WorldWideScience

Sample records for identify emerging themes

  1. Japanese situations to emerging themes

    International Nuclear Information System (INIS)

    Kubota, Ryuji

    2011-01-01

    Japanese regulatory body has audited more than ten cases of licensee's RCA since December 2007. We approve of opinions to emerging themes in 'CSNI Activity Plan', and based on achievements of these audits, Japanese situations to emerging themes are explained. As our conclusion, the more experience to identify HOF licensees have, the more problems may be solved. But as CA is difficult to measure for effectiveness, we propose to develop the outcome indicators such as the frequency of events. (author)

  2. On the emergence theme of physics

    CERN Document Server

    Carroll, Robert

    2010-01-01

    The book surveys mathematical relations between classical and quantum mechanics, gravity, time and thermodynamics from various points of view and many sources (with appropriate attribution). The emergence theme is developed with an emphasis on the meaning via mathematics. A background theme of Bohemian mechanics and connections to the quantum equivalence principle of Matone et al. is also developed in great detail. Some original work relating the quantum potential and Ricci flow is also included.

  3. Reinventing spatial planning in a borderless Europe : Emergent themes

    NARCIS (Netherlands)

    Waterhout, B.; Faludi, A.K.F.; Stead, D.; Zonneveld, W.; Milder, J.; Nadin, V.

    2009-01-01

    This paper is a follow-up to the Chicago Round Table ‘Emergent Research Themes on European Territorial Governance’ in 2008 questioning the view of EU territory as the sum of mutually exclusive territories under nation-state control and pointing out the existence of overlapping jurisdictions. Themes

  4. Emerging themes in international business research

    OpenAIRE

    David A Griffith; Salih Tamer Cavusgil; Shichun Xu

    2008-01-01

    This study is motivated by two research questions: (1) Which recent contributions have been driving the research agenda in international business? (2) Which emerging themes in the literature are likely to set the stage for future work? To examine these questions, the study examined scholarly work in international business over the time period 1996–2006 in six leading international business journals (Journal of International Business Studies, Management International Review, Journal of World B...

  5. Neuroleadership: Themes and limitations of an emerging interdisciplinary field.

    Science.gov (United States)

    Kuhlmann, Naila; Kadgien, Chelsie A

    2018-05-01

    The relationship between brain and behaviour has perplexed philosophers and scientists since the time of the ancient Greeks. Recent technological advances have allowed neuroscience to flourish, alongside growing romanticism that reductionist studies will allow us to understand complex interpersonal behaviours. Organizational cognitive neuroscience and neuroleadership are newly established interdisciplinary fields that use neuroscientific techniques to answer questions about behaviours within organizations. Neuroleadership aims to discover screening tools for good leaders, to improve leadership skills, and to identify unconscious factors affecting behaviour in hopes of improving management and leadership practices. Although proponents of neuroleadership are optimistic, if we know anything about the functions of the human brain and our interpersonal behaviours, it is that they are exquisitely complex and context dependant. Here, we briefly discuss the major themes emerging in the new field of neuroleadership and the limitations and potential consequences of applying findings from the field prematurely and with blind optimism.

  6. Normative study of theme identifiability: Instructions with and without explanation of the false memory effect.

    Science.gov (United States)

    Beato, Maria Soledad; Cadavid, Sara

    2016-12-01

    False-memory illusions have been widely studied using the Deese/Roediger-McDermott paradigm (DRM). In this paradigm, words semantically related to a single nonpresented critical word are studied. In a later memory test, critical words are often falsely recalled and recognized. The present normative study was conducted to measure the theme identifiability of 60 associative word lists in Spanish that include six words (e.g., stove, coat, blanket, scarf, chill, and bonnet) that are simultaneously associated with three critical words (e.g., HEAT, COLD, and WINTER; Beato & Díez, Psicothema, 26, 457-463, 2011). Different levels of backward associative strength were used in the construction of the DRM lists. In addition, we used two types of instructions to obtain theme identifiability. In the without-explanation condition, traditional instructions were used, requesting participants to write the theme list. In the with-explanation condition, the false-memory effect and how the lists were built were explained, and an example of a DRM list and critical words was shown. Participants then had to discover the critical words. The results showed that all lists produced theme identifiability. Moreover, some lists had a higher theme identifiability rate (e.g., 61 % for the critical words LOVE, BOYFRIEND, COUPLE) than others (e.g., 24 % for CITY, PLACE, VILLAGE). After comparing the theme identifiabilities in the different conditions, the results indicated higher theme identifiability when the false-memory effect was explained than without such an explanation. Overall, these new normative data provide a useful tool for those experiments that, for example, aim to analyze the wide differences observed in false memory with DRM lists and the role of theme identifiability.

  7. Emergent Themes from Recent Research Syntheses in Science Education and Their Implications for Research Design, Replication, and Reporting Practices

    Science.gov (United States)

    Taylor, Joseph; Furtak, Erin; Kowalski, Susan; Martinez, Alina; Slavin, Robert; Stuhlsatz, Molly; Wilson, Christopher

    2016-01-01

    This article draws upon the experiences of four recent efforts to synthesize the findings of quantitative studies in science education research. After establishing the need for research syntheses in advancing generalizable knowledge and causal effects research in our field, we identify a set themes that emerged in the process of conducting these…

  8. Critical differences between elective and emergency surgery: identifying domains for quality improvement in emergency general surgery.

    Science.gov (United States)

    Columbus, Alexandra B; Morris, Megan A; Lilley, Elizabeth J; Harlow, Alyssa F; Haider, Adil H; Salim, Ali; Havens, Joaquim M

    2018-04-01

    The objective of our study was to characterize providers' impressions of factors contributing to disproportionate rates of morbidity and mortality in emergency general surgery to identify targets for care quality improvement. Emergency general surgery is characterized by a high-cost burden and disproportionate morbidity and mortality. Factors contributing to these observed disparities are not comprehensively understood and targets for quality improvement have not been formally developed. Using a grounded theory approach, emergency general surgery providers were recruited through purposive-criterion-based sampling to participate in semi-structured interviews and focus groups. Participants were asked to identify contributors to emergency general surgery outcomes, to define effective care for EGS patients, and to describe operating room team structure. Interviews were performed to thematic saturation. Transcripts were iteratively coded and analyzed within and across cases to identify emergent themes. Member checking was performed to establish credibility of the findings. A total of 40 participants from 5 academic hospitals participated in either individual interviews (n = 25 [9 anesthesia, 12 surgery, 4 nursing]) or focus groups (n = 2 [15 nursing]). Emergency general surgery was characterized by an exceptionally high level of variability, which can be subcategorized as patient-variability (acute physiology and comorbidities) and system-variability (operating room resources and workforce). Multidisciplinary communication is identified as a modifier to variability in emergency general surgery; however, nursing is often left out of early communication exchanges. Critical variability in emergency general surgery may impact outcomes. Patient-variability and system-variability, with focus on multidisciplinary communication, represent potential domains for quality improvement in this field. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Theme: Emerging Technologies.

    Science.gov (United States)

    Malpiedi, Barbara J.; And Others

    1989-01-01

    Consists of six articles discussing the effect of emerging technologies on agriculture. Specific topics include (1) agriscience programs, (2) the National Conference on Agriscience and Emerging Occupations and Technologies, (3) biotechnology, (4) program improvement through technology, (5) the Agriscience Teacher of the Year program, and (6)…

  10. Changes in themes over time from medical student journaling.

    Science.gov (United States)

    Cayley, William; Schilling, Rae; Suechting, Ralph

    2007-12-01

    There has been little exploration of journaling in medical student education. To document the themes on which medical students reflect during training. We evaluated journals kept by primary care medical students to identify prominent themes and determine change or constancy in themes over time. We looked at third-year medical students participating in a required primary care clerkship in a university-affiliated, community-based family medicine residency program with a rural catchment area. During 1994-1996 and 2001-2003, students were asked to keep weekly journals reflecting on their thoughts and feelings regarding "topical content, course processes and methods, and personal reflections on becoming a doctor." Faculty evaluated journals to identify change or constancy in themes over time. Prominent themes included gender issues, professional identity emergence, career choice, and rural practice, the experience of learning, the experience of relating to patients, and the nature of medical practice. We found both constancy and change in student journal themes over time. Changes in journal themes appeared to correlate with outside events and educational trends, including increased attention to reflective practice, changing demographics in medicine and the increasing acceptance of female physicians, and personal life events.

  11. Success stories and emerging themes in conservation physiology

    Science.gov (United States)

    Madliger, Christine L.; Cooke, Steven J.; Crespi, Erica J.; Funk, Jennifer L.; Hultine, Kevin R.; Hunt, Kathleen E.; Rohr, Jason R.; Sinclair, Brent J.; Suski, Cory D.; Willis, Craig K. R.; Love, Oliver P.

    2016-01-01

    The potential benefits of physiology for conservation are well established and include greater specificity of management techniques, determination of cause–effect relationships, increased sensitivity of health and disturbance monitoring and greater capacity for predicting future change. While descriptions of the specific avenues in which conservation and physiology can be integrated are readily available and important to the continuing expansion of the discipline of ‘conservation physiology’, to date there has been no assessment of how the field has specifically contributed to conservation success. However, the goal of conservation physiology is to foster conservation solutions and it is therefore important to assess whether physiological approaches contribute to downstream conservation outcomes and management decisions. Here, we present eight areas of conservation concern, ranging from chemical contamination to invasive species to ecotourism, where physiological approaches have led to beneficial changes in human behaviour, management or policy. We also discuss the shared characteristics of these successes, identifying emerging themes in the discipline. Specifically, we conclude that conservation physiology: (i) goes beyond documenting change to provide solutions; (ii) offers a diversity of physiological metrics beyond glucocorticoids (stress hormones); (iii) includes approaches that are transferable among species, locations and times; (iv) simultaneously allows for human use and benefits to wildlife; and (v) is characterized by successes that can be difficult to find in the primary literature. Overall, we submit that the field of conservation physiology has a strong foundation of achievements characterized by a diversity of conservation issues, taxa, physiological traits, ecosystem types and spatial scales. We hope that these concrete successes will encourage the continued evolution and use of physiological tools within conservation-based research and

  12. Success stories and emerging themes in conservation physiology.

    Science.gov (United States)

    Madliger, Christine L; Cooke, Steven J; Crespi, Erica J; Funk, Jennifer L; Hultine, Kevin R; Hunt, Kathleen E; Rohr, Jason R; Sinclair, Brent J; Suski, Cory D; Willis, Craig K R; Love, Oliver P

    2016-01-01

    The potential benefits of physiology for conservation are well established and include greater specificity of management techniques, determination of cause-effect relationships, increased sensitivity of health and disturbance monitoring and greater capacity for predicting future change. While descriptions of the specific avenues in which conservation and physiology can be integrated are readily available and important to the continuing expansion of the discipline of 'conservation physiology', to date there has been no assessment of how the field has specifically contributed to conservation success. However, the goal of conservation physiology is to foster conservation solutions and it is therefore important to assess whether physiological approaches contribute to downstream conservation outcomes and management decisions. Here, we present eight areas of conservation concern, ranging from chemical contamination to invasive species to ecotourism, where physiological approaches have led to beneficial changes in human behaviour, management or policy. We also discuss the shared characteristics of these successes, identifying emerging themes in the discipline. Specifically, we conclude that conservation physiology: (i) goes beyond documenting change to provide solutions; (ii) offers a diversity of physiological metrics beyond glucocorticoids (stress hormones); (iii) includes approaches that are transferable among species, locations and times; (iv) simultaneously allows for human use and benefits to wildlife; and (v) is characterized by successes that can be difficult to find in the primary literature. Overall, we submit that the field of conservation physiology has a strong foundation of achievements characterized by a diversity of conservation issues, taxa, physiological traits, ecosystem types and spatial scales. We hope that these concrete successes will encourage the continued evolution and use of physiological tools within conservation-based research and management

  13. Nanomedicine-emerging or re-emerging ethical issues? A discussion of four ethical themes.

    Science.gov (United States)

    Lenk, Christian; Biller-Andorno, Nikola

    2007-06-01

    Nanomedicine plays a prominent role among emerging technologies. The spectrum of potential applications is as broad as it is promising. It includes the use of nanoparticles and nanodevices for diagnostics, targeted drug delivery in the human body, the production of new therapeutic materials as well as nanorobots or nanoprotheses. Funding agencies are investing large sums in the development of this area, among them the European Commission, which has launched a large network for life-sciences related nanotechnology. At the same time government agencies as well as the private sector are putting forward reports of working groups that have looked into the promises and risks of these developments. This paper will begin with an introduction to the central ethical themes as identified by selected reports from Europe and beyond. In a next step, it will analyse the most frequently invoked ethical concerns-risk assessment and management, the issues of human identity and enhancement, possible implications for civil liberties (e.g. nanodevices that might be used for covert surveillance), and concerns about equity and fair access. Although it seems that the main ethical issues are not unique to nanotechnologies, the conclusion will argue against shrugging them off as non-specific items that have been considered before in the context of other biomedical technologies, such as gene therapy or xenotransplantation. Rather, the paper will call on ethicists to help foster a rational, fair and participatory discourse on the different potential applications of nanotechnologies in medicine, which can form the basis for informed and responsible societal and political decisions.

  14. Examining emergency department communication through a staff-based participatory research method: identifying barriers and solutions to meaningful change.

    Science.gov (United States)

    Cameron, Kenzie A; Engel, Kirsten G; McCarthy, Danielle M; Buckley, Barbara A; Mercer Kollar, Laura Min; Donlan, Sarah M; Pang, Peter S; Makoul, Gregory; Tanabe, Paula; Gisondi, Michael A; Adams, James G

    2010-12-01

    We test an initiative with the staff-based participatory research (SBPR) method to elicit communication barriers and engage staff in identifying strategies to improve communication within our emergency department (ED). ED staff at an urban hospital with 85,000 ED visits per year participated in a 3.5-hour multidisciplinary workshop. The workshop was offered 6 times and involved: (1) large group discussion to review the importance of communication within the ED and discuss findings from a recent survey of patient perceptions of ED-team communication; (2) small group discussions eliciting staff perceptions of communication barriers and best practices/strategies to address these challenges; and (3) large group discussions sharing and refining emergent themes and suggested strategies. Three coders analyzed summaries from group discussions by using latent content and constant comparative analysis to identify focal themes. A total of 127 staff members, including attending physicians, residents, nurses, ED assistants, and secretaries, participated in the workshop (overall participation rate 59.6%; range 46.7% to 73.3% by staff type). Coders identified a framework of 4 themes describing barriers and proposed interventions: (1) greeting and initial interaction, (2) setting realistic expectations, (3) team communication and respect, and (4) information provision and delivery. The majority of participants (81.4%) reported that their participation would cause them to make changes in their clinical practice. Involving staff in discussing barriers and facilitators to communication within the ED can result in a meaningful process of empowerment, as well as the identification of feasible strategies and solutions at both the individual and system levels. Copyright © 2010 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

  15. Integrating themes, evidence gaps, and research needs identified by workshop on iron screening and supplementation in iron-replete pregnant women and young children.

    Science.gov (United States)

    Brannon, Patsy M; Stover, Patrick J; Taylor, Christine L

    2017-12-01

    This report addresses the evidence and the uncertainties, knowledge gaps, and research needs identified by participants at the NIH workshop related to iron screening and routine iron supplementation of largely iron-replete pregnant women and young children (6-24 mo) in developed countries. The workshop presentations and panel discussions focused on current understanding and knowledge gaps related to iron homeostasis, measurement of and evidence for iron status, and emerging concerns about supplementing iron-replete members of these vulnerable populations. Four integrating themes emerged across workshop presentations and discussion and centered on 1 ) physiologic or developmental adaptations of iron homeostasis to pregnancy and early infancy, respectively, and their implications, 2 ) improvement of the assessment of iron status across the full continuum from iron deficiency anemia to iron deficiency to iron replete to iron excess, 3 ) the linkage of iron status with health outcomes beyond hematologic outcomes, and 4 ) the balance of benefit and harm of iron supplementation of iron-replete pregnant women and young children. Research that addresses these themes in the context of the full continuum of iron status is needed to inform approaches to the balancing of benefits and harms of screening and routine supplementation. © 2017 American Society for Nutrition.

  16. "Anonymous Meltdown": Content Themes Emerging in a Nonfacilitated, Peer-only, Unstructured, Asynchronous Online Support Group for Family Caregivers.

    Science.gov (United States)

    Diefenbeck, Cynthia A; Klemm, Paula R; Hayes, Evelyn R

    2017-12-01

    By providing care for loved ones in the home, family caregivers save millions of dollars for our overtaxed healthcare system. Support groups can lighten the psychological burden of caregiving. Nonprofessionally facilitated (or peer) online caregiver support groups can help meet a critical need in healthcare as a low-cost resource for caregivers. Online caregiver peer support groups can promote the health and well-being of family caregivers and, by extension, the patients themselves, resulting in cost-savings for society. A better understanding of these types of groups is of critical importance, given the unrelenting pace of demographic shift in the United States. The purpose of this study was to examine content themes emerging from an unstructured, asynchronous online peer support group for family caregivers of people with chronic illness. Qualitative content analysis was used, yielding six themes: "experiencing the emotional toll," "need for catharsis/venting," "finding the silver linings," "seeking specific advice/problem solving," "realizing home is no longer a haven," and "adapting to the caregiver role." The themes reflect what emerged organically in an online support group that was not professionally facilitated or structured in any way. Heterogeneity in the relationship between caregivers and care recipients may negatively affect outcomes and requires further study.

  17. Therapeutic affordances of social media: emergent themes from a global online survey of people with chronic pain.

    Science.gov (United States)

    Merolli, Mark; Gray, Kathleen; Martin-Sanchez, Fernando

    2014-12-22

    Research continues to present tenuous suggestions that social media is well suited to enhance management of chronic disease and improve health outcomes. Various studies have presented qualitative reports of health outcomes from social media use and have examined discourse and communication themes occurring through different social media. However, there is an absence of published studies examining and unpacking the underlying therapeutic mechanisms driving social media's effects. This paper presents a qualitative analysis thoroughly describing what social media therapeutically affords people living with chronic pain who are self-managing their condition. From this therapeutic affordance perspective, we aim to formulate a preliminary conceptual model aimed at better understanding "how" social media can influence patient outcomes. In total, 218 people with chronic pain (PWCP) completed an online survey, investigating patient-reported outcomes (PROs) from social media use. Supplementary to quantitative data collected, participants were also given the opportunity to provide further open commentary regarding their use of social media as part of chronic pain management; 68/218 unique users (31.2%) chose to provide these free-text responses. Through thematic content analysis, 117 free-text responses regarding 10 types of social media were coded. Quotes were extracted and tabulated based on therapeutic affordances that we had previously identified. Inductive analysis was then performed to code defining language and emergent themes central to describing each affordance. Three investigators examined the responses, developed the coding scheme, and applied the coding to the data. We extracted 155 quotes from 117 free-text responses. The largest source of quotes came from social network site users (78/155, 50.3%). Analysis of component language used to describe the aforementioned affordances and emergent themes resulted in a final revision and renaming of therapeutic affordances

  18. The Future of Organization Design: An Interpretative Synthesis in Three Themes

    Directory of Open Access Journals (Sweden)

    Richard M. Burton

    2013-04-01

    Full Text Available In the inaugural issue of the Journal of Organization Design (Vol. 1, #1, 2012, noted scholars and experienced practitioners presented their views on the future of organization design. The seven wise and provocative statements were subsequently discussed by members of the Organizational Design Community at a conference held at Harvard University on August 3, 2012. I was asked by JOD to monitor the discussion and identify the broad organization design themes that emerged. Although the discussion was wide ranging, three themes were noticeable. The first theme is that there are fundamentals of organization design, and all agreed that design involves creating a cohesive socio-technical system from a number of constituent elements. The second theme is that the boundaries of many newer organizational forms extend beyond that of the single firm, so the scope of organization design needs to expand to include ecosystems, collaborative communities, industries, and other supra-firm architectures. The third theme involves time and change, requiring a shift in focus from how organizations become stable and predictable to how they can become more agile.

  19. Genes2WordCloud: a quick way to identify biological themes from gene lists and free text.

    Science.gov (United States)

    Baroukh, Caroline; Jenkins, Sherry L; Dannenfelser, Ruth; Ma'ayan, Avi

    2011-10-13

    Word-clouds recently emerged on the web as a solution for quickly summarizing text by maximizing the display of most relevant terms about a specific topic in the minimum amount of space. As biologists are faced with the daunting amount of new research data commonly presented in textual formats, word-clouds can be used to summarize and represent biological and/or biomedical content for various applications. Genes2WordCloud is a web application that enables users to quickly identify biological themes from gene lists and research relevant text by constructing and displaying word-clouds. It provides users with several different options and ideas for the sources that can be used to generate a word-cloud. Different options for rendering and coloring the word-clouds give users the flexibility to quickly generate customized word-clouds of their choice. Genes2WordCloud is a word-cloud generator and a word-cloud viewer that is based on WordCram implemented using Java, Processing, AJAX, mySQL, and PHP. Text is fetched from several sources and then processed to extract the most relevant terms with their computed weights based on word frequencies. Genes2WordCloud is freely available for use online; it is open source software and is available for installation on any web-site along with supporting documentation at http://www.maayanlab.net/G2W. Genes2WordCloud provides a useful way to summarize and visualize large amounts of textual biological data or to find biological themes from several different sources. The open source availability of the software enables users to implement customized word-clouds on their own web-sites and desktop applications.

  20. Therapeutic Affordances of Social Media: Emergent Themes From a Global Online Survey of People With Chronic Pain

    Science.gov (United States)

    Gray, Kathleen; Martin-Sanchez, Fernando

    2014-01-01

    Background Research continues to present tenuous suggestions that social media is well suited to enhance management of chronic disease and improve health outcomes. Various studies have presented qualitative reports of health outcomes from social media use and have examined discourse and communication themes occurring through different social media. However, there is an absence of published studies examining and unpacking the underlying therapeutic mechanisms driving social media’s effects. Objective This paper presents a qualitative analysis thoroughly describing what social media therapeutically affords people living with chronic pain who are self-managing their condition. From this therapeutic affordance perspective, we aim to formulate a preliminary conceptual model aimed at better understanding "how" social media can influence patient outcomes. Methods In total, 218 people with chronic pain (PWCP) completed an online survey, investigating patient-reported outcomes (PROs) from social media use. Supplementary to quantitative data collected, participants were also given the opportunity to provide further open commentary regarding their use of social media as part of chronic pain management; 68/218 unique users (31.2%) chose to provide these free-text responses. Through thematic content analysis, 117 free-text responses regarding 10 types of social media were coded. Quotes were extracted and tabulated based on therapeutic affordances that we had previously identified. Inductive analysis was then performed to code defining language and emergent themes central to describing each affordance. Three investigators examined the responses, developed the coding scheme, and applied the coding to the data. Results We extracted 155 quotes from 117 free-text responses. The largest source of quotes came from social network site users (78/155, 50.3%). Analysis of component language used to describe the aforementioned affordances and emergent themes resulted in a final revision

  1. Teaching Public Administration: Key Themes 1996-2016

    Science.gov (United States)

    Fenwick, John

    2018-01-01

    In this article, the aim is to explore some of the key themes to emerge in the journal during the past two decades. Each selected theme will be reviewed in the light of issues raised in particular papers. The aim of this approach is, first, to facilitate reflection upon the contribution of the journal as its subject matter has moved from a concern…

  2. Genes2WordCloud: a quick way to identify biological themes from gene lists and free text

    Directory of Open Access Journals (Sweden)

    Ma'ayan Avi

    2011-10-01

    Full Text Available Abstract Background Word-clouds recently emerged on the web as a solution for quickly summarizing text by maximizing the display of most relevant terms about a specific topic in the minimum amount of space. As biologists are faced with the daunting amount of new research data commonly presented in textual formats, word-clouds can be used to summarize and represent biological and/or biomedical content for various applications. Results Genes2WordCloud is a web application that enables users to quickly identify biological themes from gene lists and research relevant text by constructing and displaying word-clouds. It provides users with several different options and ideas for the sources that can be used to generate a word-cloud. Different options for rendering and coloring the word-clouds give users the flexibility to quickly generate customized word-clouds of their choice. Methods Genes2WordCloud is a word-cloud generator and a word-cloud viewer that is based on WordCram implemented using Java, Processing, AJAX, mySQL, and PHP. Text is fetched from several sources and then processed to extract the most relevant terms with their computed weights based on word frequencies. Genes2WordCloud is freely available for use online; it is open source software and is available for installation on any web-site along with supporting documentation at http://www.maayanlab.net/G2W. Conclusions Genes2WordCloud provides a useful way to summarize and visualize large amounts of textual biological data or to find biological themes from several different sources. The open source availability of the software enables users to implement customized word-clouds on their own web-sites and desktop applications.

  3. Intuition in emergency nursing: a phenomenological study.

    Science.gov (United States)

    Lyneham, Joy; Parkinson, Camillus; Denholm, Carey

    2008-04-01

    The evidence of experience of intuitive knowing in the clinical setting has to this point only been informal and anecdotal. Reported experiences thus need to be either validated or refuted so that its place in emergency nursing can be determined. The history, nature and component themes captured within the intuitive practice of emergency nursing are described. This study was informed by the philosophy and method of phenomenology. Participants were 14 experienced emergency nurses. Through their narrative accounts and recall of events their experience of knowing was captured. Through a Van Manen process and a Gadamerian analysis, six themes associated with the ways in which the participants experienced intuition in clinical practice, were identified. This paper reveals the six emerging themes as knowledge, experience, connection, feeling, syncretism and trust.

  4. New Themes in Physics Teaching: A personal retrospective

    OpenAIRE

    Dykstra, Dewey

    2012-01-01

    For a little over 40 years, what we label now, physics education research, has been conducted.  As a result, new themes in the research in physics learning and in physics education have emerged.  Some of these themes are cognitivism, qualitative research, learning as construction of knowledge, epistemological underpinnings that are not realist, student understanding-driven pedagogies, and scholarship in fields outside physics.  These themes have arisen in minds of our colleagues, who focus th...

  5. Effective use of forensic science in volume crime investigations: identifying recurring themes in the literature.

    Science.gov (United States)

    Ludwig, Anika; Fraser, Jim

    2014-01-01

    New scientific, technological and legal developments, particularly the introduction of national databases for DNA and fingerprints, have led to increased use of forensic science in the investigation of crime. There is an assumption, and in some instances specific assertions, that such developments bring improvements either in broad criminal justice terms or more narrowly in terms of economic or practical efficiencies. The underlying presumption is that the new technological opportunities will be understood and effectively implemented. This research investigates whether such increases in activity have also been accompanied by improvements in the effective use of forensic science. A systematic review of thirty-six reports published (predominantly in England and Wales) since the 1980s, which have considered the use of forensic science in the investigation of volume crimes, was carried out. These reports have identified a number of recurrent themes that influenced how effectively forensic science was used in investigations. The themes identified included forensic knowledge and training of investigators, communication and information exchange between specialists and investigators, timeliness of forensic results, interagency relationships and deployment of crime scene examiner resources. The research findings suggest that these factors continue to hinder the effective use of forensic science despite technological advances and this paper considers their potential causes. © 2013.

  6. New Themes in Physics Teaching: A Personal Retrospective

    Science.gov (United States)

    Dykstra, Dewey I., Jr.

    2012-01-01

    For a little over 40 years, what we label now physics education research has been conducted. As a result, a new type of theme in the research and in physics education has emerged. Some of these themes are cognitivism, research as qualitative, learning as construction of knowledge, theoretical underpinnings that are not realist, student-centered…

  7. Ask an anatomist: Identifying global trends, topics and themes of academic anatomists using twitter.

    Science.gov (United States)

    Marsland, Madeleine J; Lazarus, Michelle D

    2018-05-06

    Social media (SoMe) is increasingly used in higher education (HE) to access knowledge and enable global communication. The SoMe platform Twitter ® is particularly beneficial in these contexts because it is readily accessible, easily searchable (via hashtags) and global. Given these advantages, the twitter platform @AskAnatomist was created to foster a global weekly tweet chat, where students and academics can ask and address anatomy-related questions. The aim of this study was to identify themes arising in the early stages of the @AskAnatomy Twitter community to gain insights into current needs/key areas for academic anatomists, students, and other followers. A qualitative analysis of tweets including the hashtag #AnatQ, (the associated @AskAnatomist hashtag), was undertaken to achieve this aim. Thematic analysis revealed three core themes arising in the formative stages of the @AskAnatomist Twitter site: (1) anatomical education modalities, (2) specific anatomy content, and (3) research motivations. These themes reveal controversies within the field of anatomical sciences, areas for potential education resource improvement and research, as well as the humor of anatomists. Though the original intent of the @AskAnatomist site was to engage the general public in anatomy content and knowledge, tweet analysis suggests that academic anatomists were the primary active "tweeters". Interestingly, this analysis reveals that the @AskAnatomist site progressed into a web-based community of practice (CoP), suggesting an additional benefit of SoMe communities in the field of anatomy. Anat Sci Educ 11: 270-281. © 2017 American Association of Anatomists. © 2017 American Association of Anatomists.

  8. Exploratory Analysis of Marketing and Non-marketing E-cigarette Themes on Twitter.

    Science.gov (United States)

    Han, Sifei; Kavuluru, Ramakanth

    2016-11-01

    Electronic cigarettes (e-cigs) have been gaining popularity and have emerged as a controversial tobacco product since their introduction in 2007 in the U.S. The smoke-free aspect of e-cigs renders them less harmful than conventional cigarettes and is one of the main reasons for their use by people who plan to quit smoking. The US food and drug administration (FDA) has introduced new regulations early May 2016 that went into effect on August 8, 2016. Given this important context, in this paper, we report results of a project to identify current themes in e-cig tweets in terms of semantic interpretations of topics generated with topic modeling. Given marketing/advertising tweets constitute almost half of all e-cig tweets, we first build a classifier that identifies marketing and non-marketing tweets based on a hand-built dataset of 1000 tweets. After applying the classifier to a dataset of over a million tweets (collected during 4/2015 - 6/2016), we conduct a preliminary content analysis and run topic models on the two sets of tweets separately after identifying the appropriate numbers of topics using topic coherence. We interpret the results of the topic modeling process by relating topics generated to specific e-cig themes. We also report on themes identified from e-cig tweets generated at particular places (such as schools and churches) for geo-tagged tweets found in our dataset using the GeoNames API. To our knowledge, this is the first effort that employs topic modeling to identify e-cig themes in general and in the context of geo-tagged tweets tied to specific places of interest.

  9. Identifying and Addressing Themes of Job Dissatisfaction for Secondary Principals

    Science.gov (United States)

    De Jong, David; Grundmeyer, Trent; Yankey, Julie

    2017-01-01

    Secondary principals serve in important roles that are complex, high-stress, and include demanding job responsibilities. Key stakeholders such as superintendents, school board members, and legislators must understand the challenges facing secondary principals in order to address the current themes of job dissatisfaction. Using new survey data…

  10. Literature overview highlights lack of paediatric donation protocols but identifies common themes that could guide their development.

    Science.gov (United States)

    Vileito, A; Siebelink, M J; Verhagen, Aae

    2018-05-01

    Paediatric donation is a unique and extremely sensitive process that requires specific knowledge and competencies. Most countries use protocols for organ and tissue donation to ensure optimal care for the donor and family, but these mainly focus on adults. However, the donation process for children differs from adults in many ways. An overview of the literature was performed to identify protocols for the paediatric population. PubMed, Web of Science, EMBASE and the Internet were searched up to March 2016 for papers or other sources in English related to specific organ and tissue donation protocols for children and neonates. This comprised title, abstract and then full-text screening of relevant data. We included 12 papers and two electronic sources that were mainly from North America and Europe. Most discussed donations after cardiac death. The recurring themes included identifying potential donors, approaching parents, palliative care and collaboration with organ procurement organisations. Most papers called for paediatric donation policies to be standardised. Scientific publications in English on paediatric donation protocols are very scarce. No comprehensive paediatric donation protocol was found. We identified several recurring themes in the literature that could be used to develop such protocols. ©2018 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

  11. Mind the Gap. A systematic review to identify usability and safety challenges and practices during electronic health record implementation.

    Science.gov (United States)

    Ratwani, Raj; Fairbanks, Terry; Savage, Erica; Adams, Katie; Wittie, Michael; Boone, Edna; Hayden, Andrew; Barnes, Janey; Hettinger, Zach; Gettinger, Andrew

    2016-11-16

    Decisions made during electronic health record (EHR) implementations profoundly affect usability and safety. This study aims to identify gaps between the current literature and key stakeholders' perceptions of usability and safety practices and the challenges encountered during the implementation of EHRs. Two approaches were used: a literature review and interviews with key stakeholders. We performed a systematic review of the literature to identify usability and safety challenges and best practices during implementation. A total of 55 articles were reviewed through searches of PubMed, Web of Science and Scopus. We used a qualitative approach to identify key stakeholders' perceptions; semi-structured interviews were conducted with a diverse set of health IT stakeholders to understand their current practices and challenges related to usability during implementation. We used a grounded theory approach: data were coded, sorted, and emerging themes were identified. Conclusions from both sources of data were compared to identify areas of misalignment. We identified six emerging themes from the literature and stakeholder interviews: cost and resources, risk assessment, governance and consensus building, customization, clinical workflow and usability testing, and training. Across these themes, there were misalignments between the literature and stakeholder perspectives, indicating major gaps. Major gaps identified from each of six emerging themes are discussed as critical areas for future research, opportunities for new stakeholder initiatives, and opportunities to better disseminate resources to improve the implementation of EHRs. Our analysis identified practices and challenges across six different emerging themes, illustrated important gaps, and results suggest critical areas for future research and dissemination to improve EHR implementation.

  12. Theming Asia

    NARCIS (Netherlands)

    Erb, Maribeth; Ong, Chin Ee

    2017-01-01

    This paper introduces a special issue on Theme Parks in Asia with reflections on how the various theoretical ideas on theming and theme parks that are found in the social science literature can help us to understand the proliferation of theming and theme parks in contemporary Asia. How does theming

  13. Corporate Foresight: An Emerging Field with a Rich Tradition

    DEFF Research Database (Denmark)

    Rohrbeck, René; Battistella, Cinzia; Huizingh, Eelko

    2015-01-01

    The goal of this introductory article to the Special Issue on Corporate Foresight is to provide an overview of the state of the art, major challenges and to identify development trajectories. We define corporate foresight as an ability that permits an organization to lay the foundation for a future...... of them on corporate foresight. Based on these articles and those in this Special Issue, we identify four main themes. Two more mature themes, namely ‘organizing corporate foresight’, and ‘individual and collective cognition’, and two emerging themes ‘corporate foresight in networked organizations...

  14. A bibliometric model for identifying emerging research topics

    DEFF Research Database (Denmark)

    Wang, Qi

    2018-01-01

    –1843, 2015), the most serious problems are the lack of an acknowledged definition of emergence and incomplete elaboration of the linkages between the definitions that are used and the indicators that are created. With these issues in mind, this study first adjusts the definition of an emerging technology...... that Rotolo et al. (2015) have proposed to accommodate the analysis. Next, a set of criteria for the identification of emerging topics is proposed according to the adjusted definition and attributes of emergence. Using two sets of parameter values, several emerging research topics are identified. Finally...

  15. International Business Education: Identifying the Emergent Topics in International Business and Their Relevance for Knowledge Development.

    Science.gov (United States)

    Yeoh, Poh-Lin

    2001-01-01

    Sampled faculty in international business (IB) to better understand emerging themes in that area. Seven major topical areas were uncovered: general knowledge of IB, international trade and institutions, cross-cultural issues, managing global operations, international ethics, international monetary systems, and international political/regulatory…

  16. Themes addressed by couples with advanced cancer during a communication skills training intervention.

    Science.gov (United States)

    Porter, Laura S; Fish, Laura; Steinhauser, Karen

    2018-04-25

    Couple-based communication interventions have beneficial effects for patients with cancer and their partners. However, few studies have targeted patients with advanced stages of disease and little is known about how best to assist couples in discussing issues related to life-limiting illness. The purpose of the present study was to identify themes couples addressed during a couple communication skills intervention, and the frequency with which they discussed issues related to end-of-life. Content analyses were conducted on recordings of 72 sessions from 12 couples facing advanced gastrointestinal (GI) cancer. Coding was based six themes identified a priori from the framework for understanding what patients and family value at end of life. The percent of couples addressing each theme was calculated to gauge level of importance and acceptability of these topics. The majority of couples addressed topics previously identified as salient at end-of-life, including clear decision making, affirmation of the whole person, pain and symptom management, contributing to others, and preparation for death. In addition, novel aspects to these themes emerged in the context of couples' conversations, illustrating the importance of the couple relationship in adjusting to life with a life-limiting illness and anticipating the transition to end-of-life. Findings suggest that couples likely would be receptive to an intervention that combines training in communication skills with guidance in focusing on issues related to life completion to assist with transitions at end of life. Such interventions might enhance both individuals' abilities to cope with illness-related symptoms and demands, enjoy the time they have together, and derive meaning from the experience. Copyright © 2018. Published by Elsevier Inc.

  17. Learning from critical case reviews: emergent themes and their impact on practice.

    Science.gov (United States)

    Crofts, Linda

    2006-12-01

    This paper describes the process of conducting critical case reviews as part of a leadership programme for critical care. Forty-five cases were reviewed over 2 years in five different hospitals and permission was sought from local research ethics committees and research and development committees for the discussions to be treated as research data. Typically the cases presented were patients with complex needs whose trajectory of care had not gone smoothly. Key themes to emerge from the case reviews were: The case reviews themselves were: Communication failures between professional groups, between professional themselves, between staff and families, between wards and departments and between different hospitals. Documentation was also often less than satisfactory. Teams often had problems in working together as a team and different professionals often had different expectations of other members of the team. Individual action may compensate for weaknesses in formal clinical risk system. The case reviews themselves were showcases of the difficulties the health service faces every day and the challenges of communicating effectively. The case reviews provided an effective medium to both resolve those difficulties and model a means through which teams could effectively manage and communicate patient care issues. Furthermore their strength as a learning tool was attributed to team learning as a powerful catalyst for change.

  18. Effects of marital conflict on children: recent advances and emerging themes in process-oriented research.

    Science.gov (United States)

    Cummings, E Mark; Davies, Patrick T

    2002-01-01

    The effects of marital conflict on children's adjustment are well documented. For the past decade research has increasingly focused on advancing a process-level understanding of these effects, that is, accounting for the particular responses and patterns embedded within specific contexts, histories, and developmental periods that account for children's outcomes over time. As a vehicle for presenting an update, this review follows the framework for process-oriented research initially proposed by Cummings and Cummings (1988), concentrating on recent research developments, and also considering new and emerging themes in this area of research. In this regard, areas of advancement include (a) greater articulation of the effects of specific context/stimulus characteristics of marital conflict, (b) progress in identifying the psychological response processes in children (e.g., cognitive, emotional, social, physiological) that are affected and their possible role in accounting for relations between marital conflict and child outcomes, (c) greater understanding of the role of child characteristics, family history, and other contextual factors, including effects on children due to interrelations between marital conflict and parenting, and (d) advances in the conceptualization of children's outcomes, including that effects may be more productively viewed as dynamic processes of functioning rather than simply clinical diagnoses. Understanding of the impact of marital conflict on children as a function of time-related processes remains a gap in a process-oriented conceptualization of effects. Based on this review, a revised model for a process-oriented approach on the effects of marital discord on children is proposed and suggestions are made for future research directions.

  19. The origins of psychology in Italy: Themes and authors that emerge through a content analysis of the Rivista di Filosofia Scientifica [Journal of Scientific Philosophy].

    Science.gov (United States)

    Bartolucci, Chiara; Lombardo, Giovanni Pietro

    2012-08-01

    This article examines the scientific-cultural context of the second half of the 1800s, during which psychological science emerged in Italy. The article explores the contribution made by the emergence of the primary research traditions of that period, namely, physiological anthropology and phreniatry, by means of a methodology that combines content analysis with a classical historiographical study of the period. Themes and authors deriving from the various disciplines in the human and natural sciences were identified through a content analysis of the Rivista di Filosofia Scientifica [Journal of Scientific Philosophy], a periodical that is representative of Italian positivism. The analysis highlights the epistemological perspective held by scholars who, distancing themselves from the mechanistic reductionism of the proponents of positivism, integrated a naturalistic and evolutionary conceptualization with the neo-Kantian critique. A clearly delineated naturalistic and differential perspective of scientific research that brought about the birth of psychology as an experimental discipline in Italy in the 1900s emerges from the analysis, including psychology and psychopathology as studied by the phreniatrists Gabriele Buccola, Enrico Morselli, and Eugenio Tanzi; Tito Vignoli and Giuseppe Sergi's work in comparative anthropology; Giulio Fano's approach and contribution to physiology; and Enrico Ferri's contribution to criminology. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

  20. Developing practical knowledge content of emergency nursing professionals.

    Science.gov (United States)

    Chu, Wen; Hsu, Li-Ling

    2011-06-01

    There is a paucity of published research on clinical or practical nursing knowledge. The ways that nurses acquire, develop, and maintain emergency room (ER) nursing care skills is a research area, in particular, that deserves further investigation. This study examined clinical setting learning processes to better understand the practical knowledge content of ER nurses. This study used a phenomenological approach and in-depth interviews of 10 nurses. Each participant had at least 3 years of ER experience. Researchers used Moustakas' method to analyze interview data. Findings were checked for credibility, transferability, dependability, and confirmability. The authors identified four major practical knowledge themes for ER professionals. These were (a) basic emergency treatment procedure routines and symptom management; (b) disease mechanisms, pharmacodynamics, and treatment responses; (c) newly identified diseases, updated emergency treatments and techniques, and medical treatment discussions; and (d) identifying nursing values including nursing attitudes and continuing patient care. Participants in this study had experience with the first three themes and successfully combined various types of nursing knowledge in their nursing care duties. Only few participants indicated experience with the fourth theme. Findings clarify that clinical or practical knowledge in ER nurses evolves first from declarative knowledge (e.g., basic emergency treatment routines and operating procedures) to procedural knowledge (e.g., instructions from supervisors, actual practice, and drills) to conditional knowledge (e.g., observation and treatment involving direct interactions with patients). Nurses should combine and apply the various knowledge types in their nursing practice to assess comprehensively each patient's condition and administer effective treatment and service.

  1. A Framework for Mobile User Experiences in Theme Parks

    DEFF Research Database (Denmark)

    Østergaard, Claus Møller

    2013-01-01

    This paper proposes a framework, which contributes to a better theoretical understanding of mobile user experience in theme parks that is not limited to (a) personal smartphones, (b) a specific theme park, or (c) specific mobile content. Thus, the paper contributes to the field of mobile user...... experience in theme parks within HCI. The identified aspects constituting the mobile user experience in theme parks are the environmental context, the social context, the functional context, the mobile interface, and of course the mobile content. The framework is developed based on five diverse case studies...

  2. Emerging technologies, innovative teachers and moral cohesion

    CSIR Research Space (South Africa)

    Batchelor, J

    2012-05-01

    Full Text Available efficacy when they engage with emerging technologies. The concept of moral cohesion is further expanded and forms the main focus of this article. Keywords: emerging technologies, innovative teachers, moral cohesion, pedagogies, ethics, teacher.... African Renaissance and teacher disposition is identified as the strongest drivers. Teacher training forms the link between the strong drivers and the outcomes manifest as Stewardship and ethical considerations. 3.2 Professional Burden The theme...

  3. Scientometric methods for identifying emerging technologies

    Science.gov (United States)

    Abercrombie, Robert K; Schlicher, Bob G; Sheldon, Frederick T

    2015-11-03

    Provided is a method of generating a scientometric model that tracks the emergence of an identified technology from initial discovery (via original scientific and conference literature), through critical discoveries (via original scientific, conference literature and patents), transitioning through Technology Readiness Levels (TRLs) and ultimately on to commercial application. During the period of innovation and technology transfer, the impact of scholarly works, patents and on-line web news sources are identified. As trends develop, currency of citations, collaboration indicators, and on-line news patterns are identified. The combinations of four distinct and separate searchable on-line networked sources (i.e., scholarly publications and citation, worldwide patents, news archives, and on-line mapping networks) are assembled to become one collective network (a dataset for analysis of relations). This established network becomes the basis from which to quickly analyze the temporal flow of activity (searchable events) for the example subject domain.

  4. Research in auditing: main themes

    Directory of Open Access Journals (Sweden)

    Marcelo Porte

    Full Text Available ABSTRACT The passage of the Sarbanes-Oxley Act (SOX was a turning point in auditing and in auditors practice for the academic world. Research concerning the characterization of academic production related to auditing is in its third decade. Its analysis is accomplished by means of definition of keywords, abstracts or title, and information on thematic association within the academic production itself in auditing is undisclosed. In order to revise this gap in auditing literature, this study identified the main themes in auditing and their association in post-SOX era by analyzing the content of objectives and hypothesis of 1,650 publications in Web of Science (2002-2014. The findings in this study extended those from the study by Lesage and Wechtler (2012 from 16 auditing thematic typologies to 22. The results demonstrate that the themes audit report & financial statement users, corporate governance, audit market, external audit, socio-economic data of the company, international regulation, and fraud risk & audit risk were the most addressed in the publications about auditing. Corporate governance has a broader association with the other themes in the area. Future researches may use these themes and relate them to the methodologies applied to audit studies.

  5. Role of Pediatric Emergency Physicians in Identifying Bullying.

    Science.gov (United States)

    Waseem, Muhammad; Paul, Audrey; Schwartz, Gerald; Pauzé, Denis; Eakin, Paul; Barata, Isabel; Holtzman, Doug; Benjamin, Lee S; Wright, Joseph L; Nickerson, Amanda B; Joseph, Madeline

    2017-02-01

    Bullying is an important public health issue with broad implications. Although this issue has been studied extensively, there is limited emergency medicine literature addressing bullying. The emergency department (ED) physician has a unique opportunity to identify children and adolescents that are victims of bullying, and make a difference in their lives. Our aim is to discuss the role of the emergency physician (EP) in identifying patients who have been victims of bullying and how to provide effective management as well as referral for further resources. This document provides a framework for recognizing, stabilizing, and managing children who have experienced bullying. With the advent of social media, bullying behavior is not limited to in-person situations, and often occurs via electronic communication, further complicating recognition because it may not impart any physical harm to the child. Recognition of bullying requires a high level of suspicion, as patients may not offer this history. After the stabilization of any acute or overt indications of physical injury, along with obtaining a history of the mechanism of injury, the EP has the opportunity to identify the existence of bullying as the cause of the injury, and can address the issue in the ED while collaborating with "physician-extenders," such as social workers, toward identifying local resources for further support. The ED is an important arena for the assessment and management of children who have experienced bullying. It is imperative that EPs on the front lines of patient care address this public health epidemic. They have the opportunity to exert a positive impact on the lives of the children and families who are the victims of bullying. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Chameleon Changes: An Exploration of Racial Identity Themes of Multiracial People

    Science.gov (United States)

    Miville, Marie L.; Constantine, Madonna G.; Baysden, Matthew F.; So-Lloyd, Gloria

    2005-01-01

    The current study explored essential themes of racial identity development among 10 self-identified multiracial adults from a variety of racial backgrounds. Participants were interviewed using a semistructured protocol, and the interviews were recorded, transcribed, and then coded for themes by research team members. Four primary themes were…

  7. Societal acceptance of wind farms: Analysis of four common themes across Australian case studies

    International Nuclear Information System (INIS)

    Hall, N.; Ashworth, P.; Devine-Wright, P.

    2013-01-01

    Australia's renewable energy target (RET) seeks to provide 20 per cent of Australia's electricity generation from renewable energy sources by 2020. As wind power is relatively advanced, it was anticipated that wind power will contribute a major component of the early target. However, high levels of societal resistance to wind farms, combined with new regulatory policies, indicate the RET may not be dominated by wind power. This research involved an examination of seven case studies around wind farm deployment. Qualitative interviews were the primary data for the case studies and analysed using methods informed by grounded theory. Despite the diversity of stakeholder views, the qualitative analysis identified strong community support for wind farms but four common themes emerged that influence this societal acceptance of wind farms in Australia: trust, distributional justice, procedural justice and place attachment. Without addressing these factors through integration into policy development and engagement approaches, wind energy is unlikely to provide the early and majority of new renewable energy. Similar international experiences are incorporated in the discussion of the Australian wind industry's societal acceptance. - Highlights: ► Seven case studies of wind farms in Australia are described. ► Acceptance affects whether wind significantly contributes to the Aust. RE target. ► Four themes were identified regarding societal acceptance of Australian wind farms. ► Four themes are trust, distributional and procedural justice, and place attachment. ► International similarities to the Australian experience are provided

  8. Identifying Emerging Trends of Financial Business Method Patents

    Directory of Open Access Journals (Sweden)

    Won Sang Lee

    2017-09-01

    Full Text Available Financial technology has become an important part of the banking industry in recent times. This study attempts to propose a framework to identify emerging areas and trends using financial business method patents. Based on the abstracts of financial business method patents registered at the United States Patent and Trademark Office, this study first applies latent Dirichlet allocation to identify emerging topics. The probability of the annual occurrence of each topic is adjusted through the exponentially weighted moving average to reflect the importance of the recent probability of topics. Each topic is classified as “hot” or “cold” depending on whether the exponentially weighted moving average of the probabilities exceeds the threshold. We applied survival analysis to the time gap of recurrently becoming hot from a cold status with the associated factor of financial business method patents. The findings suggest that the topic with the short granted period and high forward citation is likely to become hot. In addition, the topic that is aged and specific in narrow areas is likely to continuously change into the hot or cold status. The approach proposed in this study contributes toward understanding topic emergence in the financial area and pursuing sustainable development.

  9. Barriers and facilitators for implementing a new screening tool in an emergency department: A qualitative study applying the Theoretical Domains Framework.

    Science.gov (United States)

    Kirk, Jeanette W; Sivertsen, Ditte M; Petersen, Janne; Nilsen, Per; Petersen, Helle V

    2016-10-01

    The aim was to identify the factors that were perceived as most important as facilitators or barriers to the introduction and intended use of a new tool in the emergency department among nurses and a geriatric team. A high incidence of functional decline after hospitalisation for acute medical illness has been shown in the oldest patients and those who are physically frail. In Denmark, more than 35% of older medical patients acutely admitted to the emergency department are readmitted within 90 days after discharge. A new screening tool for use in the emergency department aiming to identify patients at particularly high risk of functional decline and readmission was developed. Qualitative study based on semistructured interviews with nurses and a geriatric team in the emergency department and semistructured single interviews with their managers. The Theoretical Domains Framework guided data collection and analysis. Content analysis was performed whereby new themes and themes already existing within each domain were described. Six predominant domains were identified: (1) professional role and identity; (2) beliefs about consequences; (3) goals; (4) knowledge; (5) optimism and (6) environmental context and resources. The content analysis identified three themes, each containing two subthemes. The themes were professional role and identity, beliefs about consequences and preconditions for a successful implementation. Two different cultures were identified in the emergency department. These cultures applied to different professional roles and identity, different actions and sense making and identified how barriers and facilitators linked to the new screening tool were perceived. The results show that different cultures exist in the same local context and influence the perception of barriers and facilitators differently. These cultures must be identified and addressed when implementation is planned. © 2016 The Authors. Journal of Clinical Nursing Published by John

  10. Gender-specific research for emergency diagnosis and management of ischemic heart disease: proceedings from the 2014 Academic Emergency Medicine Consensus Conference Cardiovascular Research Workgroup.

    Science.gov (United States)

    Safdar, Basmah; Nagurney, John T; Anise, Ayodola; DeVon, Holli A; D'Onofrio, Gail; Hess, Erik P; Hollander, Judd E; Legato, Mariane J; McGregor, Alyson J; Scott, Jane; Tewelde, Semhar; Diercks, Deborah B

    2014-12-01

    Coronary artery disease (CAD) is the most common cause of death for both men and women. However, over the years, emergency physicians, cardiologists, and other health care practitioners have observed varying outcomes in men and women with symptomatic CAD. Women in general are 10 to 15 years older than men when they develop CAD, but suffer worse postinfarction outcomes compared to age-matched men. This article was developed by the cardiovascular workgroup at the 2014 Academic Emergency Medicine (AEM) consensus conference to identify sex- and gender-specific gaps in the key themes and research questions related to emergency cardiac ischemia care. The workgroup had diverse stakeholder representation from emergency medicine, cardiology, critical care, nursing, emergency medical services, patients, and major policy-makers in government, academia, and patient care. We implemented the nominal group technique to identify and prioritize themes and research questions using electronic mail, monthly conference calls, in-person meetings, and Web-based surveys between June 2013 and May 2014. Through three rounds of nomination and refinement, followed by an in-person meeting on May 13, 2014, we achieved consensus on five priority themes and 30 research questions. The overarching themes were as follows: 1) the full spectrum of sex-specific risk as well as presentation of cardiac ischemia may not be captured by our standard definition of CAD and needs to incorporate other forms of ischemic heart disease (IHD); 2) diagnosis is further challenged by sex/gender differences in presentation and variable sensitivity of cardiac biomarkers, imaging, and risk scores; 3) sex-specific pathophysiology of cardiac ischemia extends beyond conventional obstructive CAD to include other causes such as microvascular dysfunction, takotsubo, and coronary artery dissection, better recognized as IHD; 4) treatment and prognosis are influenced by sex-specific variations in biology, as well as patient

  11. A Critical Analysis of Global Competition in Higher Education: Synthesizing Themes

    Science.gov (United States)

    Portnoi, Laura M.; Bagley, Sylvia S.

    2014-01-01

    In this final chapter of the volume, the editors synthesize key themes that emerge from the preceding chapters. They also highlight the contributions the authors make through emphasizing critical perspectives and the tension between global and local forces.

  12. Emerging Market Multinationals

    DEFF Research Database (Denmark)

    Gammeltoft, Peter; Hobdari, Bersant

    2017-01-01

    International knowledge flows and innovation are becoming ever more important to the competitiveness of multinational corporations. Emerging market multinationals (EMNCs) in specific are deploying increasingly activist measures to harness foreign sources of knowledge and innovation as a strategy...... in which this disagreement can be reconciled through recognition of other EMNC advantages, particularly abilities to leverage country-specific assets, and possession and development of dynamic capabilities. Finally, we identify a set of core themes in the recent literature on strategic asset...

  13. Child Protection Assessment in Humanitarian Emergencies: Case Studies from Georgia, Gaza, Haiti and Yemen

    Science.gov (United States)

    Ager, Alastair; Blake, Courtney; Stark, Lindsay; Daniel, Tsufit

    2011-01-01

    Objectives: The paper reviews the experiences of conducting child protection assessments across four humanitarian emergencies where violence and insecurity, directly or indirectly, posed a major threat to children. We seek to identify common themes emerging from these experiences and propose ways to guide the planning and implementation of…

  14. Themes and challenges in making supply chains socially sustainable

    DEFF Research Database (Denmark)

    Abbasi, Maisam

    2014-01-01

    Purpose Purpose of this paper is to explore and classify pattern of the currently discussed themes and challenges in making supply chains socially sustainable. Design/methodology/approach The methodology was based on a systematic review of the existing literature in order to explore what major...... themes and challenges have been discussed as well as the significant gaps where opportunities for further research can be found. Findings In total five categories of themes were identified, namely goods/service-centric, human-centric, organization-centric, corporate-centric, and management...... holistic view of the pattern of currently discussed themes and challenges may be beneficial in increasing the absorptive capacity of industrial and business practitioners when they design and operationalize innovative strategies in developing sustainable supply chains. Originality/value This paper may...

  15. Recent Themes in Social Networking Service Research.

    Directory of Open Access Journals (Sweden)

    John S Liu

    Full Text Available The body of literature addressing the phenomenon related to social networking services (SNSs has grown rather fast recently. Through a systematic and quantitative approach, this study identifies the recent SNS research themes, which are the issues discussed by a coherent and growing subset of this literature. A set of academic articles retrieved from the Web of Science database is used as the basis for uncovering the recent themes. We begin the analysis by constructing a citation network which is further separated into groups after applying a widely used clustering method. The resulting clusters all consist of articles coherent in citation relationships. This study suggests eight fast growing recent themes. They span widely encompassing politics, romantic relationships, public relations, journalism, and health. Among them, four focus their issues largely on Twitter, three on Facebook, and one generally on both. While discussions on traditional issues in SNSs such as personality, motivations, self-disclosure, narcissism, etc. continue to lead the pack, the proliferation of the highlighted recent themes in the near future is very likely to happen.

  16. Recent Themes in Social Networking Service Research.

    Science.gov (United States)

    Liu, John S; Ho, Mei Hsiu-Ching; Lu, Louis Y Y

    2017-01-01

    The body of literature addressing the phenomenon related to social networking services (SNSs) has grown rather fast recently. Through a systematic and quantitative approach, this study identifies the recent SNS research themes, which are the issues discussed by a coherent and growing subset of this literature. A set of academic articles retrieved from the Web of Science database is used as the basis for uncovering the recent themes. We begin the analysis by constructing a citation network which is further separated into groups after applying a widely used clustering method. The resulting clusters all consist of articles coherent in citation relationships. This study suggests eight fast growing recent themes. They span widely encompassing politics, romantic relationships, public relations, journalism, and health. Among them, four focus their issues largely on Twitter, three on Facebook, and one generally on both. While discussions on traditional issues in SNSs such as personality, motivations, self-disclosure, narcissism, etc. continue to lead the pack, the proliferation of the highlighted recent themes in the near future is very likely to happen.

  17. An exploration of emergency nurses' perceptions, attitudes and experience of teamwork in the emergency department.

    Science.gov (United States)

    Grover, Elise; Porter, Joanne E; Morphet, Julia

    2017-05-01

    Teamwork may assist with increased levels of efficiency and safety of patient care in the emergency department (ED), with emergency nurses playing an indispensable role in this process. A descriptive, exploratory approach was used, drawing on principles from phenomenology and symbolic interactionism. Convenience, purposive sampling was used in a major metropolitan ED. Semi structured interviews were conducted, audio recorded, and transcribed verbatim. Transcripts were analysed using thematic analysis. Three major themes emerged from the data. The first theme 'when teamwork works' supported the notion that emergency nurses perceived teamwork as a positive and effective construct in four key areas; resuscitation, simulation training, patient outcomes and staff satisfaction. The second theme 'team support' revealed that back up behaviour and leadership were critical elements of team effectiveness within the study setting. The third theme 'no time for teamwork' centred around periods when teamwork practices failed due to various contributing factors including inadequate resources and skill mix. Outcomes of effective teamwork were valued by emergency nurses. Teamwork is about performance, and requires a certain skill set not necessarily naturally possessed among emergency nurses. Building a resilient team inclusive of strong leadership and communication skills is essential to being able to withstand the challenging demands of the ED. Copyright © 2017 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.

  18. Emergency Nurses' Perspectives: Factors Affecting Caring.

    Science.gov (United States)

    Enns, Carol L; Sawatzky, Jo-Ann V

    2016-05-01

    Caring is a universal phenomenon. However, as a result of higher patient acuity and staff shortages within the chaotic ED environment, caring behaviors may be in peril. The purpose of this study was to gain insight into the meaning of caring from the perspective of emergency nurses. Exploring nurses' perspectives of caring is central to improving staffing and retention issues in this unique work environment. As part of a larger study, a subsample of emergency nurses who work in public hospitals in Manitoba, Canada (n = 17) were interviewed. A qualitative descriptive design was used to gain insight into the caring perspectives of nurses by asking them, "What does caring meaning to you?" and "What affects caring in your practice in the emergency department?" Emerging themes were extracted through analysis of audio tapes and transcripts. Advocacy and holistic care emerged as major themes in the meaning of caring for emergency nurses. Caring was affected by a number of factors, including workload, lack of time, staffing issues, shift work, and lack of self-care. However, lack of management support was the most consistent hindrance to caring identified by study participants. Caring continues to be a unifying concept in nursing; however, influencing factors continue to undermine caring for emergency nurses. Caring is not subsidiary to nursing; it is the central core of nursing. Therefore, fostering a caring working environment is essential for nurses to practice holistic nursing care. It is also imperative to job satisfaction and the retention of emergency nurses. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  19. Identifying and Managing Engineering Design Requirements for Emerging Markets

    DEFF Research Database (Denmark)

    Li, Xuemeng

    , especially for those companies originally from developed markets, to acquire an in-depth understanding of particular design requirements in emerging markets in order to adapt both company products and approaches in such contexts. Prior studies on the identification and management of design requirements have...... predominantly been conducted in the context of developed countries and relatively affluent markets. Emerging markets are distinct from developed markets in terms of numerous contextual factors, e.g., regulatory environments and competitive landscapes. These factors influence the requirement identification...... attention. There is a need for an overview of different perspectives in requirement identification for manufacturing companies and their corresponding assessments in the context of emerging markets. Therefore, this research project is motivated to 1) investigate the process of identifying and managing...

  20. Hispanic Graduate Students' Mentoring Themes: Gender Roles in a Bicultural Context

    Science.gov (United States)

    Rudolph, Bonnie A.; Castillo, Carlos P.; Garcia, Vanessa G.; Martinez, Alina; Navarro, Fernando

    2015-01-01

    Male and female focus groups at a Hispanic Serving Institution (HSI) discussed mentoring of Hispanic graduate students. Using Thematic Analysis, investigators identified three main themes: Relationship Initiation and Development, Valued Relationship Qualities, and Context and Barriers. Relationship themes included mentor openness, trust,…

  1. Emerging Trends and New Directions in Telecollaborative Learning

    Science.gov (United States)

    O'Dowd, Robert

    2016-01-01

    This article provides an overview of the most significant emerging trends and tendencies in telecollaborative practice. In order to achieve this, I review the recent literature in the area and I identify recurring themes from the Telecollaboration in Higher Education conference which took place in Trinity College Dublin, Ireland from 21 to 23…

  2. Conflict prevention, conflict mitigation, and manifestations of conflict during emergency department consultations.

    Science.gov (United States)

    Chan, Teresa; Bakewell, Francis; Orlich, Donika; Sherbino, Jonathan

    2014-03-01

    The objective was to determine the causes of and mitigating factors for conflict between emergency physicians and other colleagues during consultations. From March to September 2010, a total of 61 physicians (31 residents and 30 attendings from emergency medicine [EM], internal medicine, and general surgery) were interviewed about how junior learners should be taught about emergency department (ED) consultations. During these interviews, they were asked if and how conflict manifests during the ED consultation process. Two investigators reviewed the transcripts independently to generate themes related to conflict until saturation was reached. Disagreements were resolved by consensus. The trustworthiness of the analysis was ensured by generating an audit trail, which was subsequently audited by an investigator not involved with the initial analysis. This analysis was compared to previously proposed models of trust and conflict from the sociology and business literature. All participants recalled some manifestation of conflict. There were 12 negative conflict-producing themes and 10 protective conflict-mitigating themes. When comparing these themes to a previously developed model of the domains of trust, each theme mapped to domains of the model. Conflict affects the ED consultation process. Areas that lead to conflict are identified that map to previous models of trust and conflict. This work extends the current understanding about intradisciplinary conflict in the clinical realm. These new findings may improve the understanding of the nature of conflicts that occur and form the foundation for interventions that may decrease conflict during ED consultations. © 2014 by the Society for Academic Emergency Medicine.

  3. Themes in human work interaction design

    DEFF Research Database (Denmark)

    Ørngreen, Rikke; Mark Pejtersen, Annelise; Clemmensen, Torkil

    2008-01-01

    Design (name HWID) through the last two and half years since the commencement of this Working Group. The paper thus provides an introduction to the theory and empirical evidence that lie behind the combination of empirical work studies and interaction design. It also recommends key topics for future......Abstract. This paper raises themes that are seen as some of the challenges facing the emerging practice and research field of Human Work Interaction Design. The paper has its offset in the discussions and writings that have been dominant within the IFIP Working Group on Human Work Interaction...

  4. Network methods to support user involvement in qualitative data analyses: an introduction to Participatory Theme Elicitation.

    Science.gov (United States)

    Best, Paul; Badham, Jennifer; Corepal, Rekesh; O'Neill, Roisin F; Tully, Mark A; Kee, Frank; Hunter, Ruth F

    2017-11-23

    While Patient and Public Involvement (PPI) is encouraged throughout the research process, engagement is typically limited to intervention design and post-analysis stages. There are few approaches to participatory data analyses within complex health interventions. Using qualitative data from a feasibility randomised controlled trial (RCT), this proof-of-concept study tests the value of a new approach to participatory data analysis called Participatory Theme Elicitation (PTE). Forty excerpts were given to eight members of a youth advisory PPI panel to sort into piles based on their perception of related thematic content. Using algorithms to detect communities in networks, excerpts were then assigned to a thematic cluster that combined the panel members' perspectives. Network analysis techniques were also used to identify key excerpts in each grouping that were then further explored qualitatively. While PTE analysis was, for the most part, consistent with the researcher-led analysis, young people also identified new emerging thematic content. PTE appears promising for encouraging user led identification of themes arising from qualitative data collected during complex interventions. Further work is required to validate and extend this method. ClinicalTrials.gov, ID: NCT02455986 . Retrospectively Registered on 21 May 2015.

  5. Content Themes of Alcohol Advertising in U.S. Television-Latent Class Analysis.

    Science.gov (United States)

    Morgenstern, Matthis; Schoeppe, Franziska; Campbell, Julie; Braam, Marloes W G; Stoolmiller, Michael; Sargent, James D

    2015-09-01

    There is little alcohol research that reports on the thematic contents of contemporary alcohol advertisements in U.S. television. Studies of alcohol ads from 2 decades ago did not identify "Partying" as a social theme. Aim of this study was to describe and classify alcohol advertisements aired in national television in terms of contents, airing times, and channel placements and to identify different marketing strategies of alcohol brands. Content analysis of all ads from the top 20 U.S. beer and spirit brands aired between July 2009 and June 2011. These were 581 unique alcohol ads accounting for 272,828 (78%) national television airings. Ads were coded according to predefined definitions of 13 content areas. A latent class analysis (LCA) was conducted to define content cluster themes and determine alcoholic brands that were more likely to exploit these themes. About half of the advertisements (46%) were aired between 3 am and 8 pm, and the majority were placed either in Entertainment (40%) and Sports (38%) channels. Beer ads comprised 64% of the sample, with significant variation in airing times and channels between types of products and brands. LCA revealed 5 content classes that exploited the "Partying," "Quality," "Sports," "Manly," and "Relax" themes. The partying class, indicative of ad messages surrounding partying, love, and sex, was the dominant theme comprising 42% of all advertisements. Ads for alcopops, flavored spirits, and liqueur were more likely to belong to the party class, but there were also some beer brands (Corona, Heineken) where more than 67% of ads exploited this theme. This is the first analysis to identify a partying theme to contemporary alcohol advertising. Future analyses can now determine whether exposure to that or other themes predicts alcohol misuse among youth audiences. Copyright © 2015 by the Research Society on Alcoholism.

  6. Content Themes of Alcohol Advertising in US Television — Latent Class Analysis

    Science.gov (United States)

    Morgenstern, Matthis; Schoeppe, Franziska; Campbell, Julie; Braam, Marloes W.G.; Stoolmiller, Michael; Sargent, James D.

    2015-01-01

    Background There is little alcohol research that reports on the thematic contents of contemporary alcohol advertisements in US television. Studies of alcohol ads from two decades ago did not identify “partying” as a social theme. Aim of the present study was to describe and classify alcohol advertisements aired in national television in terms of contents, airing times, and channel placements and to identify different marketing strategies of alcohol brands. Methods Content analysis of all ads from the top 20 US beer and spirit brands aired between July 2009 and June 2011. These were 581 unique alcohol ads accounting for 272,828 (78%) national television airings. Ads were coded according to predefined definitions of 13 content areas. A latent class analysis (LCA) was conducted to define content cluster themes and determine alcoholic brands that were more likely to exploit these themes. Results About half of the advertisements (46%) were aired between 3am and 8pm, and the majority were placed either in Entertainment (40%) and Sports (38%) channels. Beer ads comprised 64% of the sample, with significant variation in airing times and channels between types of products and brands. LCA revealed five content classes that exploited the “Partying”, “Quality”, “Sports”, “Manly”, and “Relax” themes. The partying class, indicative of ad messages surrounding partying, love and sex, was the dominant theme, comprising 42% of all advertisements. Ads for alcopops, flavored spirits, and liqueur were more likely to belong to the party class, but there were also some beer brands (Corona, Heineken) where more than 67% of ads exploited this theme. Conclusions This is the first analysis to identify a partying theme to contemporary alcohol advertising. Future analyses can now determine whether exposure to that or other themes predicts alcohol misuse among youth audiences. PMID:26207317

  7. Identifying and training non-technical skills of nuclear emergency response teams

    International Nuclear Information System (INIS)

    Crichton, M.T.; Flin, R.

    2004-01-01

    Training of the non-technical (social and cognitive) skills that are crucial to safe and effective management by teams in emergency situations is an issue that is receiving increasing emphasis in many organisations, particularly in the nuclear power industry. As teams play a major role in emergency response organisations (ERO), effective functioning and interactions within, between and across teams is crucial, particularly as the management of an emergency situation often requires that teams are extended by members from various other sections and strategic groups throughout the company, as well as members of external agencies. A series of interviews was recently conducted with members of a UK nuclear emergency response organisation to identify the non-technical skills required by team members that would be required for managing an emergency. Critical skills have been identified as decision making and situation assessment, as well as communication, teamwork, and stress management. A number of training strategies are discussed which can be tailored to the roles and responsibilities of the team members and the team leader, based on the roles within the team being defined as either Decision Maker, Evaluator, or Implementor, according to Nuclear Energy Institute (NEI) classifications. It is anticipated that enhanced learning of the necessary non-technical skills, through experience and directed practice, will improve the skills of members of emergency response teams

  8. Identifying and training non-technical skills of nuclear emergency response teams

    Energy Technology Data Exchange (ETDEWEB)

    Crichton, M.T. E-mail: m.crichton@abdn.ac.uk; Flin, R

    2004-08-01

    Training of the non-technical (social and cognitive) skills that are crucial to safe and effective management by teams in emergency situations is an issue that is receiving increasing emphasis in many organisations, particularly in the nuclear power industry. As teams play a major role in emergency response organisations (ERO), effective functioning and interactions within, between and across teams is crucial, particularly as the management of an emergency situation often requires that teams are extended by members from various other sections and strategic groups throughout the company, as well as members of external agencies. A series of interviews was recently conducted with members of a UK nuclear emergency response organisation to identify the non-technical skills required by team members that would be required for managing an emergency. Critical skills have been identified as decision making and situation assessment, as well as communication, teamwork, and stress management. A number of training strategies are discussed which can be tailored to the roles and responsibilities of the team members and the team leader, based on the roles within the team being defined as either Decision Maker, Evaluator, or Implementor, according to Nuclear Energy Institute (NEI) classifications. It is anticipated that enhanced learning of the necessary non-technical skills, through experience and directed practice, will improve the skills of members of emergency response teams.

  9. Identifying Patients at Risk of Deterioration in the Joint Emergency Department

    DEFF Research Database (Denmark)

    Schmidt, Thomas; Wiil, Uffe Kock

    2015-01-01

    at the case through the lenses of common information spaces. In particular, we apply Bossen’s seven-parameter framework to discover new dimensions of how Emergency Departments and individual clinicians identify and respond to unforeseen events, and how they handle the associated cognitive challenges. We......In recent years, Danish hospitals have merged their emergency facilities into Joint Emergency Departments. This poses new collaborative challenges across traditionally separated specialized departments, which now have to collaborate in a shared environment. Despite established protocols and patient...

  10. The moral theme in Zulu literature: a progression

    Directory of Open Access Journals (Sweden)

    M. Marggraff

    1998-04-01

    Full Text Available A moral theme in literature is not only unique to Zulu literature. Despite the relative youth of the modern branch of Zulu literature, any observer can make the interesting and important discovery that the moral theme is predominantly conveyed by the following three literary types: the folktale, the moral story, the detective story. The folktale, belonging to traditional literature, is a very well-developed form, that formed the principal means of teaching both children and adults about good and evil. The birth of modern Zulu literature in 1930 brought with it the emergence of the moral story, a literary type in which good triumphs over evil and in which justice prevails. Further development and changes have led to the appearance of the detective story in which crimes are solved and bad people are punished. This progression has developed due to ever-changing circumstances and a need for relevance.

  11. Identifying Local Hotspots of Pediatric Chronic Diseases Using Emergency Department Surveillance

    Science.gov (United States)

    Lee, David C.; Yi, Stella S.; Fong, Hiu-Fai; Athens, Jessica K.; Ravenell, Joseph E.; Sevick, Mary Ann; Wall, Stephen P.; Elbel, Brian

    2016-01-01

    Objective To use novel geographic methods and large-scale claims data to identify the local distribution of pediatric chronic diseases in New York City. Methods Using a 2009 all-payer emergency claims database, we identified the proportion of unique children aged 0 to 17 with diagnosis codes for specific medical and psychiatric conditions. As a proof of concept, we compared these prevalence estimates to traditional health surveys and registry data using the most geographically granular data available. In addition, we used home addresses to map local variation in pediatric disease burden. Results We identified 549,547 New York City children who visited an emergency department at least once in 2009. Though our sample included more publicly insured and uninsured children, we found moderate to strong correlations of prevalence estimates when compared to health surveys and registry data at pre-specified geographic levels. Strongest correlations were found for asthma and mental health conditions by county among younger children (0.88, p=0.05 and 0.99, pdisease prevalence with higher geographic resolution. More studies are needed to investigate limitations of these methods and assess reliability of local disease estimates. What’s New This study demonstrated how emergency department surveillance may improve estimates of pediatric disease prevalence with higher geographic resolution. We identified 29% of New York City children with a single year of data and identified local hotspots of pediatric chronic diseases. PMID:28385326

  12. Improvement of Theme Park Marketing Mode:A Case Study of Theme Parks in Chengdu

    Institute of Scientific and Technical Information of China (English)

    Min; LI; Gaoli; XIONG

    2013-01-01

    Construction of theme park has been launched since the early 1990s in Chengdu City,but ended up as a losing proposition after its short-term prosperity because of similar scale and similarity with those in other cities.As more international well-known theme parks entering the market,theme parks in Chengdu have been faced with the transition,and novel concepts are also introduced into the operation of these parks.To adapt to the market,it is imperative to make marketing strategies and combine marketing elements.Through analyzing current development of local theme parks and introducing successful marketing modes of domestic and overseas theme parks,a favorable marketing mode for theme parks in Chengdu was defined on the basis of fully exploring Ba-Shu culture(Ba and Shu are two ancient kingdoms in the history of Sichuan).By defining a favorable theme,focusing more on visitors’experience,devoting more in developing new products,adopting flexible price strategies,and integrating advertisement marketing,internet marketing,and other marketing methods,outstanding brands will be formed,and tourism cultures with distinguished features of Chengdu will be created.

  13. Peplau's theory of interpersonal relations: application in emergency and rural nursing.

    Science.gov (United States)

    Senn, Joanne F

    2013-01-01

    The author in this column highlights aspects of Peplau's theory of interpersonal relations and its use both in emergency nursing and rural nursing. Long and Weinert identified the concepts of rural nursing. Some differences between Peplau's theory and rural nursing can be identified through definitions of theory and conceptual models. Despite these differences, there are some common themes between both theories that are described and compared.

  14. Google Earth Grand Tour Themes

    Science.gov (United States)

    De Paor, D. G.; Whitmeyer, S. J.; Bentley, C.; Dordevic, M. M.

    2014-12-01

    As part of an NSF TUES Type 3 project entitled "Google Earth for Onsite and Distance Education (GEODE)," we are assembling a "Grand Tour" of locations on Earth and other terrestrial bodies that every geoscience student should know about and visit at least in virtual reality. Based on feedback from colleagues at previous meetings, we have identified nine Grand Tour themes: "Plates and Plumes," "Rocks and Regions," "Geology Through Time," "The Mapping Challenge*," "U.S. National Parks*," "The Magical Mystery Tour*," "Resources and Hazards," "Planets and Moons," and "Top of the Pops." Themes marked with an asterisk are most developed at this stage and will be demonstrated in real time. The Mapping Challenge invites students to trace geological contacts, measure bedding strike and dip and the plunge, trend, and facing of a fold. There is an advanced tool for modeling periclinal folds. The challenge is presented in a game-like format with an emphasis on puzzle-solving that will appeal to students regardless of gender. For the tour of U.S. national parks, we divided the most geologically important parks into four groups—Western Pacific, West Coast, Rockies, and East Coast. We are combining our own team's GigaPan imagery with imagery already available on the Internet. There is a great deal of imagery just waiting to be annotated for geological education purposes. The Magical Mystery Tour takes students to Google Streetview locations selected by instructors. Students are presented with questions or tasks and are given automatic feedback. Other themes are under development. Within each theme, we are crowd-sourcing contributions from colleagues and inviting colleagues to vote for or against proposed locations and student interactions. The GEODE team includes the authors and: Heather Almquist, Stephen Burgin, Cinzia Cervato, Gene Cooper, Paul Karabinos, Terry Pavlis, Jen Piatek, Bill Richards, Jeff Ryan, Ron Schott, Kristen St. John, and Barb Tewksbury.

  15. The Most Common Feedback Themes in Communication Skills Training in an Internal Medicine Residency Program: Lessons from the Resident Audio-Recording Project.

    Science.gov (United States)

    Han, Heeyoung; Papireddy, Muralidhar Reddy; Hingle, Susan T; Ferguson, Jacqueline Anne; Koschmann, Timothy; Sandstrom, Steve

    2018-07-01

    Individualized structured feedback is an integral part of a resident's learning in communication skills. However, it is not clear what feedback residents receive for their communication skills development in real patient care. We will identify the most common feedback topics given to residents regarding communication skills during Internal Medicine residency training. We analyzed Resident Audio-recording Project feedback data from 2008 to 2013 by using a content analysis approach. Using open coding and an iterative categorization process, we identified 15 emerging themes for both positive and negative feedback. The most recurrent feedback topics were Patient education, Thoroughness, Organization, Questioning strategy, and Management. The residents were guided to improve their communication skills regarding Patient education, Thoroughness, Management, and Holistic exploration of patient's problem. Thoroughness and Communication intelligibility were newly identified themes that were rarely discussed in existing frameworks. Assessment rubrics serve as a lens through which we assess the adequacy of the residents' communication skills. Rather than sticking to a specific rubric, we chose to let the rubric evolve through our experience.

  16. Mapping the Landscape of Future Research Themes in Supply Chain Management

    DEFF Research Database (Denmark)

    Wieland, Andreas; Handfield, Robert; Durach, Christian F.

    2016-01-01

    Supply chain researchers are confronted with a dizzying array of research questions, many of which are not mutually independent. This research was motivated by the need to map the landscape of research themes, identify potential overlapping areas and interactions, and provide guidelines on areas...... of focus for researchers to pursue. We conducted a three-phase research study, beginning with an open-ended collection of opinions on research themes collected from 102 supply chain management (SCM) researchers, followed by an evaluation of a consolidated list of themes by 141 SCM researchers...

  17. Attitudes of intensive care and emergency physicians in Australia with regard to the organ donation process: A qualitative analysis.

    Science.gov (United States)

    Macvean, Emily; Yuen, Eva Yn; Tooley, Gregory; Gardiner, Heather M; Knight, Tess

    2018-04-01

    Specialized hospital physicians have direct capacity to impact Australia's sub-optimal organ donation rates because of their responsibility to identify and facilitate donation opportunities. Australian physicians' attitudes toward this responsibility are examined. A total of 12 intensive care unit and three emergency department physicians were interviewed using a constructionist grounded theory and situational analysis approach. A major theme emerged, related to physicians' conflicts of interest in maintaining patients'/next-of-kin's best interests and a sense of duty-of-care in this context. Two sub-themes related to this main theme were identified as follows: (1) discussions about organ donation and who is best to carry these out and (2) determining whether organ donation is part of end-of-life care; including the avoidance of non-therapeutic ventilation; and some reluctance to follow clinical triggers in the emergency department. Overall, participants indicated strong support for organ donation but would not consider it part of end-of-life care, representing a major obstacle to the support of potential donation opportunities. Findings have implications for physician education and training. Continued efforts are needed to integrate the potential for organ donation into end-of-life care within intensive care units and emergency departments.

  18. Accounting for Cheating: An Evolving Theory and Emergent Themes

    Science.gov (United States)

    Brent, Edward; Atkisson, Curtis

    2011-01-01

    This study examines student responses to the question, "What circumstances, if any, could make cheating justified?" It then assesses how well those responses can be classified by existing theories and categories that emerge from a qualitative analysis of the data. Results show considerable support for techniques of neutralization, partial support…

  19. Byzantine Theme of Chios

    Directory of Open Access Journals (Sweden)

    Anton S. Mokhov

    2016-11-01

    Full Text Available The article is devoted to the study of the Byzantine theme system in the 10th - 11th centuries. The author believes that the reign of Basil II (976-1025 was marked by the mikra themata in Balkans and on Aegean Sea islands. They were in need of effective border defense. Theme of Chios was one of the mikra militaryadministrative districts, which were created in this period. The author detected five leaders of the theme in accordance with the historical sources: protospatharios and strategos Theodoros Beriboes; protospatharios, tagmatophylax and strategos Leon Karikes; protospatharios, tagmatophylax and strategos Bardas Mersiniotes; vestarches and strategos Ioannes Aristenos; vestes and strategos Michael Maurikas. The analysis of the sigillographic data led to the conclusion that the regular tagmata were the base of the military force of theme of Chios. Moreover, the fortress of Volissos was located in the northwest of Chios. The area around the fortress was inhabited by representatives of one ethnic group. They were under the leadership of doux, which was subordinate to the strategos of the theme. The famous officials of the civil administration of Chios included fiscal clerks – dioiketes, horreiarios and judicial clerks – krites of the velon. Theme of Chios had existed for about one hundred years. It was liquidated during the war between Byzantine and Tzachas, Turkish amir of Smyrna.

  20. The Tourism Experience Offered by Religious Theme Parks: Taman Tamadun Islam (TTI) in Malaysia

    OpenAIRE

    Moal - Ulvoas, Gaëlle M

    2016-01-01

    Theme parks are major drivers of tourism development and experience is a central concept in tourism research. This study investigates the experience potential associated with religious theme parks which offer a combination of religious and secular activities. The experiences of visitors to Taman Tamadun Islam (TTI), a Muslim theme park based in Malaysia, are identified through the analysis of visitors’ feedback on Tripadvisor.

  1. Identifying barriers to emergency care services.

    Science.gov (United States)

    Cannoodt, Luk; Mock, Charles; Bucagu, Maurice

    2012-01-01

    This paper aims to present a review of published evidence of barriers to emergency care, with attention towards both financial and other barriers. With the keywords (financial) accessibility, barriers and emergency care services, citations in PubMed were searched and further selected in the context of the objective of this article. Forty articles, published over a period of 15 years, showed evidence of significant barriers to emergency care. These barriers often tend to persist, despite the fact that the evidence was published many years ago. Several publications stressed the importance of the financial barriers in foregoing or delaying potentially life-saving emergency services, both in poor and rich countries. Other publications report non-financial barriers that prevent patients in need of emergency care (pre-hospital and in-patient care) from seeking care, from arriving in the proper emergency department without undue delay or from receiving proper treatment when they do arrive in these departments. It is clear that timely access to life-saving and disability-preventing emergency care is problematic in many settings. Yet, low-cost measures can likely be taken to significantly reduce these barriers. It is time to make an inventory of these measures and to implement the most cost-effective ones worldwide. Copyright © 2011 John Wiley & Sons, Ltd.

  2. Looking to the Future: Themes from the Third National Conference for Counseling Psychology.

    Science.gov (United States)

    Rude, Stephanie S.; And Others

    1988-01-01

    Presents summary of common themes from the Third National Conference for Counseling Psychology including strategies to enhance visibility and political strength, and ways to improve training of counseling psychologists by enhancing rigor, scientific thinking, professional identity, and ability to work in diverse and emerging settings. Discusses…

  3. Emerging synthesis themes from the study of social-ecological systems of a tropical city

    Science.gov (United States)

    Tischa A. Munoz; A.E. Lugo; B. Quintero

    2014-01-01

    The synthesis of the contributions in this special issue about the tropical city of San Juan has resulted in five themes. First, the city is subject to multiple vulnerabilities, but socioeconomic factors and education level affect the perception of citizens to those vulnerabilities, even in the face of imminent threat. Second, in light of the social-ecological...

  4. Interprofessional collaboration and family member involvement in intensive care units: emerging themes from a multi-sited ethnography.

    Science.gov (United States)

    Reeves, Scott; McMillan, Sarah E; Kachan, Natasha; Paradis, Elise; Leslie, Myles; Kitto, Simon

    2015-05-01

    This article presents emerging findings from the first year of a two-year study, which employed ethnographic methods to explore the culture of interprofessional collaboration (IPC) and family member involvement in eight North American intensive care units (ICUs). The study utilized a comparative ethnographic approach - gathering observation, interview and documentary data relating to the behaviors and attitudes of healthcare providers and family members across several sites. In total, 504 hours of ICU-based observational data were gathered over a 12-month period in four ICUs based in two US cities. In addition, 56 semi-structured interviews were undertaken with a range of ICU staff (e.g. nurses, doctors and pharmacists) and family members. Documentary data (e.g. clinical guidelines and unit policies) were also collected to help develop an insight into how the different sites engaged organizationally with IPC and family member involvement. Directed content analysis enabled the identification and categorization of major themes within the data. An interprofessional conceptual framework was utilized to help frame the coding for the analysis. The preliminary findings presented in this paper illuminate a number of issues related to the nature of IPC and family member involvement within an ICU context. These findings are discussed in relation to the wider interprofessional and health services literature.

  5. Theme 2 Overview: Making a Living, Training, Trade and Investment in the Circumpolar North.

    Science.gov (United States)

    McLeod, Bob

    1998-01-01

    An intergovernmental council on sustainable development in the Arctic discussed fisheries, wildlife, forestry, mining, oil and gas, tourism, finance and marketing, communication and education, and youth initiatives. Emerging themes included community involvement in decision making, acknowledging indigenous peoples' rights and knowledge,…

  6. Themes and Interplay of Beliefs in Mathematical Reasoning

    Science.gov (United States)

    Sumpter, Lovisa

    2013-01-01

    Upper secondary students' task solving reasoning was analysed with a focus on arguments for strategy choices and conclusions. Passages in their arguments for reasoning that indicated the students' beliefs were identified and, by using a thematic analysis, categorized. The results stress three themes of beliefs used as arguments for…

  7. A Qualitative Analysis of Stress and Relaxation Themes Contributing to Burnout in First-Year Psychiatry and Medicine Residents.

    Science.gov (United States)

    Benson, Nicole M; Chaukos, Deanna; Vestal, Heather; Chad-Friedman, Emma F; Denninger, John W; Borba, Christina P C

    2018-05-14

    Qualitative research on trainee well-being can add nuance to the understanding of propagators of burnout, and the role for interventions aimed at supporting well-being. This qualitative study was conducted to identify (i) situations and environments that cause stress for trainees, (ii) stress-reducing activities that trainees utilize, and (iii) whether trainees who report distress (high burnout and depression scores) describe different stressors and relaxation factors than those who do not. The study was conducted with a convenience sample of first-year medicine and psychiatry residents at a large urban teaching hospital. Participants were asked to complete electronic stress and relaxation diaries daily for 1 week. Diary entries were coded for recurrent themes. Participants were screened for burnout and depression. Codes were compared by subgroup based on baseline burnout and depression status to elucidate if specific themes emerged in these subgroups. Study sample included 51 interns. Sixteen (16/50, 32%) screened positive for burnout and three (3/50, 14%) had a positive depression screen. The most common stressors related to aspects of the learning environment, compounded by feeling under-equipped, overwhelmed, or out of time. The majority of relaxation activities involved social connection, food, other comforts, and occurred outside of the hospital environment. This study reveals that interns (regardless of burnout or depression screen) identify stressors that derive primarily from organizational, interpersonal, and cultural experiences of the learning environment; whereas relaxation themes are diversely represented across realms (home, leisure, social, health), though emphasize activities that occur outside of the work place.

  8. "The Voyage of the Dawn Treader": The World at the Dawn of 2006-2011. Understanding societal themes

    Directory of Open Access Journals (Sweden)

    Sanchen Henning

    2014-01-01

    Full Text Available This article offers a snapshot of the societal dynamics of individual countries around the world, integrated into a global view to provide the tourism and hospitality industry insight into potential customer needs and perceptions. The OPUS Reports on the Global Dynamics at the Dawn of 20...are published annually since 2006 in the Journal of Organisational and Social Dynamics in London. The researchers were interested in a metaphoric tour of the world's social dynamics over time as perceived from both the Systems psychodynamics and Positive psychology theoretical paradigms. The research methodology was qualitative using a case study approach where each of the six (2006- 2011 years' integrated hypotheses was studied as a separate case study. The six cases were integrated into new hypotheses reflecting how global social dynamics changed over the years. The findings were presented as hypotheses per individual country followed by an integrated global hypothesis. The three main emerging themes were framed as Identity, Hope and Love. Identity contains the sub-theme of Facelessness, described as the fragmentation of cultures, a loss of cultural identity and a search for shared social meaning. Hope embodies the theme Knight/s in shining armour which describes youth as saviours and Obama as saviour. The loss of Hope is illustrated by the sub-themes of the impotence of the older generation, pessimism, fear and the death of a way of life. Love consists of human connection described as affiliation, support and trust. The lack of Love consists of human alienation described as loneliness, aggression and violence. The findings of the study identify societal themes that can be operationalized in the tourism and hospitality industry through targeted offerings to provide in the unmet needs of society. In addition, training interventions to improve customer service and return on investment can be based on the findings of this research.

  9. Types of centredness in health care: themes and concepts.

    Science.gov (United States)

    Hughes, Julian C; Bamford, Claire; May, Carl

    2008-12-01

    For a variety of sociological reasons, different types of centredness have become important in health and social care. In trying to characterize one type of centredness, we were led to consider, at a conceptual level, the importance of the notion of centredness in general and the reasons for there being different types of centeredness. We searched the literature for papers on client-, family-, patient-, person- and relationship- centred care. We identified reviews or papers that defined or discussed the notions at a conceptual level. The reviews and papers were analyzed as text transcripts. We identified 10 themes that were common to all the types of centredness. At a conceptual level we could not identify thematic differences between the types of centredness. These findings were subjected to a philosophical critique using ideas derived from Wittgenstein. Different types of centredness are required in different contexts. The differences are justified by their practical utility. The unifying themes of centredness, however, reflect a movement in favour of increasing the social, psychological, cultural and ethical sensitivity of our human encounters.

  10. Workplace aggression as cause and effect: Emergency nurses' experiences of working fatigued.

    Science.gov (United States)

    Wolf, Lisa A; Perhats, Cydne; Delao, Altair M; Clark, Paul R

    2017-07-01

    Emergency nursing requires acute attention to detail to provide safe and effective care to potentially unstable or critically ill patients; this requirement may be significantly impaired by physical and mental fatigue. There is a lack of evidence regarding the effects of fatigue caused by factors other than a sleep deficit (e.g., emotional exhaustion). Fatigue affects nurses' ability to work safely in the emergency care setting and potentially impacts their health and quality of life outside of work. This was the qualitative arm of a mixed methods study; we used a qualitative exploratory design with focus group data from a sample of 16 emergency nurses. Themes were identified using an inductive approach to content analysis. The following themes were identified: "It's a weight on your back;" "Competitive nursing;" "It's never enough;" "You have to get away;" and "Engagement as a solution." Our participants reported high levels of fatigue, which compromised patient care, had a negative effect on their personal lives, and created a toxic unit environment. They reported lateral violence as both the cause and effect of mental and emotional fatigue, suggesting that unit culture affects nurses and the patients they care for. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Adherence decision making in the everyday lives of emerging adults with type 1 diabetes

    Directory of Open Access Journals (Sweden)

    Pyatak EA

    2013-07-01

    Full Text Available Elizabeth A Pyatak,1 Daniella Florindez,1 Marc J Weigensberg2 1Division of Occupational Science and Occupational Therapy, University of Southern California, 2Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California, USA Purpose: The purpose of this study was to explore motivations underlying nonadherent treatment decisions made by young adults with type 1 diabetes. Methods: Eight emerging adults each completed a series of semi-structured interviews concerning their approaches to diabetes care, relationships with clinicians, and everyday activities and routines. A narrative thematic analysis was used to develop initial themes and refine them through continued data collection and review of the research literature. Results: Five themes were identified as motivating nonadherence: (1 efforts to mislead health care providers, (2 adherence to alternative standards, (3 treatment fatigue and burnout, (4 social support problems, and (5 emotional and self-efficacy problems. Conclusion: Instances of nonadherence generally involved a combination of the five identified themes. Participants reporting nonadherence also described difficulties communicating with care providers regarding their treatment. Nonjudgmental communication between providers and emerging adults may be particularly important in promoting positive health outcomes in this population. Keywords: compliance, health behavior, nonadherence, motivations

  12. Emerging Themes in Image Informatics and Molecular Analysis for Digital Pathology.

    Science.gov (United States)

    Bhargava, Rohit; Madabhushi, Anant

    2016-07-11

    Pathology is essential for research in disease and development, as well as for clinical decision making. For more than 100 years, pathology practice has involved analyzing images of stained, thin tissue sections by a trained human using an optical microscope. Technological advances are now driving major changes in this paradigm toward digital pathology (DP). The digital transformation of pathology goes beyond recording, archiving, and retrieving images, providing new computational tools to inform better decision making for precision medicine. First, we discuss some emerging innovations in both computational image analytics and imaging instrumentation in DP. Second, we discuss molecular contrast in pathology. Molecular DP has traditionally been an extension of pathology with molecularly specific dyes. Label-free, spectroscopic images are rapidly emerging as another important information source, and we describe the benefits and potential of this evolution. Third, we describe multimodal DP, which is enabled by computational algorithms and combines the best characteristics of structural and molecular pathology. Finally, we provide examples of application areas in telepathology, education, and precision medicine. We conclude by discussing challenges and emerging opportunities in this area.

  13. A Study of Scientometric Methods to Identify Emerging Technologies

    Energy Technology Data Exchange (ETDEWEB)

    Abercrombie, Robert K [ORNL; Udoeyop, Akaninyene W [ORNL

    2011-01-01

    This work examines a scientometric model that tracks the emergence of an identified technology from initial discovery (via original scientific and conference literature), through critical discoveries (via original scientific, conference literature and patents), transitioning through Technology Readiness Levels (TRLs) and ultimately on to commercial application. During the period of innovation and technology transfer, the impact of scholarly works, patents and on-line web news sources are identified. As trends develop, currency of citations, collaboration indicators, and on-line news patterns are identified. The combinations of four distinct and separate searchable on-line networked sources (i.e., scholarly publications and citation, worldwide patents, news archives, and on-line mapping networks) are assembled to become one collective network (a dataset for analysis of relations). This established network becomes the basis from which to quickly analyze the temporal flow of activity (searchable events) for the example subject domain we investigated.

  14. Understanding communication between emergency and consulting physicians: a qualitative study that describes and defines the essential elements of the emergency department consultation-referral process for the junior learner.

    Science.gov (United States)

    Chan, Teresa; Orlich, Donika; Kulasegaram, Kulamakan; Sherbino, Jonathan

    2013-01-01

    To define the important elements of an emergency department (ED) consultation request and to develop a simple model of the process. From March to September 2010, 61 physicians (21 emergency medicine [EM], 20 general surgery [GS], 20 internal medicine [IM]; 31 residents, 30 attending staff) were questioned about how junior learners should be taught about ED consultation. Two investigators independently reviewed focus group and interview transcripts using grounded theory to generate an index of themes until saturation was reached. Disagreements were resolved by consensus, yielding an inventory of themes and subthemes. All transcripts were coded using this index of themes; 30% of transcripts were coded in duplicate to determine the agreement. A total of 245 themes and subthemes were identified. The agreement between reviewers was 77%. Important themes in the process were as follows: initial preparation and review of investigations by EM physician (overall endorsement 87% [range 70-100% in different groups]); identification of involved parties (patient and involved physicians) (100%); hypothesis of patient's diagnosis (75% [range 62-83%]) or question for the consulting physician (70% [range 55-95%]); urgency (100%) and stability (74% [range 62-80%]); questions from the consultant (100%); discussion/communication (98% [range 95-100%]); and feedback (98% [range 95-100%]). These components were reorganized into a simple framework (PIQUED). Each clinical specialty significantly contributed to the model (χ2  =  7.9; p value  =  0.019). Each group contributed uniquely to the final list of important elements (percent contributions: EM, 57%; GS, 41%; IM, 64%). We define important elements of an ED consultation with input from emergency and consulting physicians. We propose a model that organizes these elements into a simple framework (PIQUED) that may be valuable for junior learners.

  15. The Theme of Risk Management

    Directory of Open Access Journals (Sweden)

    Chua, D. K. H.

    2014-07-01

    Full Text Available The papers in this issue of the Journal come from different industry sectors, yet there can be a common theme that ties them together. Two of the papers address explicitly the issue of risk management, while the other three may be related to it in different degrees. One of the critical factors for project success is risk identification, as determined by Chua et al. (1999. The importance of risk management cannot be overemphasized. Failure to identify crucial risk elements in a project can lead to significant project failures in terms of cost and schedule.

  16. Particle physics: Themes and challenges

    Energy Technology Data Exchange (ETDEWEB)

    Quigg, C.

    1995-11-01

    I will devote this lecture to seven themes that express the essence of our understanding and our possibilities. These themes are: elementarity, symmetry, consistency, unity, identity, opportunity, and relevance.

  17. Particle physics: Themes and challenges

    International Nuclear Information System (INIS)

    Quigg, C.

    1995-11-01

    I will devote this lecture to seven themes that express the essence of our understanding and our possibilities. These themes are: elementarity, symmetry, consistency, unity, identity, opportunity, and relevance

  18. How emergency nurse practitioners view their role within the emergency department: A qualitative study.

    Science.gov (United States)

    Lloyd-Rees, Johanna

    2016-01-01

    The Emergency Nurse Practitioner (ENP) role has become established over the last two decades within emergency care. This role has developed to meet the rising demands of healthcare, combat the continuing medical workforce shortfall and address targets around healthcare delivery within emergency care. The ENP role has been widely evaluated in terms of patient satisfaction, safety and outcome. To date there is no published literature exploring what drives senior nurses to undertake this role which involves additional clinical responsibility and educational preparation for no increase in pay. This research seeks to explore how Emergency Nurse Practitioners view their role within the Emergency Department and Emergency Care Team. A qualitative approach was utilised in order to gain greater in-depth understanding of ENPs' perspectives. A purposive sample of eight ENPs was chosen and semi-structured interviews were digitally recorded. The transcribed interviews were subjected to thematic analysis to look for any recurrent themes. Following analysis of the data, four main themes emerged with a total of eight sub themes. The findings suggested that whilst the role had been accepted amongst doctors within the ED, there was still a lack of understanding of the role outside the ED and conflict still existed amongst junior nurses. ENPs were motivated to undertake the role in order to gain greater job satisfaction. The findings also highlighted the concerns regarding financial remuneration for the role, lack of standardisation of the role and educational preparation. The study concludes that education has a key role in the development and acceptance of the role and that ENPs are disappointed with the lack of financial remuneration for the role. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Picking up the Pieces: Themes in Macedonian Midcareer Transitions

    Science.gov (United States)

    Sudnik, Paul

    2012-01-01

    Addressing midcareer transition in post-socialist Macedonia, this work sought to provide practical help to participants through a range of techniques. Four themes are identified as important options for transitioners. Enthusiasm for "entrepreneurship" is tempered by a lack of funds and "portfolio careers" are also viewed with…

  20. The role of surgeons in identifying emerging technologies for health technology assessment.

    Science.gov (United States)

    Stafinski, Tania; Topfer, Leigh-Ann; Zakariasen, Ken; Menon, Devidas

    2010-04-01

    Health technology assessment (HTA) is a tool intended to help policy-makers decide which technologies to fund. However, given the proliferation of new technologies, it is not possible to undertake an HTA of each one before it becomes funded. Consequently, "horizon-scanning" processes have been developed to identify emerging technologies that are likely to have a substantial impact on clinical practice. Although the importance of physicians in the adoption of new technologies is well recognized, their role in horizon scanning in Canada has been limited. The purpose of this project was to pilot an approach to engage physicians, specifically surgeons, in provincial horizon-scanning activities. We invited 18 surgeons from Alberta's 2 medical schools to a horizon-scanning workshop to solicit their views on emerging technologies expected to impact surgical practice within the next 5 years and/or the importance of different attributes or characteristics of new technologies. Surgeons, regardless of specialty, identified developments designed to enhance existing minimally invasive surgical techniques, such as endoscopic, robotic and image-guided surgery. Several nonsurgical areas, including molecular genetics and nano technology, were also identified. Of the 13 technology attributes discussed, safety or risk, effectiveness and feasibility were rated as most important. Lastly, participating surgeons expressed an interest in becoming further involved in local HTA initiatives. Surgeons, as adopters and users of health technologies, represent an important and accessible information source for identifying emerging technologies for HTA. A more formal, ongoing relationship between the government, HTA and surgeons may help to optimize the use of HTA resources.

  1. Model-Driven Theme/UML

    Science.gov (United States)

    Carton, Andrew; Driver, Cormac; Jackson, Andrew; Clarke, Siobhán

    Theme/UML is an existing approach to aspect-oriented modelling that supports the modularisation and composition of concerns, including crosscutting ones, in design. To date, its lack of integration with model-driven engineering (MDE) techniques has limited its benefits across the development lifecycle. Here, we describe our work on facilitating the use of Theme/UML as part of an MDE process. We have developed a transformation tool that adopts model-driven architecture (MDA) standards. It defines a concern composition mechanism, implemented as a model transformation, to support the enhanced modularisation features of Theme/UML. We evaluate our approach by applying it to the development of mobile, context-aware applications-an application area characterised by many non-functional requirements that manifest themselves as crosscutting concerns.

  2. Current Themes in Understanding Children’s Emotion Regulation as Developing from within the Parent-Child Relationship

    Science.gov (United States)

    Kiel, Elizabeth J.; Kalomiris, Anne E.

    2015-01-01

    A large existing literature has established that children’s emotion regulation (ER) behaviors and capacities emerge from within the parent-child relationship. This review identified very recently published studies that exemplify contemporary themes in this area of research. Specifically, new research suggests that the influence of fathers, above and beyond that of mothers, becomes more pronounced across development. Further, culture influences how parents socialize emotion and how specific parenting behaviors relate to children’s developing ER. Lastly, studies find child-elicited effects, such that children’s ER predicts parents’ emotion socialization and other relevant behaviors. We suggest several future directions, including understanding the nature of situations that elicit ER patterns, as well as both expanding upon and integrating the areas highlighted in the review. PMID:25745639

  3. Facilitators and barriers in pain management for trauma patients in the chain of emergency care.

    Science.gov (United States)

    Berben, Sivera A A; Meijs, Tineke H J M; van Grunsven, Pierre M; Schoonhoven, Lisette; van Achterberg, Theo

    2012-09-01

    The aim of the study is to give insight into facilitators and barriers in pain management in trauma patients in the chain of emergency care in the Netherlands. A qualitative approach was adopted with the use of the implementation Model of Change of Clinical Practice. The chain of emergency care concerned prehospital Emergency Medical Services (EMS) and Emergency Departments (EDs). We included two EMS ambulance services and three EDs and conducted five focus groups and 10 individual interviews. Stakeholders and managers of organisations were interviewed individually. Focus group participants were selected based on availability and general characteristics. Transcripts of the audio recordings and field notes were analysed in consecutive steps, based on thematic content analysis. Each step was independently performed by the researchers, and was discussed afterwards. We analysed differences and similarities supported by software for qualitative analysis MaxQDA. This study identified five concepts as facilitators and barriers in pain management for trauma patients in the chain of emergency care. We described the concepts of knowledge, attitude, professional communication, organisational aspects and patient input, illustrated with quotes from the interviews and focus group sessions. Furthermore, we identified whether the themes occurred in the chain of care. Knowledge deficits, attitude problems and patient input were similar for the EMS and ED settings, despite the different positions, backgrounds and educational levels of respondents. In the chain of care a lack of professional communication and organisational feedback occurred as new themes, and were specifically related to the organisational structure of the prehospital EMS and EDs. Identified organisational aspects stressed the importance of organisational embedding of improvement of pain management. However, change of clinical practice requires a comprehensive approach focused at all five concepts. We think a shift

  4. Social media in the emergency medicine residency curriculum: social media responses to the residents' perspective article.

    Science.gov (United States)

    Hayes, Bryan D; Kobner, Scott; Trueger, N Seth; Yiu, Stella; Lin, Michelle

    2015-05-01

    In July to August 2014, Annals of Emergency Medicine continued a collaboration with an academic Web site, Academic Life in Emergency Medicine (ALiEM), to host an online discussion session featuring the 2014 Annals Residents' Perspective article "Integration of Social Media in Emergency Medicine Residency Curriculum" by Scott et al. The objective was to describe a 14-day worldwide clinician dialogue about evidence, opinions, and early relevant innovations revolving around the featured article and made possible by the immediacy of social media technologies. Six online facilitators hosted the multimodal discussion on the ALiEM Web site, Twitter, and YouTube, which featured 3 preselected questions. Engagement was tracked through various Web analytic tools, and themes were identified by content curation. The dialogue resulted in 1,222 unique page views from 325 cities in 32 countries on the ALiEM Web site, 569,403 Twitter impressions, and 120 views of the video interview with the authors. Five major themes we identified in the discussion included curriculum design, pedagogy, and learning theory; digital curation skills of the 21st-century emergency medicine practitioner; engagement challenges; proposed solutions; and best practice examples. The immediacy of social media technologies provides clinicians the unique opportunity to engage a worldwide audience within a relatively short time frame. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  5. Ethical, financial, and legal considerations to implementing emergency department HIV screening: a report from the 2007 conference of the National Emergency Department HIV Testing Consortium.

    Science.gov (United States)

    Waxman, Michael J; Popick, Rachel S; Merchant, Roland C; Rothman, Richard E; Shahan, Judy B; Almond, Gregory

    2011-07-01

    We seek to identify and analyze, from a group of participants experienced with HIV screening, the perceived challenges and solutions to the ethical, financial, and legal considerations of emergency department (ED)-based HIV screening. We performed a qualitative analysis of the focus group discussions from the ethical, financial, and legal considerations portion of the inaugural National Emergency Department HIV Testing Consortium conference. Four groups composed of 20 to 25 consortium participants engaged in semistructured, facilitated focus group discussions. The focus group discussions were audiotaped and transcribed. A primary reader identified major themes and subthemes and representative quotes from the transcripts and summarized the discussions. Secondary and tertiary readers reviewed the themes, subthemes, and summaries for accuracy. The focus group discussions centered on the following themes. Ethical considerations included appropriateness of HIV screening in the ED and ethics of key elements of the 2006 Centers for Disease Control and Prevention HIV testing recommendations. Financial considerations included models of payment and support, role of health care insurance, financial ethics and downstream financial burdens, and advocacy approaches. Legal considerations included the adequacy of obtaining consent, partner notification, disclosure of HIV results, difficulties in addressing special populations, failure of not performing universal screening, failure to notify a person of being tested, failure to notify someone of their test results, liability of inaccurate tests, and failure to link to care. This qualitative analysis provides a broadly useful foundation to the ethical, financial, and legal considerations of implementing HIV screening programs in EDs throughout the United States. Copyright © 2011. Published by Mosby, Inc.

  6. Trends in Literacy Software Publication and Marketing: Multicultural Themes.

    Science.gov (United States)

    Balajthy, Ernest

    This article provides data and discussion of multicultural theme-related issues arising from analysis of a detailed database of commercial software products targeted to reading and literacy education. The database consisted of 1152 titles, representing the offerings of 104 publishers and distributors. Of the titles, 62 were identified as having…

  7. Theme Enrichment Analysis: A Statistical Test for Identifying Significantly Enriched Themes in a List of Stories with an Application to the Star Trek Television Franchise

    OpenAIRE

    Onsjö, Mikael; Sheridan, Paul

    2017-01-01

    In this paper, we describe how the hypergeometric test can be used to determine whether a given theme of interest occurs in a storyset at a frequency more than would be expected by chance. By a storyset we mean simply a list of stories defined according to a common attribute (e.g. author, movement, period). The test works roughly as follows: Given a background storyset (e.g. 19th century adventure novels), and a sub-storyset of interest (e.g. Jules Verne novels), the test determines whether a...

  8. Episodes of care: is emergency medicine ready?

    Science.gov (United States)

    Wiler, Jennifer L; Beck, Dennis; Asplin, Brent R; Granovsky, Michael; Moorhead, John; Pilgrim, Randy; Schuur, Jeremiah D

    2012-05-01

    Optimizing resource use, eliminating waste, aligning provider incentives, reducing overall costs, and coordinating the delivery of quality care while improving outcomes have been major themes of health care reform initiatives. Recent legislation contains several provisions designed to move away from the current fee-for-service payment mechanism toward a model that reimburses providers for caring for a population of patients over time while shifting more financial risk to providers. In this article, we review current approaches to episode of care development and reimbursement. We describe the challenges of incorporating emergency medicine into the episode of care approach and the uncertain influence this delivery model will have on emergency medicine care, including quality outcomes. We discuss the limitations of the episode of care payment model for emergency services and advocate retention of the current fee-for-service payment model, as well as identify research gaps that, if addressed, could be used to inform future policy decisions of emergency medicine health policy leaders. We then describe a meaningful role for emergency medicine in an episode of care setting. Copyright © 2011. Published by Mosby, Inc.

  9. Emergence of psychotic content in psychotherapy: An exploratory qualitative analysis of content, process, and therapist variables in a single case study.

    Science.gov (United States)

    Leonhardt, Bethany L; Kukla, Marina; Belanger, Elizabeth; Chaudoin-Patzoldt, Kelly A; Buck, Kelly D; Minor, Kyle S; Vohs, Jenifer L; Hamm, Jay A; Lysaker, Paul H

    2018-03-01

    Emerging integrative metacognitive therapies for schizophrenia seek to promote subjective aspects of recovery. Beyond symptom remission, they are concerned with shared meaning-making and intersubjective processes. It is unclear, however, how such therapies should understand and respond to psychotic content that threatens meaning-making in therapeutic contexts. Accordingly, we sought to understand what factors precede and potentially trigger psychotic content within psychotherapy and what aids in resolution and return to meaning-making. Forty-eight transcripts from a single psychotherapy case were analyzed with thematic analysis. Passages of delusional or disorganized content were identified and themes present prior to the emergence and resolution of such material were identified and coded. Themes that preceded the emergence of psychotic content varied across early, middle, and late phases of therapy. Material related to the patient's experience of inadequacy and potential vulnerability, therapist setting boundaries within the therapeutic relationship and making challenges appeared to trigger psychotic content, especially early in treatment. Psychotic content may emerge in session following identifiable antecedents which change over phases of therapy. Attending to psychotic content by assuming a non-hierarchical stance and not dismissing psychotic content may aid in maintaining intersubjectivity and support patient's movements toward recovery in integrative metacognitive therapies.

  10. Identifying the emergence of design ideas

    DEFF Research Database (Denmark)

    Inie, Nanna

    This position paper outlines four types of design idea indicators that provide four starting points for exploration of the emergence of design ideas from a micro perspective. The results are derived from two empirical studies of design processes. The research builds on the assumption that we need...... better understanding and definition of design idea emergence and transformation in order to systematically explore the creative process....

  11. Exploring themes and challenges in developing sustainable supply chains – A complexity theory perspective

    DEFF Research Database (Denmark)

    Abbasi, Maisam

    identify, classify, and tackle the challenges that can hinder the execution of such strategies. To develop innovative strategies, the patterns of current trends and themes need to be learned and the missing ones need to be identified. The purpose of this research was to explore themes and challenges......To develop sustainable supply chains in a way that their negative environmental and social effects are minimized, shortand long-term targets should be set. The transformation of supply chains towards these targets calls for the development of innovative strategies and the need to continuously...... in developing sustainable supply chain activities from theoretical and empirical perspectives. Six research studies (RS) were designed and carried out. Two explored the patterns of the themes and challenges in making supply chains environmentally and socially sustainable in general (RS1, RS2). One explored...

  12. Experiences of female partners of masculine-identifying trans persons.

    Science.gov (United States)

    Theron, Liesl; Collier, Kate L

    2013-01-01

    This paper explores the intimate relationship experiences of the cisgender (i.e., not transgender) female partners of masculine-identifying transgender persons, with a particular focus on these partners' self-understanding of their sexual orientation. Limited research about this topic has been conducted to date. Semi-structured interviews were conducted with eight South African women who are or have been cisgender female partners of masculine-identifying trans persons. Although the interviews showed that the relationship experiences of female partners of masculine-identifying trans persons are diverse, several common themes emerged in the narratives. The way that participants labelled their sexual orientation did not change from before to after their relationship with a transgender partner. The participants reported varied family and community responses to their relationships. Specific emotional and informational support needs for women with transgender partners were identified.

  13. The PAGES 2k Network, Phase 3: Themes and Call for Participation

    Science.gov (United States)

    von Gunten, L.; Mcgregor, H. V.; Martrat, B.; St George, S.; Neukom, R.; Bothe, O.; Linderholm, H. W.; Phipps, S. J.; Abram, N.

    2017-12-01

    The past 2000 years (the "2k" interval) provides critical context for understanding recent anthropogenic forcing of the climate and provides baseline information about the characteristics of natural climate variability. It also presents opportunities to improve the interpretation of proxy observations and to evaluate the climate models used to make future projections. Phases 1 and 2 of the PAGES 2k Network focussed on building regional and global surface temperature reconstructions for terrestrial regions and the oceans, and comparing these with model simulations to identify mechanisms of climate variation on interannual to bicentennial time scales. Phase 3 was launched in May 2017 and aims to address major questions around past hydroclimate, climate processes and proxy uncertainties. Its scientific themes are: Theme 1: "Climate Variability, Modes and Mechanisms"Further understand the mechanisms driving regional climate variability and change on interannual to centennial time scales; Theme 2: "Methods and Uncertainties"Reduce uncertainties in the interpretation of observations imprinted in paleoclimatic archives by environmental sensors; Theme 3: "Proxy and Model Understanding"Identify and analyse the extent of agreement between reconstructions and climate model simulations. Research is organized as a linked network of well-defined projects, identified and led by 2k community members. The 2k projects focus on specific scientific questions aligned with Phase 3 themes, rather than being defined along regional boundaries. New 2k projects can be proposed at any time at http://www.pastglobalchanges.org/ini/wg/2k-network/projects An enduring element of PAGES 2k is a culture of collegiality, transparency, and reciprocity. Phase 3 seeks to stimulate community based projects and facilitate collaboration between researchers from different regions and career stages, drawing on the breadth and depth of the global PAGES 2k community. All PAGES 2k projects also promote best

  14. A 2018 Horizon Scan of Emerging Issues for Global Conservation and Biological Diversity.

    Science.gov (United States)

    Sutherland, William J; Butchart, Stuart H M; Connor, Ben; Culshaw, Caroline; Dicks, Lynn V; Dinsdale, Jason; Doran, Helen; Entwistle, Abigail C; Fleishman, Erica; Gibbons, David W; Jiang, Zhigang; Keim, Brandon; Roux, Xavier Le; Lickorish, Fiona A; Markillie, Paul; Monk, Kathryn A; Mortimer, Diana; Pearce-Higgins, James W; Peck, Lloyd S; Pretty, Jules; Seymour, Colleen L; Spalding, Mark D; Tonneijck, Femke H; Gleave, Rosalind A

    2018-01-01

    This is our ninth annual horizon scan to identify emerging issues that we believe could affect global biological diversity, natural capital and ecosystem services, and conservation efforts. Our diverse and international team, with expertise in horizon scanning, science communication, as well as conservation science, practice, and policy, reviewed 117 potential issues. We identified the 15 that may have the greatest positive or negative effects but are not yet well recognised by the global conservation community. Themes among these topics include new mechanisms driving the emergence and geographic expansion of diseases, innovative biotechnologies, reassessments of global change, and the development of strategic infrastructure to facilitate global economic priorities. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. An Historical Examination of the Development of Emergency Medical Services Education in the US through Key Reports (1966-2014).

    Science.gov (United States)

    Brooks, Ingrid A; Sayre, Michael R; Spencer, Caroline; Archer, Frank L

    2016-02-01

    The Emergency Medical Services (EMS) approach to emergency prehospital care in the United States (US) has global influence. As the 50-year anniversary of modern US EMS approaches, there is value in examining US EMS education development over this period. This report describes US EMS education milestones and identifies themes that provide context to readers outside the US. As US EMS education is described mainly in publications of federal US EMS agencies and associations, a Google search and hand searching of documents identified publications in the public domain. MEDLINE and CINAHL Plus were searched for peer reviewed publications. Documents were reviewed using both a chronological and thematic approach. Seventy-eight documents and 685 articles were screened, the full texts of 175 were reviewed, and 41 were selected for full review. Four historical periods in US EMS education became apparent: EMS education development (1966-1980); EMS education consolidation and review (1981-1989); EMS education reflection and change (1990-1999); and EMS education for the future (2000-2014). Four major themes emerged: legislative authority, physician direction, quality, and development of the profession. Documents produced through broad interprofessional consultations, with support from federal and US EMS authorities, reflect the catalysts for US EMS education development. The current model of US EMS education provides a structure to enhance educational quality into the future. Implementation evaluation of this model would be a valuable addition to the US EMS literature. The themes emerging from this review assist the understanding of the characteristics of US EMS education.

  16. Suicide note themes and suicide prevention.

    Science.gov (United States)

    Foster, Tom

    2003-01-01

    The aim was to determine if suicide note themes might inform suicide prevention strategies. The themes of 42 suicide notes from the Northern Ireland Suicide Study (major psychological autopsy study) were examined. The commonest themes were "apology/shame" (74%), "love for those left behind" (60%), "life too much to bear" (48%), "instructions regarding practical affairs post-mortem" (36%), "hopelessness/nothing to live for" (21%) and "advice for those left behind" (21%). Notes of suicides with major unipolar depression were more likely than notes of suicides without major unipolar depression to contain the themes "instructions regarding practical affairs post-mortem" (67% versus 19%, p = 0.005) and "hopelessness/nothing to live for" (40% versus 11%, p = 0.049). Notes of suicides with a previous history of deliberate self-harm were less likely than notes of suicides without a history of deliberate self-harm to contain the theme "apology/shame" (58% versus 87%, p = 0.04). Notes of elderly suicides were more likely than non-elderly notes to contain the theme "burden to others" (40% versus 3%, p = 0.03). The fact that three quarters of suicide notes contained the theme "apology/shame" suggests that the deceased may have welcomed alternative solutions for their predicaments. Scrutiny of suicide note themes in the light of previous research findings suggests that cognitive therapy techniques, especially problem solving, may have an important role to play in suicide prevention and that potential major unipolar depressive (possibly less impulsive) suicides, in particular, may provide fertile ground for therapeutic intervention (physical and psychological). Ideally all primary care doctors and mental health professionals working with (potentially) suicidal people should be familiar with basic cognitive therapy techniques, especially problem solving skills training.

  17. Activities Using a Restaurant Theme.

    Science.gov (United States)

    Modlin, Ruth

    Designed for use with elementary students, 44 activities using a restaurant theme integrate creative thinking and decision-making skills with language arts, mathematics, and art. The activities, which can be used independently by the students, deal with types of restaurants, names and themes, floor plans, interior and exterior design, house…

  18. FY16 Strategic Themes.

    Energy Technology Data Exchange (ETDEWEB)

    Leland, Robert W. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-03-01

    I am pleased to present this summary of the Division 1000 Science and Technology Strategic Plan. This plan was created with considerable participation from all levels of management in Division 1000, and is intended to chart our course as we strive to contribute our very best in service of the greater Laboratory strategy. The plan is characterized by four strategic themes: Mission Engagement, Bold Outcomes, Collaborative Environment, and the Safety Imperative. Each theme is accompanied by a brief vision statement, several goals, and planned actions to support those goals throughout FY16. I want to be clear that this is not a strategy to be pursued in tension with the Laboratory strategic plan. Rather, it is intended to describe “how” we intend to show up for the “what” described in Sandia’s Strategic Plan. I welcome your feedback and look forward to our dialogue about these strategic themes. Please join me as we move forward to implement the plan in the coming year.

  19. Condom use preferences among Latinos in Miami-Dade: emerging themes concerning men's and women's culturally-ascribed attitudes and behaviours.

    Science.gov (United States)

    Sastre, Francisco; De La Rosa, Mario; Ibanez, Gladys E; Whitt, Elaine; Martin, Steven S; O'Connell, Daniel J

    2015-01-01

    Among Latinos, cultural values such as machismo and marianismo may promote inconsistent condom use representing a significant risk factor for HIV infection. Yet there continues to be a need for additional research to explore the influence these cultural values have on Latino men and women's condom use attitudes and behaviours given increasing HIV rates of HIV infection among Latinos. The purpose of this study was to explore further Latino traditional culturally-ascribed attitudes and behaviour for emerging themes toward condom use among a diverse group of adult Latino men and women living in Miami-Dade County, Florida, USA. The study used a qualitative study-design and collected data from 16 focus groups with a total of 67 Latino men and women. Findings from the focus groups described attitudes and behaviours that counter traditional gender roles towards sex and expected sexual behaviours informed by machismo and marianismo. Common attitudes noted in the study include men's classification of women as dirty-clean to determine condom use and women's assertiveness during sexual encounters negotiating condom use--in favour and against it. As the findings of this study suggest, the process differ greatly between Latino men and women, having an impact on the risk behaviours in which each engage.

  20. Emergency Nurses' Perceptions of Providing End-of-Life Care in a Hong Kong Emergency Department: A Qualitative Study.

    Science.gov (United States)

    Tse, Johnson Wai Keung; Hung, Maria Shuk Yu; Pang, Samantha Mei Che

    2016-05-01

    Provision of end-of-life (EOL) care in the emergency department has improved globally in recent years and has a different scope of interventions than traditional emergency medicine. In 2010, a regional hospital established the first ED EOL service in Hong Kong. The aim of this study was to understand emergency nurses' perceptions regarding the provision of EOL care in the emergency department. A qualitative approach was used with purposive sampling of 16 nurses who had experience in providing EOL care. Semi-structured, face-to-face interviews were conducted from May to October, 2014. All the interviews were transcribed verbatim for content analysis. Four themes were identified: (1) doing good for the dying patients, (2) facilitating family engagement and involvement, (3) enhancing personal growth and professionalism, and (4) expressing ambiguity toward resource deployment. Provision of EOL care in the emergency department can enhance patients' last moment of life, facilitate the grief and bereavement process of families, and enhance the professional development of staff in emergency department. It is substantiated that EOL service in the emergency department enriches EOL care in the health care system. Findings from this study integrated the perspectives on ED EOL services from emergency nurses. The integration of EOL service in other emergency departments locally and worldwide is encouraged. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  1. Interaction themes in music therapy

    DEFF Research Database (Denmark)

    Holck, Ulla

    2004-01-01

    Based on a doctoral study, the author presents a type of music therapyinteraction called ?Interaction Themes.? These are developed fromsession to session and often appear in music therapy interventions withchildren with severe functional limitations, especially children withautism. Although...... whoseexpressions are often difficult to understand. The article describes thecharacteristics and functions of Interaction Themes, compares thephenomenon with music therapy case literature and delimits it in regardto other types of music therapy interaction with this client group. Theresults are described through...... the Interaction Themes are characterised by arelatively simple and self-generated content, they have an essentialfunction because they contain the child?s and music therapist?s jointinteraction history. They make up the context within which it ispossible to create meaningful interaction with a client group...

  2. Thirty years of artificial intelligence in medicine (AIME) conferences: A review of research themes.

    Science.gov (United States)

    Peek, Niels; Combi, Carlo; Marin, Roque; Bellazzi, Riccardo

    2015-09-01

    Over the past 30 years, the international conference on Artificial Intelligence in MEdicine (AIME) has been organized at different venues across Europe every 2 years, establishing a forum for scientific exchange and creating an active research community. The Artificial Intelligence in Medicine journal has published theme issues with extended versions of selected AIME papers since 1998. To review the history of AIME conferences, investigate its impact on the wider research field, and identify challenges for its future. We analyzed a total of 122 session titles to create a taxonomy of research themes and topics. We classified all 734 AIME conference papers published between 1985 and 2013 with this taxonomy. We also analyzed the citations to these conference papers and to 55 special issue papers. We identified 30 research topics across 12 themes. AIME was dominated by knowledge engineering research in its first decade, while machine learning and data mining prevailed thereafter. Together these two themes have contributed about 51% of all papers. There have been eight AIME papers that were cited at least 10 times per year since their publication. There has been a major shift from knowledge-based to data-driven methods while the interest for other research themes such as uncertainty management, image and signal processing, and natural language processing has been stable since the early 1990s. AIME papers relating to guidelines and protocols are among the most highly cited. Copyright © 2015 Elsevier B.V. All rights reserved.

  3. A qualitative systematic review of the reasons for parental attendance at the emergency department with children presenting with minor illness.

    Science.gov (United States)

    Butun, Ahmet; Hemingway, Pippa

    2018-01-01

    Over 5 million children attend the Emergency Department (ED) annually in England with an ever-increasing paediatric emergency caseload echoed globally. Approximately 60% of children present with illness and the majority have non-urgent illness creating burgeoning pressures on children's ED and this crisis resonates globally. To date no qualitative systematic review exists that focuses on the parental reasons for childhood attendance at the ED in this sub-group. To identify parental reasons for attending ED for their children presenting with minor illness. A qualitative systematic review was conducted against inclusion/exclusion criteria. Five electronic databases and key journals were searched in June 2015. 471 studies were identified and following study selection, 4 qualitative studies were included. Nine themes were identified e.g. dissatisfaction with family medical services, perceived advantages of ED and 'child suffering' with novel and insightful sub-themes of 'hereditary anxiety', 'taking it off our hands', ED as a 'magical place'. This novel qualitative systematic review examined parental attendance presenting with childhood minor illness of interest to emergency care reformers and clinicians. ED attendance is complex and multifactorial but parents provide vital insight to ED reformers on parental reasons for ED attendance in this sub-group. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. The value of the pre-hospital learning environment as part of the emergency nursing programme

    Directory of Open Access Journals (Sweden)

    Sonett van Wyk

    2015-10-01

    Objective: The study explored the views of the emergency nurse students regarding the value of rotating through the pre-hospital learning environment during an emergency nursing programme. Methods: A qualitative, explorative, descriptive and contextual research design using an Appreciative Inquiry approach was used to collect the data. Through purposive sampling a total of 45 emergency nursing students participated. Data was collected by means of selfreported Appreciative Inquiry interview guides and individual Appreciative Inquiry interviews.The data was analysed using content analysis. Results: Four major themes were identified: an unpredictable environment, role players in emergency medical services, team work, and competencies. Conclusion: The research findings support the value and continuation of utilising the prehospital clinical learning environment for placing post-basic emergency nursing students when enrolled in the emergency nursing programme.

  5. Interaction Themes in Music Therapy

    DEFF Research Database (Denmark)

    Holck, Ulla

    2006-01-01

    Based on a doctoral study, the author presents a type of music therapy interaction called ‘Interaction Themes.’ These are developed from session to session and often appear in music therapy interventions with children with severe functional limitations, especially children with autism. Although...... whose expressions are often difficult to understand. The presented article describes the characteristics and functions of Interaction Themes, compares the phenomenon with music therapy case literature and delimits it in regard to other types of music therapy interaction with this client group....... the Interaction Themes are characterised by a relatively simple and self-generated content, they have an essential function because they contain the child’s and music therapist’s joint interaction history. They make up the context within which it is possible to create meaningful interaction with a client group...

  6. On Themes of the Eagle by Alfred Tennyson

    Institute of Scientific and Technical Information of China (English)

    陈晓庆

    2009-01-01

    Theme is significant to poetry.Not only music but also theme is related to poetry since its birth.Usually great poems have more than one theme.Nowadays different approaches of literary analysis are on stage.The different approaches are employed to expound the rich themes of The Eagle-in memorial of Hallam,in praise of Britain's colonial expansion and in eulogy of nature.

  7. Architectural heritage or theme park

    Directory of Open Access Journals (Sweden)

    Ignasi Solà-Morales

    1998-04-01

    Full Text Available The growing parallelism between the perception and the consumer use of theme parks and architectural heritage gives rise to a reflection about the fact that the architectural object has been turned into a museum piece, stripped  of its original value and its initial cultural substance to become images exposed to multiple gazes, thus producing what the author calis the "Theme Park effect", with consequences on protected architecture.

  8. Theme: Urban Agriculture.

    Science.gov (United States)

    Ellibee, Margaret; And Others

    1990-01-01

    On the theme of secondary agricultural education in urban areas, this issue includes articles on opportunities, future directions, and implications for the profession; creative supervised experiences for horticulture students; floral marketing, multicultural education; and cultural diversity in urban agricultural education. (JOW)

  9. Universal design characteristic on themed streets

    Science.gov (United States)

    Harsritanto, Bangun IR; Indriastjario; Wijayanti

    2017-12-01

    People around the world can access the streets to fulfil their daily activities regardless of their gender, age, and abilities. The streetscape is an urban public space which is built to facilitate the basic needs of people as social being. The themed street is an urban streetscape designed and built in detail with a theme or special purpose in an of urban development process. Universal design facilitates the full range of human diversity as physical appearance, perception, cognitive abilities, sizes, and shapes. By designing for the diversity, the specialized streets become more functional and user-friendly. The purpose of this study is to examine several design characteristics of themed streets in several countries from three different continents using universal design principles for giving proper directions to develop more user-friendly streets. Literature review and case study were used as research methods. The literature review was extracted and compiled from manuscripts, streetscape design books, and from universal design principles. Furthermore, the constructed theory were used to examine the case studies of themed streets. The findings indicated that themed streets’ character design were strongly influenced by local cultural aspect even though the basic guidelines were universal design principles; the resumed design direction can be suggested universal along with the richness of local aspects.

  10. Enablers and Barriers to Community Engagement in Public Health Emergency Preparedness: A Literature Review.

    Science.gov (United States)

    Ramsbottom, Anna; O'Brien, Eleanor; Ciotti, Lucrezio; Takacs, Judit

    2018-04-01

    Public health emergency preparedness (PHEP) all too often focusses only on institutional capabilities, including their technical expertise and political influence, while overlooking community capabilities. However, the success of institutional emergency preparedness plans depends upon communities and institutions working together to ensure successful anticipation, response and recovery. Broader community engagement is therefore recommended worldwide. This literature review was carried out to identify enablers and barriers to community and institutional synergies in emergency preparedness. Searches were undertaken across bibliographic databases and grey literature sources. The literature identified was qualitative in nature. A qualitative, 'best fit' framework approach using a pre-existing framework was used to analyse the literature, whereby themes were added and changed as analysis progressed. A working definition of community was identified, based on a 'whole community' approach, inclusive of the whole multitude of stakeholders including community residents and emergency management staff. Given the diversity in community make-up, the types of emergencies that could be faced, the socio-economic, environmental and political range of communities, there are no set practices that will be effective for all communities. The most effective way of engaging communities in emergency preparedness is context-dependent and the review did draw out some important key messages for institutions to consider.

  11. Emergency Department Patient Perspectives on the Risk of Addiction to Prescription Opioids.

    Science.gov (United States)

    Conrardy, Michael; Lank, Patrick; Cameron, Kenzie A; McConnell, Ryan; Chevrier, Alison; Sears, Jill; Ahlstrom, Eric; Wolf, Michael S; Courtney, D Mark; McCarthy, Danielle M

    2016-01-01

    To characterize emergency department (ED) patients' knowledge and beliefs about the addictive potential of opioids. Mixed methods analysis of data from a randomized controlled trial. Urban academic ED (>88,000 visits). One hundred and seventy four discharged ED patients prescribed hydrocodone-acetaminophen for acute pain. The study analyzed data collected from a randomized controlled trial investigating patients' knowledge of opioids. ED patients discharged with hydrocodone-acetaminophen completed an audio-recorded phone interview 4–7 days later. This analysis focuses on responses about addiction. Responses were categorized using content analysis; thematic analysis identified broad themes common across different categories. Participants' mean age was 45.5 years (SD, 14.8), 58.6% female, 50.6% white, and the majority had an orthopedic diagnosis (24.1% back pain, 52.3% other injuries). Responses were categorized first based on whether the patient believed that opioids could be addictive (categorized as: yes, 58.7%; no, 19.5%; depends, 17.2%; or do not know, 4.6%), and second based on whether or not the patient discussed his/her own experience with the medication (categorized as: personalized, 35.6%; or not personalized, 64.4%). Cohen's Kappa was 0.84 for all categories. Three themes emerged in the thematic analysis: theme 1) patients expect to “feel” addicted if they are addicted, theme 2) patients fear addiction, and theme 3) side effects affected patient views of addiction. In this sample, patients had misconceptions about opioid addiction. Some patients did not know opioids could be addictive, others underestimated their personal risk of addiction, and others overtly feared addiction and, therefore, risked inadequate pain management. Despite limited data, we recommend providers discuss opioid addiction with their patients. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. 2016. This work is written by US Government

  12. Exploring Multicultural Themes through Picture Books.

    Science.gov (United States)

    Farris, Pamela J.

    1995-01-01

    Advocates inclusion of multicultural picture books in social studies instruction to offer different outlooks and visions in a short format. Describes selection of picture books with multicultural themes and those that represent various cultures, gender equity, and religious themes. Suggests that picture books may help students develop better…

  13. Theme 10: greenhouse effect transport policies and urban organization; Theme 10: effet de serre politiques de deplacements et organisation urbaine

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-07-01

    This document describes the reference framework of the theme 10 ''greenhouse effect, transport policies and urban organization'' which is a part of the urban transports interface. It presents the specific actions realized by the theme 10 for a future integration in theme 1, 5 and 8. (A.L.B.)

  14. The Fukushima radiological emergency and challenges identified for future public health responses.

    Science.gov (United States)

    Miller, Charles W

    2012-05-01

    On 11 March 2011, northern Japan was rocked by first a magnitude 9.0 earthquake off the eastern coast and then an ensuing tsunami. The Fukushima Daiichi Nuclear Power Plant complex was hit by these twin disasters, and a cascade of events was initiated that led to radionuclide releases causing widespread radioactive contamination of residential areas, agricultural land, and coastal waters. Radioactive material from Japan was subsequently transmitted to locations around the globe, including the U.S. The levels of radioactive material that arrived in the U.S. were never large enough to be a concern for health effects, but the presence of this material in the environment was enough to create a public health emergency in the U.S. The radiation safety and public health communities in the U.S. are identifying challenges they faced in responding to this incident. This paper discusses three of those challenges: (1) The growing shortage of trained radiation subject matter experts in the field of environmental transport and dosimetry of radionuclides; (2) the need to begin expressing all radiation-related quantities in terms of the International System of Units; and (3) the need to define when a radiation dose is or is not one of "public health concern." This list represents only a small subset of the list of challenges being identified by public health agencies that responded to the Fukushima incident. However, these three challenges are fundamental to any radiological emergency response. Addressing them will have a significant positive impact on how the U.S. responds to the next radiological emergency.

  15. Analysis and Comparison of Naturalistic Themes in Iranian and Britain Modern Children's Poems

    Directory of Open Access Journals (Sweden)

    Shayesteh Ebrahimi

    2016-08-01

    Full Text Available Today, children's literature given the concept of childhood, has gained a special status in the studies of humanities. Children's poetry is one of the branches of this type of literature. Naturalistic themes have the highest frequency among the themes of children poems in two countries. The population of this research consists of collections that have been published from 1921 to 2011. Children's literature was born in England in the eighteenth century and before that the first didactic books for children had come into existence in England. In addition, due to industrial growth, the emergence of the new middle class and expansion of formal education the UK was pioneering among Europe and the world countries. Therefore, to find the roots of the formation of children's literature should be referred to the UK. Therefore, in this paper Britain children’s poem has been selected to be compared with Iranian children’s poem so that by revealing the similarities and differences one can deal with the pathology of poems for children in Iran and to detect shortcomings and strengths and present some guidelines that be helpful for children and young poets as well as critics and researchers in this field. Keywords: Naturalistic themes, children literature, Iranian children's poems, Britain children's poems, comparative literature

  16. Mediating Systems of Care: Emergency Calls to Long-Term Care Facilities at Life's End.

    Science.gov (United States)

    Waldrop, Deborah P; McGinley, Jacqueline M; Clemency, Brian

    2018-04-09

    Nursing home (NH) residents account for over 2.2 million emergency department visits yearly; the majority are cared for and transported by prehospital providers (emergency medical technicians and paramedics). The purpose of this study was to investigate prehospital providers' perceptions of emergency calls at life's end. This article focuses on perceptions of end-of-life calls in long-term care (LTC). This pilot study employed a descriptive cross-sectional design. Concepts from the symbolic interaction theory guided the exploration of perceptions and interpretations of emergency calls in LTC facilities. A purposeful sample of prehospital providers was developed from one agency in a small northeastern U.S. city. Semistructured interviews were conducted with 43 prehospital providers to explore their perceptions of factors that trigger emergency end-of-life calls in LTC facilities. Qualitative data analysis involved iterative coding in an inductive process that included open, systematic, focused, and axial coding. Interview themes illustrated the contributing factors as follows: care crises; dying-related turmoil; staffing ratios; and organizational protocols. Distress was crosscutting and present in all four themes. The findings illuminate how prehospital providers become mediators between NHs and emergency departments by managing tension, conflict, and challenges in patient care between these systems and suggest the importance of further exploration of interactions between LTC staff, prehospital providers, and emergency departments. Enhanced communication between LTC facilities and prehospital providers is important to address potentially inappropriate calls and transport requests and to identify means for collaboration in the care of sick frail residents.

  17. Identifying Barriers and Enablers in the Dietary Management of Type 2 Diabetes in M'Bour, Senegal.

    Science.gov (United States)

    Foley, Evan; BeLue, Rhonda

    2017-07-01

    The purpose of this study was to identify cultural enablers and barriers to dietary management of type 2 diabetes in M'Bour, Senegal. This qualitative study used the PEN-3 cultural model to explore diabetes dietary management within a cultural framework. Content analysis identified emergent themes based on the PEN-3 model. Forty-one individuals completed interviews. Themes reflecting ways that culture affects adherence to the diabetic diet included (a) having a different diet or eating separately from the communal family plate creates feelings of social isolation; (b) forgoing the diabetic diet sometimes occurs so that family members have enough food; (c) reducing servings of traditional foods feels like abandoning culture; and (d) women being responsible for preparing food, while men typically manage money for purchasing food yet do not provide input on what food is purchased. Results suggest that educating family units on the dietary management of diabetes may be more effective than individual education.

  18. Development of a novel scoring system for identifying emerging chemical risks in the food chain.

    Science.gov (United States)

    Oltmanns, J; Licht, O; Bitsch, A; Bohlen, M-L; Escher, S E; Silano, V; MacLeod, M; Serafimova, R; Kass, G E N; Merten, C

    2018-02-21

    The European Food Safety Authority (EFSA) is responsible for risk assessment of all aspects of food safety, including the establishment of procedures aimed at the identification of emerging risks to food safety. Here, a scoring system was developed for identifying chemicals registered under the European REACH Regulation that could be of potential concern in the food chain using the following parameters: (i) environmental release based on maximum aggregated tonnages and environmental release categories; (ii) biodegradation in the environment; (iii) bioaccumulation and in vivo and in vitro toxicity. The screening approach was tested on 100 data-rich chemicals registered under the REACH Regulation at aggregated volumes of at least 1000 tonnes per annum. The results show that substance-specific data generated under the REACH Regulation can be used to identify potential emerging risks in the food chain. After application of the screening procedure, priority chemicals can be identified as potentially emerging risk chemicals through the integration of exposure, environmental fate and toxicity. The default approach is to generate a single total score for each substance using a predefined weighting scenario. However, it is also possible to use a pivot table approach to combine the individual scores in different ways that reflect user-defined priorities, which enables a very flexible, iterative definition of screening criteria. Possible applications of the approaches are discussed using illustrative examples. Either approach can then be followed by in-depth evaluation of priority substances to ensure the identification of substances that present a real emerging chemical risk in the food chain.

  19. Can the Social Vulnerability Index Be Used for More Than Emergency Preparedness? An Examination Using Youth Physical Fitness Data.

    Science.gov (United States)

    Gay, Jennifer L; Robb, Sara W; Benson, Kelsey M; White, Alice

    2016-02-01

    The Social Vulnerability Index (SVI), a publicly available dataset, is used in emergency preparedness to identify communities in greatest need of resources. The SVI includes multiple socioeconomic, demographic, and geographic indicators that also are associated with physical fitness and physical activity. This study examined the utility of using the SVI to explain variation in youth fitness, including aerobic capacity and body mass index. FITNESSGRAM data from 2,126 Georgia schools were matched at the census tract level with SVI themes of socioeconomic, household composition, minority status and language, and housing and transportation. Multivariate multiple regression models were used to test whether SVI factors explained fitness outcomes, controlling for grade level (ie, elementary, middle, high school) and stratified by gender. SVI themes explained the most variation in aerobic fitness and body mass index for both boys and girls (R2 values 11.5% to 26.6%). Socioeconomic, Minority Status and Language, and Housing and Transportation themes were salient predictors of fitness outcomes. Youth fitness in Georgia was related to socioeconomic, demographic, and geographic themes. The SVI may be a useful needs assessment tool for health officials and researchers examining multilevel influences on health behaviors or identifying communities for prevention efforts.

  20. What is shared, what is different? Core relational themes and expressive displays of eight positive emotions.

    Science.gov (United States)

    Campos, Belinda; Shiota, Michelle N; Keltner, Dacher; Gonzaga, Gian C; Goetz, Jennifer L

    2013-01-01

    Understanding positive emotions' shared and differentiating features can yield valuable insight into the structure of positive emotion space and identify emotion states, or aspects of emotion states, that are most relevant for particular psychological processes and outcomes. We report two studies that examined core relational themes (Study 1) and expressive displays (Study 2) for eight positive emotion constructs--amusement, awe, contentment, gratitude, interest, joy, love, and pride. Across studies, all eight emotions shared one quality: high positive valence. Distinctive core relational theme and expressive display patterns were found for four emotions--amusement, awe, interest, and pride. Gratitude was associated with a distinct core relational theme but not an expressive display. Joy and love were each associated with a distinct expressive display but their core relational themes also characterised pride and gratitude, respectively. Contentment was associated with a distinct expressive display but not a core relational theme. The implications of this work for the study of positive emotion are discussed.

  1. [The most cited themes in the research in the field of Mental Health: analyses of six international nursing and medical journals].

    Science.gov (United States)

    Cunico, Laura; Fredo, Susanna; Bernini, Massimo

    2017-01-01

    The review aimed to identify and analyse the future development on the topic by analysing the main themes discussed in number of scientific journal focused on Mental Health both by nurses and physicians.. 4 international journals focused on Mental health and psychiatry International Journal of Mental Health Nursing, Archives of Psychiatric Nursing, American Journal of Psychiatry, Australian and New Zeland Journal of Psychiatry as well as two journal focused generically on health, Journal of Advanced Nursing and Lancet were scrutinized. We have analysed the papers of 2012-2015 for the specialised journals and last and first 6 months of 2012 and 2013 and 2014-2015 for the generic. Editorials, comments and contributions regarding theoretical models were exluded. From the analysis we identified 9 themes and for each theme the pertinent category. For the diagnostic grouping we used the International Statistical Classification of Diseases and Related Health Problems 10th Revision. A trend in research about mood disorders, schizophrenia and addictions and comorbidity emerged according to the 2099 abstracts analysed. Within medical research antidepressants were the most studied psychotropic medication and cognitive behaviour therapy was the most studied psychotherapy. Within nursing research: the nurse-patient relationship, adherence and monitoring of pharmacological therapy, the treatment planning and the working environment, the nursing training and its efficacy. The clinical research trials were twice as frequent in the medical versus nursing research where qualitative research prevails. The research challenge will be to find a new paradigm fit for the future psychiatry having at its disposition the patient's genoma, and needing to routinely use biomarkers for a personalised therapy. A further challenge might be the promotion of interprofessional research between doctors and nurses and the acquisition of new competences of health professionals needed to tackle the

  2. The role of tobacco advertising and promotion: themes employed in litigation by tobacco industry witnesses.

    Science.gov (United States)

    Goldberg, Marvin E; Davis, Ronald M; O'Keefe, Anne Marie

    2006-12-01

    To identify key themes related to tobacco advertising and promotion in testimony provided by tobacco industry-affiliated witnesses in tobacco litigation, and to present countervailing evidence and arguments. Themes in industry testimony were identified by review of transcripts of testimony in the Tobacco Deposition and Trial Testimony Archive (http://tobaccodocuments.org/datta) from a sample of defence witnesses, including three academic expert witnesses, six senior executives of tobacco companies, and one industry advertising consultant. Counterarguments to the themes embodied in defence testimony were based on information from peer-reviewed literature, advertising trade publications, government reports, tobacco industry documents, and testimony provided by expert witnesses testifying for plaintiffs. Five major themes employed by defence witnesses were identified: (1) tobacco advertising has a relatively weak "share of voice" in the marketing environment and is a weak force in affecting smoking behaviour; (2) tobacco advertising and promotion do not create new smokers, expand markets, or increase total tobacco consumption; (3) the tobacco industry does not target, study, or track youth smoking; (4) tobacco advertising and promotion do not cause smoking initiation by youth; and (5) tobacco companies and the industry adhere closely to relevant laws, regulations, and industry voluntary codes. Substantial evidence exists in rebuttal to these arguments. Tobacco industry-affiliated witnesses have marshalled many arguments to deny the adverse effects of tobacco marketing activities and to portray tobacco companies as responsible corporate citizens. Effective rebuttals to these arguments exist, and plaintiffs' attorneys have, with varying degrees of success, presented them to judges and juries.

  3. Identifying Effective Methods of Instruction for Adult Emergent Readers through Community-Based Research

    Science.gov (United States)

    Blackmer, Rachel; Hayes-Harb, Rachel

    2016-01-01

    We present a community-based research project aimed at identifying effective methods and materials for teaching English literacy skills to adult English as a second language emergent readers. We conducted a quasi-experimental study whereby we evaluated the efficacy of two approaches, one based on current practices at the English Skills Learning…

  4. Adults Contemplating University Study at a Distance: Issues, themes and concerns

    Directory of Open Access Journals (Sweden)

    Chris Morgan

    2003-04-01

    Full Text Available This study identifies and explores a range of themes, issues and questions that commonly confront adults contemplating enrolment in university, and why they persist. The study focuses particularly on issues facing prospective adult distance education learners. From a range of interviews, six themes were identified including fears, motivation, support from home, academic preparedness, suitability of programs, and identity change.It is argued that the more effective we become at information provision, guidance and preparation of adult pre-entry open and distance learners, the more likely students will experience a smooth transition to study, thus improving both student satisfaction and retention rates. Successful intervention with prospective distance education learners at this early point should aim to assist the process of informed decision making, which could result equally in an individual deciding not to pursue university study. The findings in this study should be particularly useful for those academics, course advisors, student counsellors, teachers in preparatory programs, and university information and support officers, and others who provide adult distance students, with pre-enrolment information and advice.

  5. Trends in the investigation of social determinants of health: selected themes and methods

    Directory of Open Access Journals (Sweden)

    Roger Keller Celeste

    2011-01-01

    Full Text Available We analyze bibliometric trends of topics relevant to the epidemiologic research of social determinants of health. A search of the PubMed database, covering the period 1985-2007, was performed for the topics: socioeconomic factors, sex, race/ethnicity, discrimination/prejudice, social capital/support, lifecourse, income inequality, stress, behavioral research, contextual effects, residential segregation, multilevel modeling, regression based indices to measure inequalities, and structural equation modeling/causal diagrams/path analysis. The absolute, but not the relative, frequency of publications increased for all themes. Total publications in PubMed increased 2.3 times, while the subsets of epidemiology/public health and social epidemiologic themes/methods increased by factors of 5.3 and 5.2, respectively. Only multilevel and contextual analyses had a growth over and above that observed for epidemiology/public health. We conclude that there is clearly room for wider use of established techniques, and for new methods to emerge when they satisfy theoretical needs.

  6. MANAGEMENT OF EXTRIMITY FRACTURE IN EMERGENCY DEPARTMENT

    Directory of Open Access Journals (Sweden)

    Putu Sukma Parahita

    2013-09-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE Fracture injuries in the extremities are accounted for 40% of the incidence of fractures in the United States and causes high morbidity (physical suffering, lost time, and mental stress. High-energy fractures of the lower limbs can also cause life threatening condition like major vascular injury, crush syndrome, and compartment syndrome. Initial treatment in the emergency room is essential to save lives and to save the fractured extremities. Primary survey (securing the airway, breathing and circulation and the secondary survey will be able to quickly and accurately identify dangerous early complication of fractures, such as major arterial injury, crush syndrome and compartment syndrome. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  7. Converging cellular themes for the hereditary spastic paraplegias.

    Science.gov (United States)

    Blackstone, Craig

    2018-05-10

    Hereditary spastic paraplegias (HSPs) are neurologic disorders characterized by prominent lower-extremity spasticity, resulting from a length-dependent axonopathy of corticospinal upper motor neurons. They are among the most genetically-diverse neurologic disorders, with >80 distinct genetic loci and over 60 identified genes. Studies investigating the molecular pathogenesis underlying HSPs have emphasized the importance of converging cellular pathogenic themes in the most common forms of HSP, providing compelling targets for therapy. Most notably, these include organelle shaping and biogenesis as well as membrane and cargo trafficking. Published by Elsevier Ltd.

  8. Condom use preferences among Latinos in Miami-Dade: emerging themes concerning men’s and women’s culturally-ascribed attitudes and behaviours

    Science.gov (United States)

    Sastre, Francisco; De La Rosa, Mario; Ibanez, Gladys E.; Whitt, Elaine; Martin, Steven S.; O’Connell, Daniel J.

    2014-01-01

    Among Latinos, cultural values such as machismo and marianismo may promote inconsistent condom use representing a significant risk factor for HIV infection. Yet, there continues to be a need for additional research to explore the influence these cultural values have on Latino men and women’s condom use attitudes and behaviours given increasing HIV rates of HIV infection among Latinos. The purpose of this study was to explore further Latino traditional culturally-ascribed attitudes and behaviour for emerging themes toward condom use among a diverse group of adult Latino men and women living in Miami-Dade County, Florida (USA). The study used a qualitative study-design and collected data from sixteen focus groups with a total of 67 Latino men and women. Finding from the focus groups described attitudes and behaviours that counter traditional gender roles towards sex and expected sexual behaviours informed by machismo and marianismo. Common attitudes noted in the study include men’s classification of women as clean/dirty to determine condom use and women’s assertiveness during sexual encounters negotiating condom use-in favour and against it. As the findings of this study suggest, the process differ greatly between Latino men and women, having an impact on the risk behaviours in which each engage. PMID:25530309

  9. Impact of international humanitarian service-learning on emerging adult social competence: A mixed-methods evaluation

    Directory of Open Access Journals (Sweden)

    Paul Schvaneveldt

    2016-09-01

    Full Text Available This article presents the results from a study into international humanitarian service-learning experiences on young adult volunteers. Specifically, the service-learning experiences of emerging adults who had served in orphanages in Latin America were assessed, in a pre- and post-test design, for their development in areas of social competency such as identity, self-efficacy, self-esteem and ethnocentric attitudes. A mixed-methods design using both qualitative and quantitative measures was used. Both qualitative and quantitative results identified significant and important impacts on the development of the social competencies of these emerging adults. In addition, several qualitative themes illustrated that longer term international service-learning experiences have a profound impact on the social competence of emerging adults. Keywords: International humanitarian service, service-learning, emerging adult competency

  10. Strategy for developing and conducting nuclear emergency exercises

    International Nuclear Information System (INIS)

    2007-01-01

    Emergency situations demand that actions be taken by responsible organisations and individuals at the site of the emergency and at the local, national and international levels to mitigate the impact on people and the environment. Effective emergency response requires development and implementation of emergency plans and procedures; established arrangements at the local, national and international levels; acquisition and maintenance of resources (funding, equipment and personnel); training of personnel; conduct of exercises; and a 'feedback programme' whereby improvements to the emergency management system are made based on lessons identified from exercises and actual events. A means for demonstrating the effectiveness of an emergency programme is through the conduct of exercises. Exercises demonstrate the effectiveness of plans, procedures, training and equipment; adequacy of response arrangements and resources; capabilities of response personnel in performing their assigned tasks; ability of individuals and organisations to work together; and provide a forum for exploring and testing revisions, modifications, and new and/or proposed changes to any emergency programme element in near realistic situations. Exercises may range in scope from small-scale drills to large-scale national or international exercises. There is clear benefit to organisations in supporting, developing and conducting well-managed exercises. Exercising is a resource-intensive tool; however, it is a critical tool for enhancing performance, testing arrangements and identifying areas for improvement. A thoroughly developed strategy should therefore be in place to ensure maximum value from an exercise programme. This report contributes to the good practice and management of exercise programmes by providing a strategy for improving the value of planning, conducting, participating in and/or supporting exercises. The OECD/NEA International Nuclear Emergency Exercise (INEX) series undertaken over the

  11. Identifying Strategies to Decrease Overtime, Absenteeism and Agency Use: Insights from Healthcare Leaders.

    Science.gov (United States)

    Jeffs, Lianne; Grinspun, Doris; Closson, Tom; Mainville, Marie-Claude

    2015-09-01

    Working overtime, absenteeism and agency use can negatively impact working environments, the health of staff and patient outcomes, and increase healthcare costs. The purpose of this study was to explore how healthcare leaders in Ontario hospitals implement and sustain best practices that advance workforce stability within their organization. Qualitative study design using semi-structured interviews and thematic analysis. Participants included 23 healthcare leaders from 16 hospital sites. Two main themes emerged: (1) enacting proactive human resource practices and (2) having strong, caring and strategic leaders that create learning and supportive work environments. A number of sub-themes identified were reported through narratives stratified according to size (small/large) and performance (low/high) of each site. Insights gained from this study may offer healthcare leaders strategies to maximize the nursing workforce and minimize overtime, absenteeism and agency use to ensure safe, efficient and quality healthcare. Copyright © 2015 Longwoods Publishing.

  12. Detecting Themed Streets Using a Location Based Service Application

    Directory of Open Access Journals (Sweden)

    Byeongsuk Ji

    2016-07-01

    Full Text Available Various themed streets have recently been developed by local governments in order to stimulate local economies and to establish the identity of the corresponding places. However, the motivations behind the development of some of these themed street projects has been based on profit, without full considerations of people’s perceptions of their local areas, resulting in marginal effects on the local economies concerned. In response to this issue, this study proposed a themed street clustering method to detect the themed streets of a specific region, focusing on the commercial themed street, which is more prevalent than other types of themed streets using location based service data. This study especially uses “the street segment” as a basic unit for analysis. The Sillim and Gangnam areas of Seoul, South Korea were chosen for the evaluation of the adequacy of the proposed method. By comparing trade areas that were sourced from a market analysis report by a reliable agent with the themed streets detected in this study, the experiment results showed high proficiency of the proposed method.

  13. FY16 Strategic Themes White Paper.

    Energy Technology Data Exchange (ETDEWEB)

    Leland, Robert W. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-03-01

    The Science and Technology (S&T) Division 1000 Strategic Plan includes the Themes, Goals, and Actions for FY16. S&T will continue to support the Labs Strategic plan, Mission Areas and Program Management Units by focusing on four strategic themes that align with the targeted needs of the Labs. The themes presented in this plan are Mission Engagement, Bold Outcomes, Collaborative Environment, and the Safety Imperative. Collectively they emphasize diverse, collaborative teams and a self-reliant culture of safety that will deliver on our promise of exceptional service in the national interest like never before. Mission Engagement focuses on increasing collaboration at all levels but with emphasis at the strategic level with mission efforts across the labs. Bold Outcomes seeks to increase the ability to take thoughtful risks with the goal of achieving transformative breakthroughs more frequently. Collaborative environment strives for a self-aware, collaborative working environment that bridges the many cultures of Sandia. Finally, Safety Imperative aims to minimize the risk of serious injury and to continuously strengthen the safety culture. Each of these themes is accompanied by a brief vision statement, several goals, and planned actions to support those goals throughout FY16 and leading into FY17.

  14. Effects of Instructions on Theme Grading: Grammatical vs. Holistic

    Science.gov (United States)

    Follman, John; And Others

    1971-01-01

    Twelve college seniors in an English methods course were assigned to three treatment groups, Grammatical, Holistic, and Both. Each group received different instructions but graded the same 10 themes. Themes graded for grammatical errors received lower grades than the same themes graded holistically. (NH)

  15. Service providers' perception of the quality of emergency obsteric ...

    African Journals Online (AJOL)

    Facility/staff themes which emerged as contributing to the poor care were; inadequate resources, inadequate staffing, poor teamwork, and inadequate knowledge/supervision. Conclusion The findings of this study reveal that health care workers rate the quality of emergency obstetric care they provide as poor. They were ...

  16. Themes of nanoscience for the introductory physics course

    International Nuclear Information System (INIS)

    Planinsic, Gorazd; Lindell, Anssi; Remskar, Maja

    2009-01-01

    We present three experimental themes and one discussion theme that proved to be suitable for introducing nanoscience through topics that can be integrated into the existing introductory physics or teacher training courses. The experimental themes include two teaching models of an atomic force microscope (AFM) and an experiment with an elastic optical grating. They are all based on simple experiments that give also quantitative results and can be explained using basic physics theory.

  17. Themes of nanoscience for the introductory physics course

    Energy Technology Data Exchange (ETDEWEB)

    Planinsic, Gorazd [Faculty for Mathematics and Physics, University of Ljubljana (Slovenia); Lindell, Anssi [Department of Teacher Education, University of Jyvaskyla (Finland); Remskar, Maja [Josef Stefan Institute, Ljubljana (Slovenia)

    2009-07-15

    We present three experimental themes and one discussion theme that proved to be suitable for introducing nanoscience through topics that can be integrated into the existing introductory physics or teacher training courses. The experimental themes include two teaching models of an atomic force microscope (AFM) and an experiment with an elastic optical grating. They are all based on simple experiments that give also quantitative results and can be explained using basic physics theory.

  18. Globalisation of commercial theme parks: the walt Disney Company

    OpenAIRE

    DE GROOTE, Patrick

    2009-01-01

    The Economics Research Associates (ERA) defines a theme park as ‘A gated attraction that contains rides and/or shows in a themed environment, offers a pay-one-price ticket for its guests and attracts at least 500,000 annual visits’ (ERA, 2007). A more detailed description for theme parks is given by Philip L. Pearce (in Jafar Jafari, 2000, 124-5): ‘Theme parks are capital intensive, highly developed, self-contained recreational spaces which invariably charge admission. The entertainment, ride...

  19. Exploring the emerging profession of speech-language pathology in Vietnam through pioneering eyes.

    Science.gov (United States)

    Atherton, Marie; Davidson, Bronwyn; McAllister, Lindy

    2017-04-01

    In September 2012, 18 Vietnamese health professionals graduated as Vietnam's first university qualified speech-language pathologists (SLPs). This study details the reflections of these pioneering health professionals at 12 months following their graduation, drawing attention to their scope of practice as SLPs and to the opportunities and challenges to progressing the practice of speech-language pathology (SLP) in Vietnam. Thirteen graduates participated in small group interviews where they described their work and their perceptions of their emerging practice. Thematic analysis of the interview transcripts was employed to identify key concepts and themes within the data. Four overarching themes were identified-scope of practice, establishing identity, confidence to practise and progressing the profession. Overall analysis revealed evolving professional practice characterised by new learning, fluctuations in confidence and an active forging of professional identity. Mentoring and support by international colleagues and advancing professional recognition were identified as critical to the profession's progression and to the development of context-specific and culturally appropriate services. Participants' reflections draw focus to an important role for the international SLP community as it works in partnership with colleagues to enhance awareness of and services for people with communication disabilities in under-served communities such as Vietnam.

  20. Theme 10: greenhouse effect transport policies and urban organization

    International Nuclear Information System (INIS)

    2002-07-01

    This document describes the reference framework of the theme 10 ''greenhouse effect, transport policies and urban organization'' which is a part of the urban transports interface. It presents the specific actions realized by the theme 10 for a future integration in theme 1, 5 and 8. (A.L.B.)

  1. Surveillance of Washington OSHA exposure data to identify uncharacterized or emerging occupational health hazards.

    Science.gov (United States)

    Lofgren, Don J; Reeb-Whitaker, Carolyn K; Adams, Darrin

    2010-07-01

    Chemical substance exposure data from the Washington State Occupational Safety and Health Administration (OSHA) program were reviewed to determine if inspections conducted as a result of a report of a hazard from a complainant or referent may alert the agency to uncharacterized or emerging health hazards. Exposure and other electronically stored data from 6890 health inspection reports conducted between April 2003 and August 2008 were extracted from agency records. A total of 515 (7%) inspections with one or more personal airborne chemical substance samples were identified for further study. Inspections by report of a hazard and by targeting were compared for the following: number of inspections, number and percentage of inspections with workers exposed to substances above an agency's permissible exposure limit, types of industries inspected, and number and type of chemical substances assessed. Report of a hazard inspections documented work sites with worker overexposure at the same rate as agency targeted inspections (approximately 35% of the time), suggesting that complainants and referents are a credible pool of observers capable of directing the agency to airborne chemical substance hazards. Report of a hazard inspections were associated with significantly broader distribution of industries as well as a greater variety of chemical substance exposures than were targeted inspections. Narrative text that described business type and processes inspected was more useful than NAICS codes alone and critical in identifying processes and industries that may be associated with new hazards. Finally, previously identified emerging hazards were found among the report of a hazard data. These findings indicate that surveillance of OSHA inspection data can be a valid tool to identify uncharacterized and emerging health hazards. Additional research is needed to develop criteria for objective review and prioritization of the data for intervention. Federal OSHA and other state

  2. Using Philosophical Liberalism and Philosophical Conservatism as an Organizing Theme in the First Half of the American History Survey

    Science.gov (United States)

    Morris, Richard J.

    2009-01-01

    Since approximately 1970, many historians have been seeking a unifying theme for the American History Survey. Early in the twentieth century, Progressive historians identified class conflict as the main theme in American History, but during the 1950s and 1960s, this view was challenged by the Consensus Schools' assertion that Americans have always…

  3. The use of negative themes in television food advertising.

    Science.gov (United States)

    Pettigrew, Simone; Roberts, Michele; Chapman, Kathy; Quester, Pascale; Miller, Caroline

    2012-04-01

    The ability of food advertising to trigger food consumption and influence social norms relating to food consumption has resulted in increasing attention being given to the prevalence and nature of food advertising. The present study investigated the use of negative themes in food advertisements aired on Australian television to determine the prevalence of depictions of violence/aggression, mocking, nagging, boredom, loneliness, food craving, mood enhancement, and the emotional use of food across 61 days of programming time. The results suggest that advertisers are using negative themes to capture attention and invoke an emotional response in the target audience. Sixteen percent (14,611) of the 93,284 food advertisements contained negative themes, with mood enhancement and food craving being the most commonly depicted negative themes. Advertisements with negative themes were more likely to be for non-core foods and to be aired during children's popular viewing times than at other times. The potential for negative themes in food advertising to promote unhealthy food consumption behaviors among children is likely to be of concern to policy makers. Building on this exploratory study, further research is needed to investigate how nutrition-related decision making is affected by exposure to food advertisements employing negative emotional themes. Copyright © 2011 Elsevier Ltd. All rights reserved.

  4. Interprofessional communication supporting clinical handover in emergency departments: An observation study.

    Science.gov (United States)

    Redley, Bernice; Botti, Mari; Wood, Beverley; Bucknall, Tracey

    2017-08-01

    Poor interprofessional communication poses a risk to patient safety at change-of-shift in emergency departments (EDs). The purpose of this study was to identify and describe patterns and processes of interprofessional communication impacting quality of ED change-of-shift handovers. Observation of 66 change-of-shift handovers at two acute hospital EDs in Victoria, Australia. Focus groups with 34 nurse participants complemented the observations. Qualitative data analysis involved content and thematic methods. Four structural components of ED handover processes emerged represented by (ABCD): (1) Antecedents; (2) Behaviours and interactions; (3) Content; and (4) Delegation of ongoing care. Infrequent and ad hoc interprofessional communication and discipline-specific handover content and processes emerged as specific risks to patient safety at change-of-shift handovers. Three themes related to risky and effective practices to support interprofessional communications across the four stages of ED handovers emerged: 1) standard processes and practices, 2) teamwork and interactions and 3) communication activities and practices. Unreliable interprofessional communication can impact the quality of change-of-shift handovers in EDs and poses risk to patient safety. Structured reflective analysis of existing practices can identify opportunities for standardisation, enhanced team practices and effective communication across four stages of the handover process to support clinicians to enhance local handover practices. Future research should test and refine models to support analysis of practice, and identify and test strategies to enhance ED interprofessional communication to support clinical handovers. Copyright © 2017 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.

  5. Examining Kindergarteners' Drawings for Their Perspectives on Picture Books' Themes and Characters

    Science.gov (United States)

    Hsiao, Ching-Yuan; Chen, Chi-Mei

    2015-01-01

    The aim of this study was to identify and characterize children's perspectives on a picture book's themes and characters by examining their drawings. The study was conducted over a five-month period in a public kindergarten in southern Taiwan, with six children aged 5-6 years. Picture book appreciation activities focused on eight picture books.…

  6. Unity in Major Themes

    DEFF Research Database (Denmark)

    Booss-Bavnbek, Bernhelm; Davis, Philip J.

    We describe and explain the desire, common among mathematicians, both for unity and independence in its major themes. In the dialogue that follows, we express our spontaneous and considered judgment and reservations; by contrasting the development of mathematics as a goal-driven process as opposed...

  7. Learning to Promote Health at an Emergency Care Department: Identifying Expansive and Restrictive Conditions

    Science.gov (United States)

    Gustavsson, Maria; Ekberg, Kerstin

    2015-01-01

    This article reports on the findings of a planned workplace health promotion intervention, and the aim is to identify conditions that facilitated or restricted the learning to promote health at an emergency care department in a Swedish hospital. The study had a longitudinal design, with interviews before and after the intervention and follow-up…

  8. Current and emerging screening methods to identify post-head-emergence frost adaptation in wheat and barley.

    Science.gov (United States)

    Frederiks, T M; Christopher, J T; Harvey, G L; Sutherland, M W; Borrell, A K

    2012-09-01

    Cereal crops can suffer substantial damage if frosts occur at heading. Identification of post-head-emergence frost (PHEF) resistance in cereals poses a number of unique and difficult challenges. Many decades of research have failed to identify genotypes with PHEF resistance that could offer economically significant benefit to growers. Research and breeding gains have been limited by the available screening systems. Using traditional frost screening systems, genotypes that escape frost injury in trials due to spatial temperature differences and/or small differences in phenology can be misidentified as resistant. We believe that by improving techniques to minimize frost escapes, such 'false-positive' results can be confidently identified and eliminated. Artificial freezing chambers or manipulated natural frost treatments offer many potential advantages but are not yet at the stage where they can be reliably used for frost screening in breeding programmes. Here we describe the development of a novel photoperiod gradient method (PGM) that facilitates screening of genotypes of different phenology under natural field frosts at matched developmental stages. By identifying frost escapes and increasing the efficiency of field screening, the PGM ensures that research effort can be focused on finding genotypes with improved PHEF resistance. To maximize the likelihood of identifying PHEF resistance, we propose that the PGM form part of an integrated strategy to (i) source germplasm;(ii) facilitate high throughput screening; and (iii) permit detailed validation. PGM may also be useful in other studies where either a range of developmental stages and/or synchronized development are desired.

  9. Theme: Staying Current--Horticulture.

    Science.gov (United States)

    Shry, Carroll L., Jr.; And Others

    1986-01-01

    This theme issue on staying current in horticulture includes articles on sex equity in horticulture, Future Farmers of America, career opportunities in horticulture, staying current with your school district's needs, staying current in horticulture instruction, staying current with landscape trade associations, emphasizing the basics in vocational…

  10. Identifying the science and technology dimensions of emerging public policy issues through horizon scanning.

    Science.gov (United States)

    Parker, Miles; Acland, Andrew; Armstrong, Harry J; Bellingham, Jim R; Bland, Jessica; Bodmer, Helen C; Burall, Simon; Castell, Sarah; Chilvers, Jason; Cleevely, David D; Cope, David; Costanzo, Lucia; Dolan, James A; Doubleday, Robert; Feng, Wai Yi; Godfray, H Charles J; Good, David A; Grant, Jonathan; Green, Nick; Groen, Arnoud J; Guilliams, Tim T; Gupta, Sunjai; Hall, Amanda C; Heathfield, Adam; Hotopp, Ulrike; Kass, Gary; Leeder, Tim; Lickorish, Fiona A; Lueshi, Leila M; Magee, Chris; Mata, Tiago; McBride, Tony; McCarthy, Natasha; Mercer, Alan; Neilson, Ross; Ouchikh, Jackie; Oughton, Edward J; Oxenham, David; Pallett, Helen; Palmer, James; Patmore, Jeff; Petts, Judith; Pinkerton, Jan; Ploszek, Richard; Pratt, Alan; Rocks, Sophie A; Stansfield, Neil; Surkovic, Elizabeth; Tyler, Christopher P; Watkinson, Andrew R; Wentworth, Jonny; Willis, Rebecca; Wollner, Patrick K A; Worts, Kim; Sutherland, William J

    2014-01-01

    Public policy requires public support, which in turn implies a need to enable the public not just to understand policy but also to be engaged in its development. Where complex science and technology issues are involved in policy making, this takes time, so it is important to identify emerging issues of this type and prepare engagement plans. In our horizon scanning exercise, we used a modified Delphi technique. A wide group of people with interests in the science and policy interface (drawn from policy makers, policy adviser, practitioners, the private sector and academics) elicited a long list of emergent policy issues in which science and technology would feature strongly and which would also necessitate public engagement as policies are developed. This was then refined to a short list of top priorities for policy makers. Thirty issues were identified within broad areas of business and technology; energy and environment; government, politics and education; health, healthcare, population and aging; information, communication, infrastructure and transport; and public safety and national security.

  11. Identifying the science and technology dimensions of emerging public policy issues through horizon scanning.

    Directory of Open Access Journals (Sweden)

    Miles Parker

    Full Text Available Public policy requires public support, which in turn implies a need to enable the public not just to understand policy but also to be engaged in its development. Where complex science and technology issues are involved in policy making, this takes time, so it is important to identify emerging issues of this type and prepare engagement plans. In our horizon scanning exercise, we used a modified Delphi technique. A wide group of people with interests in the science and policy interface (drawn from policy makers, policy adviser, practitioners, the private sector and academics elicited a long list of emergent policy issues in which science and technology would feature strongly and which would also necessitate public engagement as policies are developed. This was then refined to a short list of top priorities for policy makers. Thirty issues were identified within broad areas of business and technology; energy and environment; government, politics and education; health, healthcare, population and aging; information, communication, infrastructure and transport; and public safety and national security.

  12. Identifying the Science and Technology Dimensions of Emerging Public Policy Issues through Horizon Scanning

    Science.gov (United States)

    Parker, Miles; Acland, Andrew; Armstrong, Harry J.; Bellingham, Jim R.; Bland, Jessica; Bodmer, Helen C.; Burall, Simon; Castell, Sarah; Chilvers, Jason; Cleevely, David D.; Cope, David; Costanzo, Lucia; Dolan, James A.; Doubleday, Robert; Feng, Wai Yi; Godfray, H. Charles J.; Good, David A.; Grant, Jonathan; Green, Nick; Groen, Arnoud J.; Guilliams, Tim T.; Gupta, Sunjai; Hall, Amanda C.; Heathfield, Adam; Hotopp, Ulrike; Kass, Gary; Leeder, Tim; Lickorish, Fiona A.; Lueshi, Leila M.; Magee, Chris; Mata, Tiago; McBride, Tony; McCarthy, Natasha; Mercer, Alan; Neilson, Ross; Ouchikh, Jackie; Oughton, Edward J.; Oxenham, David; Pallett, Helen; Palmer, James; Patmore, Jeff; Petts, Judith; Pinkerton, Jan; Ploszek, Richard; Pratt, Alan; Rocks, Sophie A.; Stansfield, Neil; Surkovic, Elizabeth; Tyler, Christopher P.; Watkinson, Andrew R.; Wentworth, Jonny; Willis, Rebecca; Wollner, Patrick K. A.; Worts, Kim; Sutherland, William J.

    2014-01-01

    Public policy requires public support, which in turn implies a need to enable the public not just to understand policy but also to be engaged in its development. Where complex science and technology issues are involved in policy making, this takes time, so it is important to identify emerging issues of this type and prepare engagement plans. In our horizon scanning exercise, we used a modified Delphi technique [1]. A wide group of people with interests in the science and policy interface (drawn from policy makers, policy adviser, practitioners, the private sector and academics) elicited a long list of emergent policy issues in which science and technology would feature strongly and which would also necessitate public engagement as policies are developed. This was then refined to a short list of top priorities for policy makers. Thirty issues were identified within broad areas of business and technology; energy and environment; government, politics and education; health, healthcare, population and aging; information, communication, infrastructure and transport; and public safety and national security. PMID:24879444

  13. Identifying emergency department patients with chest pain who are at low risk for acute coronary syndromes [digest].

    Science.gov (United States)

    Markel, David; Kim, Jeremy

    2017-07-21

    Though a minority of patients presenting to the emergency department with chest pain have acute coronary syndromes,identifying the patients who may be safely discharged and determining whether further testing is needed remains challenging. From the prehospital care setting to disposition and follow-up, this systematic review addresses the fundamentals of the emergency department evaluation of patients determined to be at low risk for acute coronary syndromes or adverse outcomes. Clinical risk scores are discussed, as well as the evidence and indications for confirmatory testing. The emerging role of new technologies, such as high-sensitivity troponin assays and advanced imaging techniques, are also presented. [Points & Pearls is a digest of Emergency Medicine Practice].

  14. FY17 Strategic Themes.

    Energy Technology Data Exchange (ETDEWEB)

    Leland, Robert W. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-03-01

    I am pleased to present this summary of the FY17 Division 1000 Science and Technology Strategic Plan. As this plan represents a continuation of the work we started last year, the four strategic themes (Mission Engagement, Bold Outcomes, Collaborative Environment, and Safety Imperative) remain the same, along with many of the goals. You will see most of the changes in the actions listed for each goal: We completed some actions, modified others, and added a few new ones. As I’ve stated previously, this is not a strategy to be pursued in tension with the Laboratory strategic plan. The Division 1000 strategic plan is intended to chart our course as we strive to contribute our very best in service of the greater Laboratory strategy. I welcome your feedback and look forward to our dialogue about these strategic themes. Please join me as we move forward to implement the plan in the coming months.

  15. Freedom to explore the self: How emerging adults use leisure to develop identity.

    Science.gov (United States)

    Layland, Eric K; Hill, Brian J; Nelson, Larry J

    2018-01-01

    During a period of newly attained freedom preceding commitments expected in adulthood, emerging adults are faced with the major task of identity development. Leisure provides a context with relative freedom wherein emerging adults explore new experiences and access opportunities not always available in more constrained environments like work and school. In this case study of 40 emerging adults from 18 countries ( M age =23.14 years), qualitative interviews were used to investigate the role of leisure as a context for identity development. Results indicate five major themes for leisure-based identity development in emerging adulthood: discovering identity, forming identity, defining identity, positioning identity, and forgoing opportunities. These themes support leisure as an additional context wherein emerging adults may flourish on the pathway toward adulthood. Access to both novel and familiar leisure provide a context for emerging adults to actively direct their identity development through decisions made in leisure time.

  16. Freedom to explore the self: How emerging adults use leisure to develop identity

    Science.gov (United States)

    Layland, Eric K.; Hill, Brian J.; Nelson, Larry J.

    2017-01-01

    During a period of newly attained freedom preceding commitments expected in adulthood, emerging adults are faced with the major task of identity development. Leisure provides a context with relative freedom wherein emerging adults explore new experiences and access opportunities not always available in more constrained environments like work and school. In this case study of 40 emerging adults from 18 countries (Mage=23.14 years), qualitative interviews were used to investigate the role of leisure as a context for identity development. Results indicate five major themes for leisure-based identity development in emerging adulthood: discovering identity, forming identity, defining identity, positioning identity, and forgoing opportunities. These themes support leisure as an additional context wherein emerging adults may flourish on the pathway toward adulthood. Access to both novel and familiar leisure provide a context for emerging adults to actively direct their identity development through decisions made in leisure time. PMID:29276528

  17. Mercosur's regional health agenda: architecture and themes

    Directory of Open Access Journals (Sweden)

    Luisa Guimaraes Queiroz

    Full Text Available This article describes the shaping of institutional health spaces in the Mercosur, with analysis of themes and results and considerations on the construction of the regional agenda and on the effects of regional economic integration processes on health policies and systems. We discuss the organization, operation, focus topics, and results achieved in specific health forums (Meeting of Ministers of Health and Sub-Working Group 11, seeking to analyze the architecture and issues addressed by the regional agenda and drawing parallels with the European experience. The aim of this reflection is to identify how the work done by Mercosur structures contributes to building a regional agenda, with the expectation that the integration can contribute to reducing inequalities in access to health care in the region.

  18. Overview of chytrid emergence and impacts on amphibians

    Science.gov (United States)

    2016-01-01

    Chytridiomycosis is an emerging infectious disease of amphibians that affects over 700 species on all continents where amphibians occur. The amphibian–chytridiomycosis system is complex, and the response of any amphibian species to chytrid depends on many aspects of the ecology and evolutionary history of the amphibian, the genotype and phenotype of the fungus, and how the biological and physical environment can mediate that interaction. Impacts of chytridiomycosis on amphibians are varied; some species have been driven extinct, populations of others have declined severely, whereas still others have not obviously declined. Understanding patterns and mechanisms of amphibian responses to chytrids is critical for conservation and management. Robust estimates of population numbers are needed to identify species at risk, prioritize taxa for conservation actions, design management strategies for managing populations and species, and to develop effective measures to reduce impacts of chytrids on amphibians. This article is part of the themed issue ‘Tackling emerging fungal threats to animal health, food security and ecosystem resilience’. PMID:28080989

  19. BuddyPress theme development

    CERN Document Server

    Lister, Tammie

    2013-01-01

    This book is a hands-on tutorial guide to using BuddyPress.This book is great for designers and developers who are looking to learn how to develop BuddyPress themes. It's assumed that the reader has some understanding of Wordpress and is familiar with CSS and HTML.

  20. Theme: Parents and Reading.

    Science.gov (United States)

    Jund, Suzanne, Ed.

    1977-01-01

    This journal issue concentrates on the theme "Parents and Reading." It presents articles on sharing books with young children, using public relations in a reading program, guiding preschool learning, assessing language readiness, working with reading problems, and teaching reading readiness in Wisconsin kindergartens. Resources and a review of…

  1. Why Do Emergency Medicine Residents Experience Burn Out? A qualitative study

    Directory of Open Access Journals (Sweden)

    Atefe Kamaloo

    2017-06-01

    Full Text Available Objective: Emergency medicine residents are a high–risk group for burnout syndrome. This was a qualitative study with content analysis on emergency medical residents with 2 aims: evaluating the incidence of occupational burnout syndrome and identifying the points of view and attitudes of emergency medical residents about factors related to occupational burnout syndrome.Method: For this study, 2 sessions of focus group discussions were set up at Imam Khomeini hospital affiliated to Tehran University of Medical Sciences. Each session took 90 minutes, and 20 emergency medicine residents in their first or second year of emergency medicine residency participated in the sessions. Data were coded   by MAXQDA10 software.Results: Data were categorized in 4 themes as follow: (1 the characteristics of emergency medicine; (2 ambiguity in residents’ duties; (3 educational planning; and (4 careers.Data on the proposed solutions by residents were analyzed and coded in 3 groups including (1 changes in personal life; (2 arrangement in shifts; and  (3 educational issues.Conclusion: According to findings of this qualitative study, most of emergency medicine residents have experienced exhaustion sometime during the course of their residency. Psychological supports may help the residents to cope with their career difficulties and probable burn out.

  2. [Theme: Achieving Quality Laboratory Projects.[.

    Science.gov (United States)

    Shinn, Glen C.; And Others

    1983-01-01

    The theme articles present strategies for achieving quality laboratory projects in vocational agriculture. They describe fundamentals of the construction of quality projects and stress the importance of quality instruction. (JOW)

  3. Perspectives on Bullying Among Children Who Present to the Emergency Department With Behavioral Misconduct

    Science.gov (United States)

    Waseem, Muhammad; Boutin-Foster, Carla; Robbins, Laura; Gonzalez, Rita; Vargas, Steven; Peterson, Janey C.

    2015-01-01

    The problem of bullying is an increasing public health threat encountered by emergency physicians especially in inner city emergency departments (EDs). Bullying may result in emotional disturbances and psychological trauma in children. Many children sent to the ED because of behavioral misconduct require immediate stabilization and treatment. The emergency physician performs an initial assessment and stabilization. Emergency departments are increasingly on the frontline of the bullying problem. Objectives Our objective was to explore children's perspective of bullying and their views of potential solutions. Methods A qualitative study was conducted in a cohort of 50 children (age, 8–17 years),who were referred to the ED from school because of their behavioral misconduct. An interview survey tool about bullying was administered. It focused on what bullying meant to them and what advice they have for a child who is bullied. They were also asked what advice they would have for adults who try to help. We used grounded theory to analyze the data. Similar concepts were grouped, and the categories with similar properties and dimensions were defined. Common themes were then identified. Results We interviewed 50 children, of whom 27 were boys and 23 were girls. Their mean (SD) age was 12.5 (2.12) years (range, 8–17 years). Bullying was identified by children as including physical, verbal, and emotional actions. Several themes emerged. First, a power imbalance between a bully and victim may render an individual vulnerable to bullying. Being different and weak also increases the risk of being bullied. Second, bullying is wrong, and the bully should be punished. Third, children should learn how to handle bullying situations and develop resilience against bullying. Finally, adults need to be more proactive to prevent or stop bullying. Conclusions Our results provide insights into the perceptions of children regarding bullying. We have garnered a better understanding of what

  4. EMSL Geochemistry, Biogeochemistry and Subsurface Science-Science Theme Advisory Panel Meeting

    Energy Technology Data Exchange (ETDEWEB)

    Brown, Gordon E.; Chaka, Anne; Shuh, David K.; Roden, Eric E.; Werth, Charles J.; Hess, Nancy J.; Felmy, Andrew R.; Rosso, Kevin M.; Baer, Donald R.; Bailey, Vanessa L.; Bowden, Mark E.; Grate, Jay W.; Hoyt, David W.; Kuprat, Laura R.; Lea, Alan S.; Mueller, Karl T.; Oostrom, Martinus; Orr, Galya; Pasa-Tolic, Ljiljana; Plata, Charity; Robinson, E. W.; Teller, Raymond G.; Thevuthasan, Suntharampillai; Wang, Hongfei; Wiley, H. S.; Wilkins, Michael J.

    2011-08-01

    This report covers the topics of discussion and the recommendations of the panel members. On December 8 and 9, 2010, the Geochemistry, Biogeochemistry, and Subsurface Science (GBSS) Science Theme Advisory Panel (STAP) convened for a more in-depth exploration of the five Science Theme focus areas developed at a similar meeting held in 2009. The goal for the fiscal year (FY) 2011 meeting was to identify potential topical areas for science campaigns, necessary experimental development needs, and scientific members for potential research teams. After a review of the current science in each of the five focus areas, the 2010 STAP discussions successfully led to the identification of one well focused campaign idea in pore-scale modeling and five longer-term potential research campaign ideas that would likely require additional workshops to identify specific research thrusts. These five campaign areas can be grouped into two categories: (1) the application of advanced high-resolution, high mass accuracy experimental techniques to elucidate the interplay between geochemistry and microbial communities in terrestrial ecosystems and (2) coupled computation/experimental investigations of the electron transfer reactions either between mineral surfaces and outer membranes of microbial cells or between the outer and inner membranes of microbial cells.

  5. Emergency Department Sickle Cell Assessment of Needs and Strengths (ED-SCANS), a Focus Group and Decision Support Tool Development Project

    Science.gov (United States)

    Tanabe, Paula; Reddin, Christopher; Thornton, Victoria L.; Todd, Knox H.; Wun, Ted; Lyons, John S.

    2010-01-01

    Objectives A decision support tool may guide emergency clinicians in recognizing assessment, analgesic and overall management, and health service delivery needs for patients with sickle cell disease (SCD) in the emergency department (ED). We aimed to identify data and process elements important in making decisions regarding evaluation and management of adult patients in the ED with painful episodes of sickle cell disease. Methods Qualitative methods using a series of focus groups and grounded theory were used. Eligible participants included adult clients with SCD, and emergency physicians and nurses with a minimum of one year of experience providing care to patients with SCD in the ED. Patients were recruited in conjunction with annual SCD meetings, and providers included clinicians who were and were not affiliated with sickle cell centers. Groups were conducted until saturation was reached, and included a total of two patient groups, three physician groups, and two nurse groups. Focus groups were held in New York, Durham, Chicago, New Orleans, and Denver. Clinician participants were asked the following three questions to guide the discussion: 1) what information would be important to know about patients with SCD in the ED setting to effectively care for them and help you identify patient analgesic, treatment, and referral needs? 2) what treatment decisions would you make with this information? and 3) what characteristics would a decision support tool need to have to make it meaningful and useful? Client participants were asked the same questions with re-wording to reflect what they believed providers should know to provide the best care, and what they should do with the information. All focus groups were audio taped and transcribed. The constant comparative method was used to analyze the data. Two coders independently coded participant responses and identified focal themes based on the key questions. An investigator and assistant independently reviewed the

  6. Emerging Market Attractiveness Index for hydro IPPs

    OpenAIRE

    Weaver, Tyson John

    2013-01-01

    This article addresses two primary commercial themes that affect the future development of the industry. 1. What are the most attractive future emerging markets for hydropower? 2. What parameters are utilized by international hydro IPPs to determine market attractiveness?

  7. Characteristics of Effective Simulation (Preclinical) Teachers as Identified by Dental Students: A Qualitative Study.

    Science.gov (United States)

    McAndrew, Maureen; Mucciolo, Thomas W; Jahangiri, Leila

    2016-11-01

    The aim of this qualitative research study was to identify and categorize criteria for simulation teacher quality preferences as reported by dental students. Second-year dental students at New York University College of Dentistry in 2015 were given a two-question, open-ended survey asking what qualities they liked most and least in a simulation or preclinical teacher. Responses were collected until data saturation was reached. Key words in the responses were identified and coded based on similar relationships and then were grouped into defined categories. A total of 168 respondents out of the target group of 363 students (46.3%) provided 1,062 written comments. Three core themes-character, competence, and communication-emerged from 16 defined categories, which were validated using references from the educational literature. The theme of character encompassed eight of the defined categories (motivation, available, caring, patience, professionalism, empathy, fairness, and happiness) and accounted for 50% of the total student responses. The theme of competence comprised five categories (expertise, knowledgeable, efficient, skillful, and effective) and represented 34% of all responses. The communication theme covered the remaining three categories (feedback, approachable, and interpersonal communication) and contained 17% of the responses. Positive and negative comments in the category of motivation accounted for 11.2% of all student responses. Expertise was the next highest category with 9.3% of the responses, followed closely by 9.1% in the category of available. Among these students, the top five attributes of simulation teachers were motivation, expertise, available, caring, and feedback. While the study did not attempt to correlate these findings with improved student performance, the results can be used in the development of assessment tools for faculty and targeted faculty development programs.

  8. CAEP 2016 Academic Symposium: How to have an impact as an emergency medicine educator and scholar.

    Science.gov (United States)

    Frank, Jason R; Cheung, Warren J; Sherbino, Jonathan; Primavesi, Robert; Woods, Robert A; Bandiera, Glen; LeBlanc, Constance

    2017-05-01

    In a time of major medical education transformation, emergency medicine (EM) needs to nurture education scholars who will influence EM education practice. However, the essential ingredients to ensure a career with impact in EM education are not clear. To describe how to prepare EM educators for a high-impact career. The Canadian Association of Emergency Physicians (CAEP) Academic Section commissioned an "Education Impact" working group (IWG) to guide the creation of consensus recommendations from the EM community. EM educators from across Canada were initially recruited from the networks of the IWG members, and additional educators were recruited via snowball sampling. "High impact educators" were nominated by this network. The high impact educators were then interviewed using a structured question guide. These interviews were transcribed and coded for themes using qualitative methods. The process continued until no new themes were identified. Proposed themes and recommendations were presented to the EM community at the CAEP 2016 Academic Symposium. Feedback was then incorporated into a final set of recommendations. Fifty-five (71%) of 77 of identified Canadian EM educators participated, and 170 names of high impact educators were submitted and ranked by frequency. The IWG achieved sufficiency of themes after nine interviews. Five recommendations were made: 1) EM educators can pursue a high impact career by leveraging either traditional or innovative career pathways; 2) EM educators starting their education careers should have multiple senior mentors; 3) Early-career EM educators should immerse themselves in their area of interest and cultivate a community of practice, not limited to EM; 4) Every academic EM department and EM teaching site should have access to an EM educator with protected time and recognition for their EM education scholarship; and 5) Educators at all stages should continuously compile an impact portfolio. We describe a unique set of

  9. Determining Student Competency in Field Placements: An Emerging Theoretical Model

    Directory of Open Access Journals (Sweden)

    Twyla L. Salm

    2016-06-01

    Full Text Available This paper describes a qualitative case study that explores how twenty-three field advisors, representing three human service professions including education, nursing, and social work, experience the process of assessment with students who are struggling to meet minimum competencies in field placements. Five themes emerged from the analysis of qualitative interviews. The field advisors primary concern was the level of professional competency achieved by practicum students. Related to competency were themes concerned with the field advisor's role in being accountable and protecting the reputation of his/her profession as well as the reputation of the professional program affiliated with the practicum student's professional education. The final theme – teacher-student relationship –emerged from the data, both as a stand-alone and global or umbrella theme. As an umbrella theme, teacher-student relationship permeated each of the other themes as the participants interpreted their experiences of the process of assessment through the mentor relationships. A theoretical model was derived from these findings and the description of the model is presented. Cet article décrit une étude de cas qualitative qui explore comment vingt-trois conseillers de stages, représentant trois professions de services sociaux comprenant l’éducation, les soins infirmiers et le travail social, ont vécu l’expérience du processus d’évaluation avec des étudiants qui ont des difficultés à acquérir les compétences minimales durant les stages. Cinq thèmes ont été identifiés lors de l’analyse des entrevues qualitatives. La préoccupation principale des conseillers de stages était le niveau de compétence professionnelle acquis par les stagiaires. Les thèmes liés à la compétence étaient le rôle des conseillers de stages dans leur responsabilité pour protéger la réputation de leur profession ainsi que la réputation d’un programme professionnel

  10. A Study of Scientometric Methods to Identify Emerging Technologies via Modeling of Milestones

    Energy Technology Data Exchange (ETDEWEB)

    Abercrombie, Robert K [ORNL; Udoeyop, Akaninyene W [ORNL; Schlicher, Bob G [ORNL

    2012-01-01

    This work examines a scientometric model that tracks the emergence of an identified technology from initial discovery (via original scientific and conference literature), through critical discoveries (via original scientific, conference literature and patents), transitioning through Technology Readiness Levels (TRLs) and ultimately on to commercial application. During the period of innovation and technology transfer, the impact of scholarly works, patents and on-line web news sources are identified. As trends develop, currency of citations, collaboration indicators, and on-line news patterns are identified. The combinations of four distinct and separate searchable on-line networked sources (i.e., scholarly publications and citation, patents, news archives, and online mapping networks) are assembled to become one collective network (a dataset for analysis of relations). This established network becomes the basis from which to quickly analyze the temporal flow of activity (searchable events) for the example subject domain we investigated.

  11. Themes and situations that cause embarrassment among participants in research in which questionnaires or interviews are used

    Directory of Open Access Journals (Sweden)

    Juliana Dias Reis Pessalacia

    2013-03-01

    Full Text Available Objective. To recognize the themes and situations that could make research participants feel embarrassed when questionnaires or interviews are used. Methodology. Quantitative and descriptive study, developed in 2008, involving a stratified sample of 1,1149 subjects who qualified the degree of shame in view of potentially embarrassing themes and situations. Results. For the research participants, it is embarrassing to answer questions related to the following themes: betrayal (50%, physical violence (42%, sexual harassment (42%, psychological violence (40% and death of loved ones (38%. The situations that most frequently causes embarrassment were: start of the survey or interview without requesting informed consent (83%; lack of information about the type of questions that would be addressed (79%, lack of guaranteed anonymity (78%, or use of images (66% or a recorder (58%. Conclusion. Themes and situations were identified that caused embarrassment among participants in research in which questionnaires or interviews were used, which should be considered in the ethical evaluation of studies.

  12. The effects of similarity of theme and instantiation in analogical reasoning.

    Science.gov (United States)

    Yanowitz, K L

    2001-01-01

    The influence of 2 types of structural similarity on analogical reasoning was examined. The theme of a story is a structural component that constrains other relationships in the story. Another structural component is the way in which the theme is implemented. Participants received pairs of stories that varied in the similarity of these two components. Participants in Experiment 1 judged stories containing similar themes as more analogous than stories with dissimilar themes. Likewise, stories with similar implementations were judged as more analogous than stories with dissimilar implementations. Experiment 2 revealed a similar pattern when participants had the opportunity to transfer information from source to target stories. Greater transfer was seen for stories with similar themes than for stories with dissimilar themes. Greater transfer was also seen for stories with similar implementations of different themes than for stories with different implementations.

  13. Particle physics. Themes and challenges

    Energy Technology Data Exchange (ETDEWEB)

    Quigg, C. [Fermi National Accelerator Laboratory, Batavia, IL (United States)

    1996-12-31

    It is an introductory talk to the Second Rencontres du Vietnam. This lecture is devoted to seven themes that express the essence of our understanding - and our possibilities on particle physics. (K.A.) 19 refs.

  14. NCI think tank concerning the identifiability of biospecimens and "omic" data.

    Science.gov (United States)

    Weil, Carol J; Mechanic, Leah E; Green, Tiffany; Kinsinger, Christopher; Lockhart, Nicole C; Nelson, Stefanie A; Rodriguez, Laura L; Buccini, Laura D

    2013-12-01

    On 11 and 12 June 2012, the National Cancer Institute hosted a think tank concerning the identifiability of biospecimens and "omic" data in order to explore challenges surrounding this complex and multifaceted topic. The think tank brought together 46 leaders from several fields, including cancer genomics, bioinformatics, human subject protection, patient advocacy, and commercial genetics. The first day involved presentations regarding the state of the science of reidentification; current and proposed regulatory frameworks for assessing identifiability; developments in law, industry, and biotechnology; and the expectations of patients and research participants. The second day was spent by think tank participants in small breakout groups designed to address specific subtopics under the umbrella issue of identifiability, including considerations for the development of best practices for data sharing and consent, and targeted opportunities for further empirical research. We describe the outcomes of this 2-day meeting, including two complementary themes that emerged from moderated discussions following the presentations on day 1, and ideas presented for further empirical research to discern the preferences and concerns of research participants about data sharing and individual identifiability.

  15. Incredible Years Parent and Teacher Programmes: Emerging Themes and Issues

    Science.gov (United States)

    Wetherall, Michelle

    2014-01-01

    This paper examines the Incredible Years Parent and Teacher Programmes that have originated from the work of Webster-Stratton. It provides a brief background on the programmes and a critical analysis of the issues as identified in current literature. The issues can be grouped into four main categories, the first being government decision-making…

  16. Quality of life themes in Canadian adults and street youth who are homeless or hard-to-house: a multi-site focus group study.

    Science.gov (United States)

    Palepu, Anita; Hubley, Anita M; Russell, Lara B; Gadermann, Anne M; Chinni, Mary

    2012-08-15

    The aim of this study was to identify what is most important to the quality of life (QoL) of those who experience homelessness by directly soliciting the views of homeless and hard-to-house Canadians themselves. These individuals live within a unique social context that differs considerably from that of the general population. To understand the life areas that are most important to them, it is critical to have direct input from target populations of homeless and hard-to-house persons. Focus groups were conducted with 140 individuals aged 15 to 73 years who were homeless or hard-to-house to explore the circumstances in which they were living and to capture what they find to be important and relevant domains of QoL. Participants were recruited in Toronto, Ottawa, Montreal, and Vancouver. Content analysis was used to analyze the data. Six major content themes emerged: Health/health care; Living conditions; Financial situation; Employment situation; Relationships; and Recreational and leisure activities. These themes were linked to broader concepts that included having choices, stability, respect, and the same rights as other members of society. These findings not only aid our understanding of QoL in this group, but may be used to develop measures that capture QoL in this population and help programs and policies become more effective in improving the life situation for persons who are homeless and hard-to-house. Quality of life themes in Canadian adults and street youth who are homeless or hard-to-house: A multi-site focus group study.

  17. Environmental Protection Theme at Discourses of Corporative Social Responsibility

    Directory of Open Access Journals (Sweden)

    Alfredo Rodrigues Leite da Silva

    2009-01-01

    Full Text Available This paper views and discusses discourses on social responsibility in organizations and their use of the environmental theme. We suppose that strategies are used to disseminate some discourses concerning these matters. The ambiguities of themes within organizations point to a fragmented discourse (Fineman, 1996, revealing practices of openness and dissimulation. The theoretical discussion starts with the theme of social responsibility, confronting it with an environmental theme and discusses discourses with ambiguities of organizational practice stemming from two themes. At the end, a case study of Antena completes the discussion. Data was collected with documental research and semi-structured interviews. We made use of Discourse Analysis methodology (Fiorin, 1989. In conclusion, the concern with social responsibility and its environmental thematic lie within the organization. It is found in the discourse and actions at a high administration level including managers and a high number of technical workers. The silence about the limits of this responsibility is fulfilled by a technical workers group that reveals dissimulation when openness menaces some objectives.

  18. Editorial for themed issue on ‘Managing the business of cycling’

    OpenAIRE

    Parkin, J.

    2015-01-01

    Cycling is receiving increased attention as a means of addressing urban transport problems. The integration of cycling as a more frequently used mode for all types of trip purpose requires skills in a range of disciplines, including engineering for infrastructure design, as well as planning, ethics, the law, psychology, sociology and health. This editorial sets these papers in the broader context of the subject matter concerned with managing cycling. Four themes are identified as follows: gov...

  19. The role of play themes in non-directive play therapy.

    Science.gov (United States)

    Ryan, Virginia; Edge, Andrew

    2012-07-01

    Describing the processes underlying play therapy is important for evidence based practice in child therapy. Employing play themes to describe children's play session contents is in widespread use by practitioners, but an adequate classification of these themes for non-directive play therapy practice has not yet been established. This article sets out to fill this gap by first describing how themes can be distinguished and distilled from the contents of play therapy contents. Second, a classification of main themes and sub-themes with exemplars to illustrate these concepts which is compatible with non-directive play therapy practice is set out. Finally a pilot project with experienced play therapists to test this classification in practice is suggested, along with the research questions that will need to be investigated in the shorter and longer terms.

  20. Exploring staff willingness to attend work during a disaster: a study of nurses employed in four Australian emergency departments.

    Science.gov (United States)

    Arbon, Paul; Cusack, Lynette; Ranse, Jamie; Shaban, Ramon Z; Considine, Julie; Kako, Mayumi; Woodman, Richard J; Mitchell, Belinda; Bahnisch, Laura; Hammad, Karen

    2013-08-01

    Much of the literature about emergency nurses willingness to work during disasters has been from a non-Australian perspective. Despite the many recent disasters, little is known of Australian nurse's willingness to participate in disaster response. This paper presents findings from a study that explored nurses willingness to attend work during a disaster and the factors that influenced this decision. Data were collected consecutively using a combination of focus group and interview methods. Participants in this study, registered nurses from emergency departments, were recruited through convenience sampling from four hospitals in Australia. Participant narrative was electronically recorded, transcribed and thematically analysed. The participants for both the focus groups and interviews compromised a mix of ages, genders and years of experience as emergency nurses from across four jurisdictions within Australia. Three major themes that influenced willingness emerged with a number of subthemes. Theme one reflected the uncertainty of the situation such as the type of disaster. The second theme surrounded the preparedness of the workplace, emergency nurse and colleagues, and the third theme considered personal and professional choice based on home and work circumstances and responsibilities. The decision to attend work or not during a disaster, includes a number of complex personal, work-related and professional factors that can change, depending on the type of disaster, preparedness of the work environment and the emergency nurses' personal responsibilities at that time. Copyright © 2013 College of Emergency Nursing Australasia Ltd. Published by Elsevier Ltd. All rights reserved.

  1. A Grounded Theory Qualitative Analysis of Interprofessional Providers' Perceptions on Caring for Critically Ill Infants and Children in Pediatric and General Emergency Departments.

    Science.gov (United States)

    Gangadharan, Sandeep; Tiyyagura, Gunjan; Gawel, Marcie; Walsh, Barbara M; Brown, Linda L; Lavoie, Megan; Tay, Khoon-Yen; Auerbach, Marc A

    2016-10-04

    The objective of this study was to explore pediatric emergency department (PED) and general emergency department (GED) providers' perceptions on caring for critically ill infants and children. This study utilized qualitative methods to examine the perceptions of emergency department providers caring for critically ill infants and children. Teams of providers participated in 4 in situ simulation cases followed by facilitated debriefings. Debriefings were recorded and professionally transcribed. The transcripts were reviewed independently and followed by group coding discussions to identify emerging themes. Consistent with grounded theory, the team iteratively revised the debriefing script as new understanding was gained. A total of 188 simulation debriefings were recorded in 24 departments, with 15 teams participating from 8 PEDs and 32 teams from 16 GEDs. Twenty-four debriefings were audiotaped and professionally transcribed verbatim. Thematic saturation was achieved after 20 transcripts. In our iterative qualitative analysis of these transcripts, we observed 4 themes: (1) GED provider comfort with algorithm-based pediatric care and overall comfort with pediatric care in PED, (2) GED provider reliance on cognitive aids versus experience-based recall by PED providers, (3) GED provider discomfort with locating and determining size or dose of pediatric-specific equipment and medications, and (4) PED provider reliance on larger team size and challenges with multitasking during resuscitation. Our qualitative analysis produced several themes that help us to understand providers' perceptions in caring for critically ill children in GEDs and PEDs. These data could guide the development of targeted educational and improvement interventions.

  2. Museums as Theme Parks - A Possible Marketing Approach?

    Directory of Open Access Journals (Sweden)

    Alexandra ZBUCHEA

    2015-09-01

    Full Text Available Museums compete increasingly more with very diverse entertainment providers, such as theme parks, despite the fact that their offer is mainly cultural. Museums have had to be more active and they have had to diversify their offer, in order to be more popular, therefore to better achieve their complex cultural missions. They should be more “market oriented” and aim to develop their programs according with their visitors’ needs and desires, as well as with the evolutions in the contemporary society.  One answer to this challenge would be the controversial theme parkisation of museums. The paper discusses in what extent the market approach of theme parks could be a viable marketing strategy for museums. It underlines several differences and similarities between the marketing approaches of museums and theme parks, in order to better understand how a museum could preserve its cultural functions, while obtaining economic success. Only the latter would allow it to better develop its cultural activity and thus to better serve its visitors and the community.

  3. Accessing Transgenerational Themes Through Dreamwork.

    Science.gov (United States)

    Andrews, Jennifer; And Others

    1988-01-01

    Proposes use of dreamwork to evoke historical patterns or transgenerational themes. Describes new variant of dreamwork which combines aspects of both gestalt and family systems therapies. Implications of therapeutic dramatization for couple therapy are suggested. Examples are included. (Author/NB)

  4. CAEP 2014 Academic Symposium: "How to make research succeed in your emergency department: How to develop and train career researchers in emergency medicine".

    Science.gov (United States)

    Perry, Jeffrey J; Snider, Carolyn E; Artz, Jennifer D; Stiell, Ian G; Shaeri, Sedigheh; McLeod, Shelley; Le Sage, Natalie; Hohl, Corinne; Calder, Lisa A; Vaillancourt, Christian; Holroyd, Brian; Hollander, Judd E; Morrison, Laurie J

    2015-05-01

    We sought to 1) identify best practices for training and mentoring clinician researchers, 2) characterize facilitators and barriers for Canadian emergency medicine researchers, and 3) develop pragmatic recommendations to improve and standardize emergency medicine postgraduate research training programs to build research capacity. We performed a systematic review of MEDLINE and Embase using search terms relevant to emergency medicine research fellowship/graduate training. We conducted an email survey of all Canadian emergency physician researchers. The Society for Academic Emergency Medicine (SAEM) research fellowship program was analysed, and other similar international programs were sought. An expert panel reviewed these data and presented recommendations at the Canadian Association of Emergency Physicians (CAEP) 2014 Academic Symposium. We refined our recommendations based on feedback received. Of 1,246 potentially relevant citations, we included 10 articles. We identified five key themes: 1) creating training opportunities; 2) ensuring adequate protected time; 3) salary support; 4) infrastructure; and 5) mentorship. Our survey achieved a 72% (67/93) response rate. From these responses, 42 (63%) consider themselves clinical researchers (i.e., spend a significant proportion of their career conducting research). The single largest constraint to conducting research was funding. Factors felt to be positive contributors to a clinical research career included salary support, research training (including an advanced graduate degree), mentorship, and infrastructure. The SAEM research fellowship was the only emergency medicine research fellowship program identified. This 2-year program requires approval of both the teaching centre and each applying fellow. This program requires training in 15 core competencies, manuscript preparation, and submission of a large grant to a national peer-review funding organization. We recommend that the CAEP Academic Section create a

  5. Effective communication of public health guidance to emergency department clinicians in the setting of emerging incidents: a qualitative study and framework.

    Science.gov (United States)

    Khan, Yasmin; Sanford, Sarah; Sider, Doug; Moore, Kieran; Garber, Gary; de Villa, Eileen; Schwartz, Brian

    2017-04-28

    Evidence to inform communication between emergency department clinicians and public health agencies is limited. In the context of diverse, emerging public health incidents, communication is urgent, as emergency department clinicians must implement recommendations to protect themselves and the public. The objectives of this study were to: explore current practices, barriers and facilitators at the local level for communicating public health guidance to emergency department clinicians in emerging public health incidents; and develop a framework that promotes effective communication of public health guidance to clinicians during emerging incidents. A qualitative study was conducted using semi-structured interviews with 26 key informants from emergency departments and public health agencies in Ontario, Canada. Data were analyzed inductively and the analytic approach was guided by concepts of complexity theory. Emergent themes corresponded to challenges and strategies for effective communication of public health guidance. Important challenges related to the coordination of communication across institutions and jurisdictions, and differences in work environments across sectors. Strategies for effective communication were identified as the development of partnerships and collaboration, attention to specific methods of communication used, and the importance of roles and relationship-building prior to an emerging public health incident. Following descriptive analysis, a framework was developed that consists of the following elements: 1) Anticipate; 2) Invest in building relationships and networks; 3) Establish liaison roles and redundancy; 4) Active communication; 5) Consider and respond to the target audience; 6) Leverage networks for coordination; and 7) Acknowledge and address uncertainty. The qualities inherent in local relationships cut across framework elements. This research indicates that relationships are central to effective communication between public health

  6. Prospective validation of a predictive model that identifies homeless people at risk of re-presentation to the emergency department.

    Science.gov (United States)

    Moore, Gaye; Hepworth, Graham; Weiland, Tracey; Manias, Elizabeth; Gerdtz, Marie Frances; Kelaher, Margaret; Dunt, David

    2012-02-01

    To prospectively evaluate the accuracy of a predictive model to identify homeless people at risk of representation to an emergency department. A prospective cohort analysis utilised one month of data from a Principal Referral Hospital in Melbourne, Australia. All visits involving people classified as homeless were included, excluding those who died. Homelessness was defined as living on the streets, in crisis accommodation, in boarding houses or residing in unstable housing. Rates of re-presentation, defined as the total number of visits to the same emergency department within 28 days of discharge from hospital, were measured. Performance of the risk screening tool was assessed by calculating sensitivity, specificity, positive and negative predictive values and likelihood ratios. Over the study period (April 1, 2009 to April 30, 2009), 3298 presentations from 2888 individuals were recorded. The homeless population accounted for 10% (n=327) of all visits and 7% (n=211) of all patients. A total of 90 (43%) homeless people re-presented to the emergency department. The predictive model included nine variables and achieved 98% (CI, 0.92-0.99) sensitivity and 66% (CI, 0.57-0.74) specificity. The positive predictive value was 68% and the negative predictive value was 98%. The positive likelihood ratio 2.9 (CI, 2.2-3.7) and the negative likelihood ratio was 0.03 (CI, 0.01-0.13). The high emergency department re-presentation rate for people who were homeless identifies unresolved psychosocial health needs. The emergency department remains a vital access point for homeless people, particularly after hours. The risk screening tool is key to identify medical and social aspects of a homeless patient's presentation to assist early identification and referral. Copyright © 2012 College of Emergency Nursing Australasia Ltd. Published by Elsevier Ltd. All rights reserved.

  7. Franchising Theme Parks : Disneyland Paris inFocus

    OpenAIRE

    Kocsis, Kinga

    2014-01-01

    The report consisted of the analysis of theoretical frameworks of franchise and using franchising as a promotional method of theme parks. The definition of franchise and the use, right and regulations of it are essential knowledge to understand the base of franchise based theme parks. Also it was analyzed how franchising affects tourism in specific fields of existing franchises. The role of a franchise in our society and its values was also taken into consideration. The values and the role of...

  8. Future Research Themes in Supply Chain Management

    DEFF Research Database (Denmark)

    Wieland, Andreas

    2016-01-01

    Guest post on research results published in the article "Mapping the Landscape of Future Research Themes in Supply Chain Management" by Andreas Wieland, Robert Handfield and Christian Durach ( Journal of Business Logistics (2016). Vol. 37, no. 3, pp. 205-212).......Guest post on research results published in the article "Mapping the Landscape of Future Research Themes in Supply Chain Management" by Andreas Wieland, Robert Handfield and Christian Durach ( Journal of Business Logistics (2016). Vol. 37, no. 3, pp. 205-212)....

  9. [Evaluation standards and application for photography of schistosomiasis control theme].

    Science.gov (United States)

    Chun-Li, Cao; Qing-Biao, Hong; Jing-Ping, Guo; Fang, Liu; Tian-Ping, Wang; Jian-Bin, Liu; Lin, Chen; Hao, Wang; You-Sheng, Liang; Jia-Gang, Guo

    2018-02-26

    To set up and apply the evaluation standards for photography of schistosomiasis control theme, so as to offer the scientific advice for enriching the health information carrier of schistosomiasis control. Through the literature review and expert consultation, the evaluation standard for photography of schistosomiasis control theme was formulated. The themes were divided into 4 projects, such as new construction, natural scenery, working scene, and control achievements. The evaluation criteria of the theme photography were divided into the theme (60%), photographic composition (15%), focus exposure (15%), and color saturation (10%) . A total of 495 pictures (sets) from 59 units with 77 authors were collected from schistosomiasis epidemic areas national wide. After the first-step screening and second-step evaluation, the prizes of 3 themes of control achievements and new construction, working scene, and natural scenery were selected, such as 6 pictures of first prize, 12 pictures of second prize, 18 pictures of third prize, and 20 pictures of honorable prize. The evaluation standards of theme photography should be taken into the consideration of the technical elements of photography and the work specification of schistosomiasis prevention and control. In order to improve the ability of records for propaganda purpose of schistosomiasis control and better play a role of guiding correct propaganda, the training and guidance of photography of professionals should be carried out.

  10. Implementation of a model of emergency care in an Australian hospital.

    Science.gov (United States)

    Millichamp, Tracey; Bakon, Shannon; Christensen, Martin; Stock, Kate; Howarth, Sarah

    2017-11-10

    Emergency departments are characterised by a fast-paced, quick turnover and high acuity workload, therefore appropriate staffing is vital to ensure positive patient outcomes. Models of care are frameworks in which safe and effective patient-to-nurse ratios can be ensured. The aim of this study was to implement a supportive and transparent model of emergency nursing care that provides structure - regardless of nursing staff profile, business or other demands; improvement to nursing workloads; and promotes individual responsibility and accountability for patient care. A convergent parallel mixed-method approach was used. Quantitative data were analysed using descriptive statistics and the qualitative data used a thematic analysis to identify recurrent themes. Data post-implementation of the model of emergency nursing care indicate improved staff satisfaction in relation to workload, patient care and support structures. The development and implementation of a model of care in an emergency department improved staff workload and staff's perception of their ability to provide care. ©2017 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

  11. High-Dimensional Phenotyping Identifies Age-Emergent Cells in Human Mammary Epithelia

    Directory of Open Access Journals (Sweden)

    Fanny A. Pelissier Vatter

    2018-04-01

    Full Text Available Summary: Aging is associated with tissue-level changes in cellular composition that are correlated with increased susceptibility to disease. Aging human mammary tissue shows skewed progenitor cell potency, resulting in diminished tumor-suppressive cell types and the accumulation of defective epithelial progenitors. Quantitative characterization of these age-emergent human cell subpopulations is lacking, impeding our understanding of the relationship between age and cancer susceptibility. We conducted single-cell resolution proteomic phenotyping of healthy breast epithelia from 57 women, aged 16–91 years, using mass cytometry. Remarkable heterogeneity was quantified within the two mammary epithelial lineages. Population partitioning identified a subset of aberrant basal-like luminal cells that accumulate with age and originate from age-altered progenitors. Quantification of age-emergent phenotypes enabled robust classification of breast tissues by age in healthy women. This high-resolution mapping highlighted specific epithelial subpopulations that change with age in a manner consistent with increased susceptibility to breast cancer. : Vatter et al. find that single-cell mass cytometry of human mammary epithelial cells from 57 women, from 16 to 91 years old, depicts an in-depth phenotyping of aging mammary epithelia. Subpopulations of altered luminal and progenitor cells that accumulate with age may be at increased risk for oncogenic transformation. Keywords: human mammary epithelia, aging, mass cytometry, single-cell analysis, heterogeneity, breast cancer

  12. A Foundation for Mobile User Experiences in Theme Parks

    DEFF Research Database (Denmark)

    Østergaard, Claus Møller

    2013-01-01

    Based on case studies, this paper proposes a theoretical understanding of three essential aspects, which affect mobile user experiences in theme parks. The aspect are (a) the controllability of the mobile content, (b) the balance in the hybrid space of proximate physical place and remote digital...... space, and (c) the social space. Furthermore, the social space is exceptionally important in understanding mobile user experiences in theme parks. Thus, this paper proposes to extract the social space from the physical place. This means, that mobile user experiences in theme parks can be understood...

  13. Promising Themes for Antismoking Campaigns Targeting Youth and Young Adults.

    Science.gov (United States)

    Brennan, Emily; Gibson, Laura A; Kybert-Momjian, Ani; Liu, Jiaying; Hornik, Robert C

    2017-01-01

    Behavior change campaigns typically try to change beliefs that influence behaviors, with targeted beliefs comprising the campaign theme. We present an empirical approach for choosing among a large number of potential themes, and results from the implementation of this approach for campaigns aimed at 4 behavioral targets: (1) preventing smoking initiation among youth, and (2) preventing initiation, (3) stopping progression to daily smoking and (4) encouraging cessation among young adults. An online survey of 13- to 17-year-olds and 18- to 25-year-olds in the United States (US), in which 20 potential campaign themes were represented by 154 beliefs. For each behavioral target, themes were ranked based on the strength of belief-intention and belief-behavior associations and size of the population not already endorsing the beliefs. The most promising themes varied across behavioral targets but 3 were consistently promising: consequences of smoking for mood, social acceptance and social popularity. Using a robust and systematic approach, this study provides campaign developers with empirical data to inform their selection of promising themes. Findings related to the campaign to prevent initiation among youth informed the development of the US Food and Drug Administration's "The Real Cost" campaign.

  14. Instruments to Identify Commercially Sexually Exploited Children: Feasibility of Use in an Emergency Department Setting.

    Science.gov (United States)

    Armstrong, Stephanie

    2017-12-01

    This review examines the screening instruments that are in existence today to identify commercially sexually exploited children. The instruments are compared and evaluated for their feasibility of use in an emergency department setting. Four electronic databases were searched to identify screening instruments that assessed solely for commercial sexual exploitation. Search terms included "commercially sexually exploited children," "CSEC," "domestic minor sex trafficking," "DMST," "juvenile sex trafficking," and "JST." Those terms were then searched in combination with each of the following: "tools," "instruments," "screening," "policies," "procedures," "data collection," "evidence," and "validity." Six screening instruments were found to meet the inclusion criteria. Variation among instruments included number of questions, ease of administration, information sources, scoring methods, and training information provided. Two instruments were determined to be highly feasible for use in the emergency department setting, those being the Asian Health Services and Banteay Srei's CSEC Screening Protocol and Greenbaum et al's CSEC/child sex trafficking 6-item screening tool. A current dearth of screening instruments was confirmed. It is recommended that additional screening instruments be created to include developmentally appropriate instruments for preadolescent children. Numerous positive features were identified within the instruments in this review and are suggested for use in future screening instruments, including succinctness, a simple format, easy administration, training materials, sample questions, multiple information sources, designation of questions requiring mandatory reporting, a straightforward scoring system, and an algorithm format.

  15. Italian Adolescents and Emergency Contraception: A Focus Group Study.

    Science.gov (United States)

    Olivari, Maria Giulia; Cuccì, Gaia; Confalonieri, Emanuela

    2017-02-01

    Using a qualitative method, the purpose of this study was to: (1) obtain information directly from the adolescents on their attitudes and knowledge regarding emergency contraception; and (2) investigate the presence of differences between male and female participants' attitudes and knowledge. This study consisted of 24 single-sex focus groups with 160 adolescents (male = 46.3% (74 of 160); female = 53.7% (86 of 160)) aged 15-19 years conducted among high schools in 3 regions of Italy. Data were analyzed through thematic analysis taking into account gender differences and 2 main themes emerged. The first was labeled "Adolescents' attitudes toward emergency contraception" and it was divided into 3 subthemes: You should be aware; It's a life line; and Everything but a child. The second theme was labeled "Adolescents' knowledge toward emergency contraception" and it was divided into 3 subthemes: False myths; Baseline information; and Just take it. Italian adolescents believed it is important to prevent the risk of unprotected sex by using contraceptive methods and their motivation to use emergency contraception is related to critical attitudes toward the consequences of irresponsible/ineffective contraception. Although adolescents have an awareness of emergency contraception, more comprehensive knowledge is needed. These findings can inform specific interventions aimed at educating adolescents in need of emergency contraception. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  16. Integrating Environmental and Human Health Databases in the Great Lakes Basin: Themes, Challenges and Future Directions

    Directory of Open Access Journals (Sweden)

    Kate L. Bassil

    2015-03-01

    Full Text Available Many government, academic and research institutions collect environmental data that are relevant to understanding the relationship between environmental exposures and human health. Integrating these data with health outcome data presents new challenges that are important to consider to improve our effective use of environmental health information. Our objective was to identify the common themes related to the integration of environmental and health data, and suggest ways to address the challenges and make progress toward more effective use of data already collected, to further our understanding of environmental health associations in the Great Lakes region. Environmental and human health databases were identified and reviewed using literature searches and a series of one-on-one and group expert consultations. Databases identified were predominantly environmental stressors databases, with fewer found for health outcomes and human exposure. Nine themes or factors that impact integration were identified: data availability, accessibility, harmonization, stakeholder collaboration, policy and strategic alignment, resource adequacy, environmental health indicators, and data exchange networks. The use and cost effectiveness of data currently collected could be improved by strategic changes to data collection and access systems to provide better opportunities to identify and study environmental exposures that may impact human health.

  17. Review article: A systematic review of emergency department incident classification frameworks.

    Science.gov (United States)

    Murray, Matthew; McCarthy, Sally

    2017-10-11

    As in any part of the hospital system, safety incidents can occur in the ED. These incidents arguably have a distinct character, as the ED involves unscheduled flows of urgent patients who require disparate services. To aid understanding of safety issues and support risk management of the ED, a comparison of published ED specific incident classification frameworks was performed. A review of emergency medicine, health management and general medical publications, using Ovid SP to interrogate Medline (1976-2016) was undertaken to identify any type of taxonomy or classification-like framework for ED related incidents. These frameworks were then analysed and compared. The review identified 17 publications containing an incident classification framework. Comparison of factors and themes making up the classification constituent elements revealed some commonality, but no overall consistency, nor evolution towards an ideal framework. Inconsistency arises from differences in the evidential basis and design methodology of classifications, with design itself being an inherently subjective process. It was not possible to identify an 'ideal' incident classification framework for ED risk management, and there is significant variation in the selection of categories used by frameworks. The variation in classification could risk an unbalanced emphasis in findings through application of a particular framework. Design of an ED specific, ideal incident classification framework should be informed by a much wider range of theories of how organisations and systems work, in addition to clinical and human factors. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  18. Clinical Research Informatics: Challenges, Opportunities and Definition for an Emerging Domain

    Science.gov (United States)

    Embi, Peter J.; Payne, Philip R.O.

    2009-01-01

    Objectives Clinical Research Informatics, an emerging sub-domain of Biomedical Informatics, is currently not well defined. A formal description of CRI including major challenges and opportunities is needed to direct progress in the field. Design Given the early stage of CRI knowledge and activity, we engaged in a series of qualitative studies with key stakeholders and opinion leaders to determine the range of challenges and opportunities facing CRI. These phases employed complimentary methods to triangulate upon our findings. Measurements Study phases included: 1) a group interview with key stakeholders, 2) an email follow-up survey with a larger group of self-identified CRI professionals, and 3) validation of our results via electronic peer-debriefing and member-checking with a group of CRI-related opinion leaders. Data were collected, transcribed, and organized for formal, independent content analyses by experienced qualitative investigators, followed by an iterative process to identify emergent categorizations and thematic descriptions of the data. Results We identified a range of challenges and opportunities facing the CRI domain. These included 13 distinct themes spanning academic, practical, and organizational aspects of CRI. These findings also informed the development of a formal definition of CRI and supported further representations that illustrate areas of emphasis critical to advancing the domain. Conclusions CRI has emerged as a distinct discipline that faces multiple challenges and opportunities. The findings presented summarize those challenges and opportunities and provide a framework that should help inform next steps to advance this important new discipline. PMID:19261934

  19. Death Related Themes in Anorexia Nervosa: A Practical Exploration.

    Science.gov (United States)

    Russell, Janice; And Others

    1990-01-01

    Explored death-related themes in psychodynamic etiology of anorexia nervosa by comparing anorexic adolescent patients (n=28) to age-matched controls (n=238). Results suggest that death-related themes are of significance in the understanding and management of anorexia nervosa. (Author/ABL)

  20. Establishing research priorities for patient safety in emergency medicine: a multidisciplinary consensus panel.

    Science.gov (United States)

    Plint, Amy C; Stang, Antonia S; Calder, Lisa A

    2015-01-01

    Patient safety in the context of emergency medicine is a relatively new field of study. To date, no broad research agenda for patient safety in emergency medicine has been established. The objective of this study was to establish patient safety-related research priorities for emergency medicine. These priorities would provide a foundation for high-quality research, important direction to both researchers and health-care funders, and an essential step in improving health-care safety and patient outcomes in the high-risk emergency department (ED) setting. A four-phase consensus procedure with a multidisciplinary expert panel was organized to identify, assess, and agree on research priorities for patient safety in emergency medicine. The 19-member panel consisted of clinicians, administrators, and researchers from adult and pediatric emergency medicine, patient safety, pharmacy, and mental health; as well as representatives from patient safety organizations. In phase 1, we developed an initial list of potential research priorities by electronically surveying a purposeful and convenience sample of patient safety experts, ED clinicians, administrators, and researchers from across North America using contact lists from multiple organizations. We used simple content analysis to remove duplication and categorize the research priorities identified by survey respondents. Our expert panel reached consensus on a final list of research priorities through an in-person meeting (phase 3) and two rounds of a modified Delphi process (phases 2 and 4). After phases 1 and 2, 66 unique research priorities were identified for expert panel review. At the end of phase 4, consensus was reached for 15 research priorities. These priorities represent four themes: (1) methods to identify patient safety issues (five priorities), (2) understanding human and environmental factors related to patient safety (four priorities), (3) the patient perspective (one priority), and (4) interventions for

  1. International conference on non-military radiation emergencies: [Final technical report

    International Nuclear Information System (INIS)

    1986-01-01

    The subject of this report was limited to non-military radiation emergencies because such events needed to be addressed and the topic was considered to be manageable. The Conference theme developed around the lessons learned from the radiation emergencies at Chernobyl, Three Mile Island, and Windscale. Specific topics to be considered included acute and long-term effects of radiation exposure; frequency and nature of radiation emergencies; national standards for exposures to ionizing radiation; plans and procedures for responding to emergencies at the hospital, community, and national levels; and responsibilities of physicians and other health professionals regarding radiation exposures and emergencies

  2. Perspectives on bullying among children who present to the emergency department with behavioral misconduct: a qualitative study.

    Science.gov (United States)

    Waseem, Muhammad; Boutin-Foster, Carla; Robbins, Laura; Gonzalez, Rita; Vargas, Steven; Peterson, Janey C

    2014-11-01

    The problem of bullying is an increasing public health threat encountered by emergency physicians especially in inner city emergency departments (EDs). Bullying may result in emotional disturbances and psychological trauma in children. Many children sent to the ED because of behavioral misconduct require immediate stabilization and treatment. The emergency physician performs an initial assessment and stabilization. Emergency departments are increasingly on the frontline of the bullying problem. Our objective was to explore children's perspective of bullying and their views of potential solutions. A qualitative study was conducted in a cohort of 50 children (age, 8-17 years), who were referred to the ED from school because of their behavioral misconduct. An interview survey tool about bullying was administered. It focused on what bullying meant to them and what advice they have for a child who is bullied. They were also asked what advice they would have for adults who try to help. We used grounded theory to analyze the data. Similar concepts were grouped, and the categories with similar properties and dimensions were defined. Common themes were then identified. We interviewed 50 children, of whom 27 were boys and 23 were girls. Their mean (SD) age was 12.5 (2.12) years (range, 8-17 years). Bullying was identified by children as including physical, verbal, and emotional actions. Several themes emerged. First, a power imbalance between a bully and victim may render an individual vulnerable to bullying. Being different and weak also increases the risk of being bullied. Second, bullying is wrong, and the bully should be punished. Third, children should learn how to handle bullying situations and develop resilience against bullying. Finally, adults need to be more proactive to prevent or stop bullying. Our results provide insights into the perceptions of children regarding bullying. We have garnered a better understanding of what these children feel adults should do to

  3. Quality of life themes in Canadian adults and street youth who are homeless or hard-to-house: A multi-site focus group study

    Directory of Open Access Journals (Sweden)

    Palepu Anita

    2012-08-01

    Full Text Available Abstract Background The aim of this study was to identify what is most important to the quality of life (QoL of those who experience homelessness by directly soliciting the views of homeless and hard-to-house Canadians themselves. These individuals live within a unique social context that differs considerably from that of the general population. To understand the life areas that are most important to them, it is critical to have direct input from target populations of homeless and hard-to-house persons. Methods Focus groups were conducted with 140 individuals aged 15 to 73 years who were homeless or hard-to-house to explore the circumstances in which they were living and to capture what they find to be important and relevant domains of QoL. Participants were recruited in Toronto, Ottawa, Montreal, and Vancouver. Content analysis was used to analyze the data. Results Six major content themes emerged: Health/health care; Living conditions; Financial situation; Employment situation; Relationships; and Recreational and leisure activities. These themes were linked to broader concepts that included having choices, stability, respect, and the same rights as other members of society. Conclusions These findings not only aid our understanding of QoL in this group, but may be used to develop measures that capture QoL in this population and help programs and policies become more effective in improving the life situation for persons who are homeless and hard-to-house. Quality of life themes in Canadian adults and street youth who are homeless or hard-to-house: A multi-site focus group study.

  4. Qualitative Research on Emergency Medicine Physicians

    DEFF Research Database (Denmark)

    Paltved, Charlotte; Musaeus, Peter

    2012-01-01

    Aim: This study aims to systematically review the qualitative research studying Emergency Medicine (EM) physicians in Emergency Departments (ED). Background: Qualitative research aims to study complex social phenomena. EM is a highly complex medical and social environment that can be investigated...... with qualitative research. Methods: Electronic databases of English peer-reviewed articles were searched from 1971 to 2012 using Medline through PubMed and PsychINFO. This search was supplemented with hand-searches of Academic Emergency Medicine and Emergency Medicine Journal from 1999 to 2012 and cross references...... and training, communication, professional roles, and organizational factors, and into 12 sub-themes. Conclusion: The strength of qualitative research is its ability to grasp and operationalize complex relations within EM. Although qualitative research methodologies have gained in rigour in recent years and few...

  5. Themes of rural health and aging from a program of research.

    Science.gov (United States)

    Congdon, J G; Magilvy, J K

    2001-01-01

    The culture and diversity of rural life and limitations of rural health systems to meet the changing health needs of an aging population lead to problems of obtaining appropriate care in rural America. In a program of nursing research involving three ethnographic studies in rural Colorado, transitions of older adults across differing levels of heath care were explored. The sample totaled 425 participants, of whom 25% were Hispanic. Five major themes emerged: circles of formal and informal care; integration of faith, spirituality, and family with health status; crisis nature of health care transitions; nursing homes as a housing option; and changing spirit of traditional rural nursing. Recommendations for providers included making their practices congruent with rural culture, being fully informed of available resources, facilitating acceptable health care decisions, and integrating physical, mental, and spiritual health care for elders and their families.

  6. Understanding the factors which promote registered nurses' intent to stay in emergency and critical care areas.

    Science.gov (United States)

    Van Osch, Mary; Scarborough, Kathy; Crowe, Sarah; Wolff, Angela C; Reimer-Kirkham, Sheryl

    2018-03-01

    To explore the influential factors and strategies that promote an experienced nurse's intent to stay in their emergency or critical care area. Turnover among registered nurses (herein referred to as nurses) working in specialty areas of practice can result in a range of negative outcomes. The retention of specialty nurses at the unit level has important implications for hospital and health systems. These implications include lost knowledge and experience which may in turn impact staff performance levels, patient outcomes, hiring, orientating, development of clinical competence and other aspects of organizational performance. This qualitative study used an interpretive descriptive design to understand nurses' perceptions of the current factors and strategies that promote them staying in emergency or critical care settings for two or more years. Focus groups were conducted with 13 emergency and critical care nurses. Data analysis involved thematic analysis that evolved from codes to categories to themes. Four themes were identified: leadership, interprofessional relationships, job fit and practice environment. In addition, the ideas of feeling valued, respected and acknowledged were woven throughout. Factors often associated with nurse attrition such as burnout and job stresses were not emphasised by the respondents in our study as critical to their intent to stay in their area of practice. This study has highlighted positive aspects that motivate nurses to stay in their specialty areas. To ensure quality care for patients, retention of experienced emergency and critical care nurses is essential to maintaining specialty expertise in these practice settings. © 2017 John Wiley & Sons Ltd.

  7. Exploration of the perceptions of emergency physicians and interns regarding the medical documentation practices of interns.

    Science.gov (United States)

    Isoardi, Jonathon; Spencer, Lyndall; Sinnott, Michael; Nicholls, Kim; O'Connor, Angela; Jones, Fleur

    2013-08-01

    The primary objective of the present study was to learn the factors that influence the documentation practices of ED interns. A second objective was to identify the expectations of emergency physicians (EPs) towards the medical record documentation of ED interns. A qualitative design was adopted using semi-structured interviews in convenience samples drawn from both groups. Eighteen interviews were conducted with intern volunteers and 10 with EP volunteers. One (5%) intern and two (20%) EPs had received medical documentation training. Factors that encouraged interns' documentation included: patient acuity (the more critical the condition, the more comprehensive the documentation) and the support of senior colleagues. Inhibiting factors included uncertainty about how much to write, and the shift being worked (interns indicated they wrote less at night). Factors of consequence to senior personnel included the apparent reluctance of interns to document management plans. They noted that interns frequently confine their notes to assessment, investigations and treatments, whereas EPs preferred records that demonstrated intern thought processes and included such matters as future actions to follow immediate treatment. A positive theme that emerged included the high level of support interns received from their senior colleagues. Another theme, the influence of patient acuity, held both positive and negative implications for intern writing practices. The lack of formal training is an impediment to the production of useful medical records by ED interns. One solution proposed by both interns and senior personnel was the introduction of the subject into intern education programmes. © 2013 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  8. Modelling Creativity: Identifying Key Components through a Corpus-Based Approach.

    Science.gov (United States)

    Jordanous, Anna; Keller, Bill

    2016-01-01

    Creativity is a complex, multi-faceted concept encompassing a variety of related aspects, abilities, properties and behaviours. If we wish to study creativity scientifically, then a tractable and well-articulated model of creativity is required. Such a model would be of great value to researchers investigating the nature of creativity and in particular, those concerned with the evaluation of creative practice. This paper describes a unique approach to developing a suitable model of how creative behaviour emerges that is based on the words people use to describe the concept. Using techniques from the field of statistical natural language processing, we identify a collection of fourteen key components of creativity through an analysis of a corpus of academic papers on the topic. Words are identified which appear significantly often in connection with discussions of the concept. Using a measure of lexical similarity to help cluster these words, a number of distinct themes emerge, which collectively contribute to a comprehensive and multi-perspective model of creativity. The components provide an ontology of creativity: a set of building blocks which can be used to model creative practice in a variety of domains. The components have been employed in two case studies to evaluate the creativity of computational systems and have proven useful in articulating achievements of this work and directions for further research.

  9. METHODOLOGY FOR CROSS-CURRICULAR THEME OF THE ENVIRONMENTAL AXIS

    Directory of Open Access Journals (Sweden)

    José Luis Aparicio López

    2015-04-01

    Full Text Available This article introduces a methodology to identify the presence of the environmental axis in educational programs in Bachelors in the Universidad Autónoma de Guerrero, Mexico. It is sustained on competency-based education and constructionism, due to they appeal to humanism to deal current problems. It is composed of four phases: committee conformation, theoretical and conceptual concerning analysis, construction and application of instruments on a PE, and identification of the cross-curricular theme level. Even though the proposed methodology is applied to the environment, it is feasible to adapt to other axes, such as human rights, multiculturalism, and poverty, relevant to the educational context of the state of Guerrero.

  10. Identifying Factors Associated with Risk Assessment Competencies of Public Health Emergency Responders.

    Science.gov (United States)

    Hao, Jiejing; Ren, Jiaojiao; Wu, Qunhong; Hao, Yanhua; Sun, Hong; Ning, Ning; Ding, Ding

    2017-06-04

    This study aimed to better understand the current situation of risk assessment and identify the factors associated with competence of emergency responders in public health risk assessment. The participants were selected by a multi-stage, stratified cluster sampling method in Heilongjiang Centers for Disease Control and Prevention (CDC). The questionnaires that measured their perceptions on risk assessment competences were administered through the face-to-face survey. A final sample of 1889 staff was obtained. Of this sample, 78.6% of respondents rated their own risk assessment competences as "relatively low", contrasting with 21.4% rated as "relatively high". Most of the respondents (62.7%) did not participate in any risk assessment work. Only 13.7% and 42.7% of respondents reported participating in risk assessment training and were familiar with risk assessment tools. There existed statistical significance between risk assessment-related characteristics of respondents and their self-rated competences scores. Financial support from the government and administrative attention were regarded as the important factors contributing to risk assessment competences of CDC responders. Higher attention should be given to risk assessment training and enhancing the availability of surveillance data. Continuous efforts should be made to remove the financial and technical obstacles to improve the competences of risk assessment for public health emergency responders.

  11. Exploring the practical themes for medical education social accountability in Iran.

    Science.gov (United States)

    Ahmady, Soleiman; Akbari Lakeh, Maryam

    2015-01-01

    The purpose of this paper is to explore themes for enhancing socially accountability in medical education. Medical education in Iran experience new challenges due to the enormous influence of changes in technology, development of new methods of teaching and learning, student requirements, patient management, financial credit constraints, and social and economic developments. For responding to these, use of strategic thinking in order to make appropriate decisions is the only solution. Strategic plans need to formulate practical guides which can help accountable to people's reasonable expectations. For this qualitative study, along with the 14(th)national conference on Medical Education in Iran, the opinions of experts were obtained during seven expert panels' group discussions, each lasting four hours and including 10 participants. Data were collected by audiotapes, which were then transcribed. Data analyzed using a thematic content analysis approach. Peer and member checking during analysis and data triangulation from other recent studies were used to increase the findings' trustworthiness. Among more than hundred meaning units groups identified the following eight main themes as affecting the social accountable medical education in Iran: organization of responsive education councils; development of community based courses; development in field training; organization of educational processes; homogeneity in educational rules and regulations; budget management, educational outcomes; educational programs in departments and groups. This study have found the main themes that might affecting social accountable medical education in Iran, where Iranian policymakers should consider those when plan to make changes in medical education and could potentially adopt the proven useful policies and strategies of other countries.

  12. Providing long-acting reversible contraception services in Seattle school-based health centers: key themes for facilitating implementation.

    Science.gov (United States)

    Gilmore, Kelly; Hoopes, Andrea J; Cady, Janet; Amies Oelschlager, Anne-Marie; Prager, Sarah; Vander Stoep, Ann

    2015-06-01

    The purpose of this study was to describe the implementation of a program that provides long-acting reversible contraception (LARC) services within school-based health centers (SBHCs) and to identify barriers and facilitators to implementation as reported by SBHC clinicians and administrators, public health officials, and community partners. We conducted 14 semistructured interviews with key informants involved in the implementation of LARC services. Key informants included SBHC clinicians and administrators, public health officials, and community partners. We used a content analysis approach to analyze interview transcripts for themes. We explored barriers to and facilitators of LARC service delivery across and within key informant groups. The most cited barriers across key informant groups were as follows: perceived lack of provider procedural skills and bias and negative attitudes about LARC methods. The most common facilitators identified across groups were as follows: clear communication strategies, contraceptive counseling practice changes, provider trainings, and stakeholder engagement. Two additional barriers emerged in specific key informant groups. Technical and logistical barriers to LARC service delivery were cited heavily by SBHC administrative staff, community partners, and public health officials. Expense and billing was a major barrier to SBHC administrative staff. LARC counseling and procedural services can be implemented in an SBHC setting to promote access to effective contraceptive options for adolescent women. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  13. Emerging Science and Research Opportunities for Metals and Metallic Nanostructures

    Science.gov (United States)

    Handwerker, Carol A.; Pollock, Tresa M.

    2014-07-01

    During the next decade, fundamental research on metals and metallic nanostructures (MMNs) has the potential to continue transforming metals science into innovative materials, devices, and systems. A workshop to identify emerging and potentially transformative research areas in MMNs was held June 13 and 14, 2012, at the University of California Santa Barbara. There were 47 attendees at the workshop (listed in the Acknowledgements section), representing a broad range of academic institutions, industry, and government laboratories. The metals and metallic nanostructures (MMNs) workshop aimed to identify significant research trends, scientific fundamentals, and recent breakthroughs that can enable new or enhanced MMN performance, either alone or in a more complex materials system, for a wide range of applications. Additionally, the role that MMN research can play in high-priority research and development (R&D) areas such as the U.S. Materials Genome Initiative, the National Nanotechnology Initiative, the Advanced Manufacturing Initiative, and other similar initiatives that exist internationally was assessed. The workshop also addressed critical issues related to materials research instrumentation and the cyberinfrastructure for materials science research and education, as well as science, technology, engineering, and mathematics (STEM) workforce development, with emphasis on the United States but with an appreciation that similar challenges and opportunities for the materials community exist internationally. A central theme of the workshop was that research in MMNs has provided and will continue to provide societal benefits through the integration of experiment, theory, and simulation to link atomistic, nanoscale, microscale, and mesoscale phenomena across time scales for an ever-widening range of applications. Within this overarching theme, the workshop participants identified emerging research opportunities that are categorized and described in more detail in the

  14. Emerging Themes in the Ecology and Management of North American Forests

    International Nuclear Information System (INIS)

    Sharik, T.L.; Adair, W.; Baker, F.A.

    2010-01-01

    The 7th North American Forest Ecology Workshop, consisting of 149 presentations in 16 oral sessions and a poster session, reflected a broad range of topical areas currently under investigation in forest ecology and management. There was an overarching emphasis on the role of disturbance, both natural and anthropogenic, in the dynamics of forest ecosystems, and the recognition that legacies from past disturbances strongly influence future trajectories. Climate was invoked as a major driver of ecosystem change. An emphasis was placed on application of research findings for predicting system responses to changing forest management initiatives. Several needs emerged from the discussions regarding approaches to the study of forest ecosystems, including (1) consideration of variable spatial and temporal scales, (2) long-term monitoring, (3) development of universal databases more encompassing of time and space to facilitate meta-analyses, (4) combining field studies and modeling approaches, (5) standardizing methods of measurement and assessment, (6) guarding against oversimplification or over generalization from limited site-specific results, (7) greater emphasis on plant-animal interactions, and (8) better alignment of needs and communication of results between researchers and managers.

  15. Emerging Themes in the Ecology and Management of North American Forests

    Directory of Open Access Journals (Sweden)

    Terry L. Sharik

    2010-01-01

    Full Text Available The 7th North American Forest Ecology Workshop, consisting of 149 presentations in 16 oral sessions and a poster session, reflected a broad range of topical areas currently under investigation in forest ecology and management. There was an overarching emphasis on the role of disturbance, both natural and anthropogenic, in the dynamics of forest ecosystems, and the recognition that legacies from past disturbances strongly influence future trajectories. Climate was invoked as a major driver of ecosystem change. An emphasis was placed on application of research findings for predicting system responses to changing forest management initiatives. Several “needs” emerged from the discussions regarding approaches to the study of forest ecosystems, including (1 consideration of variable spatial and temporal scales, (2 long-term monitoring, (3 development of universal databases more encompassing of time and space to facilitate meta-analyses, (4 combining field studies and modeling approaches, (5 standardizing methods of measurement and assessment, (6 guarding against oversimplification or overgeneralization from limited site-specific results, (7 greater emphasis on plant-animal interactions, and (8 better alignment of needs and communication of results between researchers and managers.

  16. Emerging themes in the ecology and management of North American forests

    Science.gov (United States)

    Sharik, Terry L.; Adair, William; Baker, Fred A.; Battaglia, Michael; Comfort, Emily J.; D'Amato, Anthony W.; Delong, Craig; DeRose, R. Justin; Ducey, Mark J.; Harmon, Mark; Levy, Louise; Logan, Jesse A.; O'Brien, Joseph; Palik, Brian J.; Roberts, Scott D.; Rogers, Paul C.; Shinneman, Douglas J.; Spies, Thomas; Taylor, Sarah L.; Woodall, Christopher; Youngblood, Andrew

    2010-01-01

    The 7th North American Forest Ecology Workshop, consisting of 149 presentations in 16 oral sessions and a poster session, reflected a broad range of topical areas currently under investigation in forest ecology and management. There was an overarching emphasis on the role of disturbance, both natural and anthropogenic, in the dynamics of forest ecosystems, and the recognition that legacies from past disturbances strongly influence future trajectories. Climate was invoked as a major driver of ecosystem change. An emphasis was placed on application of research findings for predicting system responses to changing forest management initiatives. Several “needs” emerged from the discussions regarding approaches to the study of forest ecosystems, including (1) consideration of variable spatial and temporal scales, (2) long-term monitoring, (3) development of universal databases more encompassing of time and space to facilitate meta-analyses, (4) combining field studies and modeling approaches, (5) standardizing methods of measurement and assessment, (6) guarding against oversimplification or overgeneralization from limited site-specific results, (7) greater emphasis on plant-animal interactions, and (8) better alignment of needs and communication of results between researchers and managers.

  17. Characteristics of emerging adulthood and e-cigarette use: Findings from a pilot study.

    Science.gov (United States)

    Allem, Jon-Patrick; Forster, Myriam; Neiberger, Adam; Unger, Jennifer B

    2015-11-01

    Emerging adults (ages 18 to 25) are more likely to use e-cigarettes compared to other age groups, but little is known about their risk and protective factors. A next step to understanding e-cigarette use among emerging adults may involve examining how transition-to-adulthood themes are associated with e-cigarette use. It may also be important to know which specific transitions, and how the accumulated number of role transitions experienced in emerging adulthood, are associated with e-cigarette use. Emerging adults completed surveys indicating their identification with transition-to-adulthood themes, role transitions in the past year, and e-cigarette use. Logistic regression models examined the associations between transition-to-adulthood themes and e-cigarette use. Separate logistic regression models explored the association between individual role transitions, as well as the accumulated number of role transitions experienced, and e-cigarette use, controlling for age, gender, and ethnicity. Among the participants (n = 555), 21% were male, the average age was 22, 45% reported lifetime, and 12% reported past-month, e-cigarette use. Participants who felt emerging adulthood was a time of experimentation/possibility were more likely to report e-cigarette use. Several role transitions were found to be associated with e-cigarette use such as loss of a job, dating someone new, and experiencing a breakup. The relationship between the accumulated number of role transitions and e-cigarette use was curvilinear. Findings from this pilot study can be a point of departure for future studies looking to understand the risk and protective factors of e-cigarettes among emerging adults. Copyright © 2015. Published by Elsevier Ltd.

  18. Perceptions of Unprofessional Social Media Behavior Among Emergency Medicine Physicians.

    Science.gov (United States)

    Soares, William; Shenvi, Christina; Waller, Nikki; Johnson, Reuben; Hodgson, Carol S

    2017-02-01

    Use of social media (SM) by physicians has exposed issues of privacy and professionalism. While guidelines have been created for SM use, details regarding specific SM behaviors that could lead to disciplinary action presently do not exist. To compare State Medical Board (SMB) directors' perceptions of investigation for specific SM behaviors with those of emergency medicine (EM) physicians. A multicenter anonymous survey was administered to physicians at 3 academic EM residency programs. Surveys consisted of case vignettes, asking, "If the SMB were informed of the content, how likely would they be to initiate an investigation, possibly leading to disciplinary action?" (1, very unlikely, to 4, very likely). Results were compared to published probabilities using exact binomial testing. Of 205 eligible physicians, 119 (58%) completed the survey. Compared to SMB directors, EM physicians indicated similar probabilities of investigation for themes involving identifying patient images, inappropriate communication, and discriminatory speech. Participants indicated lower probabilities of investigation for themes including derogatory speech (32%, 95% confidence interval [CI] 24-41 versus 46%, P  social identity, compared to SMB directors, particularly for images of alcohol and derogatory speech.

  19. Emergency nurses' perceptions of emergency department preparedness for an ebola outbreak: A qualitative descriptive study.

    Science.gov (United States)

    Pincha Baduge, Mihirika Sds; Moss, Cheryle; Morphet, Julia

    2017-05-01

    Ebola Virus Disease is highly contagious and has high mortality. In 2014, when the outbreak in West Africa was declared a public health emergency, emergency departments in Australia commenced preparation and vigilance for people presenting with ebola like symptoms, to limit spread of the disease. To examine Australian emergency nurses' perceptions regarding their own and their emergency departments' preparedness to manage an ebola outbreak. A qualitative descriptive design was used to collect and analyse data in one metropolitan emergency department in Victoria, Australia. Four focus groups were conducted with 13 emergency nurses. Data were thematically analysed. Major themes emerged from the data: organisational, personal and future preparedness. Participants' believed that both the organisation and themselves had achieved desirable and appropriate preparedness for ebola in their emergency setting. Participants trusted their organisation to prepare and protect them for ebola. Appropriate policies, procedures, and equipment infrastructure were reportedly in place. Nurses' decisions to care for a patient with ebola were informed by professional commitment, and personal responsibilities. Participants were concerned about transmitting ebola to their families, and suggested that more regular training in personal protective equipment would increase confidence and skill in self-protection. Copyright © 2017 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.

  20. Composing the theme of city to be diverse and sustainable

    Science.gov (United States)

    Wiranegara, H. W.

    2018-01-01

    To give a path for developing a city needs a theme. City’s goal stated in a document of a spatial plan were too broad and insufficient detail in giving a direction. To make more detail and precise, every city has to compose a city theme. It is developed based on the potential, the uniqueness, the excellence, and the sustainability of its human resources, natural resources, and man-made resources. An integration among the three of resources which have the highest score become a theme of the city. The aim of this research was to formulate the conceptual framework to compose a city theme. The research design was the interview survey in Banda Aceh, Banjarmasin, and Kupang. Informants were the government officials, academics, figures, the private sector and public who considered related to the intended information being collected. Having set the conceptual framework, the interview directed to check the implementation in realities. The result was that the conceptual framework could accommodate the phenomenon of composing the theme of the city. Yet, it was a preliminary in nature and needed more research to get a complete result.

  1. Exploring Themes and Challenges in Developing Sustainable Supply Chains - A Complexity Theory Perspective

    OpenAIRE

    Abbasi, Maisam

    2014-01-01

    To develop sustainable supply chains in a way that their negative environmental and social effects are minimized, shortand long-term targets should be set. The transformation of supply chains towards these targets calls for the development of innovative strategies and the need to continuously identify, classify, and tackle the challenges that can hinder the execution of such strategies. To develop innovative strategies, the patterns of current trends and themes need to be learned and th...

  2. Emergency Medical Services Perspectives on Identifying and Reporting Victims of Elder Abuse, Neglect, and Self-Neglect.

    Science.gov (United States)

    Rosen, Tony; Lien, Cynthia; Stern, Michael E; Bloemen, Elizabeth M; Mysliwiec, Regina; McCarthy, Thomas J; Clark, Sunday; Mulcare, Mary R; Ribaudo, Daniel S; Lachs, Mark S; Pillemer, Karl; Flomenbaum, Neal E

    2017-10-01

    Emergency Medical Services (EMS) providers, who perform initial assessments of ill and injured patients, often in a patient's home, are uniquely positioned to identify potential victims of elder abuse, neglect, or self-neglect. Despite this, few organized programs exist to ensure that EMS concerns are communicated to or further investigated by other health care providers, social workers, or the authorities. To explore attitudes and self-reported practices of EMS providers surrounding identification and reporting of elder mistreatment. Five semi-structured focus groups with 27 EMS providers. Participants reported believing they frequently encountered and were able to identify potential elder mistreatment victims. Many reported infrequently discussing their concerns with other health care providers or social workers and not reporting them to the authorities due to barriers: 1) lack of EMS protocols or training specific to vulnerable elders; 2) challenges in communication with emergency department providers, including social workers, who are often unavailable or not receptive; 3) time limitations; and 4) lack of follow-up when EMS providers do report concerns. Many participants reported interest in adopting protocols to assist in elder protection. Additional strategies included photographically documenting the home environment, additional training, improved direct communication with social workers, a dedicated location on existing forms or new form to document concerns, a reporting hotline, a system to provide feedback to EMS, and community paramedicine. EMS providers frequently identify potential victims of elder abuse, neglect, and self-neglect, but significant barriers to reporting exist. Strategies to empower EMS providers and improve reporting were identified. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Themes of Lust and Love in Popular Music Lyrics From 1971 to 2011

    Directory of Open Access Journals (Sweden)

    Yasaman Madanikia

    2014-08-01

    Full Text Available We explored themes related to sexual desire (lust and romantic desire (love in the lyrics of popular music over the past 40 years. We examined whether there have been changes in the prevalence of lust and love themes and changes in how these themes inter-relate in music lyrics over time. The study sample consisted of the top 40 songs of Billboard Year End Hot 100 single songs for every 5 years from 1971 to 2011 (N = 360. There was a linear decrease over time in the proportion of songs with a love theme and in the proportion of songs with a combination of lust and love themes. In contrast, there was a significant increase in the proportion of songs with a theme focusing on lust in the absence of love. Themes of lust in the absence of love were especially prevalent in hip-hop/rap music, although music genre did not account for the changing themes over time. These shifts in themes found in popular music may both influence cultural norms and reflect a cultural shift toward acceptance of sexuality outside of love relationships.

  4. Living in imaginary places: on the creation and consumption of themed residential architecture

    OpenAIRE

    Meier, S.O.

    2013-01-01

    This study deals with theming of residential space and architecture. In theoretical terms, theming is defined as the application of a narrative to places and the built environment to make them more appealing than they otherwise would be. In a broader sense it is argued that theming is related to an intensified commodification of places through which, in turn, the number of hyperspaces has been increased. While theming primarily has been applied to restaurants, shopping malls or theme parks, t...

  5. Barriers and Facilitators to Implementing the HEADS-ED: A Rapid Screening Tool for Pediatric Patients in Emergency Departments.

    Science.gov (United States)

    MacWilliams, Kate; Curran, Janet; Racek, Jakub; Cloutier, Paula; Cappelli, Mario

    2017-12-01

    This study sought to identify barriers and facilitators to the implementation of the HEADS-ED, a screening tool appropriate for use in the emergency department (ED) that facilitates standardized assessments, discharge planning, charting, and linking pediatric mental health patients to appropriate community resources. A qualitative theory-based design was used to identify barriers and facilitators to implementing the HEADS-ED tool. Focus groups were conducted with participants recruited from 6 different ED settings across 2 provinces (Ontario and Nova Scotia). The Theoretical Domains Framework was used as a conceptual framework to guide data collection and to identify themes from focus group discussions. The following themes spanning 12 domains were identified as reflective of participants' beliefs about the barriers and facilitators to implementing the HEADS-ED tool: knowledge, skills, beliefs about capabilities, social professional role and identity, optimism, beliefs about consequences, reinforcement, environmental context and resources, social influences, emotion, behavioral regulation and memory, and attention and decision process. The HEADS-ED has the potential to address the need for better discharge planning, complete charting, and standardized assessments for the increasing population of pediatric mental health patients who present to EDs. This study has identified potential barriers and facilitators, which should be considered when developing an implementation plan for adopting the HEADS-ED tool into practice within EDs.

  6. Ethical perspectives on emerging assistive technologies: insights from focus groups with stakeholders in long-term care facilities.

    Science.gov (United States)

    Dorsten, Aimee-Marie; Sifford, K Susan; Bharucha, Ashok; Mecca, Laurel Person; Wactlar, Howard

    2009-03-01

    ASSISTIVE TECHNOLOGIES ARE RELATIVELY novel tools for research and daily care in long-term care (LTC) facilities that are faced with the burgeoning of the older adult population and dwindling staffing resources. The degree to which stakeholders in LTC facilities are receptive to the use of these technologies is poorly understood. Eighteen semi-structured focus groups and one interview were conducted with relevant groups of stakeholders at seven LTC facilities in southwestern Pennsylvania. Common themes identified across all focus groups centered on concerns for privacy, autonomy, cost, and safety associated with implementation of novel technologies. The relative importance of each theme varied by stakeholder group as well as the perceived severity of cognitive and/or physical disability. Our findings suggest that ethical issues are critical to acceptance of novel technologies by their end users, and that stakeholder groups are interdependent and require shared communication about the acceptance of these emerging technologies.

  7. NCI Think Tank Concerning the Identifiability of Biospecimens and “-Omic” Data

    Science.gov (United States)

    Weil, Carol J.; Mechanic, Leah E.; Green, Tiffany; Kinsinger, Christopher; Lockhart, Nicole C.; Nelson, Stefanie A.; Rodriguez, Laura L.; Buccini, Laura D.

    2014-01-01

    On June 11 and 12, 2012, the National Cancer Institute (NCI) hosted a think tank concerning the identifiability of biospecimens and “omic” Data in order to explore challenges surrounding this complex and multifaceted topic. The think tank brought together forty-six leaders from several fields, including cancer genomics, bioinformatics, human subject protection, patient advocacy, and commercial genetics. The first day involved presentations regarding the state of the science of re-identification; current and proposed regulatory frameworks for assessing identifiability; developments in law, industry and biotechnology; and the expectations of patients and research participants. The second day was spent by think tank participants in small break-out groups designed to address specific sub-topics under the umbrella issue of identifiability, including considerations for the development of best practices for data sharing and consent, and targeted opportunities for further empirical research. We describe the outcomes of this two day meeting, including two complimentary themes that emerged from moderated discussions following the presentations on Day 1, and ideas presented for further empirical research to discern the preferences and concerns of research participants about data sharing and individual identifiability. PMID:23579437

  8. Underdeveloped Themes in Qualitative Research: Relationship With Interviews and Analysis.

    Science.gov (United States)

    Connelly, Lynne M; Peltzer, Jill N

    2016-01-01

    In this methodological article, the authors address the problem of underdeveloped themes in qualitative studies they have reviewed. Various possible reasons for underdeveloped themes are examined, and suggestions offered. Each problem area is explored, and literature support is provided. The suggestions that are offered are supported by the literature as well. The problem with underdeveloped themes in certain articles is related to 3 interconnected issues: (a) lack of clear relationship to the underlying research method, (b) an apparent lack of depth in interviewing techniques, and (c) lack of depth in the analysis. Underdeveloped themes in a qualitative study can lead to a lack of substantive findings that have meaningful implications for practice, research, and the nursing profession, as well as the rejection of articles for publication. Fully developed themes require knowledge about the paradigm of qualitative research, the methodology that is proposed, the effective techniques of interviewing that can produce rich data with examples and experiences, and analysis that goes beyond superficial reporting of what the participants have said. Analytic problem areas include premature closure, anxiety about how to analyze, and confusion about categories and themes. Effective qualitative research takes time and effort and is not as easy as is sometimes presumed. The usefulness of findings depends on researchers improving their research skills and practices. Increasingly researchers are using qualitative research to explore clinically important issues. As consumers of research or members of a research team, clinical nurse specialists need to understand the nature of this research that can provide in-depth insight and meaning.

  9. Emergency Department Staff Beliefs About Self-Harm: A Thematic Framework Analysis.

    Science.gov (United States)

    Koning, Kate Louise; McNaught, Angela; Tuffin, Keith

    2017-11-03

    To explore the beliefs and attitudes of emergency department staff about self-harm behaviour. Existing studies looking at views regarding self-harm rely solely on the information provided by medical and nursing staff using a questionnaire format. No studies currently consider ancillary staff members' beliefs about self-harm, even though they also work with these patients. A thematic framework analysis of interview transcripts was carried out. Individual semi-structured interviews were conducted from December 2015 to February 2016. Fifteen medical, nursing, and ancillary staff members from a large, tertiary emergency department participated. There were 5 major themes identified-causes of self-harm are multifactorial; beliefs about self-harm can change over time; emergency departments should only focus on the physical; self-harm occurs on a spectrum; and the system has failed. The results suggest participants felt ill-prepared and lacking in appropriate training to help patients that self-harm, and furthermore they have little faith in the mental health system. Staff beliefs and attitudes may change over time with exposure to patients who self-harm, possibly becoming more positive in response to a greater understanding of why the self-harm behaviour is occurring.

  10. An analysis of narratives to identify critical thinking contexts in psychiatric clinical practice.

    Science.gov (United States)

    Mun, Mi Suk

    2010-02-01

    The development of students' critical thinking abilities is one of the greatest challenges facing contemporary nursing educators. Nursing educators should know about what kind of contents or situations need critical thinking. The research was undertaken to identify the critical thinking contexts that nursing students confront in psychiatric clinical practices. Students were asked to document their everyday experience. The narratives were analysed and interpreted from the philosophical notion of hermeneutics. Four themes emerged as critical thinking contexts: anxiety, conflict, hyper-awareness, dilemmas. Writing narratives appear to provide opportunities for reflection in addition to facilitating critical thinking and communicative skills in students. Also, for the instructor, students' clinical narratives could provide insight to understand how students are thinking and to share student's personal difficulties.

  11. Process mapping as a framework for performance improvement in emergency general surgery.

    Science.gov (United States)

    DeGirolamo, Kristin; D'Souza, Karan; Hall, William; Joos, Emilie; Garraway, Naisan; Sing, Chad Kim; McLaughlin, Patrick; Hameed, Morad

    2018-02-01

    Emergency general surgery conditions are often thought of as being too acute for the development of standardized approaches to quality improvement. However, process mapping, a concept that has been applied extensively in manufacturing quality improvement, is now being used in health care. The objective of this study was to create process maps for small bowel obstruction in an effort to identify potential areas for quality improvement. We used the American College of Surgeons Emergency General Surgery Quality Improvement Program pilot database to identify patients who received nonoperative or operative management of small bowel obstruction between March 2015 and March 2016. This database, patient charts and electronic health records were used to create process maps from the time of presentation to discharge. Eighty-eight patients with small bowel obstruction (33 operative; 55 nonoperative) were identified. Patients who received surgery had a complication rate of 32%. The processes of care from the time of presentation to the time of follow-up were highly elaborate and variable in terms of duration; however, the sequences of care were found to be consistent. We used data visualization strategies to identify bottlenecks in care, and they showed substantial variability in terms of operating room access. Variability in the operative care of small bowel obstruction is high and represents an important improvement opportunity in general surgery. Process mapping can identify common themes, even in acute care, and suggest specific performance improvement measures.

  12. The New Nuffield Combined Science Themes for the Middle Years

    Science.gov (United States)

    Bingham, C. D.

    1976-01-01

    Described are the development, materials, and use of English developed science activities for junior high schools, the Nuffield Combined Science Themes for the Middle Years. The program, when completed will present 24 themes including: color, water, air, plastics, metals, insects, food, light, and electricity. (SL)

  13. Identifying potential surface water sampling sites for emerging ...

    African Journals Online (AJOL)

    Emerging chemical pollutants (ECPs) are defined as new chemicals which do not have a regulatory status, but which may have an adverse effect on human health and the environment. The occurrence and concentrations of ECPs in South African water bodies are largely unknown, so monitoring is required in order to ...

  14. Identifying potential surface water sampling sites for emerging chemical pollutants in Gauteng Province, South Africa

    OpenAIRE

    Petersen, F; Dabrowski, JM; Forbes, PBC

    2017-01-01

    Emerging chemical pollutants (ECPs) are defined as new chemicals which do not have a regulatory status, but which may have an adverse effect on human health and the environment. The occurrence and concentrations of ECPs in South African water bodies are largely unknown, so monitoring is required in order to determine the potential threat that these ECPs may pose. Relevant surface water sampling sites in the Gauteng Province of South Africa were identified utilising a geographic information sy...

  15. Complex, Dynamic Systems: A New Transdisciplinary Theme for Applied Linguistics?

    Science.gov (United States)

    Larsen-Freeman, Diane

    2012-01-01

    In this plenary address, I suggest that Complexity Theory has the potential to contribute a transdisciplinary theme to applied linguistics. Transdisciplinary themes supersede disciplines and spur new kinds of creative activity (Halliday 2001 [1990]). Investigating complex systems requires researchers to pay attention to system dynamics. Since…

  16. Cognitive Themes Emerging from Air Photo Interpretation Texts Published to 1960

    Directory of Open Access Journals (Sweden)

    Raechel A. Bianchetti

    2015-04-01

    Full Text Available Remotely sensed images are important sources of information for a range of spatial problems. Air photo interpretation emerged as a discipline in response to the need to develop a systematic method for analysis of reconnaissance photographs during World War I. Remote sensing research has focused on the development of automated methods of image analysis, shifting focus away from human interpretation processes. However, automated methods are far from perfect and human interpretation remains an important component of image analysis. One important source of information concerning human image interpretation process is textual guides written within the discipline. These early texts put more emphasis than more recent texts, on the details of the interpretation process, the role of the human in the process, and the cognitive skills involved. In the research reported here, we use content analysis to evaluate the discussion of air photo interpretation in historical texts published between 1922 and 1960. Results indicate that texts from this period emphasized the documentation of relationships between perceptual cues and images features of common interest while reasoning skill and knowledge were discussed less so. The results of this analysis provide a framework of expert image skills needed to perform image interpretation tasks. The framework is useful for informing the design of semi-automated tools for performing analysis.

  17. Spring Framework 5: Themes & Trends

    CERN Document Server

    CERN. Geneva

    2017-01-01

    Spring Framework 5.0/5.1, scheduled for release in early/late 2017, focuses on several key themes: reactive web applications based on Reactive Streams, comprehensive support for JDK 9 and HTTP/2, as well as the latest API generations in the Enterprise Java ecosystem. This talk presents the overall story in the context of wider industry trends, highlighting Spring’s unique programming model strategy.

  18. Drupal 7 Theming Cookbook

    CERN Document Server

    Kumar, Karthik

    2012-01-01

    Part of Packt's Cookbook series, this book offers solutions to common theme design problems in the form of recipes. Each recipe contains step-by-step instructions and screenshots. The book is designed so that you can read it chapter by chapter, or you can refer to each recipe in no particular order. This book is for Drupal developers and administrators who want to refresh the look and feel of their site. We assume that readers are familiar with basic PHP, CSS, and XHTML as well as the general use of Drupal.

  19. Themes of Suicide in the Kalevala.

    Science.gov (United States)

    Achte, Kalle; And Others

    1988-01-01

    The Kalevala, Finland's national epic, is a crucial element of Finnish cultural identity and important to Finnish culture. Violence, death, and suicide are often repeated themes in Finnish folklore. The Kalevala provides insight into past attitudes toward death. Traditions passed through generations have influenced people's attitudes toward…

  20. Ten themes of viscous liquid dynamics

    DEFF Research Database (Denmark)

    Dyre, J. C.

    2007-01-01

    Ten ‘themes' of viscous liquid physics are discussed with a focus on how they point to a general description of equilibrium viscous liquid dynamics (i.e., fluctuations) at a given temperature. This description is based on standard time-dependent Ginzburg-Landau equations for the density fields...

  1. Meaning and Theme in Indian Style

    Directory of Open Access Journals (Sweden)

    Mojahed Gholami

    2016-12-01

    With a glimpse on what was said and a pause on the poems of Saeb Tabrizi, as one of the most seasoned poets in Indian style, it demonstrates part of his art and also illuminates the relation among word, meaning and theme in his poetry and viewpoint. He established multiple proportions among the concepts in his poem: sometimes he expressed a semantic unit as a content with diversities in word, or in some occasions, he expressed a semantic unit by different contents, with similar or dissimilar content maker elements, or even sometimes he use content maker elements for expressing multiple meanings and so on. Also it is necessary to be noted that when Saeb and the other poets of Indian style, measure the meaning by words, their meant is subjective matter and if the meaning comes with adjectives such as unfamiliar, narrow, distant, and so on, these words have used mainly in order to replace theme.

  2. Supernatural Themes in Selected Children's Stories of Isaac Bashevis Singer.

    Science.gov (United States)

    Schlessinger, June H.; Vanderryst, June D.

    1989-01-01

    Discusses the impact of the traditional folklore theme of good versus evil on children's development and analyzes the development of this theme using magical and supernatural situations in the work of Isaac Bashevis Singer. A selected bibliography of work by and literary criticisms of Singer's writings is provided. (five references) (CLB)

  3. Creative choices and fan practices in the transformation of theme park space

    Directory of Open Access Journals (Sweden)

    Carissa Ann Baker

    2016-09-01

    Full Text Available This article describes and interprets fan activities within the theme park space related to a particular fan object. It examines an evolving paradigm wherein the role of theme park visitors is changed. Rather than being perceived as observers of spectacles, they can participate and interact with the environment in new ways. An example of this is Sorcerers of the Magic Kingdom (2012, an interactive role-playing quest and collector card game at Disney's Magic Kingdom Park in Florida. Fans participate in a variety of practices that have dynamically redefined theme park activities. Together, management, designers, and fans have cocreated and reconstructed the theme park experience as one of exploration and participation. Despite multiple levels of control, fans will likewise persist in engagement with activities (in park and online that help shape and interrogate the theme park space.

  4. Generativity and Themes of Agency and Communion in Adult Autobiography.

    Science.gov (United States)

    Mansfield, Elizabeth D.; McAdams, Dan P.

    1996-01-01

    Examines differences between 70 more- and less-generative adults through a new coding system for analyzing themes of agency and communion in significant life-story scenes. The study revealed that highly generative adults express greater levels of the communion themes of dialog and care/help and greater levels of agency/communion integration. (LSR)

  5. "It's a Burden You Carry": Describing Moral Distress in Emergency Nursing.

    Science.gov (United States)

    Wolf, Lisa A; Perhats, Cydne; Delao, Altair M; Moon, Michael D; Clark, Paul R; Zavotsky, Kathleen E

    2016-01-01

    Moral distress in nursing has been studied in many settings, but there is a paucity of research on moral distress as it manifests in the emergency department. One study suggests a correlation between moral distress and aspects of burnout, and other researchers report that nurses have considered leaving their position or even their profession because of moral distress. Further exploration of these issues may provide insight into their effects on ED patient care and the emergency nursing profession. The purpose of this study was to explore the nature of moral distress as it is experienced and described by emergency nurses. A qualitative, exploratory design was employed using semi-structured focus groups for data collection. Using an iterative process, transcripts were analyzed for emerging themes by the research team. Six researchers analyzed the transcripts using a thematic analysis approach. Themes from the data included dysfunctional practice arena, being overwhelmed, and adaptive/maladaptive coping. Participants described, overall, a profound feeling of not being able to provide patient care as they wanted to. Causes of moral distress in emergency nurses are environment driven, not incident driven, as is described in other settings, and include a high-acuity, high-demand, technical environment with insufficient resources. Interventions should be targeted to improve environmental factors that contribute to the moral distress of emergency nurses. Future research should focus on the development and validation of an instrument to measure moral distress in this setting. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  6. Instant premium Drupal themes

    CERN Document Server

    Sharma, Pankaj

    2013-01-01

    Filled with practical, step-by-step instructions and clear explanations for the most important and useful tasks. A step-by-step guide filled with recipes that will show you how to create your very own Drupal themes using HTML.This book is great for developers who are new to Drupal. It is assumed that you have some experience in HTML, PHP, and CSS. You'll need a PHP (LAMP/WAMP) environment to install Drupal. It is also assumed that you know how to install Drupal. Some familiarity with CMS will be useful but is not essential.

  7. Phylogenetic Analysis and Antimicrobial Profiles of Cultured Emerging Opportunistic Pathogens (Phyla Actinobacteria and Proteobacteria) Identified in Hot Springs.

    Science.gov (United States)

    Jardine, Jocelyn Leonie; Abia, Akebe Luther King; Mavumengwana, Vuyo; Ubomba-Jaswa, Eunice

    2017-09-15

    Hot spring water may harbour emerging waterborne opportunistic pathogens that can cause infections in humans. We have investigated the diversity and antimicrobial resistance of culturable emerging and opportunistic bacterial pathogens, in water and sediment of hot springs located in Limpopo, South Africa. Aerobic bacteria were cultured and identified using 16S ribosomal DNA (rDNA) gene sequencing. The presence of Legionella spp. was investigated using real-time polymerase chain reaction. Isolates were tested for resistance to ten antibiotics representing six different classes: β-lactam (carbenicillin), aminoglycosides (gentamycin, kanamycin, streptomycin), tetracycline, amphenicols (chloramphenicol, ceftriaxone), sulphonamides (co-trimoxazole) and quinolones (nalidixic acid, norfloxacin). Gram-positive Kocuria sp. and Arthrobacter sp. and gram-negative Cupriavidus sp., Ralstonia sp., Cronobacter sp., Tepidimonas sp., Hafnia sp. and Sphingomonas sp. were isolated, all recognised as emerging food-borne pathogens. Legionella spp. was not detected throughout the study. Isolates of Kocuria , Arthrobacter and Hafnia and an unknown species of the class Gammaproteobacteria were resistant to two antibiotics in different combinations of carbenicillin, ceftriaxone, nalidixic acid and chloramphenicol. Cronobacter sp. was sensitive to all ten antibiotics. This study suggests that hot springs are potential reservoirs for emerging opportunistic pathogens, including multiple antibiotic resistant strains, and highlights the presence of unknown populations of emerging and potential waterborne opportunistic pathogens in the environment.

  8. Port economics, policy and management : review of an emerging research field

    NARCIS (Netherlands)

    Pallis, A.A.; Vitsounis, T.K.; Langen, de P.W.

    2010-01-01

    This paper reviews research in port economics, policy and management during the period 1997-2008. In an increasingly international economy, research interest in ports is gradually emerging. This paper examines the developments, themes and characteristics of this research, by reviewing a

  9. Multi-agent simulations for emergency situations in an airport scenario

    Directory of Open Access Journals (Sweden)

    Ana Cristina BICHARRA

    2012-12-01

    Full Text Available Normal 0 21 false false false EN-US JA X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabla normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:Cambria; mso-ascii-font-family:Cambria; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Cambria; mso-hansi-theme-font:minor-latin; mso-ansi-language:EN-US;} This paper presents a multi-agent framework using Net- Logo to simulate human and collective behaviors during emergency evacuations. Emergency situation appears when an unexpected event occurs. In indoor emergency situation, evacuation plans defined by facility manager explain procedure and safety ways to follow in an emergency situation. A critical and public scenario is an airportwhere there is an everyday transit of thousands of people. In this scenario the importance is related with incidents statistics regarding overcrowding and crushing in public buildings. Simulation has the objective of evaluating building layouts considering several possible configurations. Agents could be based on reactive behavior like avoid danger or follow other agent, or in deliberative behavior based on BDI model. This tool provides decision support in a real emergency scenario like an airport, analyzing alternative solutions to the evacuation process.

  10. Multi-agent simulations for emergency situations in an airport scenario

    Directory of Open Access Journals (Sweden)

    José Manuel MOLINA

    2013-06-01

    Full Text Available Normal 0 21 false false false EN-US JA X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabla normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:Cambria; mso-ascii-font-family:Cambria; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Cambria; mso-hansi-theme-font:minor-latin; mso-ansi-language:EN-US;} This paper presents a multi-agent framework using Net- Logo to simulate human and collective behaviors during emergency evacuations. Emergency situation appears when an unexpected event occurs. In indoor emergency situation, evacuation plans defined by facility manager explain procedure and safety ways to follow in an emergency situation. A critical and public scenario is an airport where there is an everyday transit of thousands of people. In this scenario the importance is related with incidents statistics regarding overcrowding and crushing in public buildings. Simulation has the objective of evaluating building layouts considering several possible configurations. Agents could be based on reactive behavior like avoid danger or follow other agent, or in deliberative behavior based on BDI model. This tool provides decision support in a real emergency scenario like an airport, analyzing alternative solutions to the evacuation process.

  11. [Emerging infectious diseases: complex, unpredictable processes].

    Science.gov (United States)

    Guégan, Jean-François

    2016-01-01

    In the light of a double approach, at first empirical, later theoretical and comparative, illustrated by the example of the Buruli ulcer and its mycobacterial agent Mycobacterium ulcerans on which I focused my research activity these last ten years by studying determinants and factors of emerging infectious or parasitic diseases, the complexity of events explaining emerging diseases will be presented. The cascade of events occurring at various levels of spatiotemporal scales and organization of life, which lead to the numerous observed emergences, nowadays requires better taking into account the interactions between host(s), pathogen(s) and the environment by including the behavior of both individuals and the population. In numerous research studies on emerging infectious diseases, microbial hazard is described rather than infectious disease risk, the latter resulting from the confrontation between an association of threatening phenomena, or hazards, and a susceptible population. Beyond, the theme of emerging infectious diseases and its links with global environmental and societal changes leads to reconsider some well-established knowledge in infectiology and parasitology. © Société de Biologie, 2017.

  12. Identifying and Prioritizing Information Needs and Research Priorities of Public Health Emergency Preparedness and Response Practitioners.

    Science.gov (United States)

    Siegfried, Alexa L; Carbone, Eric G; Meit, Michael B; Kennedy, Mallory J; Yusuf, Hussain; Kahn, Emily B

    2017-10-01

    This study describes findings from an assessment conducted to identify perceived knowledge gaps, information needs, and research priorities among state, territorial, and local public health preparedness directors and coordinators related to public health emergency preparedness and response (PHPR). The goal of the study was to gather information that would be useful for ensuring that future funding for research and evaluation targets areas most critical for advancing public health practice. We implemented a mixed-methods approach to identify and prioritize PHPR research questions. A web survey was sent to all state, city, and territorial health agencies funded through the Public Health Emergency Preparedness (PHEP) Cooperative Agreement program and a sample of local health departments (LHDs). Three focus groups of state and local practitioners and subject matter experts from the Centers for Disease Control and Prevention (CDC) were subsequently conducted, followed by 3 meetings of an expert panel of PHPR practitioners and CDC experts to prioritize and refine the research questions. We identified a final list of 44 research questions that were deemed by study participants as priority topics where future research can inform PHPR programs and practice. We identified differences in perceived research priorities between PHEP awardees and LHD survey respondents; the number of research questions rated as important was greater among LHDs than among PHEP awardees (75%, n=33, compared to 24%, n=15). The research questions identified provide insight into public health practitioners' perceived knowledge gaps and the types of information that would be most useful for informing and advancing PHPR practice. The study also points to a higher level of information need among LHDs than among PHEP awardees. These findings are important for CDC and the PHPR research community to ensure that future research studies are responsive to practitioners' needs and provide the information

  13. Essential themes in Personnel economics

    OpenAIRE

    Josheski, Dushko

    2014-01-01

    In this paper are presented essential themes in the subject of personnel economics. In the first part analysis has been conducted on the impact of peer pressure on workplace behaviour. Then again models for compensation structures within firms, and their influence on the utility of work by employees. In the final section of the paper the productivity spillover effect has been analyzed, and the causes of existence of spillovers and their impact on workers’ productivity

  14. Gender- and sex-specific sports-related injury research in emergency medicine: a consensus on future research direction and focused application.

    Science.gov (United States)

    Raukar, Neha P; Zonfrillo, Mark R; Kane, Kathleen; Davenport, Moira; Espinoza, Tamara R; Weiland, Jessica; Franco, Vanessa; Vaca, Federico E

    2014-12-01

    Title IX, the commercialization of sports, the social change in sports participation, and the response to the obesity epidemic have contributed to the rapid proliferation of participation in both competitive organized sports and nontraditional athletic events. As a consequence, emergency physicians are regularly involved in the acute diagnosis, management, disposition, and counseling of a broad range of sports-related pathology. Three important and highly publicized mechanisms of injury in sports relevant to emergency medicine (EM) include concussion, heat illness, and sudden cardiac death. In conjunction with the 2014 Academic Emergency Medicine consensus conference "Gender-specific Research in Emergency Care: Investigate, Understand, and Translate How Gender Affects Patient Outcomes," a consensus group consisting of experts in EM, emergency neurology, sports medicine, and public health convened to deliberate and develop research questions that could ultimately advance the field of sports medicine and allow for meaningful application in the emergency department (ED) clinical setting. Sex differences in injury risk, diagnosis, ED treatment, and counseling are identified in each of these themes. This article presents the consensus-based priority research agenda. © 2014 by the Society for Academic Emergency Medicine.

  15. Exploring physiotherapists' experiences of implementing a cognitive behavioural approach for managing low back pain and identifying barriers to long-term implementation.

    Science.gov (United States)

    Richmond, Helen; Hall, Amanda M; Hansen, Zara; Williamson, Esther; Davies, David; Lamb, Sarah E

    2018-03-01

    Our objectives were two-fold: (i) to describe physiotherapists' experiences of implementing a cognitive behavioural approach (CBA) for managing low back pain (LBP) after completing an extensive online training course (iBeST), and (ii) to identify how iBeST could be enhanced to support long-term implementation before scale up for widespread use. We conducted semi-structured interviews with 11 physiotherapists from six National Health Service departments in the Midlands, Oxfordshire and Derbyshire. Questions centred on (i) using iBeST to support implementation, (ii) what barriers they encountered to implementation and (iii) what of information or resources they required to support sustained implementation. Interviews were transcribed and thematically analysed using NVivo. Themes were categorised using the Theoretical Domains Framework (TDF). Evidence-based techniques were identified using the behaviour change technique taxonomy to target relevant TDF domains. Three themes emerged from interviews: anxieties about using a CBA, experiences of implementing a CBA, and sustainability for future implementation of a CBA. Themes crossed multiple TDF domains and indicated concerns with knowledge, beliefs about capabilities and consequences, social and professional roles, social influences, emotion, and environmental context and resources. We identified evidence-based strategies that may support sustainable implementation of a CBA for LBP in a physiotherapy setting. This study highlighted potential challenges for physiotherapists in the provision of evidence-based LBP care within the current UK NHS. Using the TDF provided the foundation to develop a tailored, evidence-based, implementation intervention to support long term use of a CBA by physiotherapists managing LBP within UK NHS outpatient departments. Copyright © 2017 Chartered Society of Physiotherapy. All rights reserved.

  16. Gender role models in fictional novels for emerging adult lesbians.

    Science.gov (United States)

    Cook, Jennifer R; Rostosky, Sharon S; Riggle, Ellen D B

    2013-01-01

    Novels provide role models for young adult lesbians and thus may influence their identity development. This study focused on 16 lesbian protagonists identified in 11 young adult novels that received 2011 Lambda Literary Award nominations. Content analyses revealed six themes. Three themes defied traditional gender stereotypes: Asserting Oneself, Pursuing Intimacy with Another Woman, and Breaking Free of Constraints to Authentic Self-Expression. Three themes reinforced gender stereotypes: Negative Emotional Experiences Associated with Lesbian Identity, Traditional Masculine Gender Expression, and Traditional Gender Role-Based Sexual Scripts. Each theme is discussed in light of its possible contribution to lesbian identity development.

  17. Smashing WordPress Themes Making WordPress Beautiful

    CERN Document Server

    Hedengren, Thord Daniel

    2011-01-01

    The ultimate guide to WordPress Themes - one of the hottest topics on the web today WordPress is so much more than a blogging platform, and Smashing WordPress Themes teaches readers how to make it look any way they like - from a corporate site, to a photography gallery and moreWordPress is one of the hottest tools on the web today and is used by sites including The New York Times, Rolling Stone, flickr, CNN, NASA and of course Smashing MagazineBeautiful full colour throughout - web designers expect nothing lessSmashing Magazine will fully support this book by by promoting it through their webs

  18. The effects of gender, ethnicity, and a close relationship theme on perceptions of persons introducing a condom.

    Science.gov (United States)

    Castaneda, D M; Collins, B E

    1998-09-01

    Perceptions of persons who introduce condoms in an ongoing sexual interaction, and the effects of gender and ethnicity on these perceptions, were explored in a study involving 243 students at a large, urban university in the western US. 133 of these students identified themselves as Mexican American; the remaining students indicated they were White. A vignette methodology was used to elicit perceptions of condom introducers on six scales (Nice, Exciting, Sexually Attractive, Promiscuous, Good Relationship Partner, Unpersonable/Personable). Data were analyzed in a 2 (gender of participant) x 2 (gender of condom introducer) x 3 (low acculturated Mexican American, high acculturated Mexican American, White) x 2 (presence/absence of close relationship theme) analysis of variance and covariance. In terms of the Nice Scale, women rated condom introducers significantly higher than men, female condom introducers were rated significantly higher than male introducers, and condom introducers who expressed a care and responsibility theme while introducing a condom were rated significantly higher than those who expressed no theme. On the Exciting Scale, women condom introducers were rated significantly higher than men. Condom introducers who expressed a care and responsibility theme were rated significantly higher than those who expressed no theme on the Good Relationship Partner scale. Men rated the female condom introducer significantly higher than women on the Promiscuous scale. Low acculturated Mexicans rated the female condom introducer significantly higher than the male introducer on the Promiscuous scale and rated the condom introducer significantly higher than Whites on the Sexually Attractive scale. These findings attest that many often contradictory interpersonal gender- and ethnicity-related perceptions operate in sexual encounters.

  19. Living in imaginary places: on the creation and consumption of themed residential architecture

    NARCIS (Netherlands)

    Meier, S.O.

    2013-01-01

    This study deals with theming of residential space and architecture. In theoretical terms, theming is defined as the application of a narrative to places and the built environment to make them more appealing than they otherwise would be. In a broader sense it is argued that theming is related to an

  20. Time-constrained mother and expanding market: emerging model of under-nutrition in India

    Directory of Open Access Journals (Sweden)

    S. Chaturvedi

    2016-07-01

    Full Text Available Abstract Background Persistent high levels of under-nutrition in India despite economic growth continue to challenge political leadership and policy makers at the highest level. The present inductive enquiry was conducted to map the perceptions of mothers and other key stakeholders, to identify emerging drivers of childhood under-nutrition. Methods We conducted a multi-centric qualitative investigation in six empowered action group states of India. The study sample included 509 in-depth interviews with mothers of undernourished and normal nourished children, policy makers, district level managers, implementer and facilitators. Sixty six focus group discussions and 72 non-formal interactions were conducted in two rounds with primary caretakers of undernourished children, Anganwadi Workers and Auxiliary Nurse Midwives. Results Based on the perceptions of the mothers and other key stakeholders, a model evolved inductively showing core themes as drivers of under-nutrition. The most forceful emerging themes were: multitasking, time constrained mother with dwindling family support; fragile food security or seasonal food paucity; child targeted market with wide availability and consumption of ready-to-eat market food items; rising non-food expenditure, in the context of rising food prices; inadequate and inappropriate feeding; delayed recognition of under-nutrition and delayed care seeking; and inadequate responsiveness of health care system and Integrated Child Development Services (ICDS. The study emphasized that the persistence of child malnutrition in India is also tied closely to the high workload and consequent time constraint of mothers who are increasingly pursuing income generating activities and enrolled in paid labour force, without robust institutional support for childcare. Conclusion The emerging framework needs to be further tested through mixed and multiple method research approaches to quantify the contribution of time limitation of

  1. RNA Transcriptional Biosignature Analysis for Identifying Febrile Infants With Serious Bacterial Infections in the Emergency Department

    Science.gov (United States)

    Mahajan, Prashant; Kuppermann, Nathan; Suarez, Nicolas; Mejias, Asuncion; Casper, Charlie; Dean, J. Michael; Ramilo, Octavio

    2015-01-01

    Objectives To develop the infrastructure and demonstrate the feasibility of conducting microarray-based RNA transcriptional profile analyses for the diagnosis of serious bacterial infections in febrile infants 60 days and younger in a multicenter pediatric emergency research network. Methods We designed a prospective multicenter cohort study with the aim of enrolling more than 4000 febrile infants 60 days and younger. To ensure success of conducting complex genomic studies in emergency department (ED) settings, we established an infrastructure within the Pediatric Emergency Care Applied Research Network, including 21 sites, to evaluate RNA transcriptional profiles in young febrile infants. We developed a comprehensive manual of operations and trained site investigators to obtain and process blood samples for RNA extraction and genomic analyses. We created standard operating procedures for blood sample collection, processing, storage, shipping, and analyses. We planned to prospectively identify, enroll, and collect 1 mL blood samples for genomic analyses from eligible patients to identify logistical issues with study procedures. Finally, we planned to batch blood samples and determined RNA quantity and quality at the central microarray laboratory and organized data analysis with the Pediatric Emergency Care Applied Research Network data coordinating center. Below we report on establishment of the infrastructure and the feasibility success in the first year based on the enrollment of a limited number of patients. Results We successfully established the infrastructure at 21 EDs. Over the first 5 months we enrolled 79% (74 of 94) of eligible febrile infants. We were able to obtain and ship 1 mL of blood from 74% (55 of 74) of enrolled participants, with at least 1 sample per participating ED. The 55 samples were shipped and evaluated at the microarray laboratory, and 95% (52 of 55) of blood samples were of adequate quality and contained sufficient RNA for expression

  2. Identifying causes of laboratory turnaround time delay in the emergency department.

    Science.gov (United States)

    Jalili, Mohammad; Shalileh, Keivan; Mojtahed, Ali; Mojtahed, Mohammad; Moradi-Lakeh, Maziar

    2012-12-01

    Laboratory turnaround time (TAT) is an important determinant of patient stay and quality of care. Our objective is to evaluate laboratory TAT in our emergency department (ED) and to generate a simple model for identifying the primary causes for delay. We measured TATs of hemoglobin, potassium, and prothrombin time tests requested in the ED of a tertiary-care, metropolitan hospital during a consecutive one-week period. The time of different steps (physician order, nurse registration, blood-draw, specimen dispatch from the ED, specimen arrival at the laboratory, and result availability) in the test turnaround process were recorded and the intervals between these steps (order processing, specimen collection, ED waiting, transit, and within-laboratory time) and total TAT were calculated. Median TATs for hemoglobin and potassium were compared with those of the 1990 Q-Probes Study (25 min for hemoglobin and 36 min for potassium) and its recommended goals (45 min for 90% of tests). Intervals were compared according to the proportion of TAT they comprised. Median TATs (170 min for 132 hemoglobin tests, 225 min for 172 potassium tests, and 195.5 min for 128 prothrombin tests) were drastically longer than Q-Probes reported and recommended TATs. The longest intervals were ED waiting time and order processing.  Laboratory TAT varies among institutions, and data are sparse in developing countries. In our ED, actions to reduce ED waiting time and order processing are top priorities. We recommend utilization of this model by other institutions in settings with limited resources to identify their own priorities for reducing laboratory TAT.

  3. Social Media: Portrait of an Emerging Tool in Medical Education.

    Science.gov (United States)

    Roy, Durga; Taylor, Jacob; Cheston, Christine C; Flickinger, Tabor E; Chisolm, Margaret S

    2016-02-01

    The authors compare the prevalence of challenges and opportunities in commentaries and descriptive accounts versus evaluative studies of social media use in medical education. A previously published report of social media use in medical education provided an in-depth discussion of 14 evaluative studies, a small subset of the total number of 99 articles on this topic. This study used the full set of articles identified by that review, including the 58 commentaries and 27 descriptive accounts which had not been previously reported, to provide a glimpse into how emerging tools in medical education are initially perceived. Each commentary, descriptive account, and evaluative study was identified and compared on various characteristics, including discussion themes regarding the challenges and opportunities of social media use in medical education. Themes related to the challenges of social media use in medical education were more prevalent in commentaries and descriptive accounts than in evaluative studies. The potential of social media to affect medical professionalism adversely was the most commonly discussed challenge in the commentaries (53%) and descriptive accounts (63%) in comparison to technical issues related to implementation in the evaluative studies (50%). Results suggest that the early body of literature on social media use in medical education-like that of previous innovative education tools-comprises primarily commentaries and descriptive accounts that focus more on the challenges of social media than on potential opportunities. These results place social media tools in historical context and lay the groundwork for expanding on this novel approach to medical education.

  4. Defining European preparedness and research needs regarding emerging infectious animal diseases: results from a Delphi expert consultation.

    Science.gov (United States)

    Wentholt, M T A; Cardoen, S; Imberechts, H; Van Huffel, X; Ooms, B W; Frewer, L J

    2012-02-01

    Emerging and major infectious animal diseases can have significant international impact on social, economic and environmental level, and are being driven by various factors. Prevention and control measures should be prepared at both national and international level to mitigate these disease risks. Research to support such policy development is mostly carried out at national level and dedicated transnational research programmes are still in its infancy. This research reports on part of a process to develop a common strategic research agenda on emerging and major infectious diseases of livestock in Europe, covering a 5-15-year time span. A two round online Delphi study was conducted to explore the views of experts on issues relating to research needs on emerging infectious diseases of livestock in Europe. Drivers that may influence the incidence of emerging infectious animal diseases in both the short (next 5 years) and medium term (10-15 years) were identified. Drivers related to regulatory measures and biological science developments were thought to decrease the incidence, and socio-economic factors to increase the incidence of emerging infectious animal diseases. From the first round a list of threats to animal health was compiled and participants combined these threats with relevant drivers in the second round. Next to identifying threats to animal health, also possible mitigatory actions to reduce the negative impact of these threats were identified. Participants emphasised that interdisciplinary research is needed to understand drivers of emerging infectious animal diseases, as well as to develop prevention and control measures which are both socio-economic and technical. From this it can be concluded that interdisciplinary research combining both natural and social research themes is required. Some of the European member states research budget needs to be allocated so that effective prevention and mitigation strategies can be developed. Copyright © 2011

  5. Degree Progress of Women Doctoral Students: Factors that Constrain, Facilitate, and Differentiate

    Science.gov (United States)

    Maher, Michelle A.; Ford, Martin E.; Thompson, Candace M.

    2004-01-01

    Using survey and qualitative data, this study identified emergent themes that remain consistent across or differentiate among reports of women earning their doctoral degree relatively quickly ("early-finishers") and those taking considerably longer ("late-finishers"). Emergent themes included commitment to timely degree completion, faculty…

  6. Identifying Nonprovider Factors Affecting Pediatric Emergency Medicine Provider Efficiency.

    Science.gov (United States)

    Saleh, Fareed; Breslin, Kristen; Mullan, Paul C; Tillett, Zachary; Chamberlain, James M

    2017-10-31

    The aim of this study was to create a multivariable model of standardized relative value units per hour by adjusting for nonprovider factors that influence efficiency. We obtained productivity data based on billing records measured in emergency relative value units for (1) both evaluation and management of visits and (2) procedures for 16 pediatric emergency medicine providers with more than 750 hours worked per year. Eligible shifts were in an urban, academic pediatric emergency department (ED) with 2 sites: a tertiary care main campus and a satellite community site. We used multivariable linear regression to adjust for the impact of shift and pediatric ED characteristics on individual-provider efficiency and then removed variables from the model with minimal effect on productivity. There were 2998 eligible shifts for the 16 providers during a 3-year period. The resulting model included 4 variables when looking at both ED sites combined. These variables include the following: (1) number of procedures billed by provider, (2) season of the year, (3) shift start time, and (4) day of week. Results were improved when we separately modeled each ED location. A 3-variable model using procedures billed by provider, shift start time, and season explained 23% of the variation in provider efficiency at the academic ED site. A 3-variable model using procedures billed by provider, patient arrivals per hour, and shift start time explained 45% of the variation in provider efficiency at the satellite ED site. Several nonprovider factors affect provider efficiency. These factors should be considered when designing productivity-based incentives.

  7. Identifying Adolescents at Highly Elevated Risk for Suicidal Behavior in the Emergency Department

    Science.gov (United States)

    Berona, Johnny; Czyz, Ewa; Horwitz, Adam G.; Gipson, Polly Y.

    2015-01-01

    Abstract Objective: The feasibility and concurrent validity of adolescent suicide risk screening in medical emergency departments (EDs) has been documented. The objectives of this short-term prospective study of adolescents who screened positive for suicide risk in the ED were: 1) to examine adolescents' rate of suicidal behavior during the 2 months following their ED visits and compare it with reported rates for psychiatric samples; and 2) to identify possible predictors of acute risk for suicidal behavior in this at-risk sample. Method: Participants were 81 adolescents, ages 14–19 years, seeking services for psychiatric and nonpsychiatric chief complaints, who screened positive for suicide risk because of recent suicidal ideation, a suicide attempt, and/or depression plus alcohol or substance misuse. A comprehensive assessment of suicidal behavior, using the Columbia-Suicide Severity Rating Scale, was conducted at baseline and 2 month follow-up. Results: Six adolescents (7.4%) reported a suicide attempt and 15 (18.5%) engaged in some type of suicidal behavior (actual, aborted, or interrupted suicide attempt; preparatory behavior) during the 2 months following their ED visit. These rates suggest that this screen identified a high-risk sample. Furthermore, adolescents who screened positive for suicidal ideation and/or attempt plus depression and alcohol/substance misuse were most likely to engage in future suicidal behavior (38.9%). Conclusions: In this study, use of a higher screen threshold (multiple suicide risk factors) showed promise for identifying highly elevated acute risk for suicidal behavior. PMID:25746114

  8. Foreword to the theme issue on geospatial computer vision

    Science.gov (United States)

    Wegner, Jan Dirk; Tuia, Devis; Yang, Michael; Mallet, Clement

    2018-06-01

    Geospatial Computer Vision has become one of the most prevalent emerging fields of investigation in Earth Observation in the last few years. In this theme issue, we aim at showcasing a number of works at the interface between remote sensing, photogrammetry, image processing, computer vision and machine learning. In light of recent sensor developments - both from the ground as from above - an unprecedented (and ever growing) quantity of geospatial data is available for tackling challenging and urgent tasks such as environmental monitoring (deforestation, carbon sequestration, climate change mitigation), disaster management, autonomous driving or the monitoring of conflicts. The new bottleneck for serving these applications is the extraction of relevant information from such large amounts of multimodal data. This includes sources, stemming from multiple sensors, that exhibit distinct physical nature of heterogeneous quality, spatial, spectral and temporal resolutions. They are as diverse as multi-/hyperspectral satellite sensors, color cameras on drones, laser scanning devices, existing open land-cover geodatabases and social media. Such core data processing is mandatory so as to generate semantic land-cover maps, accurate detection and trajectories of objects of interest, as well as by-products of superior added-value: georeferenced data, images with enhanced geometric and radiometric qualities, or Digital Surface and Elevation Models.

  9. Chaotic Careers: A Narrative Analysis of Career Transition Themes and Outcomes Using Chaos Theory as a Guiding Metaphor

    Science.gov (United States)

    Peake, Sharon; McDowall, Almuth

    2012-01-01

    In a rapidly changing world of work, little research exists on mid-career transitions. We investigated these using the open-systems approach of chaos theory as a guiding metaphor and conducted interviews with seven mid-career individuals chosen for their experience of a significant mid-career transition. Four common themes were identified through…

  10. The Power of a Creative Theme: A Large-scale Study of the Implications of Working with a “Forced” Creative Theme in Strategic Partnerships

    DEFF Research Database (Denmark)

    Schmeltz, Line; Kjeldsen, Anna Karina

    the process of applying for and becoming Capital of Culture, to the subsequent processes of establishing strategic partnerships between the Aarhus 2017 Foundation (the commercial foundation in charge of planning and running the mega event) and the wide range of partners (e.g. public organizations, cultural......In 2017, Denmark’s second largest city, Aarhus, holds the title as European Capital of Culture. From the initial project proposal, a significant part of the strategy for the mega event has been centered around the chosen theme; “Rethink”. The theme has thus been a continuous, common thread from......, a predetermined theme in strategic partnerships, vis-à-vis co-branding. Most often, the choice to enter into a co-branding process would be established by partners supporting one another in reaching a shared goal on the basis of shared values. But here, the value-base is already decided upon by the Aarhus 2017...

  11. Identifying sources of emerging organic contaminants in a mixed use watershed using principal components analysis.

    Science.gov (United States)

    Karpuzcu, M Ekrem; Fairbairn, David; Arnold, William A; Barber, Brian L; Kaufenberg, Elizabeth; Koskinen, William C; Novak, Paige J; Rice, Pamela J; Swackhamer, Deborah L

    2014-01-01

    Principal components analysis (PCA) was used to identify sources of emerging organic contaminants in the Zumbro River watershed in Southeastern Minnesota. Two main principal components (PCs) were identified, which together explained more than 50% of the variance in the data. Principal Component 1 (PC1) was attributed to urban wastewater-derived sources, including municipal wastewater and residential septic tank effluents, while Principal Component 2 (PC2) was attributed to agricultural sources. The variances of the concentrations of cotinine, DEET and the prescription drugs carbamazepine, erythromycin and sulfamethoxazole were best explained by PC1, while the variances of the concentrations of the agricultural pesticides atrazine, metolachlor and acetochlor were best explained by PC2. Mixed use compounds carbaryl, iprodione and daidzein did not specifically group with either PC1 or PC2. Furthermore, despite the fact that caffeine and acetaminophen have been historically associated with human use, they could not be attributed to a single dominant land use category (e.g., urban/residential or agricultural). Contributions from septic systems did not clarify the source for these two compounds, suggesting that additional sources, such as runoff from biosolid-amended soils, may exist. Based on these results, PCA may be a useful way to broadly categorize the sources of new and previously uncharacterized emerging contaminants or may help to clarify transport pathways in a given area. Acetaminophen and caffeine were not ideal markers for urban/residential contamination sources in the study area and may need to be reconsidered as such in other areas as well.

  12. Emergency department nurses' experiences of occupational stress: A qualitative study from a public hospital in Bangkok, Thailand.

    Science.gov (United States)

    Yuwanich, Nuttapol; Sandmark, Hélène; Akhavan, Sharareh

    2015-10-30

    Occupational stress has been a health-related issue among nurses for many decades. Emergency department nurses are frequently confronted with occupational stress in their workplace; in particular, they encounter stressful situations and unpredictable events. These encounters could make them feel more stressed than nurses in other departments. Research considering occupational stress from the perspective of Thai emergency department nurses is limited. This study aimed to explore nurses' perceptions of occupational stress in an emergency department. A qualitative approach was used to gain an understanding of nurses' experiences and perceptions regarding stress in their workplace. Semi-structured interviews were used for data collection. Twenty-one emergency department nurses working in a public hospital in Thailand were interviewed, and the data were analyzed using content analysis. The findings comprised three themes: (1) perceived stress, (2) consequences of stress, and (3) stress management. The results of this study can be used by hospital management to help them adopt effective strategies, such as support programs involving co-workers/supervisors, to decrease occupational stress among emergency department nurses. Future research that explores each of the themes found in this study could offer a more comprehensive understanding of nurses' occupational stress in the emergency department.

  13. Resident Workflow and Psychiatric Emergency Consultation: Identifying Factors for Quality Improvement in a Training Environment.

    Science.gov (United States)

    Blair, Thomas; Wiener, Zev; Seroussi, Ariel; Tang, Lingqi; O'Hora, Jennifer; Cheung, Erick

    2017-06-01

    Quality improvement to optimize workflow has the potential to mitigate resident burnout and enhance patient care. This study applied mixed methods to identify factors that enhance or impede workflow for residents performing emergency psychiatric consultations. The study population consisted of all psychiatry program residents (55 eligible, 42 participating) at the Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles. The authors developed a survey through iterative piloting, surveyed all residents, and then conducted a focus group. The survey included elements hypothesized to enhance or impede workflow, and measures pertaining to self-rated efficiency and stress. Distributional and bivariate analyses were performed. Survey findings were clarified in focus group discussion. This study identified several factors subjectively associated with enhanced or impeded workflow, including difficulty with documentation, the value of personal organization systems, and struggles to communicate with patients' families. Implications for resident education are discussed.

  14. Identifying the Categories of Spiritual Experience Encountered by Therapists in Their Clinical Work

    Science.gov (United States)

    Ross, Alistair

    2016-01-01

    Spirituality has replaced religion in popular culture and its presence is being felt in the therapeutic world. Using a questionnaire completed by 104 people utilising six descriptive definitions of spirituality and 36 categories of spiritual experience, three meta-themes of forms of spirituality emerged through a thematic analysis. These are…

  15. Identifying rural-urban differences in the predictors of emergency ambulance service demand and misuse.

    Science.gov (United States)

    Wong, Ho Ting; Lin, Teng-Kang; Lin, Jen-Jia

    2018-06-13

    This study aims to assess rural-urban differences in the predictors of emergency ambulance service (EAS) demand and misuse in New Taipei City. Identifying the predictors of EAS demand will help the EAS service managing authority in formulating focused policies to maintain service quality. Over 160,000 electronic EAS usage records were used with a negative binomial regression model to assess rural-urban differences in the predictors of EAS demand and misuse. The factors of 1) ln-transformed population density, 2) percentage of residents who completed up to junior high school education, 3) accessibility of hospitals without an emergency room, and 4) accessibility of EAS were found to be predictors of EAS demand in rural areas, whereas only the factor of percentage of people aged above 65 was found to predict EAS demand in urban areas. For EAS misuse, only the factor of percentage of low-income households was found to be a predictor in rural areas, whereas no predictor was found in the urban areas. Results showed that the factors predicting EAS demand and misuse in rural areas were more complicated compared to urban areas and, therefore, formulating EAS policies for rural areas based on the results of urban studies may not be appropriate. Copyright © 2018. Published by Elsevier B.V.

  16. Teaching Spiritual Themes to African American Children: A Picture Book Approach

    Science.gov (United States)

    Harris, Demetrius B.

    2017-01-01

    "Teaching Spiritual Themes to African American Children: A Picture Book Approach" is a research project that used picture books to teach the four spiritual themes, 1.) love, 2.) forgiveness, 3.) kindness, and 4.) perseverance. This project was conducted in an after school program at Fifth Baptist Church, on Cary St. in Richmond, VA. The…

  17. Identifying research priorities for public health research to address health inequalities: use of Delphi-like survey methods.

    Science.gov (United States)

    Turner, S; Ollerhead, E; Cook, A

    2017-10-09

    In the funding of health research and public health research it is vital that research questions posed are important and that funded research meets a research need or a gap in evidence. Many methods are used in the identification of research priorities, however, these can be resource intensive, costly and logistically challenging. Identifying such research priorities can be particularly challenging for complex public health problems as there is a need to consult a number of experts across disciplines and with a range of expertise. This study investigated the use of Delphi-like survey methods in identifying important research priorities relating to health inequalities and framing tractable research questions for topic areas identified. The study was conducted in two phases, both using Delphi-like survey methods. Firstly, public health professionals with an interest in health inequalities were asked to identify research priorities. Secondly academic researchers were asked to frame tractable research questions relating to the priorities identified. These research priorities identified using Delphi-like survey methods were subsequently compared to those identified using different methods. A total of 52 public health professionals and 21 academics across the United Kingdom agreed to take part. The response rates were high, from public health professionals across three survey rounds (69%, 50% and 40%) and from academics across one round (52%), indicating that participants were receptive to the method and motivated to respond. The themes identified as encompassing the most important research priorities were mental health, healthy environment and health behaviours. Within these themes, the topic areas that emerged most strongly included community interventions for prevention of mental health problems and the food and alcohol environment. Some responses received from academic researchers were (as requested) in the form of tractable research questions, whereas others

  18. THE FIVE-COLOR THEME IN DONGBA SCRIPTURES

    Directory of Open Access Journals (Sweden)

    Xu Duoduo 许多多

    2018-05-01

    Full Text Available I compared the two translated versions of The Advent of Dragons collected during fieldwork with a Ruke Dongba priest and found many inconsistencies in the same scripture and even within single verses. These inconsistencies may derive from oral composition mechanisms, for example, the aim to adapt the content to metric patterns. These complexities are mainly attested in verses related to the five-color theme, in which the five colors correspond to the mythical creatures and landscape in the five spatial directions. In the formulaic tradition of Dongba Culture, this color-related theme is delivered as a whole message produced by mentioning several keywords. However, the various details involving the keywords do not affect the meaning of the message. Consequently, the flexibilities of the content, highlighted as inconsistencies in the word-by-word translation, leave space for variants in the development of the oral culture and become formularized in various branches of Dongbaism.

  19. Age-Graded Themes in White American Middle-Class Slang: A Hypothesis.

    Science.gov (United States)

    Donahue, Thomas S.

    It is proposed that middle- and upper-middle-class slang used among white young people in modern America shows age-related themes. For youngsters between the ages of eight and early adolescence, the major theme in slang use is to establish in-group and out-group membership, with standards of judgment based on clothes, manners, and physical appeal.…

  20. Bibliography of Papers Published in the Journal Migration Themes / Migration and Ethnic Themes (1985 – 2014

    Directory of Open Access Journals (Sweden)

    Sanja Klempić Bogadi

    2015-04-01

    Full Text Available To mark the 30th anniversary of the publication of the journal Migracijske i etničke teme / Migration and Ethnic Themes (up to 2000 it was issued under the title Migration Themes: a Journal for Migration and Ethic Studies, we consider it important and necessary to provide an overview in one place of the papers published in the journal from its first issue in 1985 to the last one in 2014. The most important aim of this bibliography is to introduce the scientific and professional public, especially new researchers, to the topics covered by this journal as well as to enable easier access to the journal and its more convenient use. The bibliography is selective. It includes scientific papers (the original scientific paper, preliminary communication and review paper professional papers, conference papers, panel discussions, discussions, reviews and bibliographies, while reviews of books and periodicals (i.e. papers from the sections Books, Reviews, From Foreign Periodicals and Movie as well as Introductions, Memories, In Memoriam and Conference Reviews (from the sections Reviews and Conferences are not included. All the papers are available at Hrčak – Portal of Scientific Journals of Croatia. Given that all kinds of papers are not included, but primarily in order to provide its better examination and insight into published papers according to specific topics and dealing with various issues, as well as to provide easier and faster access, we have decided to make a subject bibliography, and not a chronological one. (On the occasion of the 10th anniversary of the Migration Themes journal, the chronological bibliography prepared by Josip Kumper was published in the 3-4/1994 issue. From the very first issue, migration and ethnicity have been the main themes represented in the journal, but the emphasis on the basic issues in previous papers, which involved external migration, internal migration, emigration and minorities/nationalities, have gradually

  1. Mind the Gap

    Science.gov (United States)

    Fairbanks, Terry; Savage, Erica; Adams, Katie; Wittie, Michael; Boone, Edna; Hayden, Andrew; Barnes, Janey; Hettinger, Zach; Gettinger, Andrew

    2016-01-01

    Summary Objective Decisions made during electronic health record (EHR) implementations profoundly affect usability and safety. This study aims to identify gaps between the current literature and key stakeholders’ perceptions of usability and safety practices and the challenges encountered during the implementation of EHRs. Materials and Methods Two approaches were used: a literature review and interviews with key stakeholders. We performed a systematic review of the literature to identify usability and safety challenges and best practices during implementation. A total of 55 articles were reviewed through searches of PubMed, Web of Science and Scopus. We used a qualitative approach to identify key stakeholders’ perceptions; semi-structured interviews were conducted with a diverse set of health IT stakeholders to understand their current practices and challenges related to usability during implementation. We used a grounded theory approach: data were coded, sorted, and emerging themes were identified. Conclusions from both sources of data were compared to identify areas of misalignment. Results We identified six emerging themes from the literature and stakeholder interviews: cost and resources, risk assessment, governance and consensus building, customization, clinical work-flow and usability testing, and training. Across these themes, there were misalignments between the literature and stakeholder perspectives, indicating major gaps. Discussion Major gaps identified from each of six emerging themes are discussed as critical areas for future research, opportunities for new stakeholder initiatives, and opportunities to better disseminate resources to improve the implementation of EHRs. Conclusion Our analysis identified practices and challenges across six different emerging themes, illustrated important gaps, and results suggest critical areas for future research and dissemination to improve EHR implementation. PMID:27847961

  2. Profile of Students’ Critical Thinking Skill Measured by Science Virtual Test on Living Things and Environmental Sustainability Theme

    Science.gov (United States)

    Maulida, N. I.; Firman, H.; Rusyati, L.

    2017-02-01

    The aims of this study are: (1) to investigate the level of students’ critical thinking skill on living things and environmental sustainability theme for each Inch’ critical thinking elements and overall, (2) to investigate the level of students’ critical thinking skill on living things characteristic, biodiversity, energy resources, ecosystem, environmental pollution, and global warming topics. The research was conducted due to the important of critical thinking measurement to get the current skill description as the basic consideration for further critical thinking skill improvement in lower secondary science. The research method used was descriptive. 331 seventh grade students taken from five lower secondary schools in Cirebon were tested to get the critical thinking skill data by using Science Virtual Test as the instrument. Generally, the mean scores on eight Inch’ critical thinking elements and overall score from descriptive statistic reveals a moderate attainments level. Students’ critical thinking skill on biodiversity, energy resources, ecosystem, environmental pollution, and global warming topics are in moderate level. While students’ critical thinking skill on living things characteristic is identified as high level. Students’ experience in thinking critically during science learning process and the characteristic of the topic are emerged as the reason behind the students’ critical thinking skill level on certain science topic.

  3. Using Multiple Sources of Data to Gauge Outcome Differences between Academic-Themed and Transition-Themed First-Year Seminars

    Science.gov (United States)

    Zerr, Ryan J.; Bjerke, Elizabeth

    2016-01-01

    Students in two different types of first-year experience seminar courses at a moderately sized public university were compared using a large variety of measures--both direct and indirect. One of these first-year experience types was a three-credit academic-themed course offered in sections with variable content; the other was a two-credit…

  4. An open dialogue on the draft focus and themes for the next ITS strategic research plan : engaging stakeholders in their discussion and development.

    Science.gov (United States)

    2012-12-01

    The : purpose : of : this : document : is : to : identify : the : focus : and : themes : for : the : next : installment : of : the : ITS : Strategic : Research : Plan : and : to : invite : stakeholders : to : participate : in : their : discussion. : ...

  5. Public Health System Research in Public Health Emergency Preparedness in the United States (2009-2015): Actionable Knowledge Base.

    Science.gov (United States)

    Savoia, Elena; Lin, Leesa; Bernard, Dottie; Klein, Noah; James, Lyndon P; Guicciardi, Stefano

    2017-09-01

    In 2008, the Institute of Medicine released a letter report identifying 4 research priority areas for public health emergency preparedness in public health system research: (1) enhancing the usefulness of training, (2) improving timely emergency communications, (3) creating and maintaining sustainable response systems, and (4) generating effectiveness criteria and metrics. To (1) identify and characterize public health system research in public health emergency preparedness produced in the United States from 2009 to 2015, (2) synthesize research findings and assess the level of confidence in these findings, and (3) describe the evolution of knowledge production in public health emergency preparedness system research. Search Methods and Selection Criteria. We reviewed and included the titles and abstracts of 1584 articles derived from MEDLINE, EMBASE, and gray literature databases that focused on the organizational or financial aspects of public health emergency preparedness activities and were grounded on empirical studies. We included 156 articles. We appraised the quality of the studies according to the study design. We identified themes during article analysis and summarized overall findings by theme. We determined level of confidence in the findings with the GRADE-CERQual tool. Thirty-one studies provided evidence on how to enhance the usefulness of training. Results demonstrated the utility of drills and exercises to enhance decision-making capabilities and coordination across organizations, the benefit of cross-sector partnerships for successfully implementing training activities, and the value of integrating evaluation methods to support training improvement efforts. Thirty-six studies provided evidence on how to improve timely communications. Results supported the use of communication strategies that address differences in access to information, knowledge, attitudes, and practices across segments of the population as well as evidence on specific

  6. Endangered Species & Biodiversity: A Classroom Project & Theme

    Science.gov (United States)

    Lauro, Brook

    2012-01-01

    Students discover the factors contributing to species losses worldwide by conducting a project about endangered species as a component of a larger classroom theme of biodiversity. Groups conduct research using online endangered- species databases and present results to the class using PowerPoint. Students will improve computer research abilities…

  7. Exploring the psychological health of emergency dispatch centre operatives: a systematic review and narrative synthesis.

    Science.gov (United States)

    Golding, Sarah E; Horsfield, Claire; Davies, Annette; Egan, Bernadette; Jones, Martyn; Raleigh, Mary; Schofield, Patricia; Squires, Allison; Start, Kath; Quinn, Tom; Cropley, Mark

    2017-01-01

    The study objective was to investigate and synthesize available evidence relating to the psychological health of Emergency Dispatch Centre (EDC) operatives, and to identify key stressors experienced by EDC operatives. Eight electronic databases (Embase, PubMed, Medline, CINAHL, PsycInfo, PsycArticles, The Psychology and Behavioural Sciences Collection, and Google Scholar) were searched. All study designs were included, and no date limits were set. Studies were included if they were published in English, and explored the psychological health of any EDC operatives, across fire, police, and emergency medical services. Studies were excluded if they related solely to other emergency workers, such as police officers or paramedics. Methodological quality of included studies was assessed using checklists adapted from the Critical Appraisal Skills Programme. A narrative synthesis was conducted, using thematic analysis. A total of 16 articles were included in the review. Two overarching themes were identified during the narrative synthesis: 'Organisational and Operational Factors' and 'Interactions with Others'. Stressors identified included being exposed to traumatic calls, lacking control over high workload, and working in under-resourced and pressured environments. Lack of support from management and providing an emotionally demanding service were additional sources of stress. Peer support and social support from friends and family were helpful in managing work-related stress. EDC operatives experience stress as a result of their work, which appears to be related to negative psychological health outcomes. Future research should explore the long-term effects of this stress, and the potential for workplace interventions to alleviate the negative impacts on psychological health. CRD42014010806.

  8. The historical theme in the poetry of Esenin

    Directory of Open Access Journals (Sweden)

    Hunarikova P. H.

    2016-03-01

    Full Text Available the article examines the historical theme in the poetry of Esenin. The author explores in his work historical problems in poetry Esenin, shows the role of the poet in contemporary Russia.

  9. Patient Reasons for Non-Urgent Utilization of the Dwight David Eisenhower Army Medical Center Emergency Department

    National Research Council Canada - National Science Library

    Sizemore, Charles J

    2004-01-01

    .... A review of the present body of literature revealed common themes why non-urgent patients typically present at emergency departments, the impacts to hospitals, and possible initiatives that could be...

  10. Failure mode effects and criticality analysis: innovative risk assessment to identify critical areas for improvement in emergency department sepsis resuscitation.

    Science.gov (United States)

    Powell, Emilie S; O'Connor, Lanty M; Nannicelli, Anna P; Barker, Lisa T; Khare, Rahul K; Seivert, Nicholas P; Holl, Jane L; Vozenilek, John A

    2014-06-01

    Sepsis is an increasing problem in the practice of emergency medicine as the prevalence is increasing and optimal care to reduce mortality requires significant resources and time. Evidence-based septic shock resuscitation strategies exist, and rely on appropriate recognition and diagnosis, but variation in adherence to the recommendations and therefore outcomes remains. Our objective was to perform a multi-institutional prospective risk-assessment, using failure mode effects and criticality analysis (FMECA), to identify high-risk failures in ED sepsis resuscitation. We conducted a FMECA, which prospectively identifies critical areas for improvement in systems and processes of care, across three diverse hospitals. A multidisciplinary group of participants described the process of emergency department (ED) sepsis resuscitation to then create a comprehensive map and table listing all process steps and identified process failures. High-risk failures in sepsis resuscitation from each of the institutions were compiled to identify common high-risk failures. Common high-risk failures included limited availability of equipment to place the central venous catheter and conduct invasive monitoring, and cognitive overload leading to errors in decision-making. Additionally, we identified great variability in care processes across institutions. Several common high-risk failures in sepsis care exist: a disparity in resources available across hospitals, a lack of adherence to the invasive components of care, and cognitive barriers that affect expert clinicians' decision-making capabilities. Future work may concentrate on dissemination of non-invasive alternatives and overcoming cognitive barriers in diagnosis and knowledge translation.

  11. Attitudes toward Tobacco, Alcohol, and Non-Alcoholic Beverage Advertisement Themes among Adolescent Boys.

    Science.gov (United States)

    Friedman, Katherine L; Roberts, Megan E; Keller-Hamilton, Brittney; Yates, Katherine A; Paskett, Electra D; Berman, Micah L; Slater, Michael D; Lu, Bo; Ferketich, Amy K

    2018-02-13

    Previous studies have examined what adolescents find appealing in tobacco and alcohol advertisements and how different themes in advertisements are used to manipulate consumer behaviors. Yet, we know little about the relationship between the themes portrayed in advertisements and youth attitudes towards those themes. This study compared attitudes towards advertisements for different consumer products in a sample of urban and rural adolescent boys in order to examine how key marketing themes impact adolescent attitudes towards those advertisements. Participants were 11- to 16-year-old boys (N = 1220) residing in either urban or rural Ohio Appalachian counties. Each participant viewed five print advertisements (one each for cigarettes, electronic cigarettes (e-cigarettes), smokeless tobacco (SLT), non-alcoholic beverages, and alcohol), presented in a random order, for eight seconds each. All advertisements had appeared in magazines that adolescent males commonly read. Attitudes towards each of the five advertisements were assessed. The advertisements were then coded for the presence of various themes, including social acceptance and masculinity. Analyses were conducted to determine associations between advertisement type and the attitude measure, and between the presence of a theme and the attitude measure. Overall, participants preferred non-tobacco advertisements to tobacco advertisements, rural participants had less positive attitudes and participants who had peers who used tobacco had more positive attitudes. Social acceptance and entertainment themes increased the appeal of SLT advertisements, and sex appeal increased the appeal of e-cigarette advertisements. Conclusions/Importance: Findings suggest that advertisements that promote the social nature of use in SLT advertisements may be of particular concern for their influence on adolescent boys.

  12. NIH Roundtable on Opportunities to Advance Research on Neurologic and Psychiatric Emergencies.

    Science.gov (United States)

    D'Onofrio, Gail; Jauch, Edward; Jagoda, Andrew; Allen, Michael H; Anglin, Deirdre; Barsan, William G; Berger, Rachel P; Bobrow, Bentley J; Boudreaux, Edwin D; Bushnell, Cheryl; Chan, Yu-Feng; Currier, Glenn; Eggly, Susan; Ichord, Rebecca; Larkin, Gregory L; Laskowitz, Daniel; Neumar, Robert W; Newman-Toker, David E; Quinn, James; Shear, Katherine; Todd, Knox H; Zatzick, Douglas

    2010-11-01

    The Institute of Medicine Committee on the Future of Emergency Care in the United States Health System (2003) identified a need to enhance the research base for emergency care. As a result, a National Institutes of Health (NIH) Task Force on Research in Emergency Medicine was formed to enhance NIH support for emergency care research. Members of the NIH Task Force and academic leaders in emergency care participated in 3 Roundtable discussions to prioritize current opportunities for enhancing and conducting emergency care research. We identify key research questions essential to advancing the science of emergency care and discuss the barriers and strategies to advance research by exploring the collaboration between NIH and the emergency care community. Experts from emergency medicine, neurology, psychiatry, and public health assembled to review critical areas in need of investigation, current gaps in knowledge, barriers, and opportunities. Neurologic emergencies included cerebral resuscitation, pain, stroke, syncope, traumatic brain injury, and pregnancy. Mental health topics included suicide, agitation and delirium, substances, posttraumatic stress, violence, and bereavement. Presentations and group discussion firmly established the need for translational research to bring basic science concepts into the clinical arena. A coordinated continuum of the health care system that ensures rapid identification and stabilization and extends through discharge is necessary to maximize overall patient outcomes. There is a paucity of well-designed, focused research on diagnostic testing, clinical decisionmaking, and treatments in the emergency setting. Barriers include the limited number of experienced researchers in emergency medicine, limited dedicated research funding, and difficulties of conducting research in chaotic emergency environments stressed by crowding and limited resources. Several themes emerged during the course of the roundtable discussion, including the need

  13. Measuring the operational efficiency of individual theme park attractions.

    Science.gov (United States)

    Kim, Changhee; Kim, Soowook

    2016-01-01

    This study assesses the operation efficiency of theme park attractions using the data envelopment analysis, utilizing actual data on 15 attractions at Samsung Everland located in Yongin-si, Republic of Korea. In particular, this study identifies crowding and waiting time as one of the main causes of visitor's satisfaction, and analyzes the efficiency of individual attractions in terms of waiting time. The installation area, installation cost, and annual repair cost are set as input factors and the number of annual users and customer satisfaction as output factors. The results show that the roller coaster-type attractions were less efficient than other types of attractions while rotating-type attractions were relatively more efficient. However, an importance performance analysis on individual attraction's efficiency and satisfaction showed that operational efficiency should not be the sole consideration in attraction installation. In addition, the projection points for input factors for efficient use of attractions and the appropriate reference set for benchmarking are provided as guideline for attraction efficiency management.

  14. The State of Leadership Education in Emergency Medical Services: A Multi-national Qualitative Study.

    Science.gov (United States)

    Leggio, William Joseph

    2014-10-01

    This study investigated how leadership is learned in Emergency Medical Services (EMS) from a multi-national perspective by interviewing EMS providers from multiple nations working in Riyadh, Kingdom of Saudi Arabia. A phenomenological, qualitative methodology was developed and 19 EMS providers from multiple nations were interviewed in June 2013. Interview questions focused on how participants learned EMS leadership as an EMS student and throughout their careers as providers. Data were analyzed to identify themes, patterns, and codes to be used for final analysis to describe findings. Emergency Medical Services leadership is primarily learned from informal mentoring and on-the-job training in less than supportive environments. Participants described learning EMS leadership during their EMS education. A triangulation of EMS educational resources yielded limited results beyond being a leader of patient care. The only course that yielded results from triangulation was EMS Management. The need to develop EMS leadership courses was supported by the findings. Findings also supported the need to include leadership education as part of continuing medical education and training. Emergency Medical Services leadership education that prepares students for the complexities of the profession is needed. Likewise, the need for EMS leadership education and training to be part of continuing education is supported. Both are viewed as a way to advance the EMS profession. A need for further research on the topic of EMS leadership is recognized, and supported, with a call for action on suggested topics identified within the study.

  15. Intern as Patient: A Patient Experience Simulation to Cultivate Empathy in Emergency Medicine Residents

    Directory of Open Access Journals (Sweden)

    Sara W. Nelson

    2017-12-01

    Full Text Available Introduction Prior work links empathy and positive physician-patient relationships to improved healthcare outcomes. The objective of this study was to analyze a patient experience simulation for emergency medicine (EM interns as a way to teach empathy and conscientious patient care. Methods We conducted a qualitative descriptive study on an in situ, patient experience simulation held during EM residency orientation. Half the interns were patients brought into the emergency department (ED by ambulance and half were family members. Interns then took part in focus groups that discussed the experience. Data collected during these focus groups were coded by two investigators using a grounded theory approach and constant comparative methodology. Results We identified 10 major themes and 28 subthemes in the resulting qualitative data. Themes were in three broad categories: the experience as a patient or family member in the ED; application to current clinical practice; and evaluation of the exercise itself. Interns experienced firsthand the physical discomfort, emotional stress and confusion patients and families endure during the ED care process. They reflected on lessons learned, including the importance of good communication skills, frequent updates on care and timing, and being responsive to the needs and concerns of patients and families. All interns felt this was a valuable orientation experience. Conclusion Conducting a patient experience simulation may be a practical and effective way to develop empathy in EM resident physicians. Additional research evaluating the effect of participation in the simulation over a longer time period and assessing the effects on residents’ actual clinical care is warranted.

  16. Emergence of a new lineage of dengue virus type 2 identified in travelers entering Western Australia from Indonesia, 2010-2012.

    Directory of Open Access Journals (Sweden)

    Timo Ernst

    2015-01-01

    Full Text Available Dengue virus (DENV transmission is ubiquitous throughout the tropics. More than 70% of the current global dengue disease burden is borne by people who live in the Asia-Pacific region. We sequenced the E gene of DENV isolated from travellers entering Western Australia between 2010-2012, most of whom visited Indonesia, and identified a diverse array of DENV1-4, including multiple co-circulating viral lineages. Most viruses were closely related to lineages known to have circulated in Indonesia for some time, indicating that this geographic region serves as a major hub for dengue genetic diversity. Most notably, we identified a new lineage of DENV-2 (Cosmopolitan genotype that emerged in Bali in 2011-2012. The spread of this lineage should clearly be monitored. Surveillance of symptomatic returned travellers provides important and timely information on circulating DENV serotypes and genotypes, and can reveal the herald wave of dengue and other emerging infectious diseases.

  17. Exploring Factors Affecting Emergency Medical Services Staffs' Decision about Transporting Medical Patients to Medical Facilities.

    Science.gov (United States)

    Ebrahimian, Abbasali; Seyedin, Hesam; Jamshidi-Orak, Roohangiz; Masoumi, Gholamreza

    2014-01-01

    Transfer of patients in medical emergency situations is one of the most important missions of emergency medical service (EMS) staffs. So this study was performed to explore affecting factors in EMS staffs' decision during transporting of patients in medical situations to medical facilities. The participants in this qualitative study consisted of 18 EMS staffs working in prehospital care facilities in Tehran, Iran. Data were gathered through semistructured interviews. The data were analyzed using a content analysis approach. The data analysis revealed the following theme: "degree of perceived risk in EMS staffs and their patients." This theme consisted of two main categories: (1) patient's condition' and (2) the context of the EMS mission'. The patent's condition category emerged from "physical health statuses," "socioeconomic statuses," and "cultural background" subcategories. The context of the EMS mission also emerged from two subcategories of "characteristics of the mission" and EMS staffs characteristics'. EMS system managers can consider adequate technical, informational, financial, educational, and emotional supports to facilitate the decision making of their staffs. Also, development of an effective and user-friendly checklist and scoring system was recommended for quick and easy recognition of patients' needs for transportation in a prehospital situation.

  18. Virtual Reality and Its Potential Use in Special Education. Identifying Emerging Issues and Trends in Technology for Special Education.

    Science.gov (United States)

    Woodward, John

    As part of a 3-year study to identify emerging issues and trends in technology for special education, this paper addresses the possible contributions of virtual reality technology to educational services for students with disabilities. An example of the use of virtual reality in medical imaging introduces the paper and leads to a brief review of…

  19. Opioid Substitution Treatment Planning in a Disaster Context: Perspectives from Emergency Management and Health Professionals in Aotearoa/New Zealand

    Directory of Open Access Journals (Sweden)

    Denise Blake

    2016-11-01

    Full Text Available Opioid Substitution Treatment (OST is a harm reduction strategy enabling opiate consumers to avoid withdrawal symptoms and maintain health and wellbeing. Some research shows that within a disaster context service disruptions and infrastructure damage affect OST services, including problems with accessibility, dosing, and scripts. Currently little is known about planning for OST in the reduction and response phases of a disaster. This study aimed to identify the views of three professional groups working in Aotearoa/New Zealand about OST provision following a disaster. In-depth, semi-structured interviews were conducted with 17 service workers, health professionals, and emergency managers in OST and disaster planning fields. Thematic analysis of transcripts identified three key themes, namely “health and wellbeing”, “developing an emergency management plan”, and “stock, dose verification, and scripts” which led to an overarching concept of “service continuity in OST preparedness planning”. Participants viewed service continuity as essential for reducing physical and psychological distress for OST clients, their families, and wider communities. Alcohol and drug and OST health professionals understood the specific needs of clients, while emergency managers discussed the need for sufficient preparedness planning to minimise harm. It is concluded that OST preparedness planning must be multidisciplinary, flexible, and inclusive.

  20. Opioid Substitution Treatment Planning in a Disaster Context: Perspectives from Emergency Management and Health Professionals in Aotearoa/New Zealand

    Science.gov (United States)

    Blake, Denise; Lyons, Antonia

    2016-01-01

    Opioid Substitution Treatment (OST) is a harm reduction strategy enabling opiate consumers to avoid withdrawal symptoms and maintain health and wellbeing. Some research shows that within a disaster context service disruptions and infrastructure damage affect OST services, including problems with accessibility, dosing, and scripts. Currently little is known about planning for OST in the reduction and response phases of a disaster. This study aimed to identify the views of three professional groups working in Aotearoa/New Zealand about OST provision following a disaster. In-depth, semi-structured interviews were conducted with 17 service workers, health professionals, and emergency managers in OST and disaster planning fields. Thematic analysis of transcripts identified three key themes, namely “health and wellbeing”, “developing an emergency management plan”, and “stock, dose verification, and scripts” which led to an overarching concept of “service continuity in OST preparedness planning”. Participants viewed service continuity as essential for reducing physical and psychological distress for OST clients, their families, and wider communities. Alcohol and drug and OST health professionals understood the specific needs of clients, while emergency managers discussed the need for sufficient preparedness planning to minimise harm. It is concluded that OST preparedness planning must be multidisciplinary, flexible, and inclusive. PMID:27834915

  1. A Literature Analysis of Themes in Paediatric Cochlear Implant Research

    DEFF Research Database (Denmark)

    Hendar, Nils Ola Ebbe; Dammeyer, Jesper Herup

    2015-01-01

    with typical hearing and children with hearing impairment without CI. Published research in the period 1990-2013 on language development was analysed with respect to frequency of selected search terms reflecting different language acquisition themes among children with typical hearing, children with hearing...... impairment without CI, and children with CI, respectively. Results showed a relatively lower number of articles which included themes such as pre-verbal language (imitation, joint attention and gestures), extra lingual abilities (social interaction), and later language skills (semantic, syntactic, grammar...

  2. Using the Five Themes of Geography To Teach about Venezuela and Mexico.

    Science.gov (United States)

    Sunal, Cynthia Szymanski; Christensen, Lois

    Activities that employ the five themes of geography--location, place, relationships within places, movement, and regions--to teach about Venezuela and Mexico are described in this document. Each theme has objectives, a list of materials, and three types of activities--exploration, invention, and expansion. Background information on Venezuela and…

  3. Changes in Illegal Behavior During Emerging Adulthood

    Directory of Open Access Journals (Sweden)

    Badiah Haffejee

    2013-01-01

    Full Text Available Emerging adulthood marks a critical developmental juncture during which some individuals disengage from the illegal behavior of their adolescence while others continue to use substances and commit crimes. While risk factors for delinquency during adolescence are well studied, factors that influence persisting or desisting from illegal activities during emerging adulthood have not been fully explored. This mixed methods study utilizes a sample of college students aged 18-25 (N=74 and examines factors differentiating those who abstained from illegal behaviors, desisted from illegal behaviors, and persisted in illegal behaviors. Multinomial logistic regression models indicated peers offending and hours spent studying predicted desisting and peers offending predicted persisting (compared to the abstaining group. Three qualitative themes: family and peer bonds, morals and values, and fear of consequences further explained factors influencing emerging adults’ persisting and desisting choices. Implications for social work practice are explored.

  4. Introducing the JMBE Themed Issue on Scientific Citizenship

    Directory of Open Access Journals (Sweden)

    Jack A. Gilbert

    2016-01-01

    Full Text Available In this Editorial, the three Guest Editors for JMBE's first standalone themed issue introduce the topic of scientific citizenship and provide an overview of the current ideas and best practices contained within the issue. 

  5. Deliberate and emergent strategies for implementing person-centred care: a qualitative interview study with researchers, professionals and patients.

    Science.gov (United States)

    Naldemirci, Öncel; Wolf, Axel; Elam, Mark; Lydahl, Doris; Moore, Lucy; Britten, Nicky

    2017-08-04

    The introduction of innovative models of healthcare does not necessarily mean that they become embedded in everyday clinical practice. This study has two aims: first, to analyse deliberate and emergent strategies adopted by healthcare professionals to overcome barriers to normalization of a specific framework of person-centred care (PCC); and secondly, to explore how the recipients of PCC understand these strategies. This paper is based on a qualitative study of the implementation of PCC in a Swedish context. It draws on semi-structured interviews with 18 researchers and 17 practitioners who adopted a model of PCC on four different wards and 20 patients who were cared for in one of these wards. Data from these interviews were first coded inductively and emerging themes are analysed in relation to normalization process theory (NPT). In addition to deliberate strategies, we identify emergent strategies to normalize PCC by (i) creating and sustaining coherence in small but continuously communicating groups (ii) interpreting PCC flexibly when it meets specific local situations and (iii) enforcing teamwork between professional groups. These strategies resulted in patients perceiving PCC as bringing about (i) a sense of ease (ii) appreciation of inter-professional congruity (ii) non-hierarchical communication. NPT is useful to identify and analyse deliberate and emergent strategies relating to mechanisms of normalization. Emergent strategies should be interpreted not as trivial solutions to problems in implementation, but as a possible repertoire of tools, practices and skills developed in situ. As professionals and patients may have different understandings of implementation, it is also crucial to include patients' perceptions to evaluate outcomes.

  6. Sex Differences and/in the Self: Classic Themes, Feminist Variations, Postmodern Challenges

    Science.gov (United States)

    Bohan, Janis S.

    2002-01-01

    This article examines perspectives on and intersections between two recurrent themes in the history of American psychology: sex differences and theories of self. These themes and certain connections between them are considered in three eras: early American psychology, feminist psychology coincident with the second wave of feminism, and the recent…

  7. Simulacra and simulation: double simulation at a North Song Dynasty theme park

    NARCIS (Netherlands)

    Ong, C.E.; Jin, Ge

    2017-01-01

    This paper examines an unusual type of ‘cultural theme park’, one that is not based on simulating existing cultural diversity or historical places, but based in some senses on a ‘double simulation’. The theme park is based on an historical painting assumed to represent the North Song Dynasty period

  8. Life Themes and Interpersonal Motivational Systems in the Narrative Self-construction

    Science.gov (United States)

    Veglia, Fabio; Di Fini, Giulia

    2017-01-01

    What makes unique and unrepeatable individuals is their ability to write their own story attributing meaning, sharing it through narration, giving coherence to the information related to the interpersonal motivational systems, and creating alternative hierarchies to those biologically provided by the genetic code. Through clinical narratives and narrative literature, we can observe the recurrence of specific topics, across time and different cultures. Hence, we wondered whether there are some evolutionary suggestions that guide us in the construction of the narrative-autobiographical contents. In this article we proposed a theoretical-clinical hypothesis about the existence of a biological disposition to identify as fundamental six Life Themes (LTs) that contribute to defining the image of the self and the world: Love, Personal Value, Power, Justice, Truth, and Freedom. Besides the innumerable narratives dependent upon context, there may be many ways of telling stories that, instead, would be reported to these few essential themes. A narrative review of the literature about these concepts follows the systematic explanation of the perspective about the LTs as attractors of meaning. The manuscript considers also the process of co-construction of meanings within the interpersonal relationships and the influences of these on the narratives. In particular, we focused on the importance of episodic and autobiographical memory related to the attachment and significant figures, in the construction of the personal story and the LTs. We also explained the possible clinical implications of the theoretical hypothesis of LTs. Within clinical conversations, the LTs could be expressed rigidly or, otherwise, in a confused way. The lack of narrative integration may lead to the dominance of chaos or rigidity that generates suffering. A better comprehension of the LTs in patients’ narrations could be useful to identify a narrative profile about the areas of greatest suffering

  9. Symbols of menarche identified by African American females.

    Science.gov (United States)

    Hawthorne, Dorothy J

    2002-08-01

    This study was conducted to identify and describe symbolic themes of menarche. The qualitative case study design was used with a purposive sample of 30 participants (15 mothers and their 15 daughters) in answering 2 questions: (a) How do 9- and 10-year-old African American girls view the meaning of their menarcheal flow?, and (b) How do African American mothers view the meaning of menarche? Data were collected through interviews 2 to 5 days after completion of menarche. A cross-case comparison analysis of the interviews revealed 4 themes: (a) vaginal bleeding, (b) sexual maturation, (c) premenarcheal sexual activity, and (d) sexual payback to fathers. With the exception of the latter all themes were supported in earlier studies of Euro-American girls. These findings indicate the need for further research addressing self-concept at menarche, impact of menarche on family relationships, and views of fathers about sexual payback as a symbol of menarche.

  10. Strategic aspects of nuclear and radiological emergency management

    International Nuclear Information System (INIS)

    Ahier, B.

    2010-01-01

    Emergency situations demand that actions be taken by responsible organisations in a timely and effective manner to mitigate consequences for the population, infrastructure and the environment, and to support the return of affected areas to normal social and economic activity to the extent possible. To deliver an effective response over the emergency management time-line, it is necessary to make, maintain and exercise adequate plans and arrangements in advance of an emergency situation. These must contain appropriate elements and resources for preparedness, response and assistance to identified threats, recognize and include all implicated partners, and take account of international interfaces. Effective management of complex emergency situations that can lead to a wide range of consequences and involve multiple organisations at the local, national and international levels also requires anticipation of the range of decision-making needs, an understanding of the interactions between response organisations and a model for their co-ordination. Experience from managing emergency situations has shown that the integration of these factors into emergency preparedness and response arrangements should be based on a guiding strategic vision. Emergency response is a dynamic process that develops in time from a situation of little information to one of potentially overwhelming information. Within this context, emergency response organisations must be able to respond in an appropriate and timely manner at any point along the emergency management time-line. This will be facilitated by an overarching framework to guide the decision-making process. To contribute to work in this area, the NEA Committee on Radiation Protection and Public Health (CRPPH) Working Party on Nuclear Emergency Matters (WPNEM) reviewed its collective experience to extract key themes that could form a strategy for improving decision-making in emergency management. This focused on the NEA International Nuclear

  11. Theme issue on e-mental health: a growing field in internet research.

    Science.gov (United States)

    Riper, Heleen; Andersson, Gerhard; Christensen, Helen; Cuijpers, Pim; Lange, Alfred; Eysenbach, Gunther

    2010-12-19

    This theme issue on e-mental health presents 16 articles from leading researchers working on systems and theories related to supporting and improving mental health conditions and mental health care using information and communication technologies. In this editorial, we present the background of this theme issue, and highlight the content of this issue.

  12. Seeking Sepsis in the Emergency Department- Identifying Barriers to Delivery of the Sepsis 6.

    Science.gov (United States)

    Bentley, James; Henderson, Susan; Thakore, Shobhan; Donald, Michael; Wang, Weijie

    2016-01-01

    The Sepsis 6 is an internationally accepted management bundle that, when initiated within one hour of identifying sepsis, can reduce morbidity and mortality. This management bundle was advocated by the Scottish Patient Safety Programme as part of its Acute Adult campaign launched in 2008 and adopted by NHS Tayside in 2012. Despite this, the Emergency Department (ED) of Ninewells Hospital, a tertiary referral centre and major teaching hospital in Scotland, was displaying poor success in the Sepsis 6. We therefore set out to improve compliance by evaluating the application of all aspects of the NHS Tayside Sepsis 6 bundle within one hour of ED triage time, to identify what human factors may influence achieving the one hour The Sepsis 6 bundle. This allowed us to tailor a number of specific interventions including educational sessions, regular audit and personal feedback and check list Sepsis 6 sticker. These interventions promoted a steady increase in compliance from an initial rate of 51.0% to 74.3%. The project highlighted that undifferentiated patients create a challenge in initiating the Sepsis 6. Pyrexia is a key human factor-trigger for recognising sepsis with initial nursing assessment being vital in recognition and identifying the best area (resus) of the department to manage severely septic patients. EDs need to recognise these challenges and develop educational and feedback plans for staff and utilise available resources to maximise the Sepsis 6 compliance.

  13. Mathematical Communication Ability by Grade VII Students Using a Themed Problem Based Learning with Scaffolding on Rectangle Materials

    Directory of Open Access Journals (Sweden)

    Didik Adi Saputro

    2017-08-01

    Full Text Available The aim of research to test students' mathematical communication used themed of PBL with scaffolding, themed of PBL and PBL achieve mastery learning;to test students' mathematical communication that used the themed of PBL with scaffolding, themed of PBL and PBL; and to test students' mathematical communication for the low, medium group, and a high-group themed of PBL with scaffolding, themed of PBL and PBL. This type of research is quantitative research. The Population is seventh grade students of SMPN 22 Semarang and the sample class VII E, F and VII VII G. Used normality test, homogenity test, equality test on average, the proportion of one-party test, one way anova test, and scheffe test. The results showed that (1 Student’s mathematical communication ability using themed of PBLwith Scaffolding strategy,themed of PBL, and PBL achieve the completeness of learning, (2 there is a difference in the classroom using the themed of PBL with scaffolding, themed of PBL, as well as PBL, (3 For the low, medium, high and there is a difference in the classroom using the themed of PBL with scaffolding, themed of PBL and PBL.

  14. Designing a clinical dashboard to fill information gaps in the emergency department.

    Science.gov (United States)

    Swartz, Jordan L; Cimino, James J; Fred, Matthew R; Green, Robert A; Vawdrey, David K

    2014-01-01

    Data fragmentation within electronic health records causes gaps in the information readily available to clinicians. We investigated the information needs of emergency medicine clinicians in order to design an electronic dashboard to fill information gaps in the emergency department. An online survey was distributed to all emergency medicine physicians at a large, urban academic medical center. The survey response rate was 48% (52/109). The clinical information items reported to be most helpful while caring for patients in the emergency department were vital signs, electrocardiogram (ECG) reports, previous discharge summaries, and previous lab results. Brief structured interviews were also conducted with 18 clinicians during their shifts in the emergency department. From the interviews, three themes emerged: 1) difficulty accessing vital signs, 2) difficulty accessing point-of-care tests, and 3) difficulty comparing the current ECG with the previous ECG. An emergency medicine clinical dashboard was developed to address these difficulties.

  15. Plant cell surface receptor-mediated signaling - a common theme amid diversity.

    Science.gov (United States)

    He, Yunxia; Zhou, Jinggeng; Shan, Libo; Meng, Xiangzong

    2018-01-29

    Sessile plants employ a diverse array of plasma membrane-bound receptors to perceive endogenous and exogenous signals for regulation of plant growth, development and immunity. These cell surface receptors include receptor-like kinases (RLKs) and receptor-like proteins (RLPs) that harbor different extracellular domains for perception of distinct ligands. Several RLK and RLP signaling pathways converge at the somatic embryogenesis receptor kinases (SERKs), which function as shared co-receptors. A repertoire of receptor-like cytoplasmic kinases (RLCKs) associate with the receptor complexes to relay intracellular signaling. Downstream of the receptor complexes, mitogen-activated protein kinase (MAPK) cascades are among the key signaling modules at which the signals converge, and these cascades regulate diverse cellular and physiological responses through phosphorylation of different downstream substrates. In this Review, we summarize the emerging common theme that underlies cell surface receptor-mediated signaling pathways in Arabidopsis thaliana : the dynamic association of RLKs and RLPs with specific co-receptors and RLCKs for signal transduction. We further discuss how signaling specificities are maintained through modules at which signals converge, with a focus on SERK-mediated receptor signaling. © 2018. Published by The Company of Biologists Ltd.

  16. Privacy Attitudes among Early Adopters of Emerging Health Technologies.

    Directory of Open Access Journals (Sweden)

    Cynthia Cheung

    Full Text Available Advances in health technology such as genome sequencing and wearable sensors now allow for the collection of highly granular personal health data from individuals. It is unclear how people think about privacy in the context of these emerging health technologies. An open question is whether early adopters of these advances conceptualize privacy in different ways than non-early adopters.This study sought to understand privacy attitudes of early adopters of emerging health technologies.Transcripts from in-depth, semi-structured interviews with early adopters of genome sequencing and health devices and apps were analyzed with a focus on participant attitudes and perceptions of privacy. Themes were extracted using inductive content analysis.Although interviewees were willing to share personal data to support scientific advancements, they still expressed concerns, as well as uncertainty about who has access to their data, and for what purpose. In short, they were not dismissive of privacy risks. Key privacy-related findings are organized into four themes as follows: first, personal data privacy; second, control over personal information; third, concerns about discrimination; and fourth, contributing personal data to science.Early adopters of emerging health technologies appear to have more complex and nuanced conceptions of privacy than might be expected based on their adoption of personal health technologies and participation in open science. Early adopters also voiced uncertainty about the privacy implications of their decisions to use new technologies and share their data for research. Though not representative of the general public, studies of early adopters can provide important insights into evolving attitudes toward privacy in the context of emerging health technologies and personal health data research.

  17. Privacy Attitudes among Early Adopters of Emerging Health Technologies.

    Science.gov (United States)

    Cheung, Cynthia; Bietz, Matthew J; Patrick, Kevin; Bloss, Cinnamon S

    2016-01-01

    Advances in health technology such as genome sequencing and wearable sensors now allow for the collection of highly granular personal health data from individuals. It is unclear how people think about privacy in the context of these emerging health technologies. An open question is whether early adopters of these advances conceptualize privacy in different ways than non-early adopters. This study sought to understand privacy attitudes of early adopters of emerging health technologies. Transcripts from in-depth, semi-structured interviews with early adopters of genome sequencing and health devices and apps were analyzed with a focus on participant attitudes and perceptions of privacy. Themes were extracted using inductive content analysis. Although interviewees were willing to share personal data to support scientific advancements, they still expressed concerns, as well as uncertainty about who has access to their data, and for what purpose. In short, they were not dismissive of privacy risks. Key privacy-related findings are organized into four themes as follows: first, personal data privacy; second, control over personal information; third, concerns about discrimination; and fourth, contributing personal data to science. Early adopters of emerging health technologies appear to have more complex and nuanced conceptions of privacy than might be expected based on their adoption of personal health technologies and participation in open science. Early adopters also voiced uncertainty about the privacy implications of their decisions to use new technologies and share their data for research. Though not representative of the general public, studies of early adopters can provide important insights into evolving attitudes toward privacy in the context of emerging health technologies and personal health data research.

  18. Interdisciplinarity and Undergraduate Psychology Education

    Science.gov (United States)

    Goodwin-Smith, Ian; Pearson, Elissa; Ranzijn, Rob; Campbell, Alan; Lushington, Kurt

    2013-01-01

    This work identifies the human service sector as an important and growing destination for psychology graduates. It further identifies a number of key themes which flow from that observation and which are important to configuring psychology education in a way which takes account of emerging trends. The major theme identified in the research is the…

  19. Teachers Working Cooperatively with Parents and Caregivers when Implementing LGBT Themes in the Elementary Classroom

    Science.gov (United States)

    Flores, Gabriel

    2014-01-01

    Many teachers are interested in having a more inclusive multicultural education that includes lesbian, gay, bisexual, and transgender (LGBT) themes and gay-themed children's literature; unfortunately, research has found that many teachers do not implement gay themes in their multicultural education curriculum because of fear of criticism from…

  20. Aligning Theme and Information Structure to Improve the Readability of Technical Writing

    Science.gov (United States)

    Moore, N. A. J.

    2006-01-01

    The readability of technical writing, and technical manuals in particular, especially for second language readers, can be noticeably improved by pairing Theme with Given and Rheme with New. This allows for faster processing of text and easier access to the "method of development" of the text. Typical Theme-Rheme patterns are described, and the…

  1. Assessment report on NRP sub-theme 'International instruments for climate change policy'

    International Nuclear Information System (INIS)

    Bruggink, J.J.C.; Van Beek, P.; Folmer, H.; Zhang, Z.X.; Blok, K.; Phylipsen, D.; Worrell, E.; Gupta, J.; Junne, G.; Van der Wurff, R.

    1995-01-01

    The projects implemented in the Dutch National Research Programme on Global Air Pollution and Climate Change are organised in several themes and sub-themes. Within the theme on Sustainable Solutions five projects are grouped under the heading International Instruments for Climate Change Policy. These five projects deal primarily with issues concerning the position of developing countries in the debate on limiting global CO2-emissions. They cover a broad spectrum of topics: international negotiation strategies, tropical deforestation, industrial energy conservation, national energy scenarios, emission guidelines. This contribution presents an overview of the objectives, methodologies and results of the projects and includes a critical evaluation of the potential relevance of the work for policy makers. 1 tab., 36 refs

  2. Registered nurses' experiences of their decision-making at an Emergency Medical Dispatch Centre.

    Science.gov (United States)

    Ek, Bosse; Svedlund, Marianne

    2015-04-01

    To describe registered nurses' experiences at an Emergency Medical Dispatch Centre. It is important that ambulances are urgently directed to patients who are in need of immediate help and of quick transportation to a hospital. Because resources are limited, Emergency Medical Dispatch centres cannot send ambulances with high priority to all callers. The efficiency of the system is therefore dependent on triage. Nurses worldwide are involved in patient triage, both before the patient's arrival to the hospital and in the subsequent emergency care. Ambulance dispatching is traditionally a duty for operators at Emergency Medical Dispatch centres, and in Sweden this duty has become increasingly performed by registered nurses. A qualitative design was used for this study. Fifteen registered nurses with experience at Emergency Medical Dispatch centres were interviewed. The participants were asked to describe the content of their work and their experiences. They also described the most challenging and difficult situations according to the critical incidence technique. Content analysis was used. Two themes emerged during the analysis: 'Having a profession with opportunities and obstacles' and 'Meeting serious and difficult situations', with eight sub-themes. The results showed that the decisions to dispatch ambulances were both challenging and difficult. Difficulties included conveying medical advice without seeing the patient, teaching cardio-pulmonary resuscitation via telephone and dealing with intoxicated and aggressive callers. Conflicts with colleagues and ambulance crews as well as fear of making wrong decisions were also mentioned. Work at Emergency Medical Dispatch centres is a demanding but stimulating duty for registered nurses. Great benefits can be achieved using experienced triage nurses, including increased patient safety and better use of medical resources. Improved internal support systems at Emergency Medical Dispatch centres and striving for a blame

  3. Pediatric crisis resource management training improves emergency medicine trainees' perceived ability to manage emergencies and ability to identify teamwork errors.

    Science.gov (United States)

    Bank, Ilana; Snell, Linda; Bhanji, Farhan

    2014-12-01

    Improved pediatric crisis resource management (CRM) training is needed in emergency medicine residencies because of the variable nature of exposure to critically ill pediatric patients during training. We created a short, needs-based pediatric CRM simulation workshop with postactivity follow-up to determine retention of CRM knowledge. Our aims were to provide a realistic learning experience for residents and to help the learners recognize common errors in teamwork and improve their perceived abilities to manage ill pediatric patients. Residents participated in a 4-hour objectives-based workshop derived from a formal needs assessment. To quantify their subjective abilities to manage pediatric cases, the residents completed a postworkshop survey (with a retrospective precomponent to assess perceived change). Ability to identify CRM errors was determined via a written assessment of scripted errors in a prerecorded video observed before and 1 month after completion of the workshop. Fifteen of the 16 eligible emergency medicine residents (postgraduate year 1-5) attended the workshop and completed the surveys. There were significant differences in 15 of 16 retrospective pre to post survey items using the Wilcoxon rank sum test for non-parametric data. These included ability to be an effective team leader in general (P < 0.008), delegating tasks appropriately (P < 0.009), and ability to ensure closed-loop communication (P < 0.008). There was a significant improvement in identification of CRM errors through the use of the video assessment from 3 of the 12 CRM errors to 7 of the 12 CRM errors (P < 0.006). The pediatric CRM simulation-based workshop improved the residents' self-perceptions of their pediatric CRM abilities and improved their performance on a video assessment task.

  4. The emerging use of social media for health-related purposes in low and middle-income countries: A scoping review.

    Science.gov (United States)

    Hagg, Emily; Dahinten, V Susan; Currie, Leanne M

    2018-07-01

    Social media allows for instant access to, and dissemination of, information around the globe. Access to social media in low- and middle-income countries has increased exponentially in recent years due to technological advances. Despite this growth, the use of social media in low- and middle-income countries is less well-researched than in high-income countries. To identify, explore and summarize the current state of the literature on the use of social media for health in low- and middle-income countries. A scoping review was conducted on literature available to December 2017. Six databases were searched, and grey literature was identified through the Google and Google Scholar search engines. Literature was considered for inclusion if it (1) was published in English, (2) was conducted in or in relation to a low or middle-income country, (3) reported on as least one type of social media or social media use generally for health purposes, and (4) reported on at least one aspect of human health. Content analysis was performed to identify themes. Forty articles met the inclusion criteria. Thirty-one were research articles, and nine were review/discussion/descriptive and evaluative reports. Since 2010, when the first article was published, most of the literature has focused on Asian (n = 15) and African (n = 12) countries. Twitter (n = 11) and Facebook (n = 10) were the most frequently discussed individual social media platforms. Four themes were identified: (1) use for health education and influence (sub-themes were health behaviour and health education); (2) use within infectious disease and outbreak situations; (3) use within natural disaster, terrorism, crisis and emergency response situations; and (4) producers and consumers of social media for health (sub-themes were misinformation, organizational challenges, users' expectations, and challenges of unique sub-populations). Most studies addressed more than one theme. Social media has the ability to

  5. Pseudologia Fantastica in the Emergency Department: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Robyn Thom

    2017-01-01

    Full Text Available Psychiatrists commonly encounter deception in the emergency department. This article presents the case of a patient who presents to the emergency department with an unusual and elaborate web of deceptions along multiple themes including feigning medical illness, multiple losses, and grandiose academic and athletic achievements. We review the clinical characteristics of pseudologia fantastica and discuss how this patient’s constellation of malingering, factitious disorder, and personality disorder suggests this diagnosis.

  6. The themes, institutions, and people of medical education research 1988-2010: content analysis of abstracts from six journals.

    Science.gov (United States)

    Rotgans, Jerome I

    2012-10-01

    The present study aimed at providing an overview of the most common themes of research into medical education. Changes in frequency of occurrence of these themes over time and differences between US and European journals were studied. The most productive institutions and researchers in the field were examined. A content analysis was carried out on 10,168 abstracts extracted from the six most influential journals in medical education published since 1988. Twenty-nine major themes were identified, of which student assessment, clinical and communication skills, clinical clerkships, and problem-based learning were the most prominent ones. Some of these themes, such as multiple-choice examinations or computer-assisted instruction seemed to have had their day, whereas other topics, such as the study of clinical clerkships, clinical reasoning, and scholarship in education were on their way up. Medical education research turned out to be a thoroughly international affair to which both US and European research centers contribute. The medical education literature shows an overwhelming emphasis on the preparation of medical students for professional practice. Moreover, the emphasis is very much on the individual student; most research seems to have been conducted with a psychological perspective in mind. It is argued that medical education research would profit from broadening its scope, including sociological, economical, ecological, and system perspectives. These perspectives might bring answers to new questions relevant to the quality of medical education. It is suggested that medical education is in need of moving beyond the conventional effectiveness-driven research approach to a more theory- and discovery-driven approach.

  7. Identifying and overcoming implementation challenges: Experience of 59 noninstitutional long-term services and support pilot programs in the Veterans Health Administration.

    Science.gov (United States)

    Sullivan, Jennifer L; Adjognon, Omonyêlé L; Engle, Ryann L; Shin, Marlena H; Afable, Melissa K; Rudin, Whitney; White, Bert; Shay, Kenneth; Lukas, Carol VanDeusen

    From 2010 to 2013, the Department of Veterans Affairs (VA) funded a large pilot initiative to implement noninstitutional long-term services and supports (LTSS) programs to support aging Veterans. Our team evaluated implementation of 59 VA noninstitutional LTSS programs. The specific objectives of this study are to (a) examine the challenges influencing program implementation comparing active sites that remained open and inactive sites that closed during the funding period and (b) identify ways that active sites overcame the challenges they experienced. Key informant semistructured interviews occurred between 2011 and 2013. We conducted 217 telephone interviews over four time points. Content analysis was used to identify emergent themes. The study team met regularly to define each challenge, review all codes, and discuss discrepancies. For each follow-up interview with the sites, the list of established challenges was used as a priori themes. Emergent data were also coded. The challenges affecting implementation included human resources and staffing issues, infrastructure, resources allocation and geography, referrals and marketing, leadership support, and team dynamics and processes. Programs were able to overcome challenges by communicating with team members and other areas in the organization, utilizing information technology solutions, creative use of staff and flexible schedules, and obtaining additional resources. This study highlights several common challenges programs can address during the program implementation. The most often mentioned strategy was effective communication. Strategies also targeted several components of the organization including organizational functions and processes (e.g., importance of coordination within a team and across disciplines to provide good care), infrastructure (e.g., information technology and human resources), and program fit with priorities in the organization (e.g., leadership support). Anticipating potential pitfalls of

  8. Themes in Spirit Possession in Ugandan Christianity | James ...

    African Journals Online (AJOL)

    . This paper discerns a number of common themes that run through many of these experiences. In particular, sex as a motif for deviance and evil is noted as a common feature of many of the possession stories and all contact with spirits is seen ...

  9. Bio-power, Agamben, and emerging nursing knowledge.

    Science.gov (United States)

    Georges, Jane M

    2008-01-01

    This philosophical article posits that an emerging theme in contemporary nursing epistemology is bio-power and proposes the use of philosopher Giorgio Agamben's perspectives as a useful approach for the future investigation of bio-power in nursing knowledge. Building upon Meleis' characterization of diversity as the most recent "milestone" of contemporary theoretical development of the nursing discipline, selected recent texts from the nursing literature are analyzed, and implications for future nursing knowledge in the context of Agamben's work are explored.

  10. From themes to hypotheses: following up with quantitative methods.

    Science.gov (United States)

    Morgan, David L

    2015-06-01

    One important category of mixed-methods research designs consists of quantitative studies that follow up on qualitative research. In this case, the themes that serve as the results from the qualitative methods generate hypotheses for testing through the quantitative methods. That process requires operationalization to translate the concepts from the qualitative themes into quantitative variables. This article illustrates these procedures with examples that range from simple operationalization to the evaluation of complex models. It concludes with an argument for not only following up qualitative work with quantitative studies but also the reverse, and doing so by going beyond integrating methods within single projects to include broader mutual attention from qualitative and quantitative researchers who work in the same field. © The Author(s) 2015.

  11. Post-head-emergence frost in wheat and barley: defining the problem, assessing the damage, and identifying resistance.

    Science.gov (United States)

    Frederiks, T M; Christopher, J T; Sutherland, M W; Borrell, A K

    2015-06-01

    Radiant frost is a significant production constraint to wheat (Triticum aestivum) and barley (Hordeum vulgare), particularly in regions where spring-habit cereals are grown through winter, maturing in spring. However, damage to winter-habit cereals in reproductive stages is also reported. Crops are particularly susceptible to frost once awns or spikes emerge from the protection of the flag leaf sheath. Post-head-emergence frost (PHEF) is a problem distinct from other cold-mediated production constraints. To date, useful increased PHEF resistance in cereals has not been identified. Given the renewed interest in reproductive frost damage in cereals, it is timely to review the problem. Here we update the extent and impacts of PHEF and document current management options to combat this challenge. We clarify terminology useful for discussing PHEF in relation to chilling and other freezing stresses. We discuss problems characterizing radiant frost, the environmental conditions leading to PHEF damage, and the effects of frost at different growth stages. PHEF resistant cultivars would be highly desirable, to both reduce the incidence of direct frost damage and to allow the timing of crop maturity to be managed to maximize yield potential. A framework of potential adaptation mechanisms is outlined. Clarification of these critical issues will sharpen research focus, improving opportunities to identify genetic sources for improved PHEF resistance. © The Author 2015. Published by Oxford University Press on behalf of the Society for Experimental Biology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  12. The information needs of patients receiving procedural sedation in a hospital emergency department.

    Science.gov (United States)

    Revell, Sue; Searle, Judy; Thompson, Shona

    2017-07-01

    This research investigated the information needs of patients receiving ED procedural sedation to determine the best format to consistently deliver key information in a way acceptable to all involved. Of particular interest was the question concerning patients' need for receiving written information. A descriptive exploratory study gathered qualitative data through face-to-face interviews and focus groups involving patients, nurses and medical staff. Individual interviews were conducted with eight adult patients following procedural sedation. They identified very few gaps in terms of specific information they needed pertaining to procedural sedation and rejected the need for receiving information in a written format. Their information needs related to a central concern for safety and trust. Focus groups, reflecting on the findings from patients, were conducted with five ED nurses and four emergency medicine consultants/registrars who regularly provided procedural sedation. Themes that emerged from the analysis of data from all three groups identified the issues concerning patient information needs as being: competence and efficiency of staff; explanations of procedures and progress; support person presence; and medico-legal issues. The research confirms that the quality of the patient's ED experience, specifically related to procedural sedation, is enhanced by ED staff, especially nurses, providing them with ongoing and repeated verbal information relevant to their circumstances. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Exploring the psychological health of emergency dispatch centre operatives: a systematic review and narrative synthesis

    Directory of Open Access Journals (Sweden)

    Sarah E. Golding

    2017-10-01

    Full Text Available Background The study objective was to investigate and synthesize available evidence relating to the psychological health of Emergency Dispatch Centre (EDC operatives, and to identify key stressors experienced by EDC operatives. Methods Eight electronic databases (Embase, PubMed, Medline, CINAHL, PsycInfo, PsycArticles, The Psychology and Behavioural Sciences Collection, and Google Scholar were searched. All study designs were included, and no date limits were set. Studies were included if they were published in English, and explored the psychological health of any EDC operatives, across fire, police, and emergency medical services. Studies were excluded if they related solely to other emergency workers, such as police officers or paramedics. Methodological quality of included studies was assessed using checklists adapted from the Critical Appraisal Skills Programme. A narrative synthesis was conducted, using thematic analysis. Results A total of 16 articles were included in the review. Two overarching themes were identified during the narrative synthesis: ‘Organisational and Operational Factors’ and ‘Interactions with Others’. Stressors identified included being exposed to traumatic calls, lacking control over high workload, and working in under-resourced and pressured environments. Lack of support from management and providing an emotionally demanding service were additional sources of stress. Peer support and social support from friends and family were helpful in managing work-related stress. Discussion EDC operatives experience stress as a result of their work, which appears to be related to negative psychological health outcomes. Future research should explore the long-term effects of this stress, and the potential for workplace interventions to alleviate the negative impacts on psychological health. PROSPERO Registration Number CRD42014010806.

  14. Mathematical Communication Ability by Grade VII Students Using a Themed Problem Based Learning with Scaffolding on Rectangle Materials

    OpenAIRE

    Didik Adi Saputro; Masrukan Masrukan; Arief Agoestanto

    2017-01-01

    The aim of research to test students' mathematical communication used themed of PBL with scaffolding, themed of PBL and PBL achieve mastery learning;to test students' mathematical communication that used the themed of PBL with scaffolding, themed of PBL and PBL; and to test students' mathematical communication for the low, medium group, and a high-group themed of PBL with scaffolding, themed of PBL and PBL. This type of research is quantitative research. The Population is seventh grade studen...

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

    Science.gov (United States)

    Dever, Kathleen H

    2018-05-01

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

  16. Advancing the literature on designing audit and feedback interventions: identifying theory-informed hypotheses.

    Science.gov (United States)

    Colquhoun, Heather L; Carroll, Kelly; Eva, Kevin W; Grimshaw, Jeremy M; Ivers, Noah; Michie, Susan; Sales, Anne; Brehaut, Jamie C

    2017-09-29

    Audit and feedback (A&F) is a common strategy for helping health providers to implement evidence into practice. Despite being extensively studied, health care A&F interventions remain variably effective, with overall effect sizes that have not improved since 2003. Contributing to this stagnation is the fact that most health care A&F interventions have largely been designed without being informed by theoretical understanding from the behavioral and social sciences. To determine if the trend can be improved, the objective of this study was to develop a list of testable, theory-informed hypotheses about how to design more effective A&F interventions. Using purposive sampling, semi-structured 60-90-min telephone interviews were conducted with experts in theories related to A&F from a range of fields (e.g., cognitive, health and organizational psychology, medical decision-making, economics). Guided by detailed descriptions of A&F interventions from the health care literature, interviewees described how they would approach the problem of designing improved A&F interventions. Specific, theory-informed hypotheses about the conditions for effective design and delivery of A&F interventions were elicited from the interviews. The resulting hypotheses were assigned by three coders working independently into themes, and categories of themes, in an iterative process. We conducted 28 interviews and identified 313 theory-informed hypotheses, which were placed into 30 themes. The 30 themes included hypotheses related to the following five categories: A&F recipient (seven themes), content of the A&F (ten themes), process of delivery of the A&F (six themes), behavior that was the focus of the A&F (three themes), and other (four themes). We have identified a set of testable, theory-informed hypotheses from a broad range of behavioral and social science that suggest conditions for more effective A&F interventions. This work demonstrates the breadth of perspectives about A&F from non

  17. "Sometimes You Feel Like the Freak Show": A Qualitative Assessment of Emergency Care Experiences Among Transgender and Gender-Nonconforming Patients.

    Science.gov (United States)

    Samuels, Elizabeth A; Tape, Chantal; Garber, Naomi; Bowman, Sarah; Choo, Esther K

    2018-02-01

    Transgender, gender-variant, and intersex (trans) people have decreased access to care and poorer health outcomes compared with the general population. Little has been studied and documented about such patients' emergency department (ED) experiences and barriers to care. Using survey and qualitative research methods, this study aims to identify specific areas for improvement and generate testable hypotheses about the barriers and challenges for trans individuals needing acute care. A survey and 4 focus groups were conducted with trans individuals older than 18 years who had been to an ED in the last 5 years. Participants were recruited by trans e-mail listservs; outreach to local trans organizations; and lesbian, gay, bisexual, and transgender periodical advertisements. The interview guide was reviewed by qualitative research and trans health content experts. Deidentified participant demographic information was collected with a standardized instrument. All discussions were captured on digital audio recorders and professionally transcribed. Interview coding and thematic analysis were conducted with a grounded theory approach. Among 32 participants, 71.9% were male identified and 78.1% were white. Nearly half (43.8%) reported avoiding the ED when they needed acute care. The factors that had the greatest influence on ED avoidance were fear of discrimination, length of wait, and negative previous experiences. There were 4 overarching discussion themes: system structure, care competency, discrimination and trauma, and avoidance of emergency care. Improvement recommendations focused on staff and provider training about gender and trans health, assurance of private gender identity disclosure, and accurate capture of sex, gender, and sexual orientation information in the electronic medical record. Efforts to improve trans ED experiences should focus on provider competency and communication training, electronic medical record modifications, and assurance of private means

  18. Identifying Emergency Department Patients at Low Risk for a Variceal Source of Upper Gastrointestinal Hemorrhage.

    Science.gov (United States)

    Klein, Lauren R; Money, Joel; Maharaj, Kaveesh; Robinson, Aaron; Lai, Tarissa; Driver, Brian E

    2017-11-01

    Assessing the likelihood of a variceal versus nonvariceal source of upper gastrointestinal bleeding (UGIB) guides therapy, but can be difficult to determine on clinical grounds. The objective of this study was to determine if there are easily ascertainable clinical and laboratory findings that can identify a patient as low risk for a variceal source of hemorrhage. This was a retrospective cohort study of adult ED patients with UGIB between January 2008 and December 2014 who had upper endoscopy performed during hospitalization. Clinical and laboratory data were abstracted from the medical record. The source of the UGIB was defined as variceal or nonvariceal based on endoscopic reports. Binary recursive partitioning was utilized to create a clinical decision rule. The rule was internally validated and test characteristics were calculated with 1,000 bootstrap replications. A total of 719 patients were identified; mean age was 55 years and 61% were male. There were 71 (10%) patients with a variceal UGIB identified on endoscopy. Binary recursive partitioning yielded a two-step decision rule (platelet count > 200 × 10 9 /L and an international normalized ratio [INR] study must be externally validated before widespread use, patients presenting to the ED with an acute UGIB with platelet count of >200 × 10 9 /L and an INR of upper gastrointestinal hemorrhage. © 2017 by the Society for Academic Emergency Medicine.

  19. Understanding movement data and movement processes: current and emerging directions.

    Science.gov (United States)

    Schick, Robert S; Loarie, Scott R; Colchero, Fernando; Best, Benjamin D; Boustany, Andre; Conde, Dalia A; Halpin, Patrick N; Joppa, Lucas N; McClellan, Catherine M; Clark, James S

    2008-12-01

    Animal movement has been the focus on much theoretical and empirical work in ecology over the last 25 years. By studying the causes and consequences of individual movement, ecologists have gained greater insight into the behavior of individuals and the spatial dynamics of populations at increasingly higher levels of organization. In particular, ecologists have focused on the interaction between individuals and their environment in an effort to understand future impacts from habitat loss and climate change. Tools to examine this interaction have included: fractal analysis, first passage time, Lévy flights, multi-behavioral analysis, hidden markov models, and state-space models. Concurrent with the development of movement models has been an increase in the sophistication and availability of hierarchical bayesian models. In this review we bring these two threads together by using hierarchical structures as a framework for reviewing individual models. We synthesize emerging themes in movement ecology, and propose a new hierarchical model for animal movement that builds on these emerging themes. This model moves away from traditional random walks, and instead focuses inference on how moving animals with complex behavior interact with their landscape and make choices about its suitability.

  20. Exploring Factors Affecting Emergency Medical Services Staffs’ Decision about Transporting Medical Patients to Medical Facilities

    Directory of Open Access Journals (Sweden)

    Abbasali Ebrahimian

    2014-01-01

    Full Text Available Transfer of patients in medical emergency situations is one of the most important missions of emergency medical service (EMS staffs. So this study was performed to explore affecting factors in EMS staffs’ decision during transporting of patients in medical situations to medical facilities. The participants in this qualitative study consisted of 18 EMS staffs working in prehospital care facilities in Tehran, Iran. Data were gathered through semistructured interviews. The data were analyzed using a content analysis approach. The data analysis revealed the following theme: “degree of perceived risk in EMS staffs and their patients.” This theme consisted of two main categories: (1 patient’s condition’ and (2 the context of the EMS mission’. The patent’s condition category emerged from “physical health statuses,” “socioeconomic statuses,” and “cultural background” subcategories. The context of the EMS mission also emerged from two subcategories of “characteristics of the mission” and EMS staffs characteristics’. EMS system managers can consider adequate technical, informational, financial, educational, and emotional supports to facilitate the decision making of their staffs. Also, development of an effective and user-friendly checklist and scoring system was recommended for quick and easy recognition of patients’ needs for transportation in a prehospital situation.

  1. Characterization of Fashion Themes Using Fuzzy Techniques for Designing New Human Centered Products

    Directory of Open Access Journals (Sweden)

    Y. Zhu

    2010-10-01

    Full Text Available Fabric selection plays an important role in fashion garment design. Designers often use both physical and normalized linguistic criteria for fabric selection. Perception and preference of consumers in their specific sociocultural context, expressed by fashion themes or emotional linguistic criteria, affect greatly new fashion product design. Modeling the relationship between linguistic design criteria and fashion themes of a brand image perceived by consumers becomes thus significant. For setting up this model, we first use fuzzy relations and correlation techniques to select the most relevant linguistic design criteria of fabric hand for each specific fashion theme. The selected criteria can then effectively reduce the complexity of the model and interpret consumer perception of fabrics. Finally, we use a weighted aggregation operator to predict the similarity degree between any new product and fashion themes. Compared with other models, the proposed method is more robust and easier to be interpreted with real data collected for design of senior T-shirt fabrics.

  2. America's Climate Choices: Cross-Cutting Research Themes to Support Effective Responses to Climate Change

    Science.gov (United States)

    Moser, S. C.; America'S Climate Choices Science Panel

    2010-12-01

    The Science Panel of the America’s Climate Choices project concluded that the climate science research enterprise has to make substantial shifts to better meet the needs of the emerging policy and decision landscape in the US. While much scientific attention in the past necessarily and to great success focused on the physical and biogeochemical aspects of understanding the climate-Earth system, much greater focus is now needed in also developing a science of responses to climate change. To that end, the ACC Science report recommended seven cross-cutting themes, three of which will be highlighted in this talk as they touch on topics the physical science community tends to be less familiar with: (1) vulnerability and adaptation analyses of coupled human-environment systems; (2) research on strategies for limiting climate change; and (3) effective information and decision support systems. The presentation will define and sketch out the potential scope of each of these areas and provide examples from various sectors highlighted in the Science panel report.

  3. How Has the Emergence of Digital Culture Affected Professional Magic?

    Directory of Open Access Journals (Sweden)

    Olli Rissanen

    2017-10-01

    Full Text Available We examined how the emerging digital culture has affected magicians’ careers, the development of their expertise and the general practices of their professions. We used social network analysis (n=120 to identify Finland’s most highly regarded magicians (n=16 representing different generations. The participants were theme interviewed and also collected self-report questionnaire data. The results revealed that digital transformations have strongly affected the magical profession in terms of changing their career paths and entry into the profession. Magic used to be a secretive culture, where access to advanced knowledge was controlled by highly regarded gatekeepers who shared their knowledge with a selected group of committed newcomers as a function of their extended efforts. Openly sharing magical knowledge on the Internet has diminished the traditionally strong role of these gatekeepers. Although online tutorials have made magical know-how more accessible to newcomers, professional communities and networks play a crucial role in the cultivation of advanced professional competences.

  4. Nurses' Perceptions of Victims of Human Trafficking in an Urban Emergency Department: A Qualitative Study.

    Science.gov (United States)

    Long, Elizabeth; Dowdell, Elizabeth B

    2017-12-15

    Human trafficking is estimated to surpass the drug trade as the leading illegal industry in the world. According to a recent study, over 87.8% of trafficking survivors came into contact with a healthcare professional while they were enslaved and were not identified as a victim of human trafficking. The aims of this study are to understand the perceptions of emergency nurses about human trafficking, victims of violence, and prostitution. A qualitative, descriptive study using a semi-structured interview approach was done with ten registered nurses in a large, urban Emergency Department in the northeastern U.S. Interviews were recorded and transcribed; thematic analysis was performed. Six themes emerged from the interviews including, "human trafficking exists in the patient population" yet no nurse has screened or treated a victim; human trafficking victims are perceived to be "young, female, and foreign born"; all of the emergency nurses reported having worked with or screened a victim of violence; victims of violence were viewed as patients who present as "sad and grieving"; prostitutes are seen as "hard and tough"; and emergency nurses did not have education on human trafficking victims' needs or resources. Emergency nurses should be more aware about victims of human trafficking. The media portrayal of human trafficking victims had influenced the nurses' perceptions of this population. Victims of violence are perceived to be very different from prostitutes, but there is a desire for education about violence as well as information about specific resources open to victims. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. How to Mitigate Theme Park Crowding? A Prospective Coordination Approach

    Directory of Open Access Journals (Sweden)

    Yuguo Yuan

    2018-01-01

    Full Text Available Crowding is a key factor in tourists’ experience in theme parks, and mitigating crowding makes parks more competitive. This study examines how to effectively mitigate crowding in theme parks. First, a Markov-based method is developed to predict the spatial-temporal distribution of tourists in the park. Then, a prospective coordination approach based on the tourist distribution prediction is proposed. To evaluate the performance of this approach, an experiment is constructed using an agent-based simulation platform. The results indicate that the proposed method significantly outperforms existing methods. Furthermore, we conduct two experiments and, based on the results, offer several recommendations for crowd management.

  6. A Grounded Theory for Identifying Students with Emotional Disturbance: Promising Practices for Assessment, Intervention, and Service Delivery

    Science.gov (United States)

    Barnett, Dori

    2012-01-01

    A qualitative grounded theory study examined how practicing professionals involved in the ED identification process reconstructed the category of "emotional disturbance" as it applied to students in an alternative educational setting. A grounded theory integrates six emergent themes and essentially reframes the existing ED criteria in contemporary…

  7. Modelling the migration and accumulation of radionuclides in forest ecosystems. Report of the Forest Working Group of BIOMASS Theme 3

    International Nuclear Information System (INIS)

    2002-08-01

    The IAEA Programme on BIOsphere Modelling and ASSessment (BIOMASS) was launched in Vienna in October 1996. The programme was concerned with developing and improving capabilities to predict the transfer of radionuclides in the environment. The programme had three themes: Theme 1: Radioactive Waste Disposal. The objective was to develop the concept of a standard or reference biosphere for application to the assessment of the long-term safety of repositories for radioactive waste. Under the general heading of 'Reference Biospheres', six Task Groups were established: Task Group 1: Principles for the Definition of Critical and Other Exposure Groups. Task Group 2: Principles for the Application of Data to Assessment Models. Task Group 3: Consideration of Alternative Assessment Contexts. Task Group 4: Biosphere System Identification and Justification. Task Group 5: Biosphere System Descriptions. Task Group 6: Model Development. Theme 2: Environmental Releases. BIOMASS provided an international forum for activities aimed at increasing the confidence in methods and models for the assessment of radiation exposure related to environmental releases. Two Working Groups addressed issues concerned with the reconstruction of radiation doses received by people from past releases of radionuclides to the environment and the evaluation of the efficacy of remedial measures. Theme 3: Biosphere Processes. The aim of this Theme was to improve capabilities for modelling the transfer of radionuclides in particular parts of the biosphere identified as being of potential radiological significance and where there were gaps in modelling approaches. This topic was explored using a range of methods including reviews of the literature, model inter-comparison exercises and, where possible, model testing against independent sources of data. Three Working Groups were established to examine the modelling of: (1) long-term tritium dispersion in the environment; (2) radionuclide uptake by fruits; and (3

  8. Big Web data, small focus: An ethnosemiotic approach to culturally themed selective Web archiving

    Directory of Open Access Journals (Sweden)

    Saskia Huc-Hepher

    2015-07-01

    Full Text Available This paper proposes a multimodal ethnosemiotic conceptual framework for culturally themed selective Web archiving, taking as a practical example the curation of the London French Special Collection (LFSC in the UK Web Archive. Its focus on a particular ‘community’ is presented as advantageous in overcoming the sheer scale of data available on the Web; yet, it is argued that these ethnographic boundaries may be flawed if they do not map onto the collective self-perception of the London French. The approach establishes several theoretical meeting points between Pierre Bourdieu’s ethnography and Gunther Kress’s multimodal social semiotics, notably, the foregrounding of practice and the meaning-making potentialities of the everyday; the implications of language and categorisation; the interplay between (curating/researcher subject and (curated/research object; evolving notions of agency, authorship and audience; together with social engagement, and the archive as dynamic process and product. The curation rationale proposed stems from Bourdieu’s three-stage field analysis model, which places a strong emphasis on habitus, considered to be most accurately (represented through blogs, yet necessitates its contextualisation within the broader (diasporic field(s, through institutional websites, for example, whilst advocating a reflexive awareness of the researcher/curator’s (subjective role. This, alongside the Kressian acknowledgement of the inherent multimodality of on-line resources, lends itself convincingly to selection and valuation strategies, whilst the discussion of language, genre, authorship and audience is relevant to the potential cataloguing of Web objects. By conceptualising the culturally themed selective Web-archiving process within the ethnosemiotic framework constructed, concrete recommendations emerge regarding curation, classification and crowd-sourcing.

  9. Current and Emerging Ethical Issues in Counseling: A Delphi Study of Expert Opinions

    Science.gov (United States)

    Herlihy, Barbara; Dufrene, Roxane L.

    2011-01-01

    A Delphi study was conducted to ascertain the opinions of panel experts regarding the most important current and emerging ethical issues facing the counseling profession. Expert opinions on ethical issues in counselor preparation also were sought. Eighteen panelists responded to 3 rounds of data collection interspersed with feedback. Themes that…

  10. Improving access to emergent spinal care through knowledge translation: an ethnographic study.

    Science.gov (United States)

    Webster, Fiona; Fehlings, Michael G; Rice, Kathleen; Malempati, Harsha; Fawaz, Khaled; Nicholls, Fred; Baldeo, Navindra; Reeves, Scott; Singh, Anoushka; Ahn, Henry; Ginsberg, Howard; Yee, Albert J

    2014-04-14

    For patients and family members, access to timely specialty medical care for emergent spinal conditions is a significant stressor to an already serious condition. Timing to surgical care for emergent spinal conditions such as spinal trauma is an important predictor of outcome. However, few studies have explored ethnographically the views of surgeons and other key stakeholders on issues related to patient access and care for emergent spine conditions. The primary study objective was to determine the challenges to the provision of timely care as well as to identify areas of opportunities to enhance care delivery. An ethnographic study of key administrative and clinical care providers involved in the triage and care of patients referred through CritiCall Ontario was undertaken utilizing standard methods of qualitative inquiry. This comprised 21 interviews with people involved in varying capacities with the provision of emergent spinal care, as well as qualitative observations on an orthopaedic/neurosurgical ward, in operating theatres, and at CritiCall Ontario's call centre. Several themes were identified and organized into categories that range from inter-professional collaboration through to issues of hospital-level resources and the role of relationships between hospitals and external organizations at the provincial level. Underlying many of these issues is the nature of the medically complex emergent spine patient and the scientific evidentiary base upon which best practice care is delivered. Through the implementation of knowledge translation strategies facilitated from this research, a reduction of patient transfers out of province was observed in the one-year period following program implementation. Our findings suggest that competing priorities at both the hospital and provincial level create challenges in the delivery of spinal care. Key stakeholders recognized spinal care as aligning with multiple priorities such as emergent/critical care, medical through

  11. The Impacts of Theme-Based Language Instruction: A Case Study of an Advanced Chinese Intensive Program

    Directory of Open Access Journals (Sweden)

    Song Jiang

    2017-06-01

    Full Text Available Theme-based language teaching under Content-Based Instruction (CBI is a pedagogical approach that emphasizes learning professional content along with language skills. This paper reports a case study on the impacts of a theme-based advanced Chinese intensive program in a university setting. It begins with a review of CBI and its theme-based approach and then discusses the program design, curriculum development, and instructional practice of the program. The impacts of the theme-based approach are examined based on the pre- and post-proficiency test results, learners’ self-reported surveys on the themes and topics, and the reading strategies covered in the program. Qualitative analysis of learners’ self-reflections and program evaluations is also presented. Based on the evidence collected, this paper argues that the theme-based model has positive impacts on improving language proficiency, preparing for academic and professional language use, cultivating strategic language learners, and revitalizing Chinese teaching at the superior level.

  12. Adult Siblings Consider the Future: Emergent Themes

    Science.gov (United States)

    Davys, Deborah; Mitchell, Duncan; Haigh, Carol

    2016-01-01

    Background: This study aimed to explore the perceptions of adult siblings regarding a future care role and compare with perceived parental wishes as family often provide a key support role in the lives of people who have an intellectual disability. Materials and Method: Semi-structured interviews were undertaken with 15 adult siblings and an…

  13. One Health, emerging infectious diseases and wildlife: two decades of progress?

    Science.gov (United States)

    Cunningham, Andrew A; Daszak, Peter; Wood, James L N

    2017-07-19

    Infectious diseases affect people, domestic animals and wildlife alike, with many pathogens being able to infect multiple species. Fifty years ago, following the wide-scale manufacture and use of antibiotics and vaccines, it seemed that the battle against infections was being won for the human population. Since then, however, and in addition to increasing antimicrobial resistance among bacterial pathogens, there has been an increase in the emergence of, mostly viral, zoonotic diseases from wildlife, sometimes causing fatal outbreaks of epidemic proportions. Concurrently, infectious disease has been identified as an increasing threat to wildlife conservation. A synthesis published in 2000 showed common anthropogenic drivers of disease threats to biodiversity and human health, including encroachment and destruction of wildlife habitat and the human-assisted spread of pathogens. Almost two decades later, the situation has not changed and, despite improved knowledge of the underlying causes, little has been done at the policy level to address these threats. For the sake of public health and wellbeing, human-kind needs to work better to conserve nature and preserve the ecosystem services, including disease regulation, that biodiversity provides while also understanding and mitigating activities which lead to disease emergence. We consider that holistic, One Health approaches to the management and mitigation of the risks of emerging infectious diseases have the greatest chance of success.This article is part of the themed issue 'One Health for a changing world: zoonoses, ecosystems and human well-being'. © 2017 The Authors.

  14. Traffic Accident Investigation: A Suitable Theme for Teaching Mechanics.

    Science.gov (United States)

    Tao, P. K.

    1987-01-01

    Suggests the development of curriculum materials on the applications of physics to traffic accident investigations as a theme for teaching mechanics. Describes several standard investigation techniques and the physics principles involved, along with some sample exercises. (TW)

  15. 77 FR 43117 - Meeting of the Cold War Advisory Committee for the Cold War Theme Study

    Science.gov (United States)

    2012-07-23

    ... the Cold War Advisory Committee for the Cold War Theme Study AGENCY: National Park Service, Interior... Committee Act, 5 U.S.C. Appendix, that the Cold War Advisory Committee for the Cold War Theme Study will... National Park Service (NPS) concerning the Cold War Theme Study. DATES: The teleconference meeting will be...

  16. Defining our destiny: trainee working group consensus statement on the future of emergency surgery training in the United Kingdom.

    Science.gov (United States)

    Sharrock, A E; Gokani, V J; Harries, R L; Pearce, L; Smith, S R; Ali, O; Chu, H; Dubois, A; Ferguson, H; Humm, G; Marsden, M; Nepogodiev, D; Venn, M; Singh, S; Swain, C; Kirkby-Bott, J

    2015-01-01

    The United Kingdom National Health Service treats both elective and emergency patients and seeks to provide high quality care, free at the point of delivery. Equal numbers of emergency and elective general surgical procedures are performed, yet surgical training prioritisation and organisation of NHS institutions is predicated upon elective care. The increasing ratio of emergency general surgery consultant posts compared to traditional sub-specialities has yet to be addressed. How should the capability gap be bridged to equip motivated, skilled surgeons of the future to deliver a high standard of emergency surgical care? The aim was to address both training requirements for the acquisition of necessary emergency general surgery skills, and the formation of job plans for trainee and consultant posts to meet the current and future requirements of the NHS. Twenty nine trainees and a consultant emergency general surgeon convened as a Working Group at The Association of Surgeons in Training Conference, 2015, to generate a united consensus statement to the training requirement and delivery of emergency general surgery provision by future general surgeons. Unscheduled general surgical care provision, emergency general surgery, trauma competence, training to meet NHS requirements, consultant job planning and future training challenges arose as key themes. Recommendations have been made from these themes in light of published evidence. Careful workforce planning, education, training and fellowship opportunities will provide well-trained enthusiastic individuals to meet public and societal need.

  17. Wearout Effects of Different Advertising Themes: A Dynamic Bayesian Model of the Advertising-Sales Relationship

    OpenAIRE

    Frank M. Bass; Norris Bruce; Sumit Majumdar; B. P. S. Murthi

    2007-01-01

    Models of advertising response implicitly assume that the entire advertising budget is spent on disseminating one message. In practice, managers use different themes of advertising (for example, price advertisements versus product advertisements) and within each theme they employ different versions of an advertisement. In this study, we evaluate the dynamic effects of different themes of advertising that have been employed in a campaign. We develop a model that jointly considers the effects o...

  18. Business Responses to Climate Change. Identifying Emergent Strategies

    International Nuclear Information System (INIS)

    Kolk, A.; Pinkse, J.

    2005-01-01

    Companies face much uncertainty about the competitive effects of the recently adopted Kyoto Protocol on global climate change and the current and future regulations that may emerge from it. Companies have considerable discretion to explore different market strategies to address global warming and reduce greenhouse gas emissions. This article examines these strategic options by reviewing the market-oriented actions that are currently being taken by 136 large companies that are part of the Global 500. There are six different market strategies that companies use to address climate change and that consist of different combinations of the market components available to managers. Managers can choose between more emphasis on improvements in their business activities through innovation or employ compensatory approaches such as emissions trading. They can either act by themselves or work with other companies, NGOs, or (local) governments

  19. Systematic reviews addressing identified health policy priorities in Eastern Mediterranean countries: a situational analysis.

    Science.gov (United States)

    El-Jardali, Fadi; Akl, Elie A; Karroum, Lama Bou; Kdouh, Ola; Akik, Chaza; Fadlallah, Racha; Hammoud, Rawan

    2014-08-20

    Systematic reviews can offer policymakers and stakeholders concise, transparent, and relevant evidence pertaining to pressing policy priorities to help inform the decision-making process. The production and the use of systematic reviews are specifically limited in the Eastern Mediterranean region. The extent to which published systematic reviews address policy priorities in the region is still unknown. This situational analysis exercise aims at assessing the extent to which published systematic reviews address policy priorities identified by policymakers and stakeholders in Eastern Mediterranean region countries. It also provides an overview about the state of systematic review production in the region and identifies knowledge gaps. We conducted a systematic search of the Health System Evidence database to identify published systematic reviews on policy-relevant priorities pertaining to the following themes: human resources for health, health financing, the role of the non-state sector, and access to medicine. Priorities were identified from two priority-setting exercises conducted in the region. We described the distribution of these systematic reviews across themes, sub-themes, authors' affiliations, and countries where included primary studies were conducted. Out of the 1,045 systematic reviews identified in Health System Evidence on selected themes, a total of 200 systematic reviews (19.1%) addressed the priorities from the Eastern Mediterranean region. The theme with the largest number of systematic reviews included was human resources for health (115) followed by health financing (33), access to medicine (27), and role of the non-state sector (25). Authors based in the region produced only three systematic reviews addressing regional priorities (1.5%). Furthermore, no systematic review focused on the Eastern Mediterranean region. Primary studies from the region had limited contribution to systematic reviews; 17 systematic reviews (8.5%) included primary

  20. Systematic reviews addressing identified health policy priorities in Eastern Mediterranean countries: a situational analysis

    Science.gov (United States)

    2014-01-01

    Background Systematic reviews can offer policymakers and stakeholders concise, transparent, and relevant evidence pertaining to pressing policy priorities to help inform the decision-making process. The production and the use of systematic reviews are specifically limited in the Eastern Mediterranean region. The extent to which published systematic reviews address policy priorities in the region is still unknown. This situational analysis exercise aims at assessing the extent to which published systematic reviews address policy priorities identified by policymakers and stakeholders in Eastern Mediterranean region countries. It also provides an overview about the state of systematic review production in the region and identifies knowledge gaps. Methods We conducted a systematic search of the Health System Evidence database to identify published systematic reviews on policy-relevant priorities pertaining to the following themes: human resources for health, health financing, the role of the non-state sector, and access to medicine. Priorities were identified from two priority-setting exercises conducted in the region. We described the distribution of these systematic reviews across themes, sub-themes, authors’ affiliations, and countries where included primary studies were conducted. Results Out of the 1,045 systematic reviews identified in Health System Evidence on selected themes, a total of 200 systematic reviews (19.1%) addressed the priorities from the Eastern Mediterranean region. The theme with the largest number of systematic reviews included was human resources for health (115) followed by health financing (33), access to medicine (27), and role of the non-state sector (25). Authors based in the region produced only three systematic reviews addressing regional priorities (1.5%). Furthermore, no systematic review focused on the Eastern Mediterranean region. Primary studies from the region had limited contribution to systematic reviews; 17 systematic reviews

  1. Nurses’ roles, knowledge and experience in national disaster pre-paredness and emergency response: A literature review

    Directory of Open Access Journals (Sweden)

    Thomas Grochtdreis

    2016-12-01

    Results: The sub-themes of the first main theme (a roles of nurses during emergency response include the expectations of the hospital and the public, general and special roles of nurses, assignments of medical tasks, special role during a pandemic influenza, role conflicts during a disaster, willingness to respond to a disaster. For (b disaster preparedness knowledge of nurses, the corresponding sub-themes include the definition of a disaster, core competencies and curriculum, undergraduate nursing education and continuing education programs, disaster drills, training and exercises, preparedness. The sub-themes for the last theme (c disaster experiences of nurses include the work environment, nursing care, feelings, stressors, willingness to respond as well as lessons learned and impacts. Conclusion: There is consensus in the literature that nurses are key players in emergency response. However, no clear mandate for nurses exists concerning their tasks during a disaster. For a nurse, to be able to respond to a disaster, personal and professional preparedness, in terms of education and training, are central. The Framework of Disaster Nursing Competencies of the WHO and ICN, broken down into national core competencies, will serve as a sufficient complement to the knowledge and skills of nurses already acquired through basic nursing curricula. During and after a disaster, attention should be applied to the work environment, feelings and stressors of nurses, not only to raise the willingness to respond to a disaster. Where non-existent, national directives and concepts for disaster nursing should be developed and nurses should be aware of their duties. Nursing educators should prepare nurses for disasters, by adjusting the curricula and by meeting the increased need for education and training in disaster nursing for all groups of nurses. The appropriateness of theoretical and practical preparation of disaster nursing competencies in undergraduate nursing courses and

  2. Integrated pathway clusters with coherent biological themes for target prioritisation.

    Directory of Open Access Journals (Sweden)

    Yi-An Chen

    Full Text Available Prioritising candidate genes for further experimental characterisation is an essential, yet challenging task in biomedical research. One way of achieving this goal is to identify specific biological themes that are enriched within the gene set of interest to obtain insights into the biological phenomena under study. Biological pathway data have been particularly useful in identifying functional associations of genes and/or gene sets. However, biological pathway information as compiled in varied repositories often differs in scope and content, preventing a more effective and comprehensive characterisation of gene sets. Here we describe a new approach to constructing biologically coherent gene sets from pathway data in major public repositories and employing them for functional analysis of large gene sets. We first revealed significant overlaps in gene content between different pathways and then defined a clustering method based on the shared gene content and the similarity of gene overlap patterns. We established the biological relevance of the constructed pathway clusters using independent quantitative measures and we finally demonstrated the effectiveness of the constructed pathway clusters in comparative functional enrichment analysis of gene sets associated with diverse human diseases gathered from the literature. The pathway clusters and gene mappings have been integrated into the TargetMine data warehouse and are likely to provide a concise, manageable and biologically relevant means of functional analysis of gene sets and to facilitate candidate gene prioritisation.

  3. Emergency contraception in a public health emergency: exploring pharmacy availability in Brazil.

    Science.gov (United States)

    Tavares, Marilia P; Foster, Angel M

    2016-08-01

    Dedicated progestin-only emergency contraceptive pills (ECPs) have been available with a prescription in Brazil since 1999. However, utilization of emergency contraception has been limited. We conducted a mystery client study at retail pharmacies in three regions to assess current availability. Using a predetermined client profile, we approached a random sample of chain and independent pharmacies in urban areas in the southeastern, northeastern and central-west regions. We documented product availability, price and the client-pharmacy representative interaction at each site. We analyzed these data with descriptive statistics and for content and themes. We visited 122 pharmacies in early 2016. All but three pharmacies (97.5%) had ECPs in stock at the time of the interaction and offered our client the medication without a prescription. In general, pharmacy representatives did not ask questions or provide our client with information about emergency contraception. When prompted, over one third of the pharmacy representatives (37.7%) inaccurately reported that levonorgestrel ECPs could only be used immediately or within 12, 24 or 48h from the time of intercourse. Despite the current regulatory status, our findings suggest that progestin-only ECPs are widely available without a prescription. Additional efforts to ensure that women have up-to-date and medically accurate information about progestin-only ECPs appear warranted. Our findings suggest that more work needs to be done to align national regulatory policies with international standards and evidence-based practices. The Zika virus epidemic has shined a spotlight on the importance of providing timely access to emergency contraception in Latin America. This public health emergency offers a window of opportunity to advance national policies and practices to ensure that Brazilian women have access to a full range of reproductive health services. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Mis-fitting Menstrual Hygiene Products: An Examination of Advertisements to Identify Gaps in the Diffusion of Innovation

    Directory of Open Access Journals (Sweden)

    Arpan Yagnik

    2012-12-01

    Full Text Available This research examines advertisements for menstrual hygiene products to discover the roadblocks in the diffusion of innovation of menstrual hygiene products. The objective is to evaluate the advertisements to comprehend the cultural relevance of the diffusion, justify the rate of diffusion of innovation, identify the bottlenecks prohibiting the diffusion, and suggest ideas for a successful diffusion of innovation. A convenient sample of 75 television advertisements and print advertisements of sanitary hygiene products was selected for analysis. Using thematic analysis this research identifies and extracts themes that are the potential bottlenecks to successful diffusion of innovation. The main themes identified were the assumption regarding the knowledge of usage, knowledge of disposal, knowledge of sharing, existing clothing standards, affordability, role of woman, and comfort with insertion. The discovery of themes not only demonstrate ignorance and incompetent market research but also give us a sense of the glacial diffusion of menstrual hygiene products in the recipient country.

  5. RNA transcriptional biosignature analysis for identifying febrile infants with serious bacterial infections in the emergency department: a feasibility study.

    Science.gov (United States)

    Mahajan, Prashant; Kuppermann, Nathan; Suarez, Nicolas; Mejias, Asuncion; Casper, Charlie; Dean, J Michael; Ramilo, Octavio

    2015-01-01

    To develop the infrastructure and demonstrate the feasibility of conducting microarray-based RNA transcriptional profile analyses for the diagnosis of serious bacterial infections in febrile infants 60 days and younger in a multicenter pediatric emergency research network. We designed a prospective multicenter cohort study with the aim of enrolling more than 4000 febrile infants 60 days and younger. To ensure success of conducting complex genomic studies in emergency department (ED) settings, we established an infrastructure within the Pediatric Emergency Care Applied Research Network, including 21 sites, to evaluate RNA transcriptional profiles in young febrile infants. We developed a comprehensive manual of operations and trained site investigators to obtain and process blood samples for RNA extraction and genomic analyses. We created standard operating procedures for blood sample collection, processing, storage, shipping, and analyses. We planned to prospectively identify, enroll, and collect 1 mL blood samples for genomic analyses from eligible patients to identify logistical issues with study procedures. Finally, we planned to batch blood samples and determined RNA quantity and quality at the central microarray laboratory and organized data analysis with the Pediatric Emergency Care Applied Research Network data coordinating center. Below we report on establishment of the infrastructure and the feasibility success in the first year based on the enrollment of a limited number of patients. We successfully established the infrastructure at 21 EDs. Over the first 5 months we enrolled 79% (74 of 94) of eligible febrile infants. We were able to obtain and ship 1 mL of blood from 74% (55 of 74) of enrolled participants, with at least 1 sample per participating ED. The 55 samples were shipped and evaluated at the microarray laboratory, and 95% (52 of 55) of blood samples were of adequate quality and contained sufficient RNA for expression analysis. It is possible to

  6. Influence of memory theme and posttraumatic stress disorder on memory specificity in British and Iranian trauma survivors.

    Science.gov (United States)

    Jobson, Laura; Cheraghi, Sepideh

    2016-09-01

    This study investigated the influence of culture, memory theme and posttraumatic stress disorder (PTSD) on autobiographical memory specificity in Iranian and British trauma survivors. Participants completed the Autobiographical Memory Test and PTSD Diagnostic Scale. The results indicated that the British group provided significantly more personal-themed memories than the Iranian group, while the Iranian group provided significantly more social-themed memories than the British group. The British group also provided a significantly greater proportion of specific personal-themed and social-themed memories than the Iranian group. Overall, in both cultural groups memory specificity was found to be significantly correlated with PTSD symptoms. These findings provide further evidence that regardless of memory theme, specificity of autobiographical memories function to differentiate the self from others and reaffirm the independent self. They also further highlight that pan-culturally an overgeneral retrieval style may be employed by those with PTSD symptoms.

  7. Examining critical factors affecting graduate retention from an emergency medicine training program in Addis Ababa, Ethiopia: a qualitative study of stakeholder perspectives

    Directory of Open Access Journals (Sweden)

    Meredith Jane Kuipers

    2017-04-01

    Full Text Available Background: In Ethiopia, improvement and innovation of the emergency care system is hindered by lack of specialist doctors trained in emergency medicine, underdeveloped emergency care infrastructure, and consumable resource limitations. Our aim was to examine the critical factors affecting retention of graduates from the Addis Ababa University (AAU post-graduate emergency medicine (EM training program within the Ethiopian health care system. Methods: Qualitative interviews were conducted with current AAU EM residents and stakeholders in Ethiopian EM. Mixed-methods inductive thematic analysis was performed. Results: Resident and stakeholder participants identified critical factors in three domains: the individual condition, the occupational environment, and the national context. Within each domain, priority themes emerged from the responses, including the importance of career satisfaction over the career continuum (individual condition, the opportunity to be involved in the developing EM program and challenges associated with resource, economic, and employment constraints (occupational environment, and perceptions regarding the state of awareness of EM and the capacity for change at the societal level (national context. Conclusions: This work underscores the need to resolve multiple systemic and cultural issues within the Ethiopian health care landscape in order to address EM graduate retention. It also highlights the potential success of a retention strategy focused on the career ambitions of keen EM doctors.

  8. Exploring patient experiences with prescription medicines to identify unmet patient needs: implications for research and practice.

    Science.gov (United States)

    Kucukarslan, Suzan N; Lewis, Nancy J W; Shimp, Leslie A; Gaither, Caroline A; Lane, Daniel C; Baumer, Andrea L

    2012-01-01

    Pharmacy services are offered to patients, and often, they decline participation. Research is needed to better understand patients' unmet needs when taking prescribed medications. To identify and characterize patients' unmet needs related to using prescribed medication for chronic conditions. Focus groups of patients using prescription medication for chronic conditions discussed their experiences with medications, starting from initial diagnosis to ongoing management. Sessions involved 40 patients from 1 Midwestern U.S. state. Major themes were identified using content analysis. Three major themes emerged. First, patients seek information to understand their health condition and treatment rationale. Patients form an illness perception (its consequence, controllability, cause, and duration) that dictates their actions. Second, patients desire to be involved in treatment decisions, and they often feel that decisions are made for them without their understanding of the risk-to-benefit trade-off. Third, patients monitor the impact of treatment decisions to determine if anticipated outcomes are achieved. The results were consistent with Dowell's therapeutic alliance model (TAM) and Leventhal's common sense model (CSM). The TAM can be used to model the consultative services between pharmacists and patients. The impact of the new services (or interventions) can be evaluated using the CSM. Patients expressed a strong desire to be involved in their treatment decisions. The effectiveness of medication therapy management services may be enhanced if pharmacists build on patients' desire to be involved in their treatment decisions and assist them to understand the role of medications and their risks and expected outcomes within the context of the patients' perceptions of illness and desired coping strategies. Copyright © 2012 Elsevier Inc. All rights reserved.

  9. Using the Sustainability Monitoring and Assessment Routine (SMART for the Systematic Analysis of Trade-Offs and Synergies between Sustainability Dimensions and Themes at Farm Level

    Directory of Open Access Journals (Sweden)

    Christian Schader

    2016-03-01

    Full Text Available When trying to optimize the sustainability performance of farms and farming systems, a consideration of trade-offs and synergies between different themes and dimensions is required. The aim of this paper is to perform a systematic analysis of trade-offs and synergies across all dimensions and themes. To achieve this aim we used the Sustainability Monitoring and Assessment Routine (SMART-Farm Tool which operationalizes the Sustainability Assessment of Food and Agriculture Systems (SAFA Guidelines by defining science-based indicator sets and assessment procedures. It identifies the degree of goal achievement with respect to the 58 themes defined in the SAFA Guidelines using an impact matrix that defines 327 indicators and 1769 relations between sustainability themes and indicators. We illustrate how the SMART-Farm Tool can be successfully applied to assess the sustainability performance of farms of different types and in different geographic regions. Our analysis revealed important synergies between themes within a sustainability dimension and across dimensions. We found major trade-offs within the environmental dimension and between the environmental and economic dimension. The trade-offs within the environmental dimension were even larger than the trade-offs with other dimensions. The study also underlines the importance of the governance dimension with regard to achieving a good level of performance in the other dimensions.

  10. Barriers to Effective Teamwork Relating to Pediatric Resuscitations: Perceptions of Pediatric Emergency Medicine Staff.

    Science.gov (United States)

    Sherman, Joshua M; Chang, Todd P; Ziv, Nurit; Nager, Alan L

    2017-10-09

    In the pediatric emergency department (PED), resuscitations require medical teams form ad hoc, rarely communicating beforehand. Literature has shown that the medical community has deficiencies in communication and teamwork. However, we as medical providers do not know or understand the perceived barriers of our colleagues. Physicians may perceive a barrier that is different from nurses, respiratory therapists, pharmacists, or technicians. Perhaps we do not know in which area of teamwork and communication we are deficient. Only when we understand the perceptions of our fellow coworkers can we take steps toward improvement in quality resuscitations and therefore patient safety. The primary objectives of this study were to describe and understand the perceived barriers to effective communication and teamwork among different disciplines forming spontaneous resuscitation teams at a tertiary urban PED and to determine if providers of different disciplines perceived these barriers differently. This was a mixed-methods study conducted in a single, tertiary care freestanding children's hospital emergency department. Survey questions were iteratively developed to measure the construct of barriers and best practices within resuscitation teamwork, which was administered to staff among 5 selected roles: physicians, nurses, respiratory technicians, PED technicians, and PED pharmacists. It contained open-ended questions to provide statements on specific barriers or goals in effective teamwork, as well as a priority ranking on 25 different statements on teamwork extracted from the literature. From the participant data, 9 core themes related to resuscitation teamwork were coalesced using affinity diagramming by the authors. All statements from the survey were coded to the 9 core themes by 2 authors, with high reliability (κ = 0.93). Descriptive statistics were used to summarize the prevalence of themes mentioned by survey participants. A χ test was used to determine differences

  11. Setting the agenda in emergency medicine in the southern African region: Conference assumptions and recommendations, Emergency Medicine Conference 2014: Gaborone, Botswana

    Directory of Open Access Journals (Sweden)

    Lloyd D. Christopher

    2014-09-01

    Full Text Available The first international emergency medicine (EM conference in Botswana was held on 15th and 16th May 2014 at the Gaborone International Convention Centre. The support from key stakeholders positioned the conference, from its conception, to deliver expert guidance on emergency medicine relevance, education and systems implementation. The conference theme was aptly: “Setting the Agenda in Emergency Medicine in the Southern African Region.” Over 300 local, regional and international delegates convened to participate in this landmark event. Country representation included Botswana, South Africa, Zambia, Namibia, Zimbabwe, Swaziland, Lesotho, Nigeria and the United States of America. Conference assumptions intersected emergency care, African burden of injury and illness and the role of the state; the public protection ethic of emergency care, and the developmental, economic and health interest in promoting EM. The recommendations addressed emergency care relevance; health systems research as an imperative for emergency systems development in southern Africa; community agency as a requisite for emergency care resilience; emergency care workers as pivotal to the emergency medical system, and support of EM system implementation. The conference recommendations – by way of setting an agenda, augur well for emergency care development and implementation in the southern African region and are likely to prove useful to the southern African countries seeking to address health service quality, EM advocacy support and implementation guidance. Emergency medicine is the only discipline with ‘universality’ and ‘responsivity’ at the point of need. This implies the widespread potential for facilitation of access to health care: a public health goal nuanced by the African development agenda.

  12. Lost and misplaced items and assistive devices in nursing homes: Identifying problems and technological opportunities through participatory design research.

    Science.gov (United States)

    Oude Weernink, C E; Sweegers, L; Relou, L; van der Zijpp, T J; van Hoof, J

    2018-02-06

    Modern healthcare, including nursing home care, goes together with the use of technologies to support treatment, the provision of care and daily activities. The challenges concerning the implementation of such technologies are numerous. One of these emerging technologies are location technologies (RTLS or Real-Time Location Systems). that can be utilized in the nursing home for monitoring the use and location of assets. This paper describes a participatory design study of RTLS based on context mapping, conducted in two nursing home organizations. Rather than investigating the technological possibilities, this study investigates the needs and wishes from the perspective of the care professional. The study identified semantic themes that relate to the practicalities of lost and misplaced items in the nursing home, as well as latent themes that cover the wishes regarding technology in the nursing homes. The organizational culture and building typology may play a role in losing items. The participants in this study indicated that RTLS can provide a solution to some of the challenges that they encounter in the workplace. However, the implementation of new technologies should be done with care and should be integrated into existing ICT systems in order to minimize additional training and posing a burden on the workload.

  13. Emergency medicine resident physicians' perceptions of electronic documentation and workflow: a mixed methods study.

    Science.gov (United States)

    Neri, P M; Redden, L; Poole, S; Pozner, C N; Horsky, J; Raja, A S; Poon, E; Schiff, G; Landman, A

    2015-01-01

    To understand emergency department (ED) physicians' use of electronic documentation in order to identify usability and workflow considerations for the design of future ED information system (EDIS) physician documentation modules. We invited emergency medicine resident physicians to participate in a mixed methods study using task analysis and qualitative interviews. Participants completed a simulated, standardized patient encounter in a medical simulation center while documenting in the test environment of a currently used EDIS. We recorded the time on task, type and sequence of tasks performed by the participants (including tasks performed in parallel). We then conducted semi-structured interviews with each participant. We analyzed these qualitative data using the constant comparative method to generate themes. Eight resident physicians participated. The simulation session averaged 17 minutes and participants spent 11 minutes on average on tasks that included electronic documentation. Participants performed tasks in parallel, such as history taking and electronic documentation. Five of the 8 participants performed a similar workflow sequence during the first part of the session while the remaining three used different workflows. Three themes characterize electronic documentation: (1) physicians report that location and timing of documentation varies based on patient acuity and workload, (2) physicians report a need for features that support improved efficiency; and (3) physicians like viewing available patient data but struggle with integration of the EDIS with other information sources. We confirmed that physicians spend much of their time on documentation (65%) during an ED patient visit. Further, we found that resident physicians did not all use the same workflow and approach even when presented with an identical standardized patient scenario. Future EHR design should consider these varied workflows while trying to optimize efficiency, such as improving

  14. [Emerging noninfectious diseases].

    Science.gov (United States)

    Consiglio, Ezequiel

    2008-11-01

    In recent years, emerging diseases were defined as being infectious, acquiring high incidence, often suddenly, or being a threat or an unexpected phenomenon. This study discusses the hallmarks of emerging diseases, describing the existence of noninfectious emerging diseases, and elaborating on the advantages of defining noninfectious diseases as emerging ones. From the discussion of various mental health disorders, nutritional deficiencies, external injuries and violence outcomes, work injuries and occupational health, and diseases due to environmental factors, the conclusion is drawn that a wide variety of noninfectious diseases can be defined as emergent. Noninfectious emerging diseases need to be identified in order to improve their control and management. A new definition of "emergent disease" is proposed, one that emphasizes the pathways of emergence and conceptual traits, rather than descriptive features.

  15. Using systems thinking to identify workforce enablers for a whole systems approach to urgent and emergency care delivery: a multiple case study.

    Science.gov (United States)

    Manley, Kim; Martin, Anne; Jackson, Carolyn; Wright, Toni

    2016-08-09

    Overcrowding in emergency departments is a global issue, which places pressure on the shrinking workforce and threatens the future of high quality, safe and effective care. Healthcare reforms aimed at tackling this crisis have focused primarily on structural changes, which alone do not deliver anticipated improvements in quality and performance. The purpose of this study was to identify workforce enablers for achieving whole systems urgent and emergency care delivery. A multiple case study design framed around systems thinking was conducted in South East England across one Trust consisting of five hospitals, one community healthcare trust and one ambulance trust. Data sources included 14 clinical settings where upstream or downstream pinch points are likely to occur including discharge planning and rapid response teams; ten regional stakeholder events (n = 102); a qualitative survey (n = 48); and a review of literature and analysis of policy documents including care pathways and protocols. The key workforce enablers for whole systems urgent and emergency care delivery identified were: clinical systems leadership, a single integrated career and competence framework and skilled facilitation of work based learning. In this study, participants agreed that whole systems urgent and emergency care allows for the design and implementation of care delivery models that meet complexity of population healthcare needs, reduce duplication and waste and improve healthcare outcomes and patients' experiences. For this to be achieved emphasis needs to be placed on holistic changes in structures, processes and patterns of the urgent and emergency care system. Often overlooked, patterns that drive the thinking and behavior in the workplace directly impact on staff recruitment and retention and the overall effectiveness of the organization. These also need to be attended to for transformational change to be achieved and sustained. Research to refine and validate a single

  16. Violence and family bounds in Phaedra's theme

    OpenAIRE

    Soares, Filipe

    2016-01-01

    UID/HIS/04666/2013 In World Culture love is presented as one the major topics explored by its intervenients. Concerning our study, it presents love and sexuality in terms of its disruptiveness: they are characterized as a force that destabilizes the status quo of human communities, leading to situations of Love/ Violence and Love/ Death. From this point of view, the Theme of Phaedra (after Thompson‟s Motif-Index) can be analysed in this perspective. Its variations allow him to adapt to dif...

  17. Recent developments and emergent challenges in Ecohydrology: Focus on the belowground frontier

    Science.gov (United States)

    Mackay, D. S.

    2017-12-01

    The broad spectrum of ecohydrology issues touch on many areas of research in hydrology. But what are the emerging themes and challenges that represent the core of ecohydrology as a maturing discipline? To answer this question the ecohydrology lens was applied to manuscripts published in Water Resources Research over period of 2015 through July 2017. The 235 manuscripts retrieved can be broadly grouped into catchment hydrology, riparian-hyporheic-stream processes, critical zone, land-atmosphere exchange, wetlands, and sustainability. Three dominant crosscutting themes (i.e., coevolution, interfaces, and energy exchange) account for more than half the papers retrieved. In the context of ecohydrology, coevolution refers to the development of physical systems in concert with biological systems and their interactions. In an ecohydrology context, interfaces refer to subsurface, and sometime surface connections that influence transport (e.g., solutes concentration-discharge) influenced by vegetative plumbing, ecophysiology, animal behavior, and microbial processes. Energy exchange in ecohydrology connects vegetative processes to movement of water to the atmosphere through evapotranspiration. Across these themes there is emerging theory and methodology that emphasizes the integrated roles of biology and hydrology in the subsurface. In particular, there is a notable surge of interest in the role of plant roots on subsurface processes. But these are hard to observe and remain challenging to model. By adopting principles of coevolution, in particular, significant advances will be made in modeling plant roots and their depths, corroborated with new geophysical and tracer tools, for improving understanding of critical zone development, subsurface flow processes, and land-atmosphere energy exchange.

  18. How can we identify patients with delirium in the emergency department?: A review of available screening and diagnostic tools.

    Science.gov (United States)

    Tamune, Hidetaka; Yasugi, Daisuke

    2017-09-01

    Delirium is a widespread and serious but under-recognized problem. Increasing evidence argues that emergency health care providers need to assess the mental status of the patient as the "sixth vital sign". A simple, sensitive, time-efficient, and cost-effective tool is needed to identify delirium in patients in the emergency department (ED); however, a stand-alone measurement has not yet been established despite previous studies partly because the differential diagnosis of dementia and delirium superimposed on dementia (DSD) is too difficult to achieve using a single indicator. To fill up the gap, multiple aspects of a case should be assessed including inattention and arousal. For instance, we proposed the 100 countdown test as an effective means of detecting inattention. Further dedicated studies are warranted to shed light on the pathophysiology and better management of dementia, delirium and/or "altered mental status". We reviewed herein the clinical questions and controversies concerning delirium in an ED setting. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. The european emergency number 112 - the questionnaire

    Directory of Open Access Journals (Sweden)

    Krzysztof Goniewicz

    2017-07-01

    Conclusions. Most of the respondents (92% identify the 112 number as an emergency number that allows them to connect to emergency services from anywhere in the European Union. A significant number of respondents (47% identify the 112 number as an emergency number in Poland. One in three respondents will use the 999 number to contact the emergency services as a witness to an emergency in Poland. Non-medical university students more often (63% will use the 112 emergency number than medical college students (41%. Respondents (98% confirmed the usefulness of a unified emergency number throughout Europe, but decided that they were not sufficiently informed about 112 as the European emergency number.

  20. Characterization, conservation and loss of dignity at the end-of- life in the emergency department. A qualitative protocol.

    Science.gov (United States)

    Fernández-Sola, Cayetano; Granero-Molina, José; Díaz-Cortés, María Del Mar; Jiménez-López, Francisca Rosa; Roman-López, Pablo; Saez-Molina, Encarnación; Aranda-Torres, Cayetano José; Muñoz-Terrón, José María; García-Caro, María Paz; Hernández-Padilla, José Manuel

    2018-06-01

    To explore and understand the experiences of terminally ill patients and their relatives regarding dignity during end-of-life care in the emergency department. The respect given to the concept of dignity is significantly modifying the clinical relationship and the care framework involving the end-of-life patient in palliative care units, critical care units, hospices and their own homes. This situation is applicable to in-hospital emergency departments, where there is a lack of research which takes the experiences of end-of-life patients and their relatives into account. A phenomenological qualitative study. The protocol was approved in December 2016 and will be carried out from December 2016-December 2020. The Gadamer's philosophical underpinnings will be used in the design and development of the study. The data collection will include participant observation techniques in the emergency department, in-depth interviews with terminally ill patients and focus groups with their relatives. For the data analysis, the field notes and verbatim transcriptions will be read and codified using ATLAS.ti software to search for emerging themes. Emerging themes that contribute to comprehending the phenomenon of dignity in end-of-life care in the emergency department are expected to be found. This study's results could have important implications in the implementation of new interventions in emergency departments. These interventions would be focused on improving: the social acceptance of death, environmental conditions, promotion of autonomy and accompaniment and assumption (takeover) of dignified actions and attitudes (respect for human rights). © 2018 John Wiley & Sons Ltd.

  1. Understanding group design behaviour in engineering design education

    DEFF Research Database (Denmark)

    Morgan, Thea; McMahon, Christopher Alan

    2017-01-01

    of constructivist inquiry akin to case study research. Five core activity themes emerged; collecting data, analyzing and interpreting data, identifying themes, theory-building and testing, and telling the story. Students engaged spontaneously in these core activities. Findings were sense-checked from an ontological...

  2. Collective movement in ecology: from emerging technologies to conservation and management.

    Science.gov (United States)

    Westley, Peter A H; Berdahl, Andrew M; Torney, Colin J; Biro, Dora

    2018-05-19

    Recent advances in technology and quantitative methods have led to the emergence of a new field of study that stands to link insights of researchers from two closely related, but often disconnected disciplines: movement ecology and collective animal behaviour. To date, the field of movement ecology has focused on elucidating the internal and external drivers of animal movement and the influence of movement on broader ecological processes. Typically, tracking and/or remote sensing technology is employed to study individual animals in natural conditions. By contrast, the field of collective behaviour has quantified the significant role social interactions play in the decision-making of animals within groups and, to date, has predominantly relied on controlled laboratory-based studies and theoretical models owing to the constraints of studying interacting animals in the field. This themed issue is intended to formalize the burgeoning field of collective movement ecology which integrates research from both movement ecology and collective behaviour. In this introductory paper, we set the stage for the issue by briefly examining the approaches and current status of research in these areas. Next, we outline the structure of the theme issue and describe the obstacles collective movement researchers face, from data acquisition in the field to analysis and problems of scale, and highlight the key contributions of the assembled papers. We finish by presenting research that links individual and broad-scale ecological and evolutionary processes to collective movement, and finally relate these concepts to emerging challenges for the management and conservation of animals on the move in a world that is increasingly impacted by human activity.This article is part of the theme issue 'Collective movement ecology'. © 2018 The Author(s).

  3. Human Rights and the Environment: In Search of a New Relationship. Synergies and Common Themes

    Directory of Open Access Journals (Sweden)

    Evadne Grant

    2013-12-01

    Full Text Available The 2012 Oñati Workshop on Human Rights and the Environment sought to begin the important task of developing a new framework that could contribute to re-imagining the relationship between human rights and the environment. Doing full justice to the vibrant and sustained discussion that took place in response to the papers delivered in the Workshop is near impossible in an ex post facto account that can only convey the merest flavour of the richness and complexity of what took place. Nonetheless, the following sections briefly recollect common themes and valuable insights that emerged during the workshop discussions and attempt to reflect the energy and creativity that accompanied them, with a view to setting out the general context within which the various individual papers in this volume should be considered. We have arranged the subsequent discussion to centre on the core discrete yet interrelated themes that emerged and developed during our workshop deliberations, namely: vulnerability; the limits of the law; the limits of rights; responsibility; interconnection; and thinking ecologically. El seminario sobre Derechos Humanos y Medio Ambiente celebrado en Oñati en 2012, buscó iniciar la importante tarea de desarrollar un nuevo marco que podría contribuir a re-imaginar la relación entre los derechos humanos y el medio ambiente. Haciendo justicia a la discusión vibrante y prolongada que tuvo lugar en respuesta a las ponencias presentadas en el taller, es casi imposible en un recuento ex post facto que sólo puede transmitir una mínima parte de la riqueza y complejidad de lo acontecido en Oñati. No obstante, las siguientes secciones recogen brevemente temas comunes y valiosas ideas que surgieron durante las discusiones del taller y tratan de reflejar la energía y creatividad que los acompañaba, con el fin de establecer el marco general dentro del cual las diversas ponencias individuales de este volumen deberían ser consideradas. Hemos

  4. The Underlying Theme of Shakespeare's Tragedy Tempest

    Institute of Scientific and Technical Information of China (English)

    谢倩

    2014-01-01

    The Tempest is one of William Shakespeare's famous play, which mainly focused on the magic and the Postcolonial oppression. The work exposed the crucial harm and inhumanity in those years. In order to demonstrate the deep meaning of this great work and everlasting influence it has made, this essay picks out two parts of its significant themes and gives them a detailed explanation. By demonstrate those profound meanings,the real value of The Tempest may be clearer and the readers can have a better understanding of it.

  5. New Themes and Approaches in Second Language Motivation Research.

    Science.gov (United States)

    Dornyei, Zoltan

    2001-01-01

    Provides an overview of the current themes and research directions in second language motivation research. Argues that the initial research inspiration and standard-setting empirical work on second language motivation originating from Canada has borne fruit by educating a new generation of international scholars who have created a colorful mixture…

  6. Prokaryotic Argonautes - variations on the RNA interference theme

    Science.gov (United States)

    van der Oost, John; Swarts, Daan C.; Jore, Matthijs M.

    2014-01-01

    The discovery of RNA interference (RNAi) has been a major scientific breakthrough. This RNA-guided RNA interference system plays a crucial role in a wide range of regulatory and defense mechanisms in eukaryotes. The key enzyme of the RNAi system is Argonaute (Ago), an endo-ribonuclease that uses a small RNA guide molecule to specifically target a complementary RNA transcript. Two functional classes of eukaryotic Ago have been described: catalytically active Ago that cleaves RNA targets complementary to its guide, and inactive Ago that uses its guide to bind target RNA to down-regulate translation efficiency. A recent comparative genomics study has revealed that Argonaute-like proteins are also encoded by prokaryotic genomes. Interestingly, there is a lot of variation among these prokaryotic Argonaute (pAgo) proteins with respect to domain architecture: some resemble the eukaryotic Ago (long pAgo) containing a complete or disrupted catalytic site, while others are truncated versions (short pAgo) that generally contain an incomplete catalytic site. Prokaryotic Agos with an incomplete catalytic site often co-occur with (predicted) nucleases. Based on this diversity, and on the fact that homologs of other RNAi-related protein components (such as Dicer nucleases) have never been identified in prokaryotes, it has been predicted that variations on the eukaryotic RNAi theme may occur in prokaryotes. PMID:28357239

  7. The needs of families accompanying injured patients into the emergency department in a tertiary hospital in Gauteng

    Directory of Open Access Journals (Sweden)

    Meghan L. Botes

    2016-06-01

    Full Text Available Background: Families are not prepared for traumatic injuries of loved ones. Emergency nurses have the important role of caring for patients and families in this time of crisis. Family needs in the critical care setting have been explored using the Critical Care Family Needs Inventory (CCFNI, however little is known about family needs in the emergency department. Objectives: This study sought to determine the needs of family members accompanying injured patients into the emergency department, and if these needs were met. Methods: A quantitative, descriptive, study was conducted in a level 1 trauma facility in Johannesburg, South Africa. The population included families of patients admitted to the emergency department, sampling 100 participants. The instrument, based on the CCFNI, was validated in a pilot study in Melbourne, Australia and re-evaluated using the Cronbach Alpha validity test to ensure internal consistency. Five themes were explored: ‘meaning’, ‘proximity’, ‘communication’, ‘comfort’ and ‘support’ and data were analysed using descriptive statistics. Responses to open-ended questions were analysed using content analysis. Permission from the Human Research Ethics Committee was granted and participants were ensured confidentiality and the option for counselling if required. Results: Themes ranked highly important were ‘meaning’ and ‘communication’. Satisfaction was highest for ‘meaning’. Low satisfaction levels for ‘communication’ were found. Issues regarding prolonged time spent in the emergency department and discrimination were raised. Conclusion: These findings have a negative impact on the family’s satisfaction with care and it is recommended that the nurse’s role in family care be further explored and emphasised. Keywords: Family needs, emergency department, emergency nurses

  8. The needs of families accompanying injured patients into the emergency department in a tertiary hospital in Gauteng.

    Science.gov (United States)

    Botes, Meghan L; Langley, Gayle

    2016-06-24

    Families are not prepared for traumatic injuries of loved ones. Emergency nurses have the important role of caring for patients and families in this time of crisis. Family needs in the critical care setting have been explored using the Critical Care Family Needs Inventory (CCFNI), however little is known about family needs in the emergency department. This study sought to determine the needs of family members accompanying injured patients into the emergency department, and if these needs were met. A quantitative, descriptive, study was conducted in a level 1 trauma facility in Johannesburg, South Africa. The population included families of patients admitted to the emergency department, sampling 100 participants. The instrument, based on the CCFNI, was validated in a pilot study in Melbourne, Australia and re-evaluated using the Cronbach Alpha validity test to ensure internal consistency.Five themes were explored: 'meaning', 'proximity', 'communication', 'comfort' and 'support' and data were analysed using descriptive statistics. Responses to open-ended questions were analysed using content analysis. Permission from the Human Research Ethics Committee was granted and participants were ensured confidentiality and the option for counselling if required. Themes ranked highly important were 'meaning' and 'communication'. Satisfaction was highest for 'meaning'. Low satisfaction levels for 'communication' were found. Issues regarding prolonged time spent in the emergency department and discrimination were raised. These findings have a negative impact on the family's satisfaction with care and it is recommended that the nurse's role in family care be further explored and emphasised.

  9. Nursing home nurses' experiences of resident transfers to the emergency department: no empathy for our work environment difficulties.

    Science.gov (United States)

    Tsai, Hsiu-Hsin; Tsai, Yun-Fang; Huang, Hsiu-Li

    2016-03-01

    To explore the experiences of nursing home nurses when they transfer residents from nursing homes to the emergency department in Taiwan. The transfer of residents between nursing homes and emergency departments challenges continuity of care. Understanding nursing home nurses' experiences during these transfers may help to improve residents' continuity of care. However, few empirical data are available on these nurses' transfer experiences worldwide, and none could be found in Asian countries. Qualitative descriptive study. Data were collected from August 2012-June 2013 in audiotaped, individual, in-depth interviews with 25 nurses at five nursing homes in Taiwan. Interview transcripts were analysed by constant comparative analysis. Analysis of interview transcripts revealed that the core theme of nursing home nurses' transfer experience was discontinuity in nursing home to emergency department transitions. This core theme comprised three themes: discontinuity in family involvement, discontinuity in medical resources and expectations, and discontinuity in nurses' professional role. Nursing home nurses need a working environment that is better connected to residents' family members and more immediate and/or easier access to acute care for residents. Communication between nurses and residents' family could be improved by using text messages or social media by mobile phones, which are widely used in Taiwan and worldwide. To improve access to acute care, we suggest developing a real-time telehealth transfer system tailored to the medical culture and policies of each country. This system should facilitate communication among nursing home staff, family members and hospital staff. Our findings on nurses' experiences during transfer of nursing home residents to the emergency department can be used to design more effective transfer policies such as telemedicine systems in Taiwan and other Asian countries or in those with large populations of Chinese immigrants. © 2016 John

  10. Reading LGBT-Themed Literature with Young People: What's Possible?

    Science.gov (United States)

    Clark, Caroline T.; Blackburn, Mollie V.

    2009-01-01

    The authors' belief that using LGBT (lesbian, gay, bisexual and transgender)-themed literature in schools is possible and necessary, coupled with students' sense that either it cannot or is not being done, prompted them to write this article. While the authors are sympathetic with students' perspectives, and agree that examples are limited, such…

  11. The role of infections and coinfections with newly identified and emerging respiratory viruses in children

    Directory of Open Access Journals (Sweden)

    Debiaggi Maurizia

    2012-10-01

    Full Text Available Abstract Acute respiratory infections are a major cause of morbidity in children both in developed and developing countries. A wide range of respiratory viruses, including respiratory syncytial virus (RSV, influenza A and B viruses, parainfluenza viruses (PIVs, adenovirus, rhinovirus (HRV, have repeatedly been detected in acute lower respiratory tract infections (LRTI in children in the past decades. However, in the last ten years thanks to progress in molecular technologies, newly discovered viruses have been identified including human Metapneumovirus (hMPV, coronaviruses NL63 (HcoV-NL63 and HKU1 (HcoV-HKU1, human Bocavirus (HBoV, new enterovirus (HEV, parechovirus (HpeV and rhinovirus (HRV strains, polyomaviruses WU (WUPyV and KI (KIPyV and the pandemic H1N1v influenza A virus. These discoveries have heavily modified previous knowledge on respiratory infections mainly highlighting that pediatric population is exposed to a variety of viruses with similar seasonal patterns. In this context establishing a causal link between a newly identified virus and the disease as well as an association between mixed infections and an increase in disease severity can be challenging. This review will present an overview of newly recognized as well as the main emerging respiratory viruses and seek to focus on the their contribution to infection and co-infection in LRTIs in childhood.

  12. Suffering Daughters and Wives. Sentimental Themes in Finnish and Nordic Realism

    Directory of Open Access Journals (Sweden)

    Saija Isomaa

    2010-10-01

    Full Text Available This article examines sentimental themes and scenarios in Nordic nineteenthcentury literature, focusing on Finnish realism. The main claim of the article is that the treatment of the Woman Question in Nordic literature is thematically connected to French sentimentalism that depicted upper-class women caught in the conflict between personal freedom and familial duties. Typical scenarios were family barrier to marriage and love triangle, in which an unhappily married woman fell in love with another man. French sentimental social novels took a stance on the position of women. Similar themes and scenarios can be found in Nordic nineteenth-century novels and plays. The ‘daughter novel’ tradition from Fredrika Bremer’s The President’s Daughters (1834 to Minna Canth’s Hanna (1886 depict the sufferings of upper-class girls in patriarchal family and society. A Doll’s House (1879 by Henrik Ibsen centers on the theme of conflicting duties, depicting the moral awakening of a doll-like wife, and Papin rouva (1893, ‘The Wife of a Clergyman’ by Juhani Aho concentrates on the sufferings and moral considerations of the unhappily married Elli. The article suggests that the sentimentalist legacy informs the Nordic nineteenth-century literature and should be taken into account in the scholarship.

  13. A Political Campaign Strategy and Campaign Theme : How to Win a Political Campaign

    OpenAIRE

    河村, 直幸; Kawamura, Naoyuki

    2004-01-01

    The aim of this research paper is to introduce a political campaign strategy. A political campaign should do on a scientific system and needs effective strategy. Before political campaign begin, a candidate and its campaigner needs to analyze election district and sample voter opinion. An election campaign needs campaign theme. The creation of campaign theme needs careful and elaborate planning. A style of campaign varies according to incumbent or challenger. The developing of an effective po...

  14. National Identity and Migration in an Emerging Gateway Community

    Directory of Open Access Journals (Sweden)

    Jennifer Byrne

    2018-04-01

    Full Text Available This paper examines how conceptions of national and local identity influence reactions to migration in the Shenandoah Valley, a rural location in Southwest Virginia with unique demographic characteristics. While Shenandoah Valley residents have been predominantly non-Hispanic whites of European descent, a recent visible influx of Hispanic laborers, a higher than national average Muslim population, a history of refugee resettlement and the migration of urbanites from Northern Virginia have made the Valley one of the most diverse locations in the state of Virginia today. Using a qualitative methods approach with both apriori and emergent coding, I offer some insights as to how a traditional ethnic and civic framework of national identity and emergent themes of local identity, including family values and traditionalism, influence reactions to the changing demographics in this rural community.

  15. Protocol for a thematic synthesis to identify key themes and messages from a palliative care research network.

    LENUS (Irish Health Repository)

    Nicholson, Emma

    2016-10-21

    Research networks that facilitate collaborative research are increasing both regionally and globally and such collaborations contribute greatly to knowledge transfer particularly in health research. The Palliative Care Research Network is an Irish-based network that seeks to create opportunities and engender a collaborative environment to encourage innovative research that is relevant for policy and practice. The current review outlines a methodology to identify cross-cutting messages to identify how dissemination outputs can be optimized to ensure that key messages from this research reaches all knowledge users.

  16. Theme: The Role of Science in the Agricultural Education Curriculum.

    Science.gov (United States)

    Agricultural Education Magazine, 2002

    2002-01-01

    Thirteen theme articles discuss integration of science and agriculture, the role of science in agricultural education, biotechnology, agriscience in Tennessee and West Virginia, agriscience and program survival, modernization of agricultural education curriculum, agriscience and service learning, and biotechnology websites. (SK)

  17. Themes of Idealism and Nostalgia in Negritude Poetry | Okune ...

    African Journals Online (AJOL)

    The central thrust of this paper is on the themes of idealism and nostalgia in Negritude poetry. Some critics regard negritude poetry as being sentimental and idealistic. Though true, this observation may be explained by the fact that the historical antecedence that gave rise to this literacy art form, in the first place, ...

  18. Interpreting hegemonic themes in the electronic forró

    Directory of Open Access Journals (Sweden)

    Jean Henrique Costa

    2014-03-01

    Full Text Available Current investigation analyzes hegemonic themes in the music of electronic forró (Brazilian dance. The critical theory of Theodor W. Adorno and Cultural Studies revealed: a the main thematic patterns and clichés of the genre; b the meanings of these thematic patterns; c and some hypothetical implications for the consumer. The above implies certain relations of domination reinforced in and by the consumption of the electronic forró.

  19. Les barrières à la demande de service de vaccination chez les populations nomades de Danamadji, Tchad

    NARCIS (Netherlands)

    Seli, D.

    2017-01-01

    Some interesting themes emerged especially at the end of the individual interviews, focus group discussions as well as after observing the behavior of the nomads during this study. Firstly, among the themes identified is the mistrust towards the vaccinating agents by most simple rescuers or young

  20. Energy emergency handbook

    Energy Technology Data Exchange (ETDEWEB)

    1979-01-01

    This Handbook identifies selected state and federal measures available to mitigate the impact of an energy emergency, and provides a comprehensive energy emergency communications directory. In the case of state remedial actions, particular emphasis has been placed on typical implementation procedures and likely impacts. The discussions of federal actions focus on initation and implementation procedures. The directory is designed to facilitate communications of all types (telephone, Telex, TWX, or facsimile) among key energy emergency officials in the federal and state governments.

  1. Supervision and feedback for junior medical staff in Australian emergency departments: findings from the emergency medicine capacity assessment study

    Directory of Open Access Journals (Sweden)

    Weiland Tracey J

    2010-11-01

    Full Text Available Abstract Background Clinical supervision and feedback are important for the development of competency in junior doctors. This study aimed to determine the adequacy of supervision of junior medical staff in Australian emergency departments (EDs and perceived feedback provided. Methods Semi-structured telephone surveys sought quantitative and qualitative data from ED Directors, Directors of Emergency Medicine Training, registrars and interns in 37 representative Australian hospitals; quantitative data were analysed with SPSS 15.0 and qualitative data subjected to content analysis identifying themes. Results Thirty six of 37 hospitals took part. Of 233 potential interviewees, 95 (40.1% granted interviews including 100% (36/36 of ED Directors, and 96.2% (25/26 of eligible DEMTs, 24% (19/81 of advanced trainee/registrars, and 17% (15/90 of interns. Most participants (61% felt the ED was adequately supervised in general and (64.2% that medical staff were adequately supervised. Consultants and registrars were felt to provide most intern supervision, but this varied depending on shift times, with registrars more likely to provide supervision on night shift and at weekends. Senior ED medical staff (64% and junior staff (79% agreed that interns received adequate clinical supervision. Qualitative analysis revealed that good processes were in place to ensure adequate supervision, but that service demands, particularly related to access block and overcrowding, had detrimental effects on both supervision and feedback. Conclusions Consultants appear to provide the majority of supervision of junior medical staff in Australian EDs. Supervision and feedback are generally felt to be adequate, but are threatened by service demands, particularly related to access block and ED overcrowding.

  2. Identifying and tracking plumes affected by an ocean breeze in support of emergency preparedness

    International Nuclear Information System (INIS)

    Schwartz, P.E.

    1989-01-01

    To better support emergency preparedness, General Public Utilities (GPU) Nuclear has investigated the frequency of occurrence of the mesoscale ocean breeze at the Oyster Creek Nuclear Generating Station (OCNGS). Through the analysis of the horizontal wind direction and temperature patterns, simple identification of the ocean breeze along with a plume tracking procedure has been developed and incorporated into the site's emergency plant to better safeguard the public with sophisticated protective action measures in case of a nonroutine release. The ocean breeze will frequently produce wind trajectory fields within the plant's emergency planning zone that are different from the normal gradient wind flow. This could greatly alter proper protective action measures since most utilities employ straight-line trajectory air dispersion models. Knowledge of the existence of the ocean breeze and the location of the ocean breeze front become important in the results generated from the straight-line Gaussian dose calculation methodology and in the further development of a more complex dose assessment model. This paper describes the verification and existence of the sea breeze phenomenon and the incorporation of its effects into the OCNGS emergency plan

  3. Internet Gaming Disorder: An Emergent Health Issue for Men.

    Science.gov (United States)

    Chen, Kevin H; Oliffe, John L; Kelly, Mary T

    2018-03-01

    Internet gaming is a legitimate leisure activity worldwide; however, there are emerging concerns that vast numbers of gamers are becoming addicted. In 2013, the American Psychiatric Association (APA) classified Internet Gaming Disorder (IGD) as a condition warranting more clinical research ahead of formalizing it as a mental disorder. Proposed as a behavioral addiction, IGD shares many similarities in both physical and psychosocial manifestations with substance use disorder, including cerebral changes on functional magnetic resonance imaging (fMRI). Among the gaming population, compared to females, adolescent and adult males demonstrate far more addictive internet gaming use in terms of screen hours, craving, and negative impacts on health, which have, in isolated incidents, also caused death. The current article draws findings from a scoping review of literature related to IGD as a means to raising awareness about an emergent men's health issue. Included are three themes: (a) unveiling the nature, impacts and symptoms of IGD; (b) conceptualizing IGD through neuroscience; and (c) treatment approaches to IGD. Afforded by these themes is an overview and synthesis of the existing literature regarding IGD as a means of providing direction for much needed research on gaming addiction and orientating primary care providers (PCPs) to the specificities of IGD in men's health. The findings are applied to a discussion of the connections between IGD and masculinity and the importance of recognizing how behaviors such as social isolation and game immersion can be maladaptive coping strategies for males.

  4. Using Chief Complaint in Addition to Diagnosis Codes to Identify Falls in the Emergency Department.

    Science.gov (United States)

    Patterson, Brian W; Smith, Maureen A; Repplinger, Michael D; Pulia, Michael S; Svenson, James E; Kim, Michael K; Shah, Manish N

    2017-09-01

    To compare incidence of falls in an emergency department (ED) cohort using a traditional International Classification of Diseases, Ninth Revision (ICD-9) code-based scheme and an expanded definition that included chief complaint information and to examine the clinical characteristics of visits "missed" in the ICD-9-based scheme. Retrospective electronic record review. Academic medical center ED. Individuals aged 65 and older seen in the ED between January 1, 2013, and September 30, 2015. Two fall definitions were applied (individually and together) to the cohort: an ICD-9-based definition and a chief complaint definition. Admission rates and 30-day mortality (per encounter) were measured for each definition. Twenty-three thousand eight hundred eighty older adult visits occurred during the study period. Using the most-inclusive definition (ICD-9 code or chief complaint indicating a fall), 4,363 visits (18%) were fall related. Of these visits, 3,506 (80%) met the ICD-9 definition for a fall-related visit, and 2,664 (61%) met the chief complaint definition. Of visits meeting the chief complaint definition, 857 (19.6%) were missed when applying the ICD-9 definition alone. Encounters missed using the ICD-9 definition were less likely to lead to an admission (42.9%, 95% confidence interval (CI) = 39.7-46.3%) than those identified (54.4%, 95% CI = 52.7-56.0%). Identifying individuals in the ED who have fallen based on diagnosis codes underestimates the true burden of falls. Individuals missed according to the code-based definition were less likely to have been admitted than those who were captured. These findings call attention to the value of using chief complaint information to identify individuals who have fallen in the ED-for research, clinical care, or policy reasons. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  5. Ontario's emergency department process improvement program: the experience of implementation.

    Science.gov (United States)

    Rotteau, Leahora; Webster, Fiona; Salkeld, Erin; Hellings, Chelsea; Guttmann, Astrid; Vermeulen, Marian J; Bell, Robert S; Zwarenstein, Merrick; Rowe, Brian H; Nigam, Amit; Schull, Michael J

    2015-06-01

    In recent years, Lean manufacturing principles have been applied to health care quality improvement efforts to improve wait times. In Ontario, an emergency department (ED) process improvement program based on Lean principles was introduced by the Ministry of Health and Long-Term Care as part of a strategy to reduce ED length of stay (LOS) and to improve patient flow. This article aims to describe the hospital-based teams' experiences during the ED process improvement program implementation and the teams' perceptions of the key factors that influenced the program's success or failure. A qualitative evaluation was conducted based on semistructured interviews with hospital implementation team members, such as team leads, medical leads, and executive sponsors, at 10 purposively selected hospitals in Ontario, Canada. Sites were selected based, in part, on their changes in median ED LOS following the implementation period. A thematic framework approach as used for interviews, and a standard thematic coding framework was developed. Twenty-four interviews were coded and analyzed. The results are organized according to participants' experience and are grouped into four themes that were identified as significantly affecting the implementation experience: local contextual factors, relationship between improvement team and support players, staff engagement, and success and sustainability. The results demonstrate the importance of the context of implementation, establishing strong relationships and communication strategies, and preparing for implementation and sustainability prior to the start of the project. Several key factors were identified as important to the success of the program, such as preparing for implementation, ensuring strong executive support, creation of implementation teams based on the tasks and outcomes of the initiative, and using multiple communication strategies throughout the implementation process. Explicit incorporation of these factors into the

  6. Food studies in French History

    DEFF Research Database (Denmark)

    Hedegaard, Liselotte

    The overarching question of this paper is whether it is possible to identify concepts that define a specifically French tradition regarding food. Two themes seem central. The first theme is the relationship between food and place as it emerges in concepts such as authenticity and terroir....... The second theme is the "how" food is eaten and can be studied through concepts such as commensality, synchronisation and structure...

  7. Psychologists' study on how to communicate on the theme of nuclear waste

    International Nuclear Information System (INIS)

    Guilloux, Christine

    2000-01-01

    In 1998, EDF organized a study on how to communicate on the theme of nuclear waste to help understand why communication on this theme seems to be stuck. This study has involved many psychotherapists, psychologists and physicians from different schools of thought. Afterwards a team of internal and external consultants continued the work in 1999 and explored 'the hidden aspects' of the communication that is made on nuclear waste. What are those aspects? What has to be taken into account in such a communication on a theme that is 'absorbing', 'strong', 'invisible'? How to build a more efficient and relevant communication towards the public and the ecologists? How to build a communication which opens up a dialogue and mutual understanding? The first part of this qualitative study has been devoted to interviewing the psychotherapists in a non directive way on what are the representations and beliefs about waste in general, then about nuclear waste. The second part was centered on their reactions to a pamphlet 'Nuclear waste in questions' and a video document (of a presentation of a paper given on the subject). This presentation describes the findings of this study

  8. Psychologists' study on how to communicate on the theme of nuclear waste

    Energy Technology Data Exchange (ETDEWEB)

    Guilloux, Christine

    2000-07-01

    In 1998, EDF organized a study on how to communicate on the theme of nuclear waste to help understand why communication on this theme seems to be stuck. This study has involved many psychotherapists, psychologists and physicians from different schools of thought. Afterwards a team of internal and external consultants continued the work in 1999 and explored 'the hidden aspects' of the communication that is made on nuclear waste. What are those aspects? What has to be taken into account in such a communication on a theme that is 'absorbing', 'strong', 'invisible'? How to build a more efficient and relevant communication towards the public and the ecologists? How to build a communication which opens up a dialogue and mutual understanding? The first part of this qualitative study has been devoted to interviewing the psychotherapists in a non directive way on what are the representations and beliefs about waste in general, then about nuclear waste. The second part was centered on their reactions to a pamphlet 'Nuclear waste in questions' and a video document (of a presentation of a paper given on the subject). This presentation describes the findings of this study.

  9. Family Presence During Resuscitation (FPDR): Observational case studies of emergency personnel in Victoria, Australia.

    Science.gov (United States)

    Porter, Joanne E; Miller, Nareeda; Giannis, Anita; Coombs, Nicole

    2017-07-01

    Family Presence During Resuscitation (FPDR), although not a new concept, remains inconsistently implemented by emergency personnel. Many larger metropolitan emergency departments (ED) have instigated a care coordinator role, however these personnel are often from a non-nursing background and have therefore limited knowledge about the clinical aspects of the resuscitation. In rural emergency departments there are simply not enough staff to allocate an independent role. A separate care coordinator role, who is assigned to care for the family and not take part in the resuscitation has been well documented as essential to the successful implementation of FPDR. One rural and one metropolitan emergency department in the state of Victoria, Australia were observed and data was collected on FPDR events. The participants consisted of resuscitation team members, including; emergency trained nurses, senior medical officers, general nurses and doctors. The participants were not told that the data would be recorded around interactions with family members or team discussions regarding family involvement in the resuscitation, following ethical approval involving limited disclosure of the aims of the study. Seventeen adult presentations (Metro n=9, Rural n=8) were included in this study and will be presented as resuscitation case studies. The key themes identified included ambiguity around resuscitation status, keeping the family informed, family isolation and inter-professional communication. During 17 adult resuscitation cases, staff were witnessed communicating with family, which was often limited and isolation resulted. Family were often uninformed or separated from their family member, however when a family liaison person was available it was found to be beneficial. This research indicated that staff could benefit from a designated family liaison role, formal policy and further education. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Treatment of the Theme Islam in German Geographical Education: Case Study of Bavarian Geographical Curriculum

    Science.gov (United States)

    Zecha, Stefanie; Popp, Stephan

    2014-01-01

    Several previous studies have looked at the treatment of Islam and Muslim culture in western curricula. However in Germany, especially in Bavaria where Muslim immigration has been growing since the 1990s, no recent research has covered this theme. As a first step, an exploratory study of Islamic themes in the curricula of Bavarian secondary…

  11. Noise exposure during prehospital emergency physicians work on Mobile Emergency Care Units and Helicopter Emergency Medical Services

    DEFF Research Database (Denmark)

    Hansen, Mads Christian Tofte; Schmidt, Jesper Hvass; Brøchner, Anne C

    2017-01-01

    BACKGROUND: Prehospital personnel are at risk of occupational hearing loss due to high noise exposure. The aim of the study was to establish an overview of noise exposure during emergency responses in Mobile Emergency Care Units (MECU), ambulances and Helicopter Emergency Medical Services (HEMS)....... initiatives. Although no hearing loss was demonstrated in the personnel of the ground-based units, a reduced function of the outer sensory hair cells was found in the HEMS group following missions.......BACKGROUND: Prehospital personnel are at risk of occupational hearing loss due to high noise exposure. The aim of the study was to establish an overview of noise exposure during emergency responses in Mobile Emergency Care Units (MECU), ambulances and Helicopter Emergency Medical Services (HEMS......). A second objective was to identify any occupational hearing loss amongst prehospital personnel. METHODS: Noise exposure during work in the MECU and HEMS was measured using miniature microphones worn laterally to the auditory canals or within the earmuffs of the helmet. All recorded sounds were analysed...

  12. Further themes in Christian drama in Nigeria | Agoro | EJOTMAS ...

    African Journals Online (AJOL)

    We have used the following plays to illustrate the themes we are going to discuss in this paper: Cold Wings of Darkness and The Living Dead by A.E Anigala, Trial of the Beautiful Ones by Catherine Acholonu,The Secrets of the Devil, The beginning of the End and The Last Generation by Mike Bamiloye,The Church is the ...

  13. Identifying Perceived Neighborhood Stressors Across Diverse Communities in New York City.

    Science.gov (United States)

    Shmool, Jessie L C; Yonas, Michael A; Newman, Ogonnaya Dotson; Kubzansky, Laura D; Joseph, Evelyn; Parks, Ana; Callaway, Charles; Chubb, Lauren G; Shepard, Peggy; Clougherty, Jane E

    2015-09-01

    There is growing interest in the role of psychosocial stress in health disparities. Identifying which social stressors are most important to community residents is critical for accurately incorporating stressor exposures into health research. Using a community-academic partnered approach, we designed a multi-community study across the five boroughs of New York City to characterize resident perceptions of key neighborhood stressors. We conducted 14 community focus groups; two to three in each borough, with one adolescent group and one Spanish-speaking group per borough. We then used systematic content analysis and participant ranking data to describe prominent neighborhood stressors and identify dominant themes. Three inter-related themes regarding the social and structural sources of stressful experiences were most commonly identified across neighborhoods: (1) physical disorder and perceived neglect, (2) harassment by police and perceived safety and (3) gentrification and racial discrimination. Our findings suggest that multiple sources of distress, including social, political, physical and economic factors, should be considered when investigating health effects of community stressor exposures and psychological distress. Community expertise is essential for comprehensively characterizing the range of neighborhood stressors that may be implicated in psychosocial exposure pathways.

  14. Using Sustainability Themes and Multidisciplinary Approaches to Enhance STEM Education

    Science.gov (United States)

    Rogers, Michael; Pfaff, Thomas; Hamilton, Jason; Erkan, Ali

    2015-01-01

    Purpose: The purpose of this paper is to report on the Multidisciplinary Sustainability Education Project (MSEP) as a framework using sustainability-themed education modules to introduce students to the need for multidisciplinary approaches to solving twenty-first-century problems while retaining traditional course strengths and content.…

  15. Sociopolitical Development and Political Activism: Synergies between Feminist and Liberation Psychology

    Science.gov (United States)

    Moane, Geraldine

    2010-01-01

    Feminist and liberation psychologies have emerged in contexts of marginalization and oppression and have developed in diverse, and sometimes synergistic, ways. I identify key themes for fostering critical consciousness and political action that arise from the intersections of feminist and liberation psychology. These themes include the need for…

  16. Transformation of accounting business processes in emergencies

    Directory of Open Access Journals (Sweden)

    D.O. Gritsyshen

    2016-12-01

    Full Text Available In the article the transformation of the accounting business processes in emergency situations. The models identify the consequences of emergencies, which is the basis for the transformation of the elements method of accounting, to address the consequences of emergencies isolation from the totality of objects of accounting and determine the properties that affect decision-making. Designed identify complex patterns of consequences of emergencies, allows accounting system to generate information that allows for a set of properties consequences of emergencies, and management decisions taking into account complex factors. Determined the possible consequences of emergency situations for individual objects accounting, information resources, which are accounts of accounting and financial reporting indicators.

  17. Enhancing Students’ Local Knowledge Through Themed Garden Project

    Directory of Open Access Journals (Sweden)

    Esa Norizan

    2015-01-01

    Full Text Available Traditional or local knowledge is a major issue to be focused on, particularly since the implementation of the Strategic Plan for Biodiversity 2011–2020 and the Aichi Targets “Living in Harmony with Nature”. According to the strategic goals, by 2020, conservation of biodiversity and its sustainable use incorporate what local and indigenous communities have within their traditional knowledge, innovation and practice and their customary use of biological resources are respected at all relevant levels. The older generation among the local people usually use medicinal herbs for various ailments, health care and other cultural purposes. However, encroaching industrialization and the changes in today’s life styles are responsible for the decreasing practice in the local use of herbs especially for healing purposes. It is, therefore, felt worthwhile to encourage young generations such as school children to gain knowledge about these local herbs and record the native uses of these herbs before the information is lost. One biodiversity education program was conducted to facilitate secondary school students to set up a themed garden and find out the local knowledge of the plants they grew in their garden from their family members or communities. The findings revealed that students’ local knowledge on healing improved after they joined the program. Therefore, it is proposed that the themed garden project can enhance students’ local knowledge.

  18. ‘Feeling of despair’ as the leading cluster theme of conceptual descriptive analyses in participatory assessment: Russia Oxfam GB case study

    Directory of Open Access Journals (Sweden)

    Venera Zakirova

    2016-12-01

    Full Text Available This article provides a case study on participatory assessment based on experience gained from an EU–Oxfam GB project entitled “Empowering Municipalities to Effectively Address Poverty” conducted in five small towns in Russia. Participatory assessment through focus group discussions (FGDs was the main approach used in the implementation of the project. A participatory assessment was performed through 25 FGDs in five remote areas in central Russia. More than 200 participants representing people living in poverty, such as single mothers, people with disabilities, families with many children, families with disabled children, and pensioners, voluntarily participated in the meetings. Most of the participants were women (75% aged between 25 and 70 years. We consider that the participants’ representation is relevant in accordance with the official poverty studies. Through identification of patterns of recurrent ideas and opinions, a qualitative method helps us understand social phenomena from the views of and on the basis of the opinions of the participants. The FGDs’ narratives underwent pattern analysis, resulting in the framing of the cluster themes and narrative conceptualization. Cluster analysis of the FGDs’ narratives led to the framing of 10 cluster themes of importance, followed by conceptual descriptions and related narratives. The conceptual description of the leading theme, feeling of despair (theme 1, was described by respondents’ expressions/narratives, such as “Nobody needs us and there is no future for us and our children in this town,” the narrative idea that crosscuts the subsequent themes. The following nine themes are of equal importance, are interlinked, and for the major part constitute the leading theme, feeling of despair (theme 1: state social and family support (theme 2; health care (theme 3; who are those living in poverty? (theme 4; housing (theme 5; living costs (theme 6; employment (theme 7; children

  19. Emergency nurses' knowledge and self-rated practice skills when caring for older patients in the Emergency Department.

    Science.gov (United States)

    Rawson, Helen; Bennett, Paul N; Ockerby, Cherene; Hutchinson, Alison M; Considine, Julie

    2017-11-01

    Older adults are high users of emergency department services and their care requirements can present challenges for emergency nurses. Although clinical outcomes for older patients improve when they are cared for by nurses with specialist training, emergency nurses' knowledge and self-assessment of care for older patients is poorly understood. To assess emergency nurses' knowledge and self-rating of practice when caring for older patients. A cross-sectional self-report survey of emergency nurses (n=101) in Melbourne, Australia. Mean scores were 12.7 (SD 2.66) for the 25-item knowledge of older persons questionnaire, and 9.04 (SD 1.80) for the 15-item gerontic health related questions. Scores were unaffected by years of experience as a registered nurse or emergency nurse. More than 80% of nurses rated themselves as 'very good' or 'good' in assessing pain (94.9%), identifying delirium (87.8%), and identifying dementia (82.8%). Areas with a 'poor' ratings were identifying depression (46.5%), assessing polypharmacy (46.5%) and assessing nutrition (37.8%). There was variation in knowledge and self-rating of practice related to care of older patients. The relationship between knowledge and self-ratings of practice in relation to actual emergency nursing care of older people and patient outcomes warrants further exploration. Copyright © 2017 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.

  20. Gender determinants of smoking practice in Indigenous communities: an exploratory study.

    Science.gov (United States)

    Knott, V E; Gilligan, G; Maksimovic, L; Shen, D; Murphy, M

    2016-03-01

    Despite the need to urgently reduce smoking rates among Indigenous Australians, in order to close-the-gap in life expectancy, little is known regarding how this can be achieved. This study aimed to explore whether a focus on gender specific determinants of smoking among Indigenous Australians could be identified, thus providing a potentially novel approach to underpin future efforts at intervention. A qualitative research design was employed. Eighty-two participants, comprised of 43 Indigenous women (mean age 32.15, SD, 12.47) and 39 Indigenous men (mean age 34.91, SD, 11.26), participated in one of 12 focus groups held in metropolitan, regional and rural locations in South Australia. Facilitators prompted discussion in response to the question: 'What is it like being a smoker these days?' Two experienced coders assessed data for themes using Attride-Stirling's (2002) method of analysis. Two global themes emerged for men and women. The first theme, 'It's Harder to Smoke Nowadays', encompassed sub-themes capturing changed smoking practices in response to tobacco control strategies implemented in Australia. Sub-themes of 'smoking in secrecy' coupled with an 'awareness of the effects of passive smoking' were identified among women. Among men, sub-themes that depicted tension between 'a desire to be a role model' and 'guilt about smoking' emerged. The second theme, 'Push and Pull Factors', identified a range of gender specific determinants of smoking. While similar reasons for smoking ('pull factors') were identified in men and women (e.g. addiction, boredom, stress, pleasure, mood stabiliser), different 'push factors' (reasons for not wanting to smoke) emerged. For men, sport, fitness and children were identified as reasons for not wanting to smoke, whereas women identified factors such as respect for non-smokers, and body image concerns. The current findings suggest that there may be fundamental differences in the determinants of smoking (pull factors) as well as

  1. Using Participatory and Service Design to Identify Emerging Needs and Perceptions of Library Services among Science and Engineering Researchers Based at a Satellite Campus

    Science.gov (United States)

    Johnson, Andrew; Kuglitsch, Rebecca; Bresnahan, Megan

    2015-01-01

    This study used participatory and service design methods to identify emerging research needs and existing perceptions of library services among science and engineering faculty, post-graduate, and graduate student researchers based at a satellite campus at the University of Colorado Boulder. These methods, and the results of the study, allowed us…

  2. Rendezvous with the World: Missouri Southern State University's Themed Semesters

    Science.gov (United States)

    Stebbins, Chad

    2011-01-01

    Although most universities emphasize study abroad as the primary vehicle to internationalize the campus, in reality only a small percentage of students actually participate in this endeavor. The internationally themed semesters at Missouri Southern State University (MSSU) reach virtually every student, and provide a global perspective and cultural…

  3. The Great Pyramid Builders: An Integrated Theme on Ancient Egypt

    Science.gov (United States)

    Stone, Brian

    2008-01-01

    This article describes a themed classroom project designed to teach about the culture and civilization of ancient Egypt. In preparing the project, it is noted that teachers should remember that different learning styles, including activities that provide meaningful experiences, are appropriate in accommodating the various ways children learn.…

  4. Terror Park: A future theme park in 2100

    OpenAIRE

    Wright, Daniel

    2017-01-01

    In the future, tourism and entertainment could be displayed as spectacles of horror, where consumers are offered and opportunity to revisit the tragedies of the past. Current displays of death where the past is exhibited and consumed as fun, scary and as entertainment productions are widespread. The movie industry provides horror to all ages, children can be exposed to the goulash past in various forms, such as the popular book series ‘Horrible Histories’. Theme parks, rides and roller-coaste...

  5. Museums as Theme Parks - A Possible Marketing Approach?

    OpenAIRE

    Alexandra ZBUCHEA

    2015-01-01

    Museums compete increasingly more with very diverse entertainment providers, such as theme parks, despite the fact that their offer is mainly cultural. Museums have had to be more active and they have had to diversify their offer, in order to be more popular, therefore to better achieve their complex cultural missions. They should be more “market oriented” and aim to develop their programs according with their visitors’ needs and desires, as well as with the evolutions in the contemporary soc...

  6. Qualitative evaluation of a deferred consent process in paediatric emergency research: a PREDICT study.

    Science.gov (United States)

    Furyk, Jeremy; McBain-Rigg, Kristin; Watt, Kerrianne; Emeto, Theophilus I; Franklin, Richard C; Franklin, Donna; Schibler, Andreas; Dalziel, Stuart R; Babl, Franz E; Wilson, Catherine; Phillips, Natalie; Ray, Robin

    2017-11-15

    A challenge of conducting research in critically ill children is that the therapeutic window for the intervention may be too short to seek informed consent prior to enrolment. In specific circumstances, most international ethical guidelines allow for children to be enrolled in research with informed consent obtained later, termed deferred consent (DC) or retrospective consent. There is a paucity of data on the attitudes of parents to this method of enrolment in paediatric emergency research. To explore the attitudes of parents to the concept of DC and to expand the knowledge of the limitations to informed consent and DC in these situations. Children presenting with uncomplicated febrile seizures or bronchiolitis were identified from three separate hospital emergency department databases. Parents were invited to participate in a semistructured telephone interview exploring themes of limitations of prospective informed consent, acceptability of the DC process and the most appropriate time to seek DC. Transcripts underwent inductive thematic analysis with intercoder agreement, using Nvivo 11 software. A total of 39 interviews were conducted. Participants comprehended the limitations of informed consent under emergency circumstances and were generally supportive of DC. However, they frequently confused concepts of clinical care and research, and support for participation was commonly linked to their belief of personal benefit. Participants acknowledged the requirement for alternatives to prospective informed consent in emergency research, and were supportive of the concept of DC. Our results suggest that current research practice seems to align with community expectations. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  7. Emerging Fabric of Science: Persistent Identifiers and Knowledge Networks

    Science.gov (United States)

    Hugo, W.

    2017-12-01

    There is an increasing emphasis on the use of persistent identifiers in the description of scientific activity, whether this is done to cite scholarly publications and research output, reliably identify role players such as funders and researchers, or to provide long-lasting references to controlled vocabulary. The ICSU World Data System has been promoting the establishment of a "Knowledge Network" to describe research activity, realising that parts of the network will be established as a federated `system', based on linkages between registries of persistent identifiers. In addition, there is a growing focus on not only the relationship between these major role players and associated digital objects, but also on the processes of science: provenance, reproducibility, and re-usability being significant topics of discussion. The paper will focus on description of the `Fabric of Science' from the perspectives of both structure and processes, review the state of implementation of real services and infrastructure in support of it. A case is made for inclusion of persistent identifiers into the mainstream activities of scientists and data infrastructure managers, and for the development of services, such as Scholix, to make better use of the relationships between digital objects and major role players. A proposal is made for the adoption of a federated system of services that are based on a hybrid graph-object framework similar to Scholix for recording the activity of scientific research. Finally, links to related ideas are explored: novel ways of representing of knowledge (such as Nanopublications) and the possibility that the publication paradigm currently in use may have to be amended.

  8. Emergências hipertensivas Hypertensive emergencies

    Directory of Open Access Journals (Sweden)

    Gilson Soares Feitosa-Filho

    2008-09-01

    ão controlada. Este conhecimento deve ser rotineiro ao emergencista e Intensivista no momento de decidir sobre a conduta.Emergencies and hypertensive crises are clinical situations which may represent more than 25% of all medical emergency care. Considering such high prevalence, physicians should be prepared to correctly identify these crises and differentiate between urgent and emergent hypertension. Approximately 3% of all visits to emergency rooms are due to significant elevation of blood pressure. Across the spectrum of blood systemic arterial pressure, hypertensive emergency is the most critical clinical situation, thus requiring special attention and care. Such patients present with high blood pressure and signs of acute specific target organ damage (such as acute myocardial infarction, unstable angina, acute pulmonary edema, eclampsia, and stroke. Key elements of diagnosis and specific treatment for the different presentations of hypertensive emergency will be reviewed in this article. The MedLine and PubMed databases were searched for pertinent abstracts, using the key words "hypertensive crises" and "hypertensive emergencies". Additional references were obtained from review articles. Available English language clinical trials, retrospective studies and review articles were identified, reviewed and summarized in a simple and practical way. The hypertensive crisis is a clinical situation characterized by acute elevation of blood pressure followed by clinical signs and symptoms. These signs and symptoms may be mild (headache, dizziness, tinnitus or severe (dyspnea, chest pain, coma or death. If the patient presents with mild symptoms, but without acute specific target organ damage, diagnosis is hypertensive urgency. However, if severe signs and symptoms and acute specific target organ damage are present, then the patient is experiencing a hypertensive emergency. Some patients arrive at the emergency rooms with high blood pressure, but without any other sign or symptom. In

  9. Understanding the Experience of Miscarriage in the Emergency Department.

    Science.gov (United States)

    MacWilliams, Kate; Hughes, Jean; Aston, Megan; Field, Simon; Moffatt, Faith Wight

    2016-11-01

    Up to 20% of pregnancies end in miscarriage, which can be a significant life event for women with psychological implications. Because the only preventative measure for a miscarriage is risk factor modification, the treatment focuses on confirming the miscarriage has occurred and medical management of symptoms. Although women experiencing a miscarriage are frequently directed to seek medical care in emergency departments, the patients are often triaged as nonemergent patients unless they are unstable, which exposes women to potentially prolonged wait times. Research about miscarriages and emergency departments predominantly focus on medical management with little understanding of how emergency care shapes the experience of miscarriage for women. Seeking to describe the experiences of women coming to the emergency department for care while having a miscarriage, interpretive phenomenology-a form of qualitative research-guided this study. Eight women were recruited to participate in semi-structured face-to-face interviews of 60 to 90 minutes in length. Data were analyzed using hermeneutics and thematic analysis. Five themes emerged: "Pregnant/Life: Miscarriage/Death"; "Deciding to go to the emergency department: Something's wrong"; "Not an illness: A different kind of trauma"; "Need for acknowledgement"; and "Leaving the emergency department: What now?". Participants believed their losses were not acknowledged but instead dismissed. These experiences, combined with a perceived lack of discharge education and clarity regarding follow-up, created experiences of marginalization. This study describes the experience of miscarrying in emergency departments and provides insights regarding how nursing and physician care may affect patient perceptions of marginalization. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  10. Identifying elements of patient-centered care in underserved populations: a qualitative study of patient perspectives.

    Directory of Open Access Journals (Sweden)

    Sheela Raja

    Full Text Available Patient-centered care is an important goal in the delivery of healthcare. However, many patients do not engage in preventive medical care. In this pilot study, we conducted twenty in depth, semi-structured qualitative interviews at the University of Illinois at Chicago Health Sciences campus in a four month time frame. Many patients were underserved and underinsured, and we wanted to understand their experiences in the healthcare system. Using content analysis, several themes emerged from the interview data. Participants discussed the need for empathy and rapport with their providers. They identified provider behaviors that fostered a positive clinical relationship, including step-by step explanations of procedures, attention to body language and clinic atmosphere, and appropriate time management. Participants identified cost as the most common barrier to engaging in preventive care and discussed children and social support as motivating factors. A long-term relationship with a provider was an important motivator for preventive care, suggesting that the therapeutic alliance was essential to many patients. Conversely, many participants discussed a sense of dehumanization in the healthcare system, reporting that their life circumstances were overlooked, or that they were judged based on insurance status or ethnicity. We discuss implications for provider training and healthcare delivery, including the importance of patient-centered medical homes.

  11. Seeking informed consent to Phase I cancer clinical trials: identifying oncologists' communication strategies.

    Science.gov (United States)

    Brown, Richard; Bylund, Carma L; Siminoff, Laura A; Slovin, Susan F

    2011-04-01

    Phase I clinical trials are the gateway to effective new cancer treatments. Many physicians have difficulty when discussing Phase I clinical trials. Research demonstrates evidence of suboptimal communication. Little is known about communication strategies used by oncologists when recruiting patients for Phase I trials. We analyzed audio recorded Phase I consultations to identify oncologists' communication strategies. Subjects were consecutive cancer patients from six medical oncologists attending one of three outpatient clinics at a major Cancer Center in the United States. Sixteen patients signed informed consent for audio recording of their consultations in which a Phase I study was discussed. These were transcribed in full and analyzed to identify communication strategies. Six communication themes emerged from the analysis: (1) orienting, (2) educating patients, (3) describing uncertainty and prognosis, (4) persuading, (5) decision making, and (6) making a treatment recommendation. As expected, although there was some common ground between communication in Phase I and the Phase II and III settings, there were distinct differences. Oncologists used persuasive communication, made explicit recommendations, or implicitly expressed a treatment preference and were choice limiting. This highlights the complexity of discussing Phase I trials and the need to develop strategies to aid oncologists and patients in these difficult conversations. Patient centered communication that values patient preferences while preserving the oncologist's agenda can be a helpful approach to these discussions. Copyright © 2010 John Wiley & Sons, Ltd.

  12. Rotating swings—a theme with variations

    Science.gov (United States)

    Pendrill, Ann-Marie

    2016-01-01

    Rotating swing rides can be found in many amusement parks, in many different versions. The ‘wave swinger’ ride, which introduces a wave motion by tilting the roof, is among the classical amusement rides that are found in many different parks, in different sizes, from a number of different makes and names, and varying thematization. The ‘StarFlyer’ is a more recent version, adding the thrill of lifting the riders 60 m or more over the ground. These rotating swing rides involve beautiful physics, often surprising, but easily observed, when brought to attention. The rides can be used for student worksheet tasks and assignments of different degrees of difficulty, across many math and physics topics. This paper presents a number of variations of student tasks relating to the theme of rotating swing rides.

  13. I. L. Caragiale. Theme and Variations

    Directory of Open Access Journals (Sweden)

    Adela Drăucean

    2010-11-01

    Full Text Available Analyzing Caragiale’s work, a so called “unity in variety” can be noticed and his entire creation may be named after one of his sketches, Plot and variations. Since the fire on Dealul Spirii, a real story, had been given five different interpretations by the local media, so must we understand Caragiale’s literary pieces: they have a “plot”, i.e. the society, and several “variants” (forms, i.e. the events or happenings of all kinds. As an urban writer, Caragiale was preoccupied with the town and its very life, but also with folk themes and motifs. He also described the countryside with its scenery, inns and innkeepers, the places where people used to meet and talk. Trades and their professions were presented in his sketches and stories, too

  14. The Internet Marketing of Disney Theme Parks

    Directory of Open Access Journals (Sweden)

    Carol J. Auster

    2013-03-01

    Full Text Available The purpose of this study was to analyze the portrayal of gender and race in the images on the official Disney websites used to market five theme parks: the Disneyland Parks in California, Paris, Tokyo, and Hong Kong, and the Magic Kingdom in Florida. This is important because of the growth of e-commerce, Disney’s global influence, and the potential impact on those who view the images. The 452 images that had Disney human characters, human-like characters, animals, cast members, or guests were coded for gender. The main gender hypothesis, that the percentage of male-dominated images would exceed the percentage of female-dominated images, was tested using gender disparity values, which measured the gap between the percentage of male-dominated and female-dominated images. The hypothesis tended to be supported overall, and for most of the resorts (e.g., Florida, lands (e.g., Adventureland, and activities (attractions, entertainment, dining for human characters, human-like characters, animals, and cast members, but not for guests. Furthermore, the hypotheses that gender disparity values would be highest for images of animals and lowest for images of guests was supported for all five resorts, six of eight lands, and all three activities. Additional analysis also revealed the preponderance of same-sex pairings in parent–child combinations in the images. With regard to race, while the images of some theme parks displayed more racial diversity among their guests than others, in some images, individuals of different races were shown interacting whereas in others they were not. Explanations for these findings and suggestions for future research are discussed.

  15. Opportunities to preserve forensic evidence in emergency departments.

    Science.gov (United States)

    Peel, Matthew

    2016-11-10

    Victims of violence often seek assistance from emergency departments, so emergency nurses are ideally placed to identify them, and other 'forensic' patients, and protect the evidence that could support any ensuing legal process. Emergency nurses who are trained to identify, collect and preserve forensic evidence can support the identification, elimination and prosecution of suspects. This article gives an overview of forensic evidence, and explains how emergency nurses can preserve and collect samples effectively.

  16. Celebrating Love in All Shades: YA Books with LGBTQ Themes

    Science.gov (United States)

    Letcher, Mark, Ed.

    2009-01-01

    In this article, the author highlights outstanding literature written for young adults that contains LGBTQ (lesbian, gay, bisexual, transgender, queer/questioning) themes, or contains LGBTQ characters. One of the most critically hailed books with LGBTQ characters from 2007 was Perry Moore's debut novel, "Hero" (Hyperion). This book won the Lambda…

  17. "Community" as a Guiding Theme for the Public Speaking Course

    Science.gov (United States)

    Swenson-Lepper, Tammy

    2012-01-01

    First-year students at many universities find themselves in new communities, with little understanding of how their new university, city, academic, or career communities function. Developing a student's sense of community can have long-term benefits. Using the theme of "Community" in the basic public speaking course provides students with…

  18. Pedagogical workshops as a teaching and learning strategy: the hydrographic basic as a theme

    OpenAIRE

    Valéria Brumato Regina Fornazari; Ana Tiyomi Obara

    2017-01-01

    Current research investigates the ideas and practices of a team of teachers of the Natural Sciences working in schools in the state of Paraná, Brazil, with regard to pedagogical workshops as teaching and learning strategies on Hydrographic Basin as theme. A continuous formation course was conducted on the theme, with data retrieved by a questionnaire applied prior to the course and after the development of workshops by the teachers. Films, recordings and descriptive memorials were analyzed ac...

  19. Thoughts on identifiers

    CERN Multimedia

    CERN. Geneva

    2005-01-01

    As business processes and information transactions have become an inextricably intertwined with the Web, the importance of assignment, registration, discovery, and maintenance of identifiers has increased. In spite of this, integrated frameworks for managing identifiers have been slow to emerge. Instead, identification systems arise (quite naturally) from immediate business needs without consideration for how they fit into larger information architectures. In addition, many legacy identifier systems further complicate the landscape, making it difficult for content managers to select and deploy identifier systems that meet both the business case and long term information management objectives. This presentation will outline a model for evaluating identifier applications and the functional requirements of the systems necessary to support them. The model is based on a layered analysis of the characteristics of identifier systems, including: * Functional characteristics * Technology * Policy * Business * Social T...

  20. A qualitative study of tobacco interventions for LGBTQ+ youth and young adults: overarching themes and key learnings.

    Science.gov (United States)

    Bruce Baskerville, N; Wong, Katy; Shuh, Alanna; Abramowicz, Aneta; Dash, Darly; Esmail, Aamer; Kennedy, Ryan

    2018-01-18

    Smoking prevalence is very high among lesbian, gay, bisexual, transgendered and queer (LGBTQ+) youth and young adults (YYA) compared to non-LGBTQ+ YYA. A knowledge gap exists on culturally appropriate and effective prevention and cessation efforts for members of this diverse community, as limited interventions have been developed with and for this population, and there are very few studies determining the impact of these interventions. This study identifies the most salient elements of LGBTQ+ cessation and prevention interventions from the perspective of LGBTQ+ YYA. Three descriptions of interventions tailored for LGBTQ+ YYA (group cessation counselling, social marketing, and a mobile phone app with social media incorporated), were shared with LGBTQ+ YYA via 24 focus groups with 204 participants in Toronto and Ottawa, Canada. Open-ended questions focused on their feelings, likes and dislikes, and concerns about the culturally modified intervention descriptions. Framework analysis was used to identify overarching themes across all three intervention descriptions. The data revealed eight overarching themes across all three intervention descriptions. Smoking cessation and prevention interventions should have the following key attributes: 1) be LGBTQ+ - specific; 2) be accessible in terms of location, time, availability, and cost; 3) be inclusive, relatable, and highlight diversity; 4) incorporate LGBTQ+ peer support and counselling services; 5) integrate other activities beyond smoking; 6) be positive, motivational, uplifting, and empowering; 7) provide concrete coping mechanisms; and 8) integrate rewards and incentives. LGBTQ+ YYA focus group participants expressed a desire for an intervention that can incorporate these key elements. The mobile phone app and social media campaign were noted as potential interventions that could include all the essential elements.

  1. Analysis of emergency physicians' Twitter accounts.

    Science.gov (United States)

    Lulic, Ileana; Kovic, Ivor

    2013-05-01

    Twitter is one of the fastest growing social media networks for communication between users via short messages. Technology proficient physicians have demonstrated enthusiasm in adopting social media for their work. To identify and create the largest directory of emergency physicians on Twitter, analyse their user accounts and reveal details behind their connections. Several web search tools were used to identify emergency physicians on Twitter with biographies completely or partially written in English. NodeXL software was used to calculate emergency physicians' Twitter network metrics and create visualisation graphs. The authors found 672 Twitter accounts of self-identified emergency physicians. Protected accounts were excluded from the study, leaving 632 for further analysis. Most emergency physicians were located in USA (55.4%), had created their accounts in 2009 (43.4%), used their full personal name (77.5%) and provided a custom profile picture (92.2%). Based on at least one published tweet in the last 15 days, there were 345 (54.6%) active users on 31 December 2011. Active users mostly used mobile devices based on the Apple operating system to publish tweets (69.2%). Visualisation of emergency physicians' Twitter network revealed many users with no connections with their colleagues, and a small group of most influential users who were highly interconnected. Only a small proportion of registered emergency physicians use Twitter. Among them exists a smaller inner network of emergency physicians with strong social bonds that is using Twitter's full potentials for professional development.

  2. Patient satisfaction with physiotherapy in the emergency department.

    Science.gov (United States)

    Sheppard, Lorraine A; Anaf, Sophie; Gordon, Jane

    2010-10-01

    This research aims to explore patient satisfaction with ED physiotherapy within the Australian context by providing a qualitative perspective with in-depth exploration of the factors underlying patients' satisfaction. The physiotherapist was part of the Emergency Department Allied Health Team of social worker and occupational therapist. A qualitative, interpretive, field-based study using face-to-face interviews were carried out post-physiotherapy treatment within the emergency department, followed-up 2-3 weeks later with telephone interviews. Twenty two participants took part in the face-to-face interviews and 15 in the follow-up interviews. Of the 22 participants who took part in the initial interviews 19 were over 65 years of age, with a mean age of 78 years. Within the category 'Physiotherapy in the emergency department' the themes were; expectations, bedside manner, physiotherapy management (i.e. assessment, advice, hands-on, exercise, follow-up/referral) and satisfaction. The physiotherapist at the Australian emergency department appeared to make an impact on patients' experiences in the emergency department through his thorough subjective assessment of the patients' home environment, coping skills and social supports, his assessment of functional mobility, his provision of exercises, advice and hands-on treatment, as well as his involvement in organising follow-up or referral to other services. The physiotherapist's bedside manner shaped patients' perceptions throughout their assessment and treatment, reassuring and comforting patients within the emergency environment. Participants were satisfied with the experience of attending the physiotherapist in the emergency department and commented the blend of skills of the physiotherapists enhanced the service provision and self reported patient outcomes. Copyright © 2009 Elsevier Ltd. All rights reserved.

  3. Qualitative data analysis for health services research: developing taxonomy, themes, and theory.

    Science.gov (United States)

    Bradley, Elizabeth H; Curry, Leslie A; Devers, Kelly J

    2007-08-01

    To provide practical strategies for conducting and evaluating analyses of qualitative data applicable for health services researchers. DATA SOURCES AND DESIGN: We draw on extant qualitative methodological literature to describe practical approaches to qualitative data analysis. Approaches to data analysis vary by discipline and analytic tradition; however, we focus on qualitative data analysis that has as a goal the generation of taxonomy, themes, and theory germane to health services research. We describe an approach to qualitative data analysis that applies the principles of inductive reasoning while also employing predetermined code types to guide data analysis and interpretation. These code types (conceptual, relationship, perspective, participant characteristics, and setting codes) define a structure that is appropriate for generation of taxonomy, themes, and theory. Conceptual codes and subcodes facilitate the development of taxonomies. Relationship and perspective codes facilitate the development of themes and theory. Intersectional analyses with data coded for participant characteristics and setting codes can facilitate comparative analyses. Qualitative inquiry can improve the description and explanation of complex, real-world phenomena pertinent to health services research. Greater understanding of the processes of qualitative data analysis can be helpful for health services researchers as they use these methods themselves or collaborate with qualitative researchers from a wide range of disciplines.

  4. Simple webs of natural environment theme as a result of sharing in science teacher training

    Science.gov (United States)

    Tapilouw, M. C.; Firman, H.; Redjeki, S.; Chandra, D. T.

    2018-03-01

    Thematic learning is one type of integrated science (Biology, Physics, Chemistry and Earth Science) in Science Education. This study is concerning about simple webs of natural environment theme in science learning, as one of training material in science teacher training program. Making simple web is a goal of first step in teacher training program. Every group explain their web illustration to other group. Twenty Junior High School science teacher above one education foundation participate in science teacher training program. In order to gather simple webs, sharing method was used in this first step of science teacher training. The result of this study is five different simple web of natural environment themes. These webs represent science learning in class VII/Semester I, class VII/Semester II, Class VIII, Class IX/Semester I, Class IX/Semester II based on basic competency in National Curriculum 2013. Each group discussed web of natural environment theme based on their learning experience in real class which basic competency and subject matters are linked with natural environment theme. As a conclusion, simple webs are potential to develop in the next step of science teacher training program and to be implemented in real class.

  5. Exploring emergency nurse practitioners' perceptions of their role.

    Science.gov (United States)

    Bagley, Sue

    2018-02-21

    Since the 1980s, the emergency nurse practitioner (ENP) role has evolved as increasing socioeconomic pressures and changing government policy have led to new working practices in emergency departments. Similarly, a lack of consensus regarding educational support for ENPs and the regulation of ENP training, mean that variations remain in the scope of practice, role description and academic requirements for ENPs. To explore ENPs' perceptions of their changing role, including their educational requirements and whether their training needs are being met. This qualitative phenomenological study examined the views of six ENPs using semi-structured interviews. The study identified four themes: inadequate protected time for continuing professional development (CPD); importance of senior medical support in role expansion and CPD; inconsistent educational preparation for expanded roles; and the ENPs' perceived reasons for role expansion. Although all the participants stated that it was challenging to find time for CPD when working in busy clinical environments, this was regarded as less important than the positive effect of senior medical support for advanced roles. Over the past three decades, the ENP role has become well established, which has led to increased confidence, and the development of collaborative ways of working, among ENPs and their colleagues. However, while ENPs have embraced the challenges of their changing role, educational support has not been consistent. There are still disparities in ENPs' scope of practice, expectations of the role between services, and the educational preparation required to undertake the role. ©2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

  6. Threats from emerging and re-emerging neglected tropical diseases (NTDs).

    Science.gov (United States)

    Mackey, Tim K; Liang, Bryan A

    2012-01-01

    Neglected tropical diseases impact over 1 billion of the world's poorest populations and require special attention. However, within the NTDs recognized by the World Health Organization, some are also dually categorized as emerging and re-emerging infectious diseases requiring more detailed examination on potential global health risks. We reviewed the 17 NTDs classified by the WHO to determine if those NTDs were also categorized by the US Centers for Disease Control and Prevention as emerging and re-emerging infectious diseases (''EReNTDs''). We then identified common characteristics and risks associated with EReNTDs. Identified EReNTDs of dengue, rabies, Chagas Disease, and cysticercosis disproportionately impact resource-poor settings with poor social determinants of health, spread through globalization, are impacted by vector control, lack available treatments, and threaten global health security. This traditionally neglected subset of diseases requires urgent attention and unique incentive structures to encourage investment in innovation and coordination. Multi-sectorial efforts and targeted public-private partnerships would spur needed R&D for effective and accessible EReNTD treatments, improvement of social determinants of health, crucial low-income country development, and health system strengthening efforts. Utilization of One Health principles is essential for enhancing knowledge to efficaciously address public health aspects of these EReNTDs globally.

  7. Refugee-Themed Picture Books for Ethical Understanding in Curriculum English

    Science.gov (United States)

    Dooley, Karen; Tait, Gordon; Zabarjadi Sar, Hora

    2016-01-01

    This study looked at the curricular resource potential of refugee-themed picture books for embedding an ethics of responsibility for linguistic diversity into the subject of English studied by all students in English-dominant western societies. Selected picture books were analysed in terms of a Levinasean ethics of responsibility for alterity in…

  8. Language and Theme Symbiosis: A Stylistic Analysis of use of ...

    African Journals Online (AJOL)

    ... parallelism, balanced construction, figures of speech, idioms, and proverbs to reinforce the themes. The enormous use of titles and aliases and the undue emphasis on their use before people's name not only speak volumes about vainglory but also give the work a touch of humour. The language is etched with meticulous ...

  9. Implementing Sexual Orientation and Gender Identity Data Collection in Emergency Departments: Patient and Staff Perspectives.

    Science.gov (United States)

    German, Danielle; Kodadek, Lisa; Shields, Ryan; Peterson, Susan; Snyder, Claire; Schneider, Eric; Vail, Laura; Ranjit, Anju; Torain, Maya; Schuur, Jeremiah; Lau, Brandyn; Haider, Adil

    2016-12-01

    To identify patient and provider perspectives concerning collection of sexual orientation and gender identity (SO&GI) information in emergency departments (EDs). Semistructured interviews were conducted during the period of 2014-2015 with a diverse purposive sample of patients across the spectrum of sexual orientation and gender identities (n = 53) and ED nurses, physician assistants, physicians, and registrars (n = 38) in a major metropolitan area. Interviews were recorded, transcribed verbatim, and analyzed by multiple coders using constant comparative methods. Patients were willing to provide SO&GI information if collected safely and appropriately, and staff described willingness to collect SO&GI information to inform understanding of health disparities. Key themes across respondents were as follows: What will be done with the data? How will it be collected? Who will collect it? Is the environment conducive to safe disclosure? Confidentiality and potential sensitivity; standardized collection emphasizing population health; nurse intake and/or nonverbal data collection; and environmental cues and cultural competency promoting comfort for sexual and gender minorities emerged as critical considerations for effective implementation. Staff and patients are amenable to SO&GI data collection in EDs, but data quality and patient and provider comfort may be compromised without attention to specific implementation considerations.

  10. Occupational therapy practice in emergency care: Occupational therapists' perspectives.

    Science.gov (United States)

    Spang, Lisa; Holmqvist, Kajsa

    2015-01-01

    Emergency care takes place in a complex work environment that is characterized by critically ill patients, short hospital stays, and a wide variety of different healthcare professionals. Studies of occupational therapists' (OTs) experiences of working within emergency care have shown that they often experience difficulties in explaining the essence of occupational therapy and have to justify their approaches. Much effort has been made in Sweden to help OTs dispel the notion that occupational therapy is difficult to explain, and the aim of this study was to describe how Swedish OTs perceive their work in emergency care. A qualitative descriptive approach was taken, and 14 interviews were conducted with OTs working in emergency care. Qualitative content analysis was used to analyse the data. The overall theme that emerged was "Feeling established through deliberate occupation-based work". The underlying categories showed different strategies used by the OTs to provide occupational therapy in an emergency care context. Deliberate strategies were used to demonstrate the effectiveness of occupational therapy and its approaches to patients and other health care professionals, and this resulted in the OTs feeling both established and needed. Unlike the OTs in previous studies, the Swedish OTs experienced no difficulties in explaining occupational therapy and could make convincing arguments for their interventions. Parallel to their clinical work, the OTs worked with on-going development to find ways to improve their approaches. In summary, these Swedish OTs seem to have been provided with a professional language and the knowledge required to establish themselves in an emergency care setting.

  11. Environmental Justice Research: Contemporary Issues and Emerging Topics.

    Science.gov (United States)

    Chakraborty, Jayajit; Collins, Timothy W; Grineski, Sara E

    2016-11-01

    Environmental justice (EJ) research seeks to document and redress the disproportionate environmental burdens and benefits associated with social inequalities. Although its initial focus was on disparities in exposure to anthropogenic pollution, the scope of EJ research has expanded. In the context of intensifying social inequalities and environmental problems, there is a need to further strengthen the EJ research framework and diversify its application. This Special Issue of the International Journal of Environmental Research and Public Health (IJERPH) incorporates 19 articles that broaden EJ research by considering emerging topics such as energy, food, drinking water, flooding, sustainability, and gender dynamics, including issues in Canada, the UK, and Eastern Europe. Additionally, the articles contribute to three research themes: (1) documenting connections between unjust environmental exposures and health impacts by examining unsafe infrastructure, substance use, and children's obesity and academic performance; (2) promoting and achieving EJ by implementing interventions to improve environmental knowledge and health, identifying avenues for sustainable community change, and incorporating EJ metrics in government programs; and (3) clarifying stakeholder perceptions of EJ issues to extend research beyond the documentation of unjust conditions and processes. Collectively, the articles highlight potentially compounding injustices and an array of approaches being employed to achieve EJ.

  12. Environmental Justice Research: Contemporary Issues and Emerging Topics

    Directory of Open Access Journals (Sweden)

    Jayajit Chakraborty

    2016-11-01

    Full Text Available Environmental justice (EJ research seeks to document and redress the disproportionate environmental burdens and benefits associated with social inequalities. Although its initial focus was on disparities in exposure to anthropogenic pollution, the scope of EJ research has expanded. In the context of intensifying social inequalities and environmental problems, there is a need to further strengthen the EJ research framework and diversify its application. This Special Issue of the International Journal of Environmental Research and Public Health (IJERPH incorporates 19 articles that broaden EJ research by considering emerging topics such as energy, food, drinking water, flooding, sustainability, and gender dynamics, including issues in Canada, the UK, and Eastern Europe. Additionally, the articles contribute to three research themes: (1 documenting connections between unjust environmental exposures and health impacts by examining unsafe infrastructure, substance use, and children’s obesity and academic performance; (2 promoting and achieving EJ by implementing interventions to improve environmental knowledge and health, identifying avenues for sustainable community change, and incorporating EJ metrics in government programs; and (3 clarifying stakeholder perceptions of EJ issues to extend research beyond the documentation of unjust conditions and processes. Collectively, the articles highlight potentially compounding injustices and an array of approaches being employed to achieve EJ.

  13. Strategies for enhancing information, motivation, and skills for self-management behavior changes: a qualitative study of diabetes care for older adults in Korea.

    Science.gov (United States)

    Choi, Suyoung; Song, Misoon; Chang, Sun Ju; Kim, Se-An

    2014-01-01

    To describe strategies for enhancing information, motivation, and skills related to changes in diabetes self-management behavior among community-dwelling older adults in Korea. A total of five focus group interviews (three separate focus groups) were conducted with 12 older adults with type 2 diabetes and five diabetes educators. Qualitative content analysis was used. "One's own willingness and ability" emerged as a fundamental belief about the strategies for diabetes self-management. Six major themes under three categories were identified. Under the information category, the recurrent themes were: 1) repeatedly offering detailed knowledge regarding self-management, 2) providing information about current health status, and 3) identifying experiential knowledge of blood glucose control. The recurrent themes in the motivation category were: 1) ensuring a positive attitude regarding self-management, and 2) encouragement or feedback from significant others. Furthermore, in the skills category, we found that the following theme emerged: hands-on skills training with numerical standards. This study identified six tailored strategies for enhancing information, motivation, and skills for diabetes self-management behavior changes. These strategies can be used in the development of a culturally sensitive diabetes self-management program for older adults.

  14. Ecological Economics: Themes, Approaches, and Differences with Environmental Economics

    OpenAIRE

    Jeroen C.J.M. van den Bergh

    2000-01-01

    This provides a short overview of the main themes of ecological economics (EE). It isargued that EE provides a platform that fosters multidisciplinary environmental research bybringing together the core contributing disciplines economics and ecology. In addition, EE isregarded as a pluralistic approach to environmental research that can be set opposite to, and hasindeed developed as a response to, traditional environmental and resource economics. Acomparison of the two fields is presented to ...

  15. Hindemith: Symphonic Metamorphosis on Themes of Carl Maria von Weber / Jonathan Swain

    Index Scriptorium Estoniae

    Swain, Jonathan

    1990-01-01

    Uuest heliplaadist "Hindemith: Symphonic Metamorphosis on Themes of Carl Maria von Weber, Mathis der Maler - Symphony, Nobilissima visione - suite. Atlanta Symphony Orchestra, Yoel Levi" Telarc/ Conifer CD 80 195

  16. Identifying frailty in primary care: a qualitative description of family physicians' gestalt impressions of their older adult patients.

    Science.gov (United States)

    Korenvain, Clara; Famiyeh, Ida-Maisie; Dunn, Sheila; Whitehead, Cynthia R; Rochon, Paula A; McCarthy, Lisa M

    2018-05-14

    Many tools exist to guide family physicians' impressions about frailty status of older adults, but no single tool, instrument, or set of criteria has emerged as most useful. The role of physicians' subjective impressions in frailty decisions has not been studied. This study explores how family physicians conceptualize frailty, and the factors that they consider when making subjective decisions about patients' frailty statuses. Descriptive qualitative study of family physicians who practice in a large urban academic family medicine center as they participated in one-on-one "think-aloud" interviews about the frailty status of their patients aged 80 years and over. Of 23 eligible family physicians, 18 shared their impressions about the frailty status of their older adult patients and the factors influencing their decisions. Interviews were audio-recorded, transcribed, and thematically analyzed. Four themes were identified, the first of which described how physicians conceptualized frailty as a spectrum and dynamic in nature, but also struggled to conceptualize it without a formal definition in place. The remaining three themes described factors considered before determining patients' frailty statuses: physical characteristics (age, weight, medical conditions), functional characteristics (physical, cognitive, social) and living conditions (level of independence, availability of supports, physical environment). Family physicians viewed frailty as multifactorial, dynamic, and inclusive of functional and environmental factors. This conceptualization can be useful to make comprehensive and flexible evaluations of frailty status in conjunction with more objective frailty tools.

  17. Identifying Barriers and Facilitators at Affect Community Pharmacists' Ability to Engage Children in Medication Counseling: A Pilot Study

    Science.gov (United States)

    Alexander, Dayna S.; Schleiden, Loren J.; Carpenter, Delesha M.

    2017-01-01

    OBJECTIVES This study aimed to describe the barriers and facilitators that influence community pharmacists' ability to provide medication counseling to pediatric patients. METHODS Semistructured interviews (n = 16) were conducted with pharmacy staff at 3 community pharmacies in 2 Eastern states. The interview guide elicited pharmacy staff experiences interacting with children and their perceived barriers and facilitators to providing medication counseling. Transcripts were reviewed for accuracy and a codebook was developed for data analysis. NVivo 10 was used for content analysis and identifying relevant themes. RESULTS Ten pharmacists and 6 pharmacy technicians were interviewed. Most participants were female (69%), aged 30 to 49 years (56%), with ≥5 years of pharmacy practice experience. Eight themes emerged as barriers to pharmacists' engaging children in medication counseling, the most prevalent being the child's absence during medication pickup, the child appearing to be distracted or uninterested, and having an unconducive pharmacy environment. Pharmacy staff noted 7 common facilitators to engaging children, most importantly, availability of demonstrative and interactive devices/technology, pharmacist demeanor and communication approach, and having child-friendly educational materials. CONCLUSIONS Findings suggest that pharmacy personnel are rarely able to engage children in medication counseling because of the patient's absence during medication pickup; however, having child-friendly materials could facilitate interactions when the child is present. These findings can inform programs and interventions aimed at addressing the barriers pharmacists encounter while educating children about safe and appropriate use of medicines. PMID:29290741

  18. ATTENTION TO THE EMERGENCY ROOM WITH EMPHASIS ON PRE-HOSPITAL CARE: INTEGRATIVE REVIEW

    Directory of Open Access Journals (Sweden)

    B. S. Santos

    2017-08-01

    Full Text Available The study aims to identify the factors, which influence positively and negatively the implementation of public policies geared to the needs in scope of mobile, found in the publications of brazilian researchers since the implementation of the National Policy of Attention to the Emergency room in Brazil. This is a study of Integrative Literature Review. Composing the basis of methodology, have been used official documents to guide the findings that comprised the conceptual bases of the study and to guide the Integrative Review were used publications that report on the issue in question respecting all steps of the protocol review. The results show the changes in the organizational structure of the Service Mobile Emergency, given the regionalization as something positive for the growth of this service modality and discuss prematurely early articulation between the sectors that make up the public health system in Brazil. In conclusion, the policies of attention to the urgencies, in particular within mobile, have favored beneficially all of the users who require this type of care, in the meantime, make the necessary reflections about this theme in the attempt of a better understanding of the regionalization process and coordination among the municipalities that will offer the mobile care so as to ensure continuity of care through the mechanisms of reference and counter-reference

  19. Rates of workplace aggression in the emergency department and nurses' perceptions of this challenging behaviour: A multimethod study.

    Science.gov (United States)

    Hyland, Simone; Watts, Joanne; Fry, Margaret

    2016-08-01

    Over the last 10 years, the rate of people presenting with challenging behaviour to emergency departments (EDs) has increased and is recognised as a frequent occurrence facing clinicians today. Challenging behaviour often includes verbal aggression, physical aggression, intimidation and destruction of property. The aim of this research was to (i) identify the characteristics and patterns of ED-reported incidents of challenging behaviour and (ii) explore emergency nurses' perceptions of caring for patients displaying challenging behaviour. This was a multi-method study conducted across two metropolitan Sydney district hospitals. Phase 1 involved a 12-month review of the hospital's incident management database. Phase 2 involved a survey of emergency nurses' perceptions of caring for patients displaying challenging behaviour. Over 12 months there were 34 incidents of aggression documented and the perpetrators were often male (n=18; 53.0%). The average age was 34.5 years. The majority of reported incidents (n=33; 90.1%) involved intimidation, verbal assault and threatening behaviour. The median time between patient arrival and incident was 109.5min (IQR 192min). The median length of stay for patients was 302.5min (IQR 479min). There was no statistical difference between day of arrival and time of actual incident (t-test p=0.235), length of stay (t-test p=0.963) or ED arrival to incident time (t-test p=0.337). The survey (n=53; 66.2%) identified the average ED experience was 12.2 years (SD 9.8 years). All participants surveyed had experienced verbal abuse and/or physical abuse. Participants (n=52) ranked being spat at (n=37; 71.1%) the most difficult to manage. Qualitative survey open-ended comments were analysed and organised thematically. The survey identified three themes which were (i) increasing security, (ii) open access and (iii) rostering imbalance. The study provides insight into emergency nurses' reported perceptions of patients who display challenging

  20. Snake fungal disease: an emerging threat to wild snakes.

    Science.gov (United States)

    Lorch, Jeffrey M; Knowles, Susan; Lankton, Julia S; Michell, Kathy; Edwards, Jaime L; Kapfer, Joshua M; Staffen, Richard A; Wild, Erik R; Schmidt, Katie Z; Ballmann, Anne E; Blodgett, Doug; Farrell, Terence M; Glorioso, Brad M; Last, Lisa A; Price, Steven J; Schuler, Krysten L; Smith, Christopher E; Wellehan, James F X; Blehert, David S

    2016-12-05

    Since 2006, there has been a marked increase in the number of reports of severe and often fatal fungal skin infections in wild snakes in the eastern USA. The emerging condition, referred to as snake fungal disease (SFD), was initially documented in rattlesnakes, where the infections were believed to pose a risk to the viability of affected populations. The disease is caused by Ophidiomyces ophiodiicola, a fungus recently split from a complex of fungi long referred to as the Chrysosporium anamorph of Nannizziopsis vriesii (CANV). Here we review the current state of knowledge about O. ophiodiicola and SFD. In addition, we provide original findings which demonstrate that O. ophiodiicola is widely distributed in eastern North America, has a broad host range, is the predominant cause of fungal skin infections in wild snakes and often causes mild infections in snakes emerging from hibernation. This new information, together with what is already available in the scientific literature, advances our knowledge of the cause, pathogenesis and ecology of SFD. However, additional research is necessary to elucidate the factors driving the emergence of this disease and develop strategies to mitigate its impacts.This article is part of the themed issue 'Tackling emerging fungal threats to animal health, food security and ecosystem resilience'. © 2016 The Author(s).

  1. Acute Testicular Ischemia following Endovascular Abdominal Aortic Aneurysm Repair Identified in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Nathan Finnerty

    2014-01-01

    Full Text Available Endovascular aneurysm repair (EVAR is perhaps the most widely utilized surgical procedure for patients with large abdominal aortic aneurysms. This procedure is minimally invasive and reduces inpatient hospitalization requirements. The case involves a 72-year-old male who presented to the emergency department with right testicular ischemia two days following EVAR. Given the minimal inpatient hospitalization associated with this procedure, emergency physicians are likely to encounter associated complications. Ischemic and thromboembolic events following EVAR are extremely rare but require prompt vascular surgery intervention to minimize morbidity and mortality.

  2. Creation of meanings on the theme

    Directory of Open Access Journals (Sweden)

    Eveline Borges

    2011-12-01

    Full Text Available Investments in policies for science teachers, as well as their adaptation to new realities and technologies are essential, since the teacher is the key to changing mindsets and attitudes of their students. Thus, conceptual discussions are proposed between chemistry teachers in a virtual environment on the Moodle platform on topics previously chosen by the education teacher. The objective is to analyze the process of creating meanings of participants of the forum on the theme "nature of science." It was noticed that new media can help building students' knowledge and motivate them to expand their research and scientific readings; however, rules must be preestablished so that a real interaction and mediation could occur. Initiatives like these are useful for the understanding of scientific and technical fields, and may also facilitate communication and interaction between teachers and students.

  3. [Suicide -- an essay trying to reveal the theme].

    Science.gov (United States)

    Sampaio, M A; Boemer, M R

    2000-12-01

    This essay proposes to reveal facets of the suicide through the discourse of different authors treating this theme as well as through contacts that I was able to have in my nursing training, through my academic trajectory. This trajectory includes an incursion by phenomenological ideas, mainly by the ideas of Heidegger and his existential analysis of the man as being-there. In this way, the understanding of a person who decides to finalize his/her existence, can be, by the existential analysis perspective, a way to reconstruct and redimension his/her existential perspectives.

  4. The value of the pre-hospital learning environment as part of the ...

    African Journals Online (AJOL)

    Results: Four major themes were identified: an unpredictable environment, role players in emergency medical services, team work, and competencies. Conclusion: The research findings support the value and continuation of utilising the prehospital clinical learning environment for placing post-basic emergency nursing ...

  5. The Cambia Sojourns Scholars Leadership Program: Conversations with Emerging Leaders in Palliative Care.

    Science.gov (United States)

    Cruz-Oliver, Dulce M; Bernacki, Rachelle; Cooper, Zara; Grudzen, Corita; Izumi, Seiko; Lafond, Deborah; Lam, Daniel; LeBlanc, Thomas W; Tjia, Jennifer; Walter, Jennifer

    2017-08-01

    There is a pressing workforce shortage and leadership scarcity in palliative care to adequately meet the demands of individuals with serious illness and their families. To address this gap, the Cambia Health Foundation launched its Sojourns Scholars Leadership Program in 2014, an initiative designed to identify, cultivate, and advance the next generation of palliative care leaders. This report intends to summarize the second cohort of Sojourns Scholars' projects and their reflection on their leadership needs. This report summarizes the second cohort of sojourns scholars' project and their reflection on leadership needs. After providing a written reflection on their own projects, the second cohort participated in a group interview (fireside chat) to elicit their perspectives on barriers and facilitators in providing palliative care, issues facing leadership in palliative care in the United States, and lessons from personal and professional growth as leaders in palliative care. They analyzed the transcript of the group interview using qualitative content analysis methodology. Three themes emerged from descriptions of the scholars' project experience: challenges in palliative care practice, leadership strategies in palliative care, and three lessons learned to be a leader were identified. Challenges included perceptions of palliative care, payment and policy, and workforce development. Educating and collaborating with other clinicians and influencing policy change are important strategies used to advance palliative care. Time management, leading team effort, and inspiring others are important skills that promote effectiveness as a leader. Emerging leaders have a unique view of conceptualizing contemporary palliative care and shaping the future. Providing comprehensive, coordinated care that is high quality, patient and family centered, and readily available depends on strong leadership in palliative care. The Cambia Scholars Program represents a unique opportunity.

  6. Themes of Death and Violence in Lullabies of Different Countries.

    Science.gov (United States)

    Achte, Kalle; And Others

    1990-01-01

    Lullabies are often divided into songs describing death or funeral of child and songs which threaten child with violence if he/she does not sleep. Survey of lullabies from 26 countries and various ethnic groups revealed that threat songs were more common than lullabies with death themes. Latter were frequent in Finno-Ugris and Slavic cultures, not…

  7. "Teachosaurus" and "Learnoceratops": Dinosaurs as a Motivating Cross-Curricular Theme

    Science.gov (United States)

    Duggan, Denis

    2011-01-01

    The author takes a look into the benefits that dinosaurs may bring to the classroom. He discusses how he used dinosaurs as a cross-curricular theme to improve children's understanding and knowledge of science concepts. To investigate what a child might learn from dinosaurs, he started by comparing the many non-fiction dinosaur books using the…

  8. Barriers to knowledge sharing in Chinese healthcare referral services: an emergent theoretical model

    Science.gov (United States)

    Nunes, Miguel Baptista

    2016-01-01

    Background This paper reports on a research study that aims to identify and explain barriers to knowledge sharing (KS) in the provision of healthcare referral services in Chinese healthcare organisations. Design An inductive case study approach was employed, in which 24 healthcare professionals and workers from four healthcare organisations in the province of Hubei, Central China, were interviewed using semi-structured scripts. Results Through data analysis, 14 KS barriers emerged in four main themes: interpersonal trust barriers, communication barriers, management and leadership barriers, and inter-institutional barriers. A cause–consequence analysis of the identified barriers revealed that three of them are at the core of the majority of problems, namely, the absence of national and local policies for inter-hospital KS, lack of a specific hospital KS requirement, and lack of mutual acquaintance. Conclusions To resolve KS problems, it is of great importance that healthcare governance agencies, both at the national and regional levels, take leadership in the process of KS implementation by establishing specific and strong policies for inter-institutional KS in the referral process. This paper raises important issues that exceed academic interests and are important to healthcare professionals, hospital managers, and Information communication technology (ICT) managers in hospitals, as well as healthcare politicians and policy makers. PMID:26895146

  9. Emerging Patterns Of Bangsa Malaysia In Anthony Burgess’ Time For A Tiger

    Directory of Open Access Journals (Sweden)

    Farahanna Abd Razak

    2016-01-01

    Full Text Available Time for a Tiger (1956, a novel by Anthony Burgess, is believed to have been overlooked in the Malaysian literary context. Existing scholarship has maintained that the central themes of Time for a Tiger are colliding cultures, clashes of religion and racial conflicts but, in spite of these themes, this paper attempts to argue that there are in fact emerging patterns of Bangsa Malaysia in Time for a Tiger, which in turn reflect the elements of unity among the rich mixture of multi-ethnic characters. Bangsa Malaysia is not only the first of the nine challenges listed in Vision 2020 as conceptualised by Dr. Mahathir Mohamad (1991, but also marks the first time the Malaysian government is officially putting forward a clear vision in building a nation, launched to create a oneness atmosphere among the ethnic groups, in hopes it will reduce, if not erase, the tension among them. This study reveals that there are indeed emerging patterns of Bangsa Malaysia depicted through a mixture of characters from various ethnicities, namely the Malays, the Chinese and the Indians, through the implementation of government policies, education, a change of mindset and personal judgement, patriotism and the unifying role of the monarchy. Additionally, the patterns do support the earlier stage of the formation of Bangsa Malaysia, namely tolerance.

  10. Making Sense of the Brutality of the Holocaust: Critical Themes and New Perspectives.

    Science.gov (United States)

    Miller, Eric D

    2017-01-02

    This article offers an analytic, integrative review of select themes associated with one of history's greatest atrocities: the Holocaust. Much of this review considers general and Holocaust-specific themes as they pertain to the nature of senseless violence and evil. The importance of having a greater understanding of the sheer brutality of violence perpetuated in the Holocaust is emphasized. As part of this discussion, considerable attention is given to how Internet-based photographs and videos from the Holocaust era can provide greater insight into understanding the evil associated with this genocide. Some consideration of the larger meaning of the Holocaust, particularly for Jews, is also examined.

  11. Simulations, Imaging, and Modeling: A Unique Theme for an Undergraduate Research Program in Biomechanics.

    Science.gov (United States)

    George, Stephanie M; Domire, Zachary J

    2017-07-01

    As the reliance on computational models to inform experiments and evaluate medical devices grows, the demand for students with modeling experience will grow. In this paper, we report on the 3-yr experience of a National Science Foundation (NSF) funded Research Experiences for Undergraduates (REU) based on the theme simulations, imaging, and modeling in biomechanics. While directly applicable to REU sites, our findings also apply to those creating other types of summer undergraduate research programs. The objective of the paper is to examine if a theme of simulations, imaging, and modeling will improve students' understanding of the important topic of modeling, provide an overall positive research experience, and provide an interdisciplinary experience. The structure of the program and the evaluation plan are described. We report on the results from 25 students over three summers from 2014 to 2016. Overall, students reported significant gains in the knowledge of modeling, research process, and graduate school based on self-reported mastery levels and open-ended qualitative responses. This theme provides students with a skill set that is adaptable to other applications illustrating the interdisciplinary nature of modeling in biomechanics. Another advantage is that students may also be able to continue working on their project following the summer experience through network connections. In conclusion, we have described the successful implementation of the theme simulation, imaging, and modeling for an REU site and the overall positive response of the student participants.

  12. A pilot analysis of the psychological themes found during the CARING at Columbia--Music Therapy program with refugee adolescents from North Korea.

    Science.gov (United States)

    Choi, Carolyn Mi Hwan

    2010-01-01

    The purpose of this study was to identify the psychological themes found during the modified CARING at Columbia-Music Therapy (CAC-MT) program with refugee adolescents from North Korea. Nine students attending an alternative school participated in this study. Academically, students belong to an equivalent middle school level. Students participated in a music therapy program comprised of 25 sessions. A multiple case analysis was conducted to gather qualitative results. Students were found to be exposed to various psychosocially stressful life situations such as lack of social support system, family separation, academic difficulty, and economic hardship throughout their adaptation process to their new country. There were 5 common psychological themes--avoidance, distrust, loneliness, feelings of loss, and fear--found among the refugee students over the course of the CAC-MT treatment. For future research, studies with a larger sample size and differing types of session structure should be conducted to closely examine the effects of this program on refugee adolescents.

  13. Mortality following emergency groin hernia surgery in Denmark

    DEFF Research Database (Denmark)

    Kjærgaard, Jesper; Bay-Nielsen, M; Kehlet, H

    2010-01-01

    The mortality following emergency groin hernia repair in Denmark is more than twice as high (7%) as in comparable countries. This article describes in detail the population that died following emergency herniotomy in order to identify aspects of care that may improve outcome.......The mortality following emergency groin hernia repair in Denmark is more than twice as high (7%) as in comparable countries. This article describes in detail the population that died following emergency herniotomy in order to identify aspects of care that may improve outcome....

  14. OSCAAR calculations for the Iput dose reconstruction scenario of BIOMASS theme 2

    Energy Technology Data Exchange (ETDEWEB)

    Homma, Toshimitsu; Matsunaga, Takeshi [Department of Reactor Safety Research, Nuclear Safety Research Center, Tokai Research Establishment, Japan Atomic Energy Research Institute, Tokai, Ibaraki (Japan)

    2001-01-01

    This report presents the results obtained from the application of the accident consequence assessment code, called OSCAAR, developed in Japan Atomic Energy Research Institute to the Iput dose reconstruction scenario of BIOMASS Theme 2 organized by International Atomic Energy Agency. The Iput Scenario deals with {sup 137}Cs contamination of the catchment basin and agricultural area in the Bryansk Region of Russia, which was heavily contaminated after the Chernobyl accident. This exercise was used to test the chronic exposure pathway models in OSCAAR with actual measurements and to identify the most important sources of uncertainly with respect to each part of the assessment. The OSCAAR chronic exposure pathway models almost successfully reconstructed the whole 10-year time course of {sup 137}Cs activity concentrations in most requested types of agricultural products and natural foodstuffs. Modeling of {sup 137}Cs downward migration in soils is, however, still incomplete and more detail modeling of the changes of cesium bioavailability with time is needed for long term predictions of the contamination of food. (author)

  15. OSCAAR calculations for the Iput dose reconstruction scenario of BIOMASS theme 2

    International Nuclear Information System (INIS)

    Homma, Toshimitsu; Matsunaga, Takeshi

    2001-01-01

    This report presents the results obtained from the application of the accident consequence assessment code, called OSCAAR, developed in Japan Atomic Energy Research Institute to the Iput dose reconstruction scenario of BIOMASS Theme 2 organized by International Atomic Energy Agency. The Iput Scenario deals with 137 Cs contamination of the catchment basin and agricultural area in the Bryansk Region of Russia, which was heavily contaminated after the Chernobyl accident. This exercise was used to test the chronic exposure pathway models in OSCAAR with actual measurements and to identify the most important sources of uncertainly with respect to each part of the assessment. The OSCAAR chronic exposure pathway models almost successfully reconstructed the whole 10-year time course of 137 Cs activity concentrations in most requested types of agricultural products and natural foodstuffs. Modeling of 137 Cs downward migration in soils is, however, still incomplete and more detail modeling of the changes of cesium bioavailability with time is needed for long term predictions of the contamination of food. (author)

  16. Threats from emerging and re-emerging neglected tropical diseases (NTDs

    Directory of Open Access Journals (Sweden)

    Tim K. Mackey

    2012-08-01

    Full Text Available Background: Neglected tropical diseases impact over 1 billion of the world's poorest populations and require special attention. However, within the NTDs recognized by the World Health Organization, some are also dually categorized as emerging and re-emerging infectious diseases requiring more detailed examination on potential global health risks. Methods: We reviewed the 17 NTDs classified by the WHO to determine if those NTDs were also categorized by the US Centers for Disease Control and Prevention as emerging and re-emerging infectious diseases (‘‘EReNTDs’’. We then identified common characteristics and risks associated with EReNTDs. Results: Identified EReNTDs of dengue, rabies, Chagas Disease, and cysticercosis disproportionately impact resource-poor settings with poor social determinants of health, spread through globalization, are impacted by vector control, lack available treatments, and threaten global health security. This traditionally neglected subset of diseases requires urgent attention and unique incentive structures to encourage investment in innovation and coordination. Discussion: Multi-sectorial efforts and targeted public–private partnerships would spur needed R&D for effective and accessible EReNTD treatments, improvement of social determinants of health, crucial low-income country development, and health system strengthening efforts. Utilization of One Health principles is essential for enhancing knowledge to efficaciously address public health aspects of these EReNTDs globally.

  17. Complexity: Outline of the NWO strategic theme Dynamics of complex systems

    NARCIS (Netherlands)

    Burgers, G.; Doelman, A.; Frenken, K.; Hogeweg, P.; Hommes, C.; van der Maas, H.; Mulder, B.; Stam, K.; van Steen, M.; Zandee, L.

    2008-01-01

    Dynamics of complex systems is one of the program 5 themes in the NWO (Netherlands Organisation for Scientific Research) strategy for the years 2007-2011. The ambition of the current proposal is to initiate integrated activities in the field of complex systems within the Netherlands, to provide

  18. Complexity : outline of the NWO strategic theme dynamics of complex systems

    NARCIS (Netherlands)

    Burgers, G.; Doelman, A.; Frenken, K.; Hogeweg, P.; Hommes, C.; Maas, van der H.; Mulder, B.; Stam, K.; Steen, van M.; Zandee, L.

    2008-01-01

    Dynamics of complex systems is one of the program 5 themes in the NWO (Netherlands Organisation for Scientific Research) strategy for the years 2007-2011. The ambition of the current proposal is to initiate integrated activities in the field of complex systems within the Netherlands, to provide

  19. The re-production of homosexually-themed discourse in educationally-based organised sport.

    Science.gov (United States)

    McCormack, Mark; Anderson, Eric

    2010-11-01

    In this study, we draw on findings from one year of participant observation and 12 in-depth interviews with men in a highly-ranked English university rugby team in order to nuance theoretical understandings concerning the re-production of homosexually-themed discourse in organised sport. We use ethnographic data to theorise the complex relationship between language, homosocial masculine relationships and organised sport. In examining the political, intentional and inadvertent effects of these men's discourses, we define and discuss the notion of gay discourse as a form of heteronormativity that is dissimilar to the traditional use of homophobic discourse. Highlighting that homosexually-themed discourse is best understood as a continuum, we stress the importance of context in interpreting the meaning and explicating the effects of this kind of discourse.

  20. Application of Satellite Remote Sensing to Identify Climatic and Anthropogenic Changes Related to Water and Health Conditions in Emerging Megacities

    Science.gov (United States)

    Akanda, A. S.; Serman, E. A.; Jutla, A.

    2014-12-01

    By 2050, more than 70% of the world's population is expected to be living in a city. In many of the urbanizing regions in Asia and Africa, most new development is taking place without adequate urban or regional planning, and a majority population is crowded into densely populated unplanned settlements, also known as slums. During the same period, precipitation and temperature patterns are likely to see significant changes in many of these regions while coastal megacities will have to accommodate sea-level rise in their ecosystems. The rapid increase in population is usually observed in fringes of the urban sprawl without adequate water or sanitation facilities or access to other municipal amenities (such as utilities, healthcare, and education). Collectively, these issues make the ever increasing slum dwellers in emerging megacities significantly vulnerable to a combination of climatic and anthropogenic threats. However, how the growth of unplanned urban and peri-urban sprawl and simultaneous change in climatic patterns have impacted public health in the emerging megacities remain largely unexplored due to lack of readily available and usable data. We employ a number of Remote Sensing products (GRACE, LANDSAT, MODIS) to bridge above knowledge gaps and to identify relevant hydrologic and anthropogenic changes in emerging megacities that are most vulnerable due to the climate-water-health nexus. We explore one of the largest and the fastest growing megacities in the world - Dhaka, Bangladesh - on identifying and investigating the changes in the water environment and growth of slum areas, and impact on water services and health outcomes. The hydroclimatology of South Asia is highly seasonal and the asymmetric availability of water affects vast areas of Bangladesh differently in space and time, exposing the population of Dhaka region to both droughts and floods and periodic spring-fall outbreaks of diarrheal diseases, such as cholera and rotavirus. This research