[Gerocomy -- gerontology -- geriatrics. The naming of a modern medical discipline].

Science.gov (United States)

Schäfer, D; Moog, F P

2005-11-25

300 years ago, the lawyer Theodosius Schöpffer coined the notion gerontology. On this occasion, this paper offers terms and corresponding concepts of gerontology which arose in the western tradition: 1. From the Graeco-Roman antiquity until 1750, gerocomy (the care for the elderly) was defined as a branch of medicine, but in practice almost did not exist. Basically, it provided instructions for a way of life in conformity with the physiological circumstances of elderly people. Its implementation was left to the patient. Furthermore, in the early modern times medical treatises dealt more frequently with diseases of the elderly and their therapy. The gerokomia succeeded in evolving a specific technical literature. Yet it failed to get institutionalized. 2. At the beginning of the 20th century, Ignaz Nascher interpreted geriatrics as a counterpart to pediatrics and opposed it to a clinical-pathological consideration of old age before 1900. He aimed at the exploration and treatment of old age as an autonomous physiological entity. Under the influence of the demographic transformation the institutionalization of geriatrics as a interdisciplinary branch within medicine could be realized relatively soon. 3. Around 1930, we experience the recreation of the notion gerontology, initially restricted to medical gerontology. However, with the integration of the non-medical sciences of old age the spectrum and the objectives changed. Today gerontology signifies on a international level a generic term or independent scientific discipline beside medicine. This evolution corresponds with the intentions pursued 300 years ago.

[Working together in gerontology].

Science.gov (United States)

Bonnery, Anne-Marie

2014-01-01

The complexity of care situations notablywith regard to the care of frail dependent elderly people suffering from chronic pathologies, requires a specific approach, a partnership between a nurse and nursing auxiliary and inter-disciplinarity. This work organisation positions the elderly person at the centre of the approach to ensure they are considered as a partner in the care. Improving exchanges and constructing a common understanding are real necessities for professionals working in gerontology.

Is Gerontology Ready for Accreditation?

Science.gov (United States)

Haley, William E.; Ferraro, Kenneth F.; Montgomery, Rhonda J. V.

2012-01-01

The authors review widely accepted criteria for program accreditation and compare gerontology with well-established accredited fields including clinical psychology and social work. At present gerontology lacks many necessary elements for credible professional accreditation, including defined scope of practice, applied curriculum, faculty with…

The National Hartford Center of Gerontological Nursing Excellence: An Evolution of a Nursing Initiative to Improve Care of Older Adults.

Science.gov (United States)

Harden, J Taylor; Watman, Rachael A

2015-06-01

The mission of the John A. Hartford Foundation is to improve the health of older Americans. This mission has been realized throughout the evolution of the National Hartford Center of Gerontological Nursing Excellence-an international collaboration between Schools of Nursing and Sigma Theta Tau International Honor Society of Nursing-whose goal is to support research, education, and practice to provide better nursing care for our aging society. The National Hartford Center is the focus of this supplement and an example of the Foundation's grant-making to prepare the nursing workforce to be competent to care for our aging society. This article traces the innovative origin and inception of the National Hartford Center, first as the Building Academic Geriatric Nursing Capacity (BAGNC) Initiative in 2000 under the leadership of two groundbreaking scholars in nursing and aging sciences: Claire M. Fagin, PhD, RN, and Patricia G. Archbold, DNSc. We continue through to today's leadership and culminate by describing the Center's influence on the gerontological nursing workforce and clinical practice; the paper also includes a brief introduction to the articles, highlighting advances in gerontological nursing science. With funding from the John A. Hartford Foundation, The Atlantic Philanthropies, The Mayday Fund, and a number of creative public and nonprofit partnerships, the National Hartford Center celebrates two decades and its greatest asset-the nearly 300 gerontological nursing leaders, including Archbold nursing pre-docs, Fagin nursing post-docs, and expert faculty, along with its Hartford Centers of Gerontological Nursing Excellence across the country. We trace the transition of BAGNC to the membership-based National Hartford Center and its move to The Gerontological Society of America to become a self-sustaining, autonomous unit. Current needs, challenges, lessons learned, and strategies of the National Hartford Center are examined within the context of sustainability

[Principles of social gerontology].

Science.gov (United States)

Kricheldorff, Cornelia; Aner, Kirsten; Himmelsbach, Ines; Thiesemann, Rüdiger

2015-12-01

Social gerontology is seen as a science-based but application-oriented subdiscipline of gerontology. It focuses particularly on social relationships in old age, social participation of elderly and old people and the protection of their individual needs. Self-determination and autonomy are important value orientations. Central issues are the quality of life and life satisfaction from the perspective of personal resources and biographical influences and the conditions of individual aging in the sense of differential gerontology. Against this background, in the first part of this article Kirsten Aner discusses the social construction of aging and in part two Ines Himmelsbach describes the typical life events and developmental tasks in the process of aging. The article concludes with a theoretical basis in which Cornelia Kricheldorff outlines social aging theories and derives a brief description of approaches and interventions.

Globalization of Gerontology Education: Current Practices and Perceptions for Graduate Gerontology Education in the United States

Science.gov (United States)

Mwangi, Samuel M.; Yamashita, Takashi; Ewen, Heidi H.; Manning, Lydia K.; Kunkel, Suzanne R.

2012-01-01

The purpose of this study is to document current practices and understandings about globalization of gerontology education in the United States. Better understanding of aging requires international perspectives in global communities. However, little is known about how globalization of gerontology education is practiced in U.S. graduate-level…

Space Gerontology

Science.gov (United States)

Miquel, J. (Editor); Economos, A. C. (Editor)

1982-01-01

Presentations are given which address the effects of space flght on the older person, the parallels between the physiological responses to weightlessness and the aging process, and experimental possibilities afforded by the weightless environment to fundamental research in gerontology and geriatrics.

The gerontology revolution.

Science.gov (United States)

Littenberg, R L

1986-01-01

America is aging. There are more people over 65 than under 25 for the first time in history, and the age of the average American is increasing daily. As the baby boomers become the soon-to-be-elderly, they bring with them enough economic and political clout to be able to force change. This "gerontology revolution" will create demands for new and altered services, new marketing strategies, new arenas for competition, and as is often the case, new opportunities for those prepared. The time has come for medical groups to face the future of gerontology in a more proactive fashion--with new and effective programs for both the advantaged and the disadvantaged elderly.

Feminist gerontology and old men.

Science.gov (United States)

Calasanti, Toni

2004-11-01

This article outlines feminist gerontology and shows how its focus on power relations lends insight into the lives of those people disadvantaged by them as well as the people privileged by social inequalities. To illustrate the latter, I discuss how feminist gerontology might examine old men, using the topic of health as an example. For instance, arrangements that maintain privilege in young adulthood and middle age can lead to poor health in old age. These practices of masculinity include physical risk in competition with other men, neglect of social networks and medical care, and avoidance of any self-report of emotional strain. However, with its focus on diversity, feminist gerontology also emphasizes that experiences of manhood, aging, and health vary by one's location in a network of inequalities.

A Review of Behavioural Gerontology and Dementia Related Interventions

Directory of Open Access Journals (Sweden)

Josling, Megan

2015-12-01

Full Text Available Behavioural Gerontology is concerned with the interaction of the aging individual and their environment. One aspect of behavioural gerontology has focussed on the use of behaviourist methods to improve the functioning and quality of life of individuals with dementia. Positive reinforcement techniques have shown to have an effect on dementia related behavioural excesses (wandering, disruptive vocalisations, behavioural deficits (incontinence, self feeding and mood changes (depression. One of the major concerns of using reinforcement techniques in the case of dementia is maintenance of the behavioural changes with the continual implementation of the intervention. Research has indicated that individuals with dementia meet behavioural extinction criteria at an advanced rate in comparison with individuals without dementia. Thus for a behavioural change to be successfully maintained it requires diligence on the part of the caregiver and/or nursing home staff. In the case of dementia care centres and nursing homes, when using behavioural interventions to modify the behavioural symptoms of dementia, there needs to be a considerable overlap between Behavioural Gerontology and Organisational Behavioural Management to ensure the successful maintenance of behavioural change.

European initiatives in postgraduate education in gerontology

NARCIS (Netherlands)

van Rijsselt, R.J.T.; Parkatti, T.; Troisi, J.

2007-01-01

This paper describes three innovative European initiatives in postgraduate education in gerontology. The first is the European Masters Program in Gerontology (EuMaG), developed as an interdisciplinary joint program, supported and delivered by 22 European universities. Second, the Nordplus initiative

Gerontological research in the Netherlands: An inventory

NARCIS (Netherlands)

Haaijman, J.J.; Borne, H.W. van den

1978-01-01

An inventory of the recently concluded, current and planned gerontological research in the Netherlands has been made. About 160 investigators are committed to this kind of research, on which they spend 71 man years. In terms of manpower, the most effort is spent in social gerontology (76

Gerontology course in the nursing undergraduate curricula

Directory of Open Access Journals (Sweden)

Samira AlSenany

2014-12-01

Full Text Available Objective To explores nursing faculty members’ attitudes towards older people, their thoughts about gerontological nursing education. Method Five focus groups and a survey were used with nursing faculty members 132 at the three nursing schools to explore their attitudes towards the care of older people and the perceived status of gerontological nursing education. The survey was given to 132 faculty members, including 76 clinical instructors, 40 associate professors and 16 professors. The nursing faculty in general had a positive attitude toward older people (M=3.36, SD 0.25, and teachers’ attitudes were higher than those of their nursing students (M=3.18, SD0.29. Results This study results suggests that Saudi nursing curricula should include more extensive gerontology content and clinical experience with older people. Conclusion This is the first time in Saudi Arabia that research has listened to their voices and examined their commitments toward gerontology education.

European Initiatives in Postgraduate Education in Gerontology

Science.gov (United States)

van Rijsselt, Rene J. T.; Parkatti, Terttu; Troisi, Joseph

2007-01-01

This paper describes three innovative European initiatives in postgraduate education in gerontology. The first is the European Masters Program in Gerontology (EuMaG), developed as an interdisciplinary joint program, supported and delivered by 22 European universities. Second, the Nordplus initiative to increase mobility of students and staff in…

Why should medical students study Social Gerontology?

