice teachers should not just wait until their first year to learn the skills of reflective practice but should do so much earlier in their teacher education programs so that they can be better prepared for the transition from their teacher education programs to the first year of teaching.

Significant Published Articles for Pharmacy Nutrition Support Practice in 2014 and 2015.

Science.gov (United States)

Dickerson, Roland N; Kumpf, Vanessa J; Blackmer, Allison B; Bingham, Angela L; Tucker, Anne M; Ybarra, Joseph V; Kraft, Michael D; Canada, Todd W

2016-07-01

To assist the pharmacy clinician engaged in nutrition support in staying current with the most pertinent literature. Several experienced board-certified clinical pharmacists engaged in nutrition support therapy compiled a list of articles published in 2014 and 2015 that they considered to be important to their practice. Only those articles available in print format were considered for potential inclusion. Articles available only in preprint electronic format were not evaluated. The citation list was compiled into a single spreadsheet where the author participants were asked to ascertain whether they considered the paper important to nutrition support pharmacy practice. A culled list of publications was then identified whereby the majority of author participants (at least 5 out of 8) considered the paper to be important. A total of 108 articles were identified; 36 of which were considered to be of high importance. An important guideline article published in early 2016, but not ranked, was also included. The top-ranked articles from the primary literature were reviewed. It is recommended that the informed pharmacist, who is engaged in nutrition support therapy, be familiar with the majority of these articles.

Permutation importance: a corrected feature importance measure.

Science.gov (United States)

Altmann, André; Toloşi, Laura; Sander, Oliver; Lengauer, Thomas

2010-05-15

In life sciences, interpretability of machine learning models is as important as their prediction accuracy. Linear models are probably the most frequently used methods for assessing feature relevance, despite their relative inflexibility. However, in the past years effective estimators of feature relevance have been derived for highly complex or non-parametric models such as support vector machines and RandomForest (RF) models. Recently, it has been observed that RF models are biased in such a way that categorical variables with a large number of categories are preferred. In this work, we introduce a heuristic for normalizing feature importance measures that can correct the feature importance bias. The method is based on repeated permutations of the outcome vector for estimating the distribution of measured importance for each variable in a non-informative setting. The P-value of the observed importance provides a corrected measure of feature importance. We apply our method to simulated data and demonstrate that (i) non-informative predictors do not receive significant P-values, (ii) informative variables can successfully be recovered among non-informative variables and (iii) P-values computed with permutation importance (PIMP) are very helpful for deciding the significance of variables, and therefore improve model interpretability. Furthermore, PIMP was used to correct RF-based importance measures for two real-world case studies. We propose an improved RF model that uses the significant variables with respect to the PIMP measure and show that its prediction accuracy is superior to that of other existing models. R code for the method presented in this article is available at http://www.mpi-inf.mpg.de/ approximately altmann/download/PIMP.R CONTACT: altmann@mpi-inf.mpg.de, laura.tolosi@mpi-inf.mpg.de Supplementary data are available at Bioinformatics online.

The role of practical training in educating future cadre in hotel industry and tourism

Directory of Open Access Journals (Sweden)

Sekulić Dejan

2015-01-01

Full Text Available Tourism stimulates the work of a large number of small and medium companies, who provide increase of the number of employees. By following the trends, high education institutions try to provide expert cadre who will be future transmitters of trends in the field. In order to preserve and enhance the quality of education in this area it is necessary to take care of the quality of the program of practical training as the bridge between formal education and work in tourism. In that context, the aim of the research was to explore the role and importance of practical training in the education of students in hotel industry and tourism. The research included 134 respondents, divided in two groups depending upon whether they had any experience in practical training in hotels and tourist agencies. The result shows that there are no significant differences in the perception of the importance of practical training and the factors which influence the selection of the company in which students perform practical training. On the other hand, the results show that there are significant differences, related to the role of hotels and tourist agencies in their practical education and competencies they should master at the end of the training, between those students who had practical training and those who have not had it yet.

Latent Cluster Analysis of Instructional Practices Reported by High- and Low-Performing Mathematics Teachers in Four Countries

Science.gov (United States)

Cheng, Qiang; Hsu, Hsien-Yuan

2017-01-01

Using Trends in International Mathematics and Science Study (TIMSS) 2011 eighth-grade international dataset, this study explored the profiles of instructional practices reported by high- and low-performing mathematics teachers across the US, Finland, Korea, and Russia. Concepts of conceptual teaching and procedural teaching were used to frame the…

Practices and Procedures to Prevent the Transmission of Skin and Soft Tissue Infections in High School Athletes

Science.gov (United States)

Fritz, Stephanie A.; Long, Marcus; Gaebelein, Claude J.; Martin, Madeline S.; Hogan, Patrick G.; Yetter, John

2012-01-01

Skin and soft tissue infections (SSTIs) are frequent in student athletes and are often caused by community-associated methicillin-resistant "Staphylococcus aureus" (CA-MRSA). We evaluated the awareness of CA-MRSA among high school coaches and athletic directors in Missouri (n = 4,408) and evaluated hygiene practices affecting SSTI…

Women in rural family medicine: a qualitative exploration of practice attributes that promote physician satisfaction.

Science.gov (United States)

Hustedde, Carol; Paladine, Heather; Wendling, Andrea; Prasad, Rupa; Sola, Orlando; Bjorkman, Sarah; Phillips, Julie

2018-04-01

The USA needs more rural physicians. Although women represent half of all US trained medical students, the rural physician workforce has remained predominantly male. Insight is needed into what makes rural practice attractive for women and which practice characteristics allow women physicians to practice successfully in rural areas. This study's purpose was to examine aspects of the practice environment that impact women physicians' professional satisfaction and commitment to rural medicine. Twenty-five women family physicians practicing in rural areas of the USA were interviewed by phone using a semi-structured format. Transcribed interviews were analyzed using an immersion and crystallization approach. Emergent themes were identified, coded, and discussed until team consensus was attained. Interviews continued until saturation of themes was reached. Three themes emerged from the data, in relationship to practice and employment attributes that contribute to US women physicians' professional satisfaction and willingness to remain in a rural setting: professional relationships, practice characteristics, and support during times of transition. Participants placed high importance on professional relationships, both within and outside of their rural practice. Rural women physicians enjoyed practicing an expanded scope of care, valued loan repayment opportunities, and appreciated supportive practice partners. Importantly, women physicians who found themselves struggling to maintain rural careers often had experienced difficulty during times of practice transition, including maternity leaves. Understanding practice attributes valued by successful rural women family physicians in the USA will help rural health systems, practices, and physicians-in-training to develop and evaluate opportunities that will best contribute to successful rural practice. Supporting women physicians during periods of practice transition may improve retention.

High-resolution satellite imagery is an important yet underutilized resource in conservation biology.

Science.gov (United States)

Boyle, Sarah A; Kennedy, Christina M; Torres, Julio; Colman, Karen; Pérez-Estigarribia, Pastor E; de la Sancha, Noé U

2014-01-01

Technological advances and increasing availability of high-resolution satellite imagery offer the potential for more accurate land cover classifications and pattern analyses, which could greatly improve the detection and quantification of land cover change for conservation. Such remotely-sensed products, however, are often expensive and difficult to acquire, which prohibits or reduces their use. We tested whether imagery of high spatial resolution (≤5 m) differs from lower-resolution imagery (≥30 m) in performance and extent of use for conservation applications. To assess performance, we classified land cover in a heterogeneous region of Interior Atlantic Forest in Paraguay, which has undergone recent and dramatic human-induced habitat loss and fragmentation. We used 4 m multispectral IKONOS and 30 m multispectral Landsat imagery and determined the extent to which resolution influenced the delineation of land cover classes and patch-level metrics. Higher-resolution imagery more accurately delineated cover classes, identified smaller patches, retained patch shape, and detected narrower, linear patches. To assess extent of use, we surveyed three conservation journals (Biological Conservation, Biotropica, Conservation Biology) and found limited application of high-resolution imagery in research, with only 26.8% of land cover studies analyzing satellite imagery, and of these studies only 10.4% used imagery ≤5 m resolution. Our results suggest that high-resolution imagery is warranted yet under-utilized in conservation research, but is needed to adequately monitor and evaluate forest loss and conversion, and to delineate potentially important stepping-stone fragments that may serve as corridors in a human-modified landscape. Greater access to low-cost, multiband, high-resolution satellite imagery would therefore greatly facilitate conservation management and decision-making.

Traditional Belief and Practice on Postpartum Recovery among Mothers in East Coast of Peninsular Malaysia

Directory of Open Access Journals (Sweden)

Abdul Ghani Radiah

2018-01-01

Full Text Available Postpartum care is highly important to prevent maternal and infant morbidity. In Malaysia, there are several traditional postpartum care practices by mothers. Different states adopted different ways to perform those practices. In spite of long and established practices in Malaysia, its effect and safety profile is not well understood. This study aims to gain an understanding of the traditional practices that Malay women follow in relation to postpartum care and the rationales underpinning such practices. A cross sectional study (n=100 was conducted using self-administered questionnaire consists of demographic information, practice of postpartum care and knowledge of postpartum care. Data was analyzed using Statistical Package Social Software (2.0. The findings shown that, there was no significant association of socio-demographic data with confinement period (p>0.05. For postpartum dietary practice, there were only association between age and encourage more water intake (p=0.047, p<0.05 and also between number of children and prohibit greasy food (p=0.032, p<0.05. For association between socio-demographic data and postpartum physical practice, there was only association between age and body scrub (p=0.046, p<0.05. The most significant factor that influenced postpartum care practice and its knowledge was family tradition with 83% and 97%, respectively. Traditional postpartum care practice is still significant and dominant among mothers in Kuantan, Pahang. This information is important for health care professional to educate women and provide strategies to help them to integrate their beliefs and the practices recommended in contemporary health care practice.

Health Visiting: Preparation for Practice (Fourth edition) Luker Karen McHugh Gretl and Bryar Rosamund Health Visiting: Preparation for Practice (Fourth edition) 312pp £32.99 Wiley Blackwell 9781119078586 111907858X [Formula: see text].

Science.gov (United States)

2017-04-12

Children, families and the communities they live in deserve high-quality care from well-informed health visitors and healthcare staff. Having an understanding of the role and responsibilities of health visitors and the wider influences on their practice has never been more important.

Sphygmomanometers--an audit in general practice.

Science.gov (United States)

Shah, Nayankumar C; Sibbritt, David W; Heaney, Susan; Sharples, Jan

2004-11-01

The accuracy of sphygmomanometers used in Australian general practice is unknown but potentially important. We measured the accuracy of sphygmomanometers in general practice in the Hunter region of New South Wales using a gold standard. Practices were recruited by an advertisement in the division newsletter. Sixty practices (35%) volunteered. A total of 404 instruments were checked. Over 95% of sphygmomanometers were within 4 mmHg of gold standard sphygmomanometer across the clinical pressure range. Mercury sphygmomanometers were more accurate than aneroid (pmercury.

The Growing Importance of Linear Algebra in Undergraduate Mathematics.

Science.gov (United States)

Tucker, Alan

1993-01-01

Discusses the theoretical and practical importance of linear algebra. Presents a brief history of linear algebra and matrix theory and describes the place of linear algebra in the undergraduate curriculum. (MDH)

Economic benefits of high value medicinal plants to Pakistani communities: an analysis of current practice and potential.

Science.gov (United States)

Sher, Hassan; Aldosari, Ali; Ali, Ahmad; de Boer, Hugo J

2014-10-10

Poverty is pervasive in the Swat Valley, Pakistan. Most of the people survive by farming small landholdings. Many earn additional income by collecting and selling plant material for use in herbal medicine. This material is collected from wild populations but the people involved have little appreciation of the potential value of the plant material they collect and the long term impact their collecting has on local plant populations. In 2012, existing practices in collecting and trading high value minor crops from Swat District, Pakistan, were analyzed. The focus of the study was on the collection pattern of medicinal plants as an economic activity within Swat District and the likely destinations of these products in national or international markets. Local collectors/farmers and dealers were surveyed about their collection efforts, quantities collected, prices received, and resulting incomes. Herbal markets in major cities of Pakistan were surveyed for current market trends, domestic sources of supply, imports and exports of herbal material, price patterns, and market product-quality requirements. It was observed that wild collection is almost the only source of medicinal plant raw material in the country, with virtually no cultivation. Gathering is mostly done by women and children of nomadic Middle Hill tribes who earn supplementary income through this activity, with the plants then brought into the market by collectors who are usually local farmers. The individuals involved in gathering and collecting are largely untrained regarding the pre-harvest and post-harvest treatment of collected material. Most of the collected material is sold to local middlemen. After that, the trade pattern is complex and heterogeneous, involving many players. Pakistan exports of high value plants generate over US$10.5 million annually in 2012, with a substantial percentage of the supply coming from Swat District, but its market share has been declining. Reasons for the decline were

The Importance of Agriculture Science Course Sequencing in High Schools: A View from Collegiate Agriculture Students

Science.gov (United States)

Wheelus, Robin P.

2009-01-01

The objective of this study was to investigate the importance of Agriculture Science course sequencing in high schools, as a preparatory factor for students enrolled in collegiate agriculture classes. With the variety of courses listed in the Texas Essential Knowledge and Skills (TEKS) for Agriculture Science, it has been possible for counselors,…

The Order of Importance of Component Parts of the Biblical Worldview in Christian High School Students

Science.gov (United States)

Van Meter, Kenneth G.

2009-01-01

This micro-ethnographic study is an exploration of the relative degree of importance of the several components of a worldview as articulated by a purposive sample of fourteen upper division students currently enrolled in advance placement classes in ACSI and WASC accredited Christian high schools in Northern California. The research design uses an…

United States import safety, environmental health, and food safety regulation in China.

Science.gov (United States)

Nyambok, Edward O; Kastner, Justin J

2012-01-01

China boasts a rapidly growing economy and is a leading food exporter. Since China has dominated world export markets in food, electronics, and toys, many safety concerns about Chinese exports have emerged. For example, many countries have had problems with Chinese food products and food-processing ingredients. Factors behind food safety and environmental health problems in China include poor industrial waste management, the use of counterfeit agricultural inputs, inadequate training of farmers on good farm management practices, and weak food safety laws and poor enforcement. In the face of rising import safety problems, the U.S. is now requiring certification of products and foreign importers, pursuing providing incentives to importers who uphold good safety practices, and considering publicizing the names of certified importers.

Testing and Validation of Timing Properties for High Speed Digital Cameras - A Best Practices Guide

Science.gov (United States)

2016-07-27

range, and frame rate get all the press when it comes to high-speed video viewed in Range Control; however, most optical data is practically...introduction of hydraulic and electrically-driven mount servo systems  The replacement of fixed optics sites with remotely-controlled mobile systems  The...support (e.g., VendorX Timing Tests with staggered 10-μs pulse sequence). (5) Select Press to Locate Board ID. The Define Board ID file should

Pizza Parties, Pep Rallies, and Practice Tests: Strategies Used by High School Principals to Raise Percent Proficient

Science.gov (United States)

Hollingworth, Liz; Dude, David J.; Shepherd, Julie K.

2010-01-01

This study explores ways high school principals are responding to the demands of education reform to raise student test scores on achievement tests used for accountability purposes. Anecdotal evidence suggests administrators have instituted pizza parties and pep rallies to motivate students to do their best and practice tests to prepare students…

Manufactured but not imported: new directions for research in shared decision making support and skills.

Science.gov (United States)

Edwards, Adrian; Evans, Rhodri; Elwyn, Glyn

2003-05-01

Significant conceptual work on shared decision making has taken place but there are still significant challenges in achieving it in routine clinical practice. This paper outlines what research has identified to date that may promote shared decision making, and the further research that is required to enable continuing progress. Greater understanding of the models of decision making and instruments to identify them in practice are still required. Specifying consumer competences, developing instruments to assess these and interventions to enhance them may also be important. Clarifying all these aspects may enable those charged with training professionals to improve the content of professional development programmes. This may be particularly important in the field of cancer treatments where the stakes are high-patients usually desire much information but their desire for involvement in decision making is more variable. The consequences of getting this balance right or wrong are significant with much to be gained or lost. Continued development and evaluation of decision aids and decision explorers that use interactive technology will also be important in identifying how to progress with consumer involvement. If we can learn these lessons, then wider implementation of shared decision making or consumer involvement may become a nearer prospect.

Shoes, Dues, and Other Barriers to College Attainment: Perspectives of Students Attending High-Poverty Urban High Schools

Science.gov (United States)

Drotos, Stephanie M.; Cilesiz, Sebnem

2016-01-01

Facilitating economically disadvantaged students' access to higher education is an important goal of educational policy. However, some practices toward this goal are based on theories and assumptions not informed by the students' conditions or needs. The purpose of this study was to understand the challenges faced by students from high poverty,…

Achieving optimal business performance through business practices ...

African Journals Online (AJOL)

Kirstam

marketing practices, strategic planning practices, human resource .... on the importance of having a profound appreciation for the customer so that the marketer can .... such as commitment, intention to quit and satisfaction. .... Sampling method.

Client and parent feedback on a Youth Mental Health Service: The importance of family inclusive practice and working with client preferences.

Science.gov (United States)

Coates, Dominiek

2016-12-01

In mental health settings, feedback from clients and carers is central to service evaluation, development and delivery. Increasingly, client and carer feedback is considered an integral part of service planning, and recognized as a critical element of the provision of recovery oriented service. This paper outlines the findings of a qualitative evaluation of a Youth Mental Health (YMH) service from the perspective of discharged clients and their parents. The service researcher conducted telephone interviews with 39 parents of discharged clients, and 17 young people themselves. Participants reported positive or mixed experiences with the service. In addition to more generic positive statements about the service, analysis identified two key themes: the importance of 'family inclusive practice' and the importance of 'working with client preferences'. Young people and their parents want to be actively engaged in treatment and have their treatment preferences considered in treatment planning. Participants expressed the importance of "a good fit" between the client and the worker in terms of the clinician's gender, personality and treatment style/modality. While for some participants these themes were raised in the context of service strengths, others identified them as limitations or opportunities for service improvement. The extent to which clients and their parents felt engaged and heard by their allocated clinician is critical to their satisfaction or dissatisfaction with the service, depending on their unique experience. As an outcome of this evaluation, a range of service improvement strategies have been recommended. © 2016 Australian College of Mental Health Nurses Inc.

Radioactive waste management practices in India: achievements and challenges

International Nuclear Information System (INIS)

Wattal, P.K.; Basu, S.

2013-01-01

Safe and effective management of radioactive waste has been given utmost importance from the very inception of nuclear industry in India. This article gives an account of the basic principles, practices being followed in our country to achieve this objective. A brief description of the existing methods for management of diverse kinds of radioactive wastes including high level radioactive waste and also the research and development activities to address the future challenges is presented in the article. (author)

From research to practice: one organisational model for promoting research based practice.

Science.gov (United States)

Kitson, A

1997-01-01

This paper describes a framework used by the National Institute for Nursing in Oxford to integrate research, development and practice. With the increasing attention given to the topic of how research findings are implemented into clinical practice, it was felt important to share the challenges that have arisen in attempting to combine traditional research activities with more practice based development work. The emerging conceptual framework, structures and functions are described highlighting the variety of partnerships to be established in order to achieve the goal of integrating research into practice. While the underpinning principles of the framework--generating knowledge, implementing research into practice and evaluating the effectiveness of programmes--are not new, it is the way they have been combined within an organisational structure that could be helpful to others considering such a strategy. Both the strengths and weaknesses of the model are discussed, a number of conclusions drawn as to its robustness and consideration given to its replication.

Practical design constraints for using secondary concentrators at high temperatures

Energy Technology Data Exchange (ETDEWEB)

O' Gallagher, J.J.; Winston, R.

1999-07-01

The optical advantages of using nonimaging secondary concentrators in two-stage solar thermal dish systems are well understood. However, practical questions having to do with the thermal behavior of any secondary and its possible effects on the performance of cavity type receivers have only recently begun to be investigated. A few years ago an experimental demonstration of a trumpet type nonimaging secondary concentrator was carried out with a cavity receiver operating 660 C in combination with the Cummins Power Generation CPG-460 7.5 kWe concentrator system. Lessons learned from this and previous experiments are reviewed. The tests alleviated any operational concerns about the effectiveness of active water cooling and have shown that secondaries can be operated successfully at high temperatures without significant problems. There was no evidence of direct heat loss from the hot receiver to the cooled trumpet. The optical quality of any primary can be expected to fall well below design goals and to deteriorate further with time. This expectation should be taken into account in planning future experiments and developing new concentrating systems.

Communities of Practice Transition Online - Lessons learned from NASA's EPO Online Workspace

Science.gov (United States)

Davey, B.

2012-12-01

The Earth Forum Education and Public Outreach (EP/O) community has long interacted to better their practice as a community as well as individually. Working together to share knowledge and grow, they function as a community of practice. In 2009, NASA designed and implemented an online workspace in hopes of promoting the communities continued interactions. This study examines the role of an online workspace component of a community in the work of a community of practice. Much has been studied revealing the importance of communities of practice to organizations, project success, and knowledge management and some of these same successes hold true for virtual communities of practice. Study participants were 75 Education and Public Outreach community members of NASA's Science Mission Directorate Earth Forum. In this mixed methods study, online workspace metrics were used to track participation and a survey completed by 21 members was used to quantify participation. For a more detailed analysis, 15 community members (five highly active users, five average users, and five infrequent users) selected based on survey responses, were interviewed. Finally, survey data was gathered from seven online facilitators to understand their role in the community. Data collected from these 21 community members and five facilitating members suggest that highly active users (logging into the workspace daily), were more likely to have transformative experiences, co-create knowledge, feel ownership of community knowledge, have extended opportunities for community exchange, and find new forms of evaluation. Average users shared some similar characteristics with both the highly active members and infrequent users, representing a group in transition as they become more engaged and active in the online workspace. Inactive users viewed the workspace as having little value, being difficult to navigate, being mainly for gaining basic information about events and community news, and as another demand

A survey of food allergen control practices in the U.S. food industry.

Science.gov (United States)

Gendel, Steven M; Khan, Nazleen; Yajnik, Monali

2013-02-01

Despite awareness of the importance of food allergy as a public health issue, recalls and adverse reactions linked to undeclared allergens in foods continue to occur with high frequency. To reduce the overall incidence of such problems and to ensure that food-allergic consumers have the information they need to prevent adverse reactions, it is important to understand which allergen control practices are currently used by the food industry. Therefore, the U.S. Food and Drug Administration carried out directed inspections of registered food facilities in 2010 to obtain a broader understanding of industry allergen control practices in the United States. The results of these inspections show that allergen awareness and the use of allergen controls have increased greatly in the last decade, but that small facilities lag in implementing allergen controls.

Designing high availability systems DFSS and classical reliability techniques with practical real life examples

CERN Document Server

Taylor, Zachary

2014-01-01

A practical, step-by-step guide to designing world-class, high availability systems using both classical and DFSS reliability techniques Whether designing telecom, aerospace, automotive, medical, financial, or public safety systems, every engineer aims for the utmost reliability and availability in the systems he, or she, designs. But between the dream of world-class performance and reality falls the shadow of complexities that can bedevil even the most rigorous design process. While there are an array of robust predictive engineering tools, there has been no single-source guide to understan

Serving high-risk foods in a high-risk setting: survey of hospital food service practices after an outbreak of listeriosis in a hospital.

Science.gov (United States)

Cokes, Carolyn; France, Anne Marie; Reddy, Vasudha; Hanson, Heather; Lee, Lillian; Kornstein, Laura; Stavinsky, Faina; Balter, Sharon

2011-04-01

Prepared ready-to-eat salads and ready-to-eat delicatessen-style meats present a high risk for Listeria contamination. Because no foodborne illness risk management guidelines exist specifically for US hospitals, a survey of New York City (NYC) hospitals was conducted to characterize policies and practices after a listeriosis outbreak occurred in a NYC hospital. From August through October 2008, a listeriosis outbreak in a NYC hospital was investigated. From February through April 2009, NYC's 61 acute-care hospitals were asked to participate in a telephone survey regarding food safety practices and policies, specifically service of high-risk foods to patients at increased risk for listeriosis. Five patients with medical conditions that put them at high risk for listeriosis had laboratory-confirmed Listeria monocytogenes infection. The Listeria outbreak strain was isolated from tuna salad prepared in the hospital. Fifty-four (89%) of 61 hospitals responded to the survey. Overall, 81% of respondents reported serving ready-to-eat deli meats to patients, and 100% reported serving prepared ready-to-eat salads. Pregnant women, patients receiving immunosuppressive drugs, and patients undergoing chemotherapy were served ready-to-eat deli meats at 77%, 59%, and 49% of hospitals, respectively, and were served prepared ready-to-eat salads at 94%, 89%, and 73% of hospitals, respectively. Only 4 (25%) of 16 respondents reported having a policy that ready-to-eat deli meats must be heated until steaming hot before serving. Despite the potential for severe outcomes of Listeria infection among hospitalized patients, the majority of NYC hospitals had no food preparation policies to minimize risk. Hospitals should implement policies to avoid serving high-risk foods to patients at risk for listeriosis.

Awareness of breast cancer risk factors and practice of breast self examination among high school students in Turkey

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Çetinkaya Aynur

2008-10-01

Full Text Available Abstract Background Young breast cancer patients have a lower rate of survival than old breast cancer patients due to being diagnosed at advanced stages. Breast self-examination makes women more "breast aware", which in turn may lead to an earlier diagnosis of breast cancer. The purpose of this study was to investigate knowledge and practice of breast self-examination and to determine knowledge of risk factors for breast cancer among high school students. Methods This is a descriptive and cross-sectional study. It was conducted in a high school in Manisa, Turkey. The study sample included 718 female high school students. A socio-demographic characteristics data form, knowledge of breast self examination and risk factors for breast cancer form and breast self examination practice form were used to collect data. Results The female high school students had insufficient knowledge about breast self-examination and a low percentage of students reported that they had performed breast self examination monthly. The most common reason for not doing breast self- examination was "not knowing how to perform breast self-examination" (98.5%. Most of the students had little knowledge of the risk factors for breast cancer. The most widely known risk factor by the students was personal history of breast cancer (68.7%. There was a significant relation between breast self-examination practice and age, school grade, knowledge about breast cancer and knowledge about breast self- examination. Conclusion There is a need to increase knowledge of adolescent females about the risks of breast cancer and benefits of early detection. In fact, health care professionals can develop effective breast health care programs and help young women to acquire good health habits.

A practical approach to the management of high-output stoma

Science.gov (United States)

Mountford, Christopher G; Manas, Derek M; Thompson, Nicholas P

2014-01-01

The development of a high-output stoma (HOS) is associated with water, electrolyte and nutritional complications. Prompt, careful assessment and management is required to avoid rapid clinical deterioration in this patient population. A multidisciplinary approach to management ensures the best possible outcome and quality of life for patients who experience HOS. This article outlines the important considerations in the identification and pathophysiology of HOS. A systematic approach to the management of the condition is outlined, considering fluid and electrolyte requirements, nutrient deficiencies and manipulation of gastrointestinal absorption, motility and secretions using medical and surgical therapies. PMID:28839771