Science.gov (United States)

Tinker, Anthea; Hussain, Labib; D'Cruz, Jack Lilly; Tai, William Yee Seng; Zaidman, Sebastian

2016-03-01

The General Medical Council (GMC) provides a core curriculum for all medical degrees in the UK. However, these guidelines do not provide in-depth, specific learning outcomes for the various medical specialties. Recognising our ageing population, the British Geriatrics Society in 2013 published their own supplementary guidelines to encourage and further direct teaching on Gerontology and Geriatric Medicine in medical school curricula. Although teaching on Geriatric Medicine, a sub-discipline of Gerontology, has reassuringly increased in UK medical schools, there are convincing arguments for greater emphasis to be placed on the teaching of another sub-discipline: Social Gerontology. Considering the skills and knowledge likely to be gained from the teaching of Social Gerontology, in this paper we argue for the greater universal adoption of its teaching. This would help ensure that the doctors of tomorrow are better equipped to manage more successfully and holistically the growing cohort of older patients. © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Research Note-Testing for Gerontological Competencies: A Pilot Study

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Galambos, Colleen; Curl, Angela L.; Woodbury, Karen

2014-01-01

This article reports on the pilot delivery of an evaluation method to gauge student learning of gerontological competencies. Using a pretest and posttest design, data were collected on 46 students over 3 classes. Results indicated significant improvement in how students rated or perceived their competencies skill level between pretest and posttest…

76 FR 54536 - Geriatrics and Gerontology Advisory Committee; Notice of Meeting

Science.gov (United States)

2011-09-01

... DEPARTMENT OF VETERANS AFFAIRS Geriatrics and Gerontology Advisory Committee; Notice of Meeting... Committee Act) that a meeting of the Geriatrics and Gerontology Advisory Committee will be held on September... all matters pertaining to geriatrics and gerontology. The Committee assesses the capability of VA...

78 FR 55778 - Geriatrics and Gerontology Advisory Committee, Notice of Meeting

Science.gov (United States)

2013-09-11

... DEPARTMENT OF VETERANS AFFAIRS Geriatrics and Gerontology Advisory Committee, Notice of Meeting.... App. 2, that a meeting of the Geriatrics and Gerontology Advisory Committee will be held on September... all matters pertaining to geriatrics and gerontology. The Committee assesses the capability of VA...

77 FR 49865 - Geriatrics and Gerontology Advisory Committee, Notice of Meeting

Science.gov (United States)

2012-08-17

... DEPARTMENT OF VETERANS AFFAIRS Geriatrics and Gerontology Advisory Committee, Notice of Meeting... Committee Act) that a meeting of the Geriatrics and Gerontology Advisory Committee will be held on September... all matters pertaining to geriatrics and gerontology. The Committee assesses the capability of VA...

Gerontology found me: gaining understanding of advanced practice nurses in geriatrics.

Science.gov (United States)

Campbell-Detrixhe, Dia D; Grassley, Jane S; Zeigler, Vicki L

2013-10-01

Examining the meanings of the experiences of advanced practice nurses (APNs) who chose to work with older adults and why they continue to work with this population was the focus of this hermeneutic qualitative research study. Twelve geriatric APNs currently practicing in two South Central states were interviewed using an open-ended interview guide. Using Gadamerian hermeneutics, the researchers identified Gerontology Found Me as the significant expression that reflected the fundamental meaning of the experience as a whole. Four themes emerged that further described the meanings of the participants' personal, educational, and professional experiences: Becoming a Gerontology Nurse, Being a Gerontology Nurse, Belonging to Gerontology, and Bringing Others to Gerontology. This study concluded that APNs' personal and professional experiences were more influential than educational experiences to become geriatric nurses, and having these personal and professional experiences of being in relationship with older individuals further contributed to their choice of gerontology.

Teaching Psychological and Social Gerontology to Millennial Undergraduates

Science.gov (United States)

Siegal, Brittany; Kagan, Sarah H.

2012-01-01

Matters of development and generation may create barriers in teaching millennial undergraduates psychological and social gerontology. We introduce strategy to mitigate these barriers by teaching psychological and social gerontology as undergraduate honors courses, augmented with the use of social networking tools. We detail honors programming,…

76 FR 17999 - Geriatrics and Gerontology Advisory Committee; Notice of Meeting

Science.gov (United States)

2011-03-31

... DEPARTMENT OF VETERANS AFFAIRS Geriatrics and Gerontology Advisory Committee; Notice of Meeting... Committee Act) that a meeting of the Geriatrics and Gerontology Advisory Committee will be held on April 14... pertaining to geriatrics and gerontology. The Committee assesses the capability of VA health care facilities...

75 FR 54232 - Geriatrics and Gerontology Advisory Committee; Notice of Meeting

Science.gov (United States)

2010-09-03

... DEPARTMENT OF VETERANS AFFAIRS Geriatrics and Gerontology Advisory Committee; Notice of Meeting... Committee Act) that a meeting of the Geriatrics and Gerontology Advisory Committee will be held on September... pertaining to geriatrics and gerontology. The Committee assesses the capability of VA health care facilities...

77 FR 14860 - Geriatrics and Gerontology Advisory Committee, Notice of Meeting

Science.gov (United States)

2012-03-13

... DEPARTMENT OF VETERANS AFFAIRS Geriatrics and Gerontology Advisory Committee, Notice of Meeting... Committee Act) that a meeting of the Geriatrics and Gerontology Advisory Committee will be held on April 11... matters pertaining to geriatrics and gerontology. The Committee assesses the capability of VA health care...

75 FR 11638 - Geriatrics and Gerontology Advisory Committee; Notice of Meeting

Science.gov (United States)

2010-03-11

... DEPARTMENT OF VETERANS AFFAIRS Geriatrics and Gerontology Advisory Committee; Notice of Meeting... Committee Act) that a meeting of the Geriatrics and Gerontology Advisory Committee will be held on April 22... all matters pertaining to geriatrics and gerontology. The Committee assesses the capability of VA...

78 FR 6406 - Geriatrics and Gerontology Advisory Committee, Notice of Meeting

Science.gov (United States)

2013-01-30

... DEPARTMENT OF VETERANS AFFAIRS Geriatrics and Gerontology Advisory Committee, Notice of Meeting.... App. 2, that a meeting of the Geriatrics and Gerontology Advisory Committee will be held on April 10... matters pertaining to geriatrics and gerontology. The Committee assesses the capability of VA health care...

Accreditation of Gerontology Programs: A Look from Inside

Science.gov (United States)

Van Dussen, Daniel J.; Applebaum, Robert; Sterns, Harvey

2012-01-01

For over three decades, there has been considerable discussion about the development of gerontology education in the United States. A debate about accreditation is a logical outgrowth in this evolution. The dialogue about accreditation raises some important questions and gives gerontology an opportunity to further define itself. Accreditation…

[The French Society of Geriatrics and Gerontology position paper on the concept of integration. Part two].

Science.gov (United States)

Somme, Dominique; Trouvé, Hélène; Passadori, Yves; Corvez, Alain; Jeandel, Claude; Bloch, Marie-Aline; Ruault, Geneviève; Dupont, Olivier; de Stampa, Matthieu

2014-06-01

The concept of integrated services delivery, although dating from the 1990s, has only recently appeared in French public health policy. To clarify the concept and its adaptation to the reality of the French systems of healthcare and social services, the French Society of Geriatrics and Gerontology established an interdisciplinary working group. This article reports that group's findings according to three axes: the definition of integration, the objectives of this organizational approach and the means needed to achieve them. Analysis of the literature indicated that integration is a process that aims to overcome the fragmentation of services for vulnerable people. This process requires a multilevel approach, particularly concerning how to modify public policies and financing systems. Notably, all relevant levels need to develop shared processes, tools, resources, finance, interventions and returns on the latter. Indeed, this sharing is the ultimate proof of evolution towards integration. In the second part of the position paper, its authors have developed arguments that could lead professionals and non-professional caregivers to adopt integrated care as an answer to their aspirations. Policy-maker perspectives and politicians are also analyzed. Bearing in mind that integrated care necessarily will always involve a human component which may find expression during individual case-management; relations between integration and case managements are clarified. Finally, lessons learned from national and international experiments are examined. Results suggest that integrated care must to be accompanied by a local pilot. Results of recent experiments have shown that it is possible to initiate a dynamic towards integrated care in France and hence join the international movement towards adapting our healthcare systems to new challenges.

GAMDB: a web resource to connect microRNAs with autophagy in gerontology.

Science.gov (United States)

Zhang, Lan; Xie, Tao; Tian, Mao; Li, Jingjing; Song, Sicheng; Ouyang, Liang; Liu, Bo; Cai, Haoyang

2016-04-01

MicroRNAs (miRNAs) are endogenous ~23 nucleotides (nt) RNAs, regulating gene expression by pairing to the mRNAs of protein-coding genes to direct their post-transcriptional repression. Both in normal and aberrant activities, miRNAs contribute to a recurring paradigm of cellular behaviors in pathological settings, especially in gerontology. Autophagy, a multi-step lysosomal degradation process with function to degrade long-lived proteins and damaged organelles, has significant impact on gerontology. Thus, elucidating how miRNAs participate in autophagy may enlarge the scope of miRNA in autophagy and facilitate researches in gerontology. Herein, based upon the published studies, predicted targets and gerontology-related diseases, we constructed a web resource named Gerontology-Autophagic-MicroRNA Database (GAMDB) (http://gamdb.liu-lab.com/index.php), which contained 836 autophagy-related miRNAs, 197 targeted genes/proteins and 56 aging-related diseases such as Parkinson' disease, Alzheimer's disease and Huntington's disease. We made use of large amounts of data to elucidate the intricate relationships between microRNA-regulated autophagic mechanisms and gerontology. This database will facilitate better understanding of autophagy regulation network in gerontology and thus promoting gerontology-related therapy in the future. © 2016 John Wiley & Sons Ltd.

Gerontologi i uddannelserne

DEFF Research Database (Denmark)

Glasdam, Stinne; Jacobsen, Frode Fadnes

2011-01-01

Artiklen viser, hvordan gerontologi er lavt prioriteret i uddannelser på bachelor-, diplom- og masterniveau (kandidat) i primært Danmark og Norge. Der tages udgangspunkt i et nordisk kortlægningsarbejde, som blev gennemført i 2008. Dette suppleres med danske og norske aktiviteter, som er kommet til...

Policies and Practices in Educational Gerontology in Taiwan

Science.gov (United States)

Lin, Yi-Yin; Huang, Chin-Shan

2013-01-01

Policy on educational gerontology seems a relatively recent subfield in most countries' social policies. The concept of education for older adults did not appear in Taiwan's political discourse until 1980. The purposes of this paper are to provide an overall introduction to the development of educational gerontology policies and practices in…

[Discussion paper on participation and participative methods in gerontology].

Science.gov (United States)

Aner, Kirsten

2016-02-01

The concept of "participation" and the demand for the use of "participative methods" in human, healthcare, nursing and gerontological research as well as the corresponding fields of practice are in great demand; however, the targets and organization of "participation" are not always sufficiently explicated. The working group on critical gerontology of the German Society of Gerontology and Geriatrics uses this phenomenon as an opportunity for positioning and develops a catalogue of criteria for reflection and assessment of participation of elderly people in science and practice, which can also be considered a stimulus for further discussions.

Discussion paper on participation and participatory methods in gerontology.

Science.gov (United States)

Aner, K

2016-12-01

The concept of "participation" and the use of "participatory methods" in human, healthcare, nursing, and gerontological research, as well as the corresponding fields of practice, represent an expanding field of interest. However, the objectives and organization of "participation" are not always sufficiently explicated. The Critical Gerontology Working Group of the German Society of Gerontology and Geriatrics presents a statement on this phenomenon, and proposes a catalogue of criteria for reflection upon and assessment of participation by older people in research and practice, which can also be considered a stimulus for further discussions.

Financial gerontology and the rehabilitation nurse.

Science.gov (United States)

Mauk, Kristen L; Mauk, James M

2006-01-01

Rehabilitation nurses, particularly those who work in geriatrics, recognize that the elderly have become increasingly heterogeneous, with many remaining active well into their 80s and beyond. As the baby boomers enter older adulthood, the senior healthcare market will be greatly affected. The areas of finance, economics, and marketing are seeing new trends that combine the expertise of financial planners with healthcare advisors and advocates for seniors. One emerging specialty area is financial gerontology. This article defines financial gerontology, presents emerging trends and certifications related to the field, and discusses implications for the rehabilitation nurse.

Quality Assurance in Gerontological and Geriatric Training Programs: The European Case

Science.gov (United States)

Politynska, Barbara; van Rijsselt, Rene J. T.; Lewko, Jolanta; Philp, Ian; Figueiredo, Daniella; De Sousa, Lilliana

2012-01-01

Quality assurance (QA) in gerontological and geriatric education programs is regarded as essential to maintain standards, strengthen accountability, improve readability of qualifications, and facilitate professional mobility. In this article the authors present a summary of international developments in QA and elaborate four international trends,…

Lessons learned about ageing and gerontological nursing in South Africa

Directory of Open Access Journals (Sweden)

Staja Q. Booker

2015-07-01

Full Text Available Background: The unprecedented global growth in older adults merits high-quality gerontological nursing care. As gerontological nursing grows in visibility in developed and developing countries, nurses must possess a broader worldview of ageing with knowledge of physiological, psychosocial, and cultural issues. Purpose: The purpose of this article is to: (1 highlight lessons learned on differences and similarities in ageing and care of older adults in the United States of America (USA and South Africa (SA; and (2 provide recommendations on how to advance gerontological nursingeducation in SA. Methods: A two-week international service-learning project was undertaken by visiting SA and learning about their nursing system and care of older adults. Service-learning is an innovative teaching-learning-service method that provided reflective and hands-on experience of gerontological nursing. This article provides a personal reflection of lessons learned about ageing and gerontological nursing during the service-learning project. Findings: Care of older adults in SA is in many ways different from and similar to that in the USA. Consequently global nurses should recognise those differences and provide culturally appropriate care. This service-learning experience also demonstrated the need for gerontological nursing education in SA. Based on this, recommendations on how to infuse and advance gerontological nursing education in SA are provided. Conclusion: Caring for older adults in a global context requires knowledge and understanding of cultures and their values and practices. With a growing population of diverse older adults, there is a need for incorporation

The increasing use of theory in social gerontology: 1990-2004.

Science.gov (United States)

Alley, Dawn E; Putney, Norella M; Rice, Melissa; Bengtson, Vern L

2010-09-01

To determine how often theory is used in published research in social gerontology, compare theory use over a 10-year period (1990-1994 to 2000-2004), and identify the theories most frequently used in social gerontology research. Systematic review of articles published in eight leading journals from 2000 to 2004 (N = 1,046) and comparison with a review conducted 10 years earlier. Theory was mentioned in 39% of articles published from 2000 to 2004, representing a 12% increase in the use of theory over 10 years. This increase was driven by theories outside the core sociology of aging theories identified by Bengtson, V. L., Burgess, E. O., and Parrott, T. M. (1997). Theory, explanation, and a third generation of theoretical development in social gerontology. Journal of Gerontology: Social Sciences, 52B, S72-S88. The five most frequently used theories included the life course perspective, life-span developmental theories, role theory, exchange theory, and person-environment theory/ecological theories of aging. Commonly used models included stress process/stress and coping models, successful aging models, the Andersen behavioral model of health services use, models of control/self-efficacy/mastery, and disablement process models. Theory use in social gerontology increased between 1990 and 2004, with a shift toward theories that cross disciplines. However, the majority of research in social gerontology continues to be atheoretical. Models are widely used as a supplement to or substitute for theory. Many of these models are currently being debated and elaborated, and over time, they may emerge as important theoretical contributions to social gerontology.

78 FR 12831 - Geriatrics and Gerontology Advisory Committee, Notice of Meeting Amendment

Science.gov (United States)

2013-02-25

... DEPARTMENT OF VETERANS AFFAIRS Geriatrics and Gerontology Advisory Committee, Notice of Meeting....S.C. App. 2, that a meeting of the Geriatrics and Gerontology Advisory Committee has been... and the Under Secretary for Health on all matters pertaining to geriatrics and gerontology. The...

Student nurses' motivation to choose gerontological nursing as a career in China: a survey study.

Science.gov (United States)

Cheng, Min; Cheng, Cheng; Tian, Yan; Fan, Xiuzhen

2015-07-01

The world's population is aging, and the need for nurses is increasing. Working with older adults, however, has always been an unpopular career choice among student nurses. It is important to understand student nurses' motivation for choosing gerontological nursing as a career. The purpose of this study was to examine the motivation for choosing gerontological nursing as a career and to identify the associated factors among student nurses. Cross-sectional survey. Participants were last-semester student nurses from 7 universities offering nursing undergraduate programs in Shandong, China. Of the 1290 student nurses, 916 completed the survey (a response rate of 71.0%). The outcome variable was the motivation to choose gerontological nursing as a career. This was measured using a motivation questionnaire that included expectancy and value subscales. Other instruments included the Chinese version of the Facts on Aging Quiz I, the Geriatrics Attitudes Scale, the Anxiety about Aging Scale, a clinical practice environment questionnaire and a self-administered general information questionnaire. Student nurses' expectancy and value aspects of motivation for choosing gerontological nursing as a career were both at a moderate level; the highest value they held was of personal interest. Clinical practice environment, anxiety about aging and the attitudes about geriatrics were the main factors influencing student nurses' motivation to choose gerontological nursing as a career in China. It is imperative for nurse educators to improve the gerontological nursing clinical practice environment for student nurses. Moreover, cultivating student nurses' positive attitudes about geriatrics and relieving anxiety about aging could be beneficial. Copyright © 2015. Published by Elsevier Ltd.

Gerontology Education and Research in Kenya: Establishing a U.S.-African Partnership in Aging

Science.gov (United States)

King, Sharon V.; Gachuhi, Mugo; Ice, Gillian; Cattell, Maria; Whittington, Frank

2005-01-01

This article reprises four presentations on "Gerontology Education in Kenya," a seminar at the 2004 Annual Meeting of the Association of Gerontology in Higher Education. It describes the process by which the Gerontology Institute of Georgia State University established a 3-year gerontology education and research partnership with Kenyatta…

The Development of Educational Gerontology in Taiwan: An Interpretive and Critical Perspective

Science.gov (United States)

Huang, Chin-Shan

2010-01-01

Educational gerontology is increasingly becoming a global phenomenon. Taiwan, a small island in the western Pacific Ocean, has responded to its aging population with the development of the studies and practices of educational gerontology. This study, first, traces the development of educational gerontology in Taiwan, based on Peterson's definition…

European Master's Program in Gerontology (EuMaG): Goals, Curriculum, and Students

Science.gov (United States)

Aartsen, Marja

2011-01-01

The European Master's Program in Gerontology (EuMaG) started in September 2003 with support from the European Commission. The EuMaG is a modular, 2-year, part-time international training program about the aging process and its societal implications. The multidisciplinary curriculum comprises four domains of gerontology (i.e., social gerontology,…

Survey of master's gerontology students spanning over 40 years.

Science.gov (United States)

Molinari, Victor; Ellis, Michelle L

2014-01-01

The University of South Florida's master's degree in gerontology is a long-established program that focuses on a multidisciplinary approach to population aging. This study identifies graduate students' needs in preparation for a professional career in gerontology. An online survey was distributed to graduates and those currently enrolled (N = 56) in order to better understand expectations for the program, identify outcomes of graduation, and obtain program recommendations for future students. The program's 40 year history was well represented with participants ranging from the first graduating class to current students. Results indicated high satisfaction in students' expectations of the program, educational experience, and assessment of faculty. Further, 68% of graduates reported success in gaining age-related employment shortly after graduation. However, students echoed well-known barriers in gerontology, reporting tough competition for jobs versus those with licensure, and challenges in promoting their nonclinical gerontology degree to employers. Respondents recommended more applied coursework and assistance with career planning to enhance employment opportunities upon graduation. Implications of these findings are discussed in further detail.

Early Journals and Their Influences on the Development of Gerontology

Science.gov (United States)

Mercer, Lorraine; Carter, Lorraine

2012-01-01

This examination of early gerontology journals identifies the multidisciplinary backgrounds of contributors, methods of investigation, nascent theory development, and formative themes and controversies. Through use of content, thematic, and critical analyses of second year issues of "The Gerontologist," "Educational Gerontology," "Research on…

The Increasing Use of Theory in Social Gerontology: 1990–2004

Science.gov (United States)

Putney, Norella M.; Rice, Melissa; Bengtson, Vern L.

2010-01-01

Objectives. To determine how often theory is used in published research in social gerontology, compare theory use over a 10-year period (1990–1994 to 2000–2004), and identify the theories most frequently used in social gerontology research. Methods. Systematic review of articles published in eight leading journals from 2000 to 2004 (N = 1,046) and comparison with a review conducted 10 years earlier. Results. Theory was mentioned in 39% of articles published from 2000 to 2004, representing a 12% increase in the use of theory over 10 years. This increase was driven by theories outside the core sociology of aging theories identified by Bengtson, V. L., Burgess, E. O., and Parrott, T. M. (1997). Theory, explanation, and a third generation of theoretical development in social gerontology. Journal of Gerontology: Social Sciences, 52B, S72–S88. The five most frequently used theories included the life course perspective, life-span developmental theories, role theory, exchange theory, and person–environment theory/ecological theories of aging. Commonly used models included stress process/stress and coping models, successful aging models, the Andersen behavioral model of health services use, models of control/self-efficacy/mastery, and disablement process models. Discussion. Theory use in social gerontology increased between 1990 and 2004, with a shift toward theories that cross disciplines. However, the majority of research in social gerontology continues to be atheoretical. Models are widely used as a supplement to or substitute for theory. Many of these models are currently being debated and elaborated, and over time, they may emerge as important theoretical contributions to social gerontology. PMID:20675614

Evolution, Fruit Flies and Gerontology

Indian Academy of Sciences (India)

Home; Journals; Resonance – Journal of Science Education; Volume 1; Issue 11. Evolution, Fruit Flies and Gerontology Evolutionary Biology Helps Unravel the Mysteries of Ageing. Amitabh Joshi. General Article Volume 1 Issue 11 November 1996 pp 51-63 ...

Images of Sexuality and Aging in Gerontological Literature

OpenAIRE

Scherrer, Kristin S.

2009-01-01

Discursive portrayals of aging and sexuality have important implications for the creation and reproduction of inequalities. This article delineates some of the images of older adults’ sexualities using an interpretive content analysis of gerontology articles dealing with issues of sexuality in 21 gerontological journals over a 20-year span (1988–2007). The 3 main findings of this analysis were (a) that aging sexualities are asserted, (b) that the sexual identities of older adults vary, and (c...

Expanding Gerontology Enrollments: Successful Results of an Innovative Outreach Program

Science.gov (United States)

Reynolds, Sandra L.; Haley, William E.; Hyer, Kathryn

2007-01-01

As state budget allocations for higher education decrease, "specialty" programs such as gerontology must continually demonstrate their productivity. State and private universities increasingly rely on student credit hours (SCH) or tuition generated, which is making it difficult for many gerontology programs to expand. The School of Aging Studies…

Review of Nursing Literature: Evolution of Gerontological Education in Nursing.

Science.gov (United States)

Philipose, Vimala; And Others

1991-01-01

A literature review found that (1) many students and nurses held negative views of the elderly, affecting career choices; (2) gerontological content in baccalaureate nursing programs ranged from little or none to adequate; and (3) a severe shortage of faculty prepared to teach gerontological nursing and negative attitudes toward this…

Higher education in gerontology: A comparison of master's programs in Japan, Taiwan, and Turkey.

Science.gov (United States)

Ikeuchi, Tomoko; Lu, Feng-Hwa; Holdsworth, Jason K; Arun, Özgür; Wang, Shan-Tair; Murakami, Ikuko; Osada, Hisao

2017-01-01

As of 2015, there is only one master's program of gerontology acknowledged by each of the following countries: Japan, Taiwan, and Turkey. All three programs have fewer than 15 years of history. These three countries differ in society types based on the proportion of older adults, rate of population aging, and population size. However, in terms of gerontological education, they seem to share great commonalities. Common challenges are a lack of awareness of the field of gerontology, insufficient numbers of gerontology programs and faculty members to produce trained gerontologists within society, and the inadequacy of opportunities for trained gerontologists to play an active role in various fields. This study intends not only to compare the differences and similarities among three countries and programs, but also to elucidate characteristics of a unique gerontology program in each country and identify challenges and possibilities from the perspective of gerontological educators.

[Aspects for data mining implementation in gerontology and geriatrics].

Science.gov (United States)

Mikhal'skiĭ, A I

2014-01-01

Current challenges facing theory and practice in ageing sciences need new methods of experimental data investigation. This is a result as of experimental basis developments in biological research, so of information technology progress. These achievements make it possible to use well proven in different fields of science and engineering data mining methods for tasks in gerontology and geriatrics. Some examples of data mining methods implementation in gerontology are presented.

[Some problems of modern gerontology and geriatrics in the Russian Federation: the sight of the clinical physician].

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Miakotnykh, V S

2012-01-01

This article presents some problems of modern Russian gerontology and geriatrics by eyes of the scientist--the clinical physician having long-term experience in the field. Educational, scientific, practical aspects of gerontology and those stereotypes of understanding of problems of elderly which developed for years are subjected the certain criticism, decades, but in the modern world any more absolutely correspond to a today's reality. It is offered to transform the ideology of the major directions of gerontology, having put at the head of a corner not ideas of prolongation of life as that and carrying out basically actions in relation to seriously ill, but improvements of quality of life, preventive maintenance and treatment of set of the age-related diseases, overcoming of the developed practice of the relation to elderly and senile patients as to persons dependent and demanding the constant help. The author urges the public health governing bodies to reconsider the norms of the geriatric help existing for many years but not meeting modern requirements in the conditions of polyclinic and a hospital and to make more clear and claimed by a society the possibilities and achievements of gerontology.

Successful aging and its discontents: a systematic review of the social gerontology literature.

Science.gov (United States)

Martinson, Marty; Berridge, Clara

2015-02-01

The purpose of this study was to analyze the range of critiques of successful aging models and the suggestions for improvement as expressed in the social gerontology literature. We conducted a systematic literature review using the following criteria: journal articles retrieved in the Abstracts in Social Gerontology, published 1987-2013, successful aging/ageing in the title or text (n = 453), a critique of successful aging models as a key component of the article. Sixty-seven articles met the criteria. Qualitative methods were used to identify key themes and inductively configure meanings across the range of critiques. The critiques and remedies fell into 4 categories. The Add and Stir group suggested a multidimensional expansion of successful aging criteria and offered an array of additions. The Missing Voices group advocated for adding older adults' subjective meanings of successful aging to established objective measures. The Hard Hitting Critiques group called for more just and inclusive frameworks that embrace diversity, avoid stigma and discrimination, and intervene at structural contexts of aging. The New Frames and Names group presented alternative ideal models often grounded in Eastern philosophies. The vast array of criteria that gerontologists collectively offered to expand Rowe and Kahn's original successful model is symptomatic of the problem that a normative model is by definition exclusionary. Greater reflexivity about gerontology's use of "successful aging" and other normative models is needed. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Gerontology Content in MSW Curricula and Student Attitudes toward Older Adults

Science.gov (United States)

Olson, Mark D.

2007-01-01

The unprecedented growth in the nation's older adult population has called attention to the increasing need for geriatric social workers. However, research suggests that social work students hold ageist attitudes that prevent many from pursuing careers in gerontology. The present study sought to identify student perceptions of gerontology content…

Infusing gerontology into grades 7-12 social studies curricula.

Science.gov (United States)

Krout, John A; Wasyliw, Zenon

2002-06-01

This paper describes a model process to increase the exposure of middle and high school students to information on aging so they better understand the implications of an aging population and the stereotypes of older adults. A college Gerontology Institute, a social studies teacher education faculty member, and middle/high school social studies teachers collaborated on a program to develop and implement lesson plans that incorporate information on aging into existing courses. Institute staff provided expertise on gerontology and student teachers assisted in writing lesson plan objectives. Teachers developed about a dozen lessons covering from one class to two weeks in subjects such as global history, participation in government, Western civilizations, economics, and government. This experience suggests a number of issues that should be addressed when developing a gerontology infusion initiative with school teachers. Information on aging can be successfully incorporated into existing school curricula within the constraints of mandated learning objectives.

The delivery of distance education--is it time for doctoral programs in gerontology?

Science.gov (United States)

Heinz, Melinda; Martin, Peter; Doll, Gayle; Pearson-Scott, Jean

2015-01-01

The delivery of higher education in gerontology is changing; students are now able to receive an education solely online. Perhaps it is time to consider offering this option at the doctoral level. A needs assessment was conducted to assess whether a doctoral program in gerontology should be created in the Great Plains Interactive Distance Education Alliance (GPIDEA) program. An online survey was sent to 247 students enrolled in the GPIDEA program and to students who had taken a GPIDEA course in gerontology but were not currently enrolled in the program. One hundred and twenty-three students began the survey, although only 120 students completed the survey. Findings indicated students are interested in a doctoral program in gerontology. Approximately 65% of students were interested in obtaining a PhD from a distance education program. However, an applied program focusing on community outreach and leadership was of most interest to students. Students were less interested in research-based programs or in research residency. Therefore, the development of distance education doctoral degree programs in gerontology may need to be created differently than "traditional" formats.

Why gerontology and geriatrics can teach us a lot about mentoring.

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Clark, Phillip G

2018-05-15

Gerontology, geriatrics, and mentoring have a lot in common. The prototype of this role was Mentor, an older adult in Homer's The Odyssey, who was enlisted to look after Odysseus' son, Telemachus, while his father was away fighting the Trojan War. Portrayed as an older man, the name "mentor" literally means "a man who thinks," which is not a bad characterization generally for faculty members in gerontology! In particular, gerontological and geriatrics education can teach us a lot about the importance of mentoring and provide some critical insights into this role: (1) the importance of interprofessional leadership and modeling, (2) the application of the concept of "grand-generativity" to mentoring, (3) "it takes a community" to be effective in mentoring others, and (4) the need to tailor mentorship styles to the person and the situation. This discussion explores these topics and argues that gerontological and geriatrics educators have a particularly important role and responsibility in mentoring students, colleagues, and administrators related to the very future of our field.

Prevalence of depression in residents of gerontology centre in Sarajevo

Directory of Open Access Journals (Sweden)

Jasmina Mahmutović

2012-04-01

Full Text Available Introduction: Depressive disorder, as a major problem of public health, takes high fourth place in its prevalence in general population, and is considered to be the second most frequent health problem of femalepopulation. Depression is the most frequent mental problem of persons in their third age of life. The aim of this study is to evaluate prevalence of depression and establish the ratio between the current number ofdiagnosed and of unrecognised depression among the residents of Gerontology Centre in Sarajevo.Methods: This is a cross-sectional, descriptive, and analytical study undertaken throughout May and June 2011 on the sample of 150 residents of “The Gerontology Centre“ in Sarajevo that were above 65 years of age. The following instruments were used for the research: the Geriatric Depression Scale (GDS, modified questionnaire consisting of two parts (general data and data related to health state, and the medical records of the residents. For statistic analysis of data was used the SPSS program for Windows.Results: According to GDS, prevalence of depression was 65.3%, out of which mild depression occurred in 46.7% cases and severe depression in 18.7%. The prevalence of verified (diagnosed depression was 11.3per cents.Conclusions: According to the GD scale, unrecognised depressions seem to be almost six times more frequent (65.3:11% than is the case with depressions diagnosed in medical records of the protégées of theGerontology Centre in Sarajevo. Timely recognition of depression and its treating in institutions for protection of health of persons in third age of life can substantially improve the quality of life of these patients.

Mentoring in Gerontology Doctoral Education: The Role of Elders in Mentoring Gerontologists

Science.gov (United States)

Wangmo, Tenzin; Ewen, Heidi H.; Webb, Alicia K.; Teaster, Pamela B.; Russell Hatch, Laurie

2009-01-01

This study examined elder mentors' and students' roles, functions, and satisfaction with the Elder Mentorship program at the Graduate Center for Gerontology, University of Kentucky. The Elder Mentorship program matches gerontology doctoral students with older adults in the community. Parallel surveys were constructed to evaluate the program from…

[Swiss research agenda for gerontological nursing].

Science.gov (United States)

Imhof, Lorenz; Naef, Rahel; Mahrer-Imhof, Romy

2008-12-01

In Switzerland life expectancy is currently 84 years in women and 79 years in men. By 2030 the number of people over 80 will increase by 83% to 625 000. The need of nursing care in this population is expected to double. In order to ensure high quality care, scientific knowledge generated by nursing research is, therefore, pivotal. Within the framework of a national project, a nursing research agenda has been formulated based on a literature review, expert panels, a national survey, and a consensus conference; seven priorities for clinical nursing research for the years 2007-2017 have been developed. In the field of gerontological nursing twenty-one research priorities have been identified. They include among others interventions to support independent living and autonomy at home or the impact of new technology on nursing care of the elderly. Support for caregivers and the health of caregivers of patients with dementia have to be addressed as well as interventions for specific challenges in the elderly such as fall prevention, delirium, malnutrition, and depression. Pivotal questions in nursing research are concerned with the continuity of nursing care that exceeds institutional and professional boundaries. Moreover, it is recommended that research projects address the impact of political decisions on nursing care and provide knowledge to improve quality in nursing homes and community health care. With this article the first research agenda for gerontological nursing is presented, that is based on the seven priorities of the Swiss Research Agenda for Nursing-SRAN and in turn can be used as a basis for strategic discussion, action plans, and research projects.

The growth of gerontology and geriatrics in Mexico: Past, present, and future.

Science.gov (United States)

Rivera-Hernandez, Maricruz; Flores Cerqueda, Sergio; García Ramírez, José Carlos

2017-01-01

Life expectancy is increasing in Mexico, creating new opportunities and challenges in different areas, including gerontology and geriatric education and research. Although in the European Union there are more than 3,000 institutions that focus on aging research, in Latin America there are only 250 programs where theoretical and practical knowledge is taught. In Mexico, the number of institutions that offer gerontology and geriatric education is relatively small. One of the major concerns is that Mexico is not adequately prepared to optimally deal with the aging of its population. Thus, the main challenge that Mexico faces is to train practitioners, researchers, and policy makers to be able to respond to the aging priorities of this country. The goal of this review is to investigate the literature regarding 60 years in the fields of gerontology and geriatrics in Mexico. Even when programs have evolved within the past decades, there are some challenges to gerontological and geriatric education and aging research in Mexico. The implications for Mexico are discussed, as well as opportunities for moving these fields forward.

Theoretically Based Pedagogical Strategies Leading to Deep Learning in Asynchronous Online Gerontology Courses

Science.gov (United States)

Majeski, Robin; Stover, Merrily

2007-01-01

Online learning has enjoyed increasing popularity in gerontology. This paper presents instructional strategies grounded in Fink's (2003) theory of significant learning designed for the completely asynchronous online gerontology classroom. It links these components with the development of mastery learning goals and provides specific guidelines for…

[Geriatrics and gerontology in Senegal].

Science.gov (United States)

Coumé, Mamadou; Touré, Kamadore; Faye, Atoumane; Moreira, Therese Diop

2013-01-01

Senegal is dealing positively with its demographic transition. On September 1st 2006, the Senegalese government introduced the "Plan Sesame", a national free health care program for elderly people aged 60 years and over. The University of Dakar academic authorities support the Sesame plan through an innovative training program in geriatrics and gerontology. Such programs aim to address the challenge of ageing in a developing country.

Self-Assessment of Gerontology Teaching Practice: A First-Step in Enhancing Student Learning

Science.gov (United States)

VonDras, Dean D.

2008-01-01

This article discusses self-assessment of gerontology teaching practice. Through a process of self-reflection one may find insight into their teaching and, concomitantly, develop best-practices for enhancing student learning in gerontology. A self-assessment framework is presented, illuminating best-practices in the areas of the lecture-discussion…

Is gerontology ready for anti-racist pedagogy? A survey of educators' practices and perspectives.

Science.gov (United States)

Karasik, Rona J; Kishimoto, Kyoko

2018-01-01

The older population in the United States is becoming more diverse, bringing increasing attention to the ways in which diversity and multiculturalism are addressed in gerontological education. Although diversity and multiculturalism have long been recognized as important components of the aging experience, our approach to understanding their significance and impact continues to grow and change. Anti-racist pedagogy represents one catalyst to stimulate such change. To evaluate the potential for anti-racist pedagogy in gerontology, this study explored gerontological educators' (N = 121) current practices and perspectives regarding the inclusion of diversity content in their courses, as well as the extent to which they are familiar with and/or use anti-racist pedagogy in their classes. The findings suggest that greater attention to issues of race, ethnicity, and multicultural diversity throughout the gerontological curriculum is needed and wanted. Although respondents were generally unfamiliar with the name anti-racist pedagogy, many indicated that their current teaching practices employed select components of it. Overall, the findings point toward the need for continued exploration of how anti-racist pedagogy may be brought into the gerontological classroom, as well as its implications for future research, policy, and practice.

Collaborative learning in gerontological clinical settings: The students' perspective.

Science.gov (United States)

Suikkala, Arja; Kivelä, Eeva; Käyhkö, Pirjo

2016-03-01

This study deals with student nurses' experiences of collaborative learning in gerontological clinical settings where aged people are involved as age-experts in students' learning processes. The data were collected in 2012 using the contents of students' reflective writing assignments concerning elderly persons' life history interviews and the students' own assessments of their learning experiences in authentic elder care settings. The results, analyzed using qualitative content analysis, revealed mostly positive learning experiences. Interaction and collaborative learning activities in genuine gerontological clinical settings contributed to the students' understanding of the multiple age-related and disease-specific challenges as well as the issues of functional decline that aged patients face. Three types of factors influenced the students' collaborative learning experiences in gerontological clinical settings: student-related, patient-related and learning environment-related factors. According to the results, theoretical studies in combination with collaboration, in an authentic clinical environment, by student nurses, elderly patients, representatives of the elder care staff and nurse educators provide a feasible method for helping students transform their experiences with patients into actual skills. Their awareness of and sensitivity to the needs of the elderly increase as they learn. Copyright © 2016 Elsevier Ltd. All rights reserved.

Using Today's Headlines for Teaching Gerontology

Science.gov (United States)

Haber, David

2008-01-01

It is a challenge to attract undergraduate students into the gerontology field. Many do not believe the aging field is exciting and at the cutting edge. Students, however, can be convinced of the timeliness, relevance, and excitement of the field by, literally, bringing up today's headlines in class. The author collected over 250 articles during…

Value of Gerontology for Occupational Social Work.

Science.gov (United States)

Safford, Florence

1988-01-01

As aging affects society increasingly, occupational social workers can benefit from gerontological research and practice in developing programs to help older employees counteract ageism, prepare for retirement, cope with health challenges, and reduce stress in family relations. The workplace is a convenient site for preventive and therapeutic…

Expanding gerontology enrollments: successful results of an innovative outreach program.

Science.gov (United States)

Reynolds, Sandra L; Haley, William E; Hyer, Kathryn

2007-01-01

As state budget allocations for higher education decrease, "specialty" programs such as gerontology must continually demonstrate their productivity. State and private universities increasingly rely on student credit hours (SCH) or tuition generated, which is making it difficult for many gerontology programs to expand. The School of Aging Studies at the University of South Florida has achieved a 236% increase in annual SCH productivity over the past 5 years by methods including qualifying courses for university liberal arts requirements, and designing and cross-listing interdisciplinary courses. This increased productivity has supported program expansion and led to beneficial outreach to students from diverse majors.

Music Therapy Training for Undergraduate Nursing Students: A Modality to Foster Interest in Gerontological Nursing.

Science.gov (United States)

Lin, Hui-Chuan; Chen, Shu-Ling; Hsieh, Chia-En; Lin, Ping-Yi

2016-06-01

gerontological nursing. 2. Describe the results of using music therapy to create positive attitudes toward older adults. DISCLOSURE STATEMENT Neither the planners nor the authors have any conflicts of interest to disclose. Nursing students generally have a negative attitude toward older adults. Preparing nurses to meet the care needs of an expanding aging population is a challenge for nursing educators. The purpose of the current study was to explore whether incorporating music therapy into a practical geriatric nursing course at a nursing home cultivates positive attitudes toward older adults, raises students' willingness to work with older adults, and increases their interest in specializing in gerontological nursing after graduation. Focus groups were conducted to collect data from three participant groups (N = 20). Verbatim transcripts of audiorecorded interviews were analyzed using content analysis, which revealed four themes: (a) better appreciation and understanding of music therapy, (b) role modeling instructors' successful experience and positive attitude toward older adults, (c) changing attitudes toward older adults, and (d) improving interaction skills with older adults. Results suggested music can be integrated into a gerontological nursing course to enhance students' motivation to learn, empathize, and approach older adults. [Journal of Gerontological Nursing, 42(6), 25-31.]. Copyright 2016, SLACK Incorporated.

Use of a screening tool and primary health care gerontology nurse specialist for high-needs older people.

Science.gov (United States)

King, Anna; Boyd, Michal; Dagley, Lynelle

2017-02-01

To describe implementation of an innovative gerontology nurse specialist role within one primary health organisation in Auckland, New Zealand. Quantitative outcomes of the screening tool as well as the nurse specialist assessment will be presented. The intervention involved use of the Brief Risk Identification for Geriatric Health Tool (BRIGHT) to identify high-needs older people with subsequent comprehensive geriatric assessment (CGA) performed by the gerontology nurse specialist. A total 384 of the 416 BRIGHTs were completed (92% response rate) and 15% of these were identified as high risk (n = 57). The BRIGHTs for high-risk older people revealed the highest scoring question was 'needing help with housework' (26%). The most frequent intervention by the gerontology nurse specialist was education (30%). The primary health care gerontology nurse specialist model delivers a proactive case finding and specialist gerontology intervention for older people at high risk of functional or health decline.

A Review of Our Roots: Blacks in Gerontology

Science.gov (United States)

Brown, Candace S.; Baker, Tamara A.; Mingo, Chivon A.; Harden, J. Taylor; Whitfield, Keith; Aiken-Morgan, Adrienne T.; Phillips, Karon L.; Washington, Tiffany

2014-01-01

The historical underpinnings in the field of gerontology rest on the contributions of scholars across a myriad of racial and ethnic backgrounds. With the increasing diversity of the adult population, there is a need to increase the number of researchers who study older adults from diverse racial and ethnic populations in general and Black elderly people in particular. Furthermore, it is important to document the participation of Black older adults in our earliest and continuing research efforts. Understanding the historical context and the foundational influence of Black scholars in this field is critical. To realize its humble beginnings, one must become aware of the contributions by Black scholars who have a vested interest in the aging process. With universal similarities and unique differences among older adults, there is a need to acknowledge the past and current scholarship of those who study the aging processes of Blacks while marveling over the future possibilities. The purpose of this review is to elucidate the legacy and current contributions, philosophies, and research of Black scholars in the field of gerontology. In addition, exploration of the theoretical and conceptual frameworks used to establish national and organizational initiatives is reviewed. The impetus in initiating and continuing this work requires a “knowledge of our roots” while moving into the future. It is important to learn the history and significance of Black scholars in gerontology, the contributions of older Blacks, and appreciate the resiliency and marveled life course of this unique population. PMID:24022695

Beyond Assessment: Conducting Theoretically Grounded Research on Service-Learning in Gerontology Courses.

Science.gov (United States)

Kruger, Tina M; Pearl, Andrew J

2016-01-01

Service-learning is a useful pedagogical tool and high-impact practice, providing multiple benefits. Gerontology (and other) courses frequently include service-learning activities but lack theory-based, intentional research on outcomes. Here, the authors define service-learning and contextualize it in higher education, provide an overview of research and assessment in service-learning and gerontology courses, demonstrate the shortcomings of program evaluations, and offer suggestions for future research to advance and generate theory.

Gerontology Programs in Japanese Higher Education: A Brief History, Current Status, and Future Prospects

Science.gov (United States)

Tsukada, Noriko; Tatara, Toshio

2005-01-01

The development of gerontological education is lagging behind in Japan in spite of Japan's large population of elders. Nevertheless, there are signs that this may be changing. In this paper we discuss how gerontology education has evolved in Japan over the past 40 years. Specifically, we provide an overview of the development of academic societies…

Oral History in the Classroom: A Comparison of Traditional and On-Line Gerontology Classes

Science.gov (United States)

Ehlman, Katie; Ligon, Mary; Moriello, Gabriele; Welleford, E. Ayn; Schuster, Kirsten

2011-01-01

In this study, the effectiveness of an oral history assignment was assessed in a traditional gerontology class versus a distance education (DE) gerontology class. Attitudes toward older adults and the aging process were measured before and after students in the traditional (n = 29) and DE (n = 16) setting completed an oral history assignment.…

The Current State and Developments in Higher Education in Gerontology in the Nordic Countries

Science.gov (United States)

Hietanen, Heidi; Lyyra, Tiina-Mari; Parkatti, Terttu; Heikkinen, Eino

2012-01-01

The growing size of the older population challenges not only researchers but also higher education in gerontology. On the basis of an online survey the authors describe the situation of Nordic higher education in gerontology in 2008 and 2009 and also give some good examples of Nordic- and European-level collaboration. The survey results showed…

What's stopping a career in gerontological nursing?: literature review.

Science.gov (United States)

Neville, Christine; Dickie, Robyn; Goetz, Sandra

2014-01-01

Despite the rapid aging of the world's population, many countries are experiencing difficulty in recruiting nurses to work with older people. A literature review was conducted regarding the career preferences of undergraduate nursing students from seven different countries. The literature review has identified that gerontological nursing does not feature highly as a career goal. Notably, this has been the situation for the past decade. There is no indication that the situation is going to change at any time in the future unless some serious decisions are made at professional, health service, community, and government levels. This literature review has identified the reasons why undergraduate nurses are not choosing gerontological nursing as a career, what has been done in an attempt to address the problem, and what else may be done. Copyright 2014, SLACK Incorporated.

What Should Gerontology Learn from Health Education Accreditation?

Science.gov (United States)

Bradley, Dana Burr; Fitzgerald, Kelly

2012-01-01

Quality assurance and accreditation are closely tied together. This article documents the work toward a unified and comprehensive national accreditation program in health education. By exploring the accreditation journey of another discipline, the field of gerontology should learn valuable lessons. These include an attention to inclusivity, a…

Perceptions on the importance of gerontological education by teachers and students of undergraduate health sciences

Directory of Open Access Journals (Sweden)

Correa-Muñoz Elsa

2007-01-01

Full Text Available Abstract Background The main challenge of higher education institutions throughout the world is to develop professionals capable of understanding and responding to the current social priorities of our countries. Given the utmost importance of addressing the complex needs of an increasingly elderly population in Mexico, the National Autonomous University of Mexico has systematically incorporated modules dealing with primary gerontological health care into several of its undergraduate programs in health sciences. The objective of this study was to analyze teacher's and student's perceptions about the current educational practices on gerontology. Methods A cross-sectional study was carried out with a sample of 26 teachers and 122 undergraduate students. Subjects were administered interviews and responded survey instrument. Results A vast proportion of the teachers (42% reported students' attitudes towards their academic training as the most important factor affecting learning in the field of gerontology, whereas students reported that the main problems of education in gerontology were theoretical (32% and methodological (28%. In addition, 41% of students considered education on ageing matters as an essential element for their professional development, as compared to 19% of teachers (p Conclusion Our findings suggest that the teachers' perceptions about the low importance of education on ageing matters for the professional practice of health sciences could be a negative factor for gerontology teaching.

[Politics and power in gerontological nursing in Brazil].

Science.gov (United States)

Kletemberg, Denise Faucz; Padilha, Maria Itayra

2012-10-01

The objective of the present study was to identify the politic activities implemented by gerontological nursing in Brazil in the period spanning 1970 to 1996, which aimed at making it an effective specialty in elderly care. This descriptive-qualitative study was performed using a historical approach, using thematic oral history. Fourteen nurses, pioneers in the field, took part in the study. The following categories were identified: 1) Political organization of the field; and 2) Relationship between the field and the State. Results identified the following examples of political activities: traveling throughout Brazil, aimed at getting researchers interested in the theme; creating the Scientific Department of Gerontological Nursing; and assuming an effective participation in the creation of public policies in the country. The specialty is aware of the political relevance for its construction and has been making efforts to achieve recognition as a field of knowledge within the multidisciplinary team of elderly care.

Time and ageing: a physicist's look at gerontology

NARCIS (Netherlands)

Uffink, J.

2000-01-01

To enter, as a physicist, into the field of gerontology brings along certain dangers. I will presumably fall into pitfalls of misunderstanding or step on some other booby traps which those who are familiar with the terrain have learned to avoid. This danger is probably even greater since the

Teaching an Interdisciplinary Gerontological Course to Pharmacy Students

Science.gov (United States)

Sumner, Edward D.

1978-01-01

An interdisciplinary course on gerontology has been developed and offered as an elective at the Medical University of South Carolina College of Pharmacy. Instruction is provided in the physical, psychological, and social influences with ambulatory and institutionalized geriatrics patients. A course outline and course objectives are included. (SW)

Learning from internships in gerontology and geriatrics: assessment and program evaluation.

Science.gov (United States)

Karasik, Rona J

2009-01-01

Internships are an essential component of gerontological education. Harvesting the learning from internships, however, requires careful attention to assessing an intern's work. In addition to providing feedback to students, internship assessment can also yield data useful for academic program evaluation. Drawing on internship assessment data collected from undergraduate and graduate gerontology interns and their community preceptors over a period of seven semesters, this article explores (1) concerns regarding how to assess what interns are learning, (2) ways to provide students with additional opportunities for learning from their internships, and (3) how information from these student-learning outcomes may be used to evaluate the effectiveness of the overall academic program.

Maximizing the Potential of Internships in Gerontology and Geriatrics

Science.gov (United States)

Karasik, Rona J.

2009-01-01

Internships and similar applied opportunities have long been valued for providing students with opportunities for practical experience, career preparation, and personal growth. The need for applied experiences in gerontology and geriatrics is particularly salient. Creating and sustaining effective internship experiences, however, requires careful…

Professional and Personal Development in Contemporary Gerontology Doctoral Education

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Ewen, Heidi H.; Rowles, Graham D.; Watkins, John F.

2012-01-01

This article reports on the Gerontology Doctoral Student Assessment Model (GDSAM), a comprehensive web-based system premised on developing an evaluation mechanism attuned to the special requirements of advanced graduate education at the doctoral level. The system focuses on longitudinal tracking of selected dimensions of intellectual,…

El envejecimiento como relato: Una invitación a la gerontología narrativa

Directory of Open Access Journals (Sweden)

Feliciano Villar

2015-07-01

Full Text Available El presente artículo tiene como objetivo presentar una panorámica actual de la aplicación de un enfoque narrativo al estudio del envejecimiento. En primer lugar se delinea cuál es el objeto de conocimiento de la gerontología narrativa, que se extiende en un doble nivel interrelacionado: la identidad narrativa en la vejez por una parte, y los relatos culturales sobre el envejecimiento por otra. En segundo lugar, se describen las principales metodologías utilizadas en la gerontología narrativa, diferenciando entre aquellas interesadas en el contenido de los relatos (qué se narra de las interesadas en el proceso de elaboración dialogada de los relatos (cómo se narra. El artículo finaliza con algunas reflexiones sobre el futuro y desafíos a los que se enfrenta la gerontología narrativa.  

[Physical and pharmacological restraints in geriatric and gerontology services and centers].

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Ramos Cordero, Primitivo; López Trigo, José Antonio; Maíllo Pedraz, Herminio; Paz Rubio, José María

2015-01-01

Physical and pharmacological restraints are a controversial issue in the context of geriatric care due to their moral, ethical, social and legal repercussions and, despite this fact, no specific legislation exists at a national level. The use of restraints is being questioned with growing frequency, as there are studies that demonstrate that restraints do not reduce the number of falls or their consequences, but rather can increase them, cause complications, injuries and potentially fatal accidents. Restraints are not always used rationally, despite compromising a fundamental human right, that is, freedom, protected in the Constitution, as well as values and principles, such as dignity and personal self-esteem. There are centers where restraints are applied to more than 50% of patients, and in some cases without the consent of their legal representatives. On some occasions, restraints are used for attaining organizational or environmental objectives, such as complying with tight schedules, and for reducing or avoiding the supervision of patients who walk erratically and, at times, are used indefinitely. Even greater confusion exists with respect to the emerging concept of chemical or pharmacological restraints, since no conceptual framework exists based on scientific evidence, and with sufficient consensus for guiding healthcare workers. In this context, the Sociedad Española de Geriatría y Gerontología (SEGG--Spanish Geriatrics and Gerontology Society), aware of the significance and transcendence of the issue, and in an attempt to preserve and guarantee maximum freedom, dignity and self-esteem, on the one hand, and to ensure the maximum integrity and legal certainty of the persons cared for in geriatric and gerontology services and centers, on the other, decided to create an "Interdisciplinary Committee on Restraints" made up by members from different disciplines and members of SEGG Working Groups or Committees, external health care workers, groups

Sexuality and Aging: A Timely Addition to the Gerontology Curriculum.

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Fitzpatrick, Tanya R.

2000-01-01

Describes the development and content of a course on sexuality in aging for a gerontology master's program. Topics include physical health, AIDS, gay/lesbian issues, widows/widowers, marriage, ethnic issues, menopause, and impotence. Provides a 33-item bibliography. (SK)

What can I do with a doctoral degree in gerontology? Expanding your options.

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Dassel, Kara Bottiggi; Ewen, Heidi; Carr, Dawn; Manning, Lydia; Leach, Corinne; Fitzgerald, Kelly

2014-01-01

An endless number of career trajectories are possible for gerontologists. With a growing aging population, our skills and areas of expertise are of high value to numerous industries. The purpose of this study is to describe the professional development and career trajectories of alumni of U.S. doctoral gerontology programs obtained through the Gerontology Education Longitudinal Study (GELS). Specifically, the authors examine how professional identification, doctoral program career preparation, and perception of job prospects affect alumni decisions to pursue "traditional" (i.e., academic) versus "nontraditional" (i.e., non-academic) careers. Results from the GELS revealed a fairly even split in the alumni sample of careers in traditional and nontraditional settings. The decision to pursue a traditional versus nontraditional career was not significantly associated with personal identification, doctoral program career preparation, or perception of employment options. These results suggest that the skill set obtained in doctoral gerontology programs is useful and is in demand in a variety of careers; therefore, doctoral programs may want to consider tailoring training to meet students' future career goals in both academic and non-academic settings.

Nurturing gerontology students' intrinsic motivation to cocreate: The design of a powerful learning environment.

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Jukema, Jan S; Veerman, Mieke; Van Alphen, Jacqueline; Visser, Geraldine; Smits, Carolien; Kingma, Tineke

2017-09-21

Professionals such as gerontologists play an important role in the design, development and implementation of age-friendly services. and products, by using working methods and principles of co-creation. A Dutch undergraduate applied gerontology programme aims to train students in the why, how and what of co-creation. The degree to which students are intrinsically motivated to develop competencies depends on how their psychological needs are met. These needs are autonomy, an awareness of competence and a sense of relatedness, as described in the self-determination theory. To nurture the intrinsic motivation of the applied gerontology students, a realistic, powerful learning environment called the Living Lab Applied Gerontology was designed and implemented. The aim of this paper is to present the design of this powerful learning environment and to discuss its value for nurturing the students' intrinsic motivation for co-creation. Based on a focus group with eight students, we identify directions for further research and development of living labs.

Web-Based Gerontology Courses: How Do They Measure Up?

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Hills, William E.; Brallier, Sara A.; Palm, Linda J.; Graham, Jamie M.

2009-01-01

This study compared Web-based and lecture-based Gerontology and Psychology of Aging courses in terms of student performance, demographic and academic characteristics of students enrolled in the courses, and extent to which these characteristics differentially predicted outcomes of learning in the two course types. Participants for this study were…

Intergenerational service learning: to promote active aging, and occupational therapy gerontology practice.

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Horowitz, Beverly P; Wong, Stephanie Dapice; Dechello, Karen

2010-01-01

Americans are living longer, and the meaning of age has changed, particularly for Boomers and seniors. These demographic changes have economic and social ramifications with implications for health care, including rehabilitation services, and health science education. Service learning is an experiential learning pedagogy that integrates traditional higher education with structured active learning experiences. This article reports on one intergenerational service learning program spanning 3 years. It was designed to facilitate community dialogue on fall prevention and active aging, and to provide intergenerational educational community-based experiences in occupational therapy professional education. The program additionally sought to promote students' understanding of aging and issues related to aging in place, students' professional development and civic engagement, and to encourage students to consider pursuing a career in occupational therapy gerontology practice.

Advancing nursing home practice: the International Association of Geriatrics and Gerontology Recommendations.

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Tolson, Debbie; Morley, John E; Rolland, Yves; Vellas, Bruno

2011-01-01

Recognition of the urgent need to improve the provision of long-term care, as well as the known variations in standards of nursing home care around the world, prompted the International Association of Geriatrics and Gerontology (IAGG), in association with the World Health Organization (WHO), to form a task force. This task force was charged with the identification of the key concerns, research priorities, and actions that would enhance the care provided to older people in nursing homes. Nurses are equipped with the knowledge to take a leadership role in the IAGG/WHO initiative, and the task force eagerly seeks their input. Copyright © 2011 Mosby, Inc. All rights reserved.

Educational Gerontology in Korea: An Interpretive and Critical Study

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Kee, Youngwha

2010-01-01

Wilma Donahue's book in 1955, "Education for Later Maturity", was considered the first major work to identify the educational needs of the aging person. Peterson considers it one of the earliest comprehensive surveys of older learners. However, the idea of educational gerontology was probably first used in 1970 at the University of…

A Gerontology Practitioner Continuing Education Certificate Program: Lessons Learned

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Englehardt, Jacqueline; Hash, Kristina M.; Mankowski, Mariann; Harper-Dorton, Karen V.; Pilarte, Ann E.

2016-01-01

This article discusses the results of a school of social work survey assessing the geriatric training needs of social workers and other professionals in aging and the need for a gerontology practitioner's continuing education (CE) certificate program. A total of 391 professionals, the majority of whom were social workers, participated in an online…

Generations and the Generation of Theory in Social Gerontology.

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Hendricks, Jon

1992-01-01

Looks at theorizing in gerontology as career-related activity engaged in by scholars who are prone to same demographic imperatives as other human beings as way of shedding more light on many uses of theory. Uses concept of theoretical generations as means of accounting for succession of models and explanatory frameworks. (Author/NB)

A gerontologia e a interdisciplinaridade: aspectos relevantes para a enfermagem La gerontología e interdisciplinaridade: los aspectos relevantes para la enfermería Gerontology and interdisciplinarity: relevant aspects to nursing

Directory of Open Access Journals (Sweden)

Alessandra Conceição Leite Funchal Camacho

2002-04-01

Full Text Available Este artigo retrata a Gerontologia como área rica e cheia de lacunas a serem preenchidas pelas disciplinas que a compõem, indo além das abordagens convencionais à clientela idosa, visando a caminhos renovados para a Enfermagem, que, dentre tantas disciplinas, também está no processo construtivo de conhecimento. Tem como objetivo destacar a importância da Gerontologia para a atuação interdisciplinar, principalmente para Enfermagem, ressaltando o cliente idoso no contexto social. A interdisciplinaridade é instrumento condutor para Gerontologia em busca de mudanças que venham a somar conhecimentos e redundar em esforços no processo de desenvolvimento da área da saúde em relação ao cliente idoso e às diversas disciplinas que contemplam uma atuação relevante que, sem dúvida, permitem avanços para a Enfermagem.Este artículo retrata la Gerontología como área rica y llena de lagunas para ser resueltas por las disciplinas que la componen, yendo más allá de los abordajes convencionales a la población anciana, buscando caminos renovados para enfermería, que dentro de tantas disciplinas, también está en el proceso constructivo del conocimiento. Tiene como objetivo destacar la importancia de la gerontología para la actuación interdisciplinaria, principalmente para enfermería, resaltando al paciente anciano en el contexto social. La interdisciplinariedad La interdisciplinariedad es instrumento conductor para la Gerontología en busca de cambios que vengan a agregar conocimientos que redunden en esfuerzos para el proceso de desarrollo del área de la salud en relación con el cliente anciano, y las diversas disciplinas que contemplan una actuación relevante que, sin duda, permitan avances para enfermería.This article shows Gerontology as a rich area and full of gaps to be filled by the disciplines that form it, going beyond the conventional approaches to the elderly client and aiming at finding new Nursing paths as, among

Auto-Gerontology: A Personal Odyssey.

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Palmore, Erdman B

2017-11-01

The four leading theories of optimal aging are activity, continuity, successful aging, and selective optimization with adaptation. All tend to support the slogan, "Use it or lose it." I have tried to continue using my abilities in four key areas: professional, volunteer, personal relationships, and physical fitness. Ageism also has become personal for me because I have made it a personal priority to do what I can to reduce ageism. This includes research and writing, developing a list of 45 advantages to aging, avoiding ageist jokes and language, developing positive slogans about aging, maintaining personal fitness, going on birthday adventures, and being proud of my age (85). I close with answers to some questions about auto-gerontology.

Time, Story, and Wisdom: Emerging Themes in Narrative Gerontology

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Randall, William Lowell; Kenyon, Gary M.

2004-01-01

Narrative approaches in the field of aging are receiving increasing attention by theorists and practitioners alike. This article draws on recent thinking in narrative gerontology to look at three aspects of aging on which a narrative perspective can shed further light. In relation to the temporal aspects, the notion of storytime is examined.…

Collaborative Online Teaching: A Model for Gerontological Social Work Education

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Fulton, Amy E.; Walsh, Christine A.; Azulai, Anna; Gulbrandsen, Cari; Tong, Hongmei

2015-01-01

Social work students and faculty are increasingly embracing online education and collaborative teaching. Yet models to support these activities have not been adequately developed. This paper describes how a team of instructors developed, delivered, and evaluated an undergraduate gerontological social work course using a collaborative online…

Geezer Poet? A Member of the Gerontology Therapeutic Team?

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Herbert, Mary Kennan

2014-01-01

Poetry and gerontology are often not viewed as congenial or likely companions. Yet these two approaches to communication, creativity, and health may have much in common. I would like to present some of my own work, five poems in fact, in light of my personal history and as a teacher/facilitator. My goal here is to reveal ideas and directions that…

In Support of a Gerontological Nursing Program: A Resource Exchange Model.

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Newbern, Virginia B.; Kennedy-Malone, Laurie

1994-01-01

At the University of North Carolina-Greensboro, the Gerontological Nursing Network serves as advocates for older adults, helps graduates find employment, identifies preceptors and practicum sites, and advises about trends. Its interdisciplinary membership is drawn from nursing, medicine, psychology, politics, religion, and sociology. (SK)

Elderly patients with Vascular Brain Accident: A gerontogeriatric vision, from a literature review of studies published in the Journal Kairos Gerontology

OpenAIRE

Ana Cristina dos Santos Silva; Flamínia Manzano Moreira Lodovici; Ruth Gelehrter da Costa Lopes; Maria Helena Villas Bôas Concone

2015-01-01

This research aimed to assess the work published in the journal Kairos Gerontology, from 1998 to 2014, with the theme: elderly affected by cerebrovascular accident. It was intended to be a reflection of the importance of this thematic gerontogeriatria, contributing to the social integration of older persons, from a holistic look. At the end of this survey, we can affirm the importance of respect to reality of these elderly people in its context of life, as well as preventive measures in prima...

Paradigms in the Gerontology Classroom: Connections and Challenges to Learning

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Morgan, Leslie

2012-01-01

The article explores paradigms for approaching course content to be studied in the classroom. These paradigms, or global views about what is of interest or importance and ways of knowing, relate to key questions in gerontology, such as what is the relevant domain/content to be studied, what is the central level of analysis or action, what are…

[When the disabled sector meets that of gerontology].

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Felgines, Marjorie

Denis is a 62-year-old man with Down syndrome. He lives in a residential home and is retired from a supported employment service centre. Since suffering a stroke, Denis has been relatively immobile, looking on as a spectator in the medical-social centre where he is living. Anticipating his advancing years, the team has turned to a gerontological team which will intervene in a centre for people with disabilities. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Setting Priorities for Gerontological Social Work Research: A National Delphi Study

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Burnette, Denise; Morrow-Howell, Nancy; Chen, Li-Mei

2003-01-01

Purpose: An increasingly important task for all disciplines involved in aging research is to identify and prioritize areas for investigation. This article reports the results of a national Delphi study on setting research priorities for gerontological social work. Design and Methods: Delphi methodology, a structured process for eliciting and…

The Great Plains IDEA Gerontology Program: An Online, Interinstitutional Graduate Degree

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Sanders, Gregory F.

2011-01-01

The Great-Plains IDEA Gerontology Program is a graduate program developed and implemented by the Great Plains Interactive Distance Education Alliance (Great Plains IDEA). The Great Plains IDEA (Alliance) originated as a consortium of Colleges of Human Sciences ranging across the central United States. This Alliance's accomplishments have included…

Just say know: an examination of substance use disorders among older adults in gerontological and substance abuse journals.

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Rosen, Daniel; Engel, Rafael J; Hunsaker, Amanda E; Engel, Yael; Detlefsen, Ellen Gay; Reynolds, Charles F

2013-01-01

This article examines the extent to which studies of alcohol abuse, illicit drug use, and prescription drug abuse among older adults appear in the leading gerontological and substance abuse journals. The authors reviewed articles published in the 10 social science gerontological journals and the 10 social science substance abuse journals with the highest 5-year impact factors in PubMed from 2000 to 2010. Articles were selected that presented original research on alcohol, substance, or prescription abuse with older adults aged 50 and older; and were identified through aging and substance abuse-related Medical Subject Headings and word searches of titles and abstracts (N = 634). Full text of each article was reviewed by the authors, and consensus determined inclusion in the final sample. Of the 19,953 articles published respectively in the top 10 gerontological and substance abuse journals, 181 articles met the inclusion criteria of reporting findings related to substance use disorders among older adults. Specifically, 0.9% (102 of 11,700) of articles from the top 10 gerontology journals and 1.0% (79 of 8,253) of articles from the top 10 substance abuse journals met the criteria. Most published articles addressed alcohol misuse/abuse or polysubstance abuse with few articles addressing illicit drug use or the misuse of prescription medications. Less than 1% of articles published in the 10 gerontology journals and the 10 substance abuse journals with the highest 5-year impact scores addressed substance abuse in older adults. Practitioners treating health and/or mental health problems are at a disadvantage in accurately identifying and treating these conditions in older adult populations without a proper understanding of the role of comorbid substance use disorders.

Applying Theories of Adult Learning in Developing Online Programs in Gerontology

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Carter, Christy S.; Solberg, Lauren B.; Solberg, Laurence M.

2017-01-01

The Department of Aging and Geriatric Research at the University of Florida College of Medicine has established online education programs to provide healthcare professionals with advanced training in the field of gerontology to establish proficiency in providing quality care to older individuals. A major barrier to creating our online education…

European Master's program in Gerontology (EuMaG): Goals, curriculum, and students

NARCIS (Netherlands)

Aartsen, M.J.

2011-01-01

The European Master's Program in Gerontology (EuMaG) started in September 2003 with support from the European Commission. The EuMaG is a modular, 2-year, part-time international training program about the aging process and its societal implications. The multidisciplinary curriculum comprises four

“Exchange of letters between generations”: Gerontological intergenerational project, carried out in a elderly long-term institution of São Paulo

Directory of Open Access Journals (Sweden)

Marcelo Piovezan

2015-12-01

Full Text Available The work promoted a gerontological action through anonymous letters that provided intergenerational link between institutionalized elderly and high school students. Allowed the inclusion of the elderly aiming positive impact on their depression and provided positive promotion on aging to the students. The intervention showed the possibility to establish links between the elderly and the young students, improving their sense of belonging, self-efficacy and better self-esteem.  

Old-age stereotypes related to the gerontology education: an intergenerational study Estereotipos sobre la vejez y su relación con la formación en gerontología: un estudio intergeneracional.

Directory of Open Access Journals (Sweden)

José J. Gázquez

2009-10-01

Full Text Available

The aim of this paper is to determine the level of agreement with a series of stereotypes present in our society. These stereotypes are related to sexuality, personality, and cognitive aspects in old people. A sample of 806 people was divided into four groups: youths and older people who had some gerontology education and youths and older people without gerontology education. The analysis carried out shows that gerontology education is extremely relevant to avoid erroneous beliefs about old people. The results reveal the low degree of agreement with the statements: Impotence is usually psychological, but in old men, it is due to age; Old people do not benefit much from education due to their cognitive deficits; Intelligence peaks around the age of 30 and then declines gradually; Sooner or later, old people become senile; Senile people cannot be helped by psychotherapy; Personality is relatively stable in adulthood; and Menopause causes nervous breakdowns.

Key words: Beliefs, youths, elderly, gerontology education.

El objetivo de este estudio es conocer el grado de aceptación o de acuerdo, hacia una serie de estereotipos que se encuentran presentes en la sociedad. Dichos estereotipos guardan relación con aspectos, tales como: la sexualidad, la personalidad y los aspectos cognitivos de las personas mayores. Para ello, se seleccionó a una muestra de 806 sujetos, divididos en cuatro grupos: jóvenes y mayores con formación gerontológica, y jóvenes y mayores sin formación gerontológica. De los análisis realizados se desprende, que la educación, en este supuesto, en gerontología, es sumamente relevante para evitar las creencias erróneas hacia las personas mayores, así observamos cómo muestran menor acuerdo con afirmaciones como que la impotencia suele ser psicológica, pero en los viejos es por la edad; por sus muchas carencias, los viejos no pueden servirse de la educación; a los 30 años la

Assessing Needs for Gerontological Education in Urban and Rural Areas of Ohio

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Van Dussen, Daniel J.; Leson, Suzanne M.; Emerick, Eric S.; Voytek, Joseph A.; Ewen, Heidi H.

2016-01-01

Purpose of the Study: This project surveyed health care professionals from both urban and rural care settings in Ohio and examined differences in professionals' needs and interests in continuing gerontological education. Design and Methods: The survey data were analyzed for 766 health care professionals descriptively, using cross-tabulations and…

Peer and Faculty Mentoring for Students Pursuing a PhD in Gerontology

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Webb, Alicia K.; Wangmo, Tenzin; Ewen, Heidi H.; Teaster, Pamela B.; Hatch, Laurie R.

2009-01-01

The Graduate Center for Gerontology at the University of Kentucky incorporates three levels of mentoring in its PhD program. This project assessed satisfaction with peer and faculty mentoring and explored their perceived benefits and purposes. Core and affiliate faculty and current and graduated students were surveyed. Participants seemed…

Interdisciplinary collaboration in gerontology and geriatrics in Latin America: conceptual approaches and health care teams.

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Gomez, Fernando; Curcio, Carmen Lucia

2013-01-01

The underlying rationale to support interdisciplinary collaboration in geriatrics and gerontology is based on the complexity of elderly care. The most important characteristic about interdisciplinary health care teams for older people in Latin America is their subjective-basis framework. In other regions, teams are organized according to a theoretical knowledge basis with well-justified priorities, functions, and long-term goals, in Latin America teams are arranged according to subjective interests on solving their problems. Three distinct approaches of interdisciplinary collaboration in gerontology are proposed. The first approach is grounded in the scientific rationalism of European origin. Denominated "logical-rational approach," its core is to identify the significance of knowledge. The second approach is grounded in pragmatism and is more associated with a North American tradition. The core of this approach consists in enhancing the skills and competences of each participant; denominated "logical-instrumental approach." The third approach denominated "logical-subjective approach" has a Latin America origin. Its core consists in taking into account the internal and emotional dimensions of the team. These conceptual frameworks based in geographical contexts will permit establishing the differences and shared characteristics of interdisciplinary collaboration in geriatrics and gerontology to look for operational answers to solve the "complex problems" of older adults.

Developing a Postbasic Gerontology Program for International Learners: Considerations for the Process.

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Bolan, Christine M.

2003-01-01

Chilean and Canadian schools of nursing collaborated in the development of 13 self-paced print modules in gerontology with web-based components. A 6-week preceptored clinical experience followed completion of the theory portion to support learner mastery of program outcomes. The curriculum was developed using a creative, systematic approach that…

Development and Implementation of a Peer Mentoring Program for Early Career Gerontological Faculty

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Bryant, Ashley Leak; Brody, Ab; Perez, Adriana; Shillam, Casey; Edelman, Linda S.; Bond, Stewart M.; Foster, Victoria; Siegel, Elena

2016-01-01

Purpose In conjunction with the National Hartford Centers of Gerontological Nursing Excellence (NHCGNE), formerly known as the Building Academic Geriatric Nursing Capacity Initiative (BAGNC), the Hartford Gerontological Nursing Leaders (HGNL) developed and executed a program beginning in 2011 to enhance both (a) the experience of newly selected scholars and fellows to the NHCGNE and (b) the ongoing professional development of the HGNL. The purpose of this article is to describe key strategies used to develop and execute the mentoring program and to present the formative and summative program evaluation. Design The program was launched in January 2011 with seven peer mentor and mentee matches. In June 2012, the peer mentoring committee solicited feedback on the development of the peer mentoring program and changes were made for the subsequent cohorts. Findings An additional 12 matches were made in the following 2 years (2012 and 2013), for a total of 31 matches to date. We have learned several key lessons from our three cohorts regarding how to structure, implement, and carefully evaluate a peer mentoring program. Conclusions Informal evaluation of our peer mentoring program noted several challenges for both peer mentors and mentees. Having knowledge of and addressing those challenges may increase the overall quality and effectiveness of peer mentoring programs and, in turn, benefit academic nursing by strengthening the faculty workforce. Clinical Relevance Findings from development and implementation of a peer mentoring program for gerontological faculty could lead to new and adaptable programs in a variety of clinical and education settings. PMID:25808927

Development and implementation of a peer mentoring program for early career gerontological faculty.

Science.gov (United States)

Bryant, Ashley Leak; Aizer Brody, Abraham; Perez, Adriana; Shillam, Casey; Edelman, Linda S; Bond, Stewart M; Foster, Victoria; Siegel, Elena O

2015-05-01

The Hartford Gerontological Nursing Leaders (HGNL) formerly known as the Building Academic Geriatric Nursing Capacity Initiative (BAGNC), in conjunction with the National Hartford Centers of Gerontological Nursing Excellence (NHCGNE), developed and executed a peer mentoring program beginning in 2011 to enhance both (a) the experience of newly selected scholars and fellows to the NHCGNE and (b) the ongoing professional development of HGNL members. The purpose of this article is to describe key strategies used to develop and execute the peer mentoring program and to present formative program evaluation. The program was launched in January 2011 with seven peer mentor and mentee matches. In June 2012, the peer mentoring committee solicited feedback on the development of the peer mentoring program and changes were made for the subsequent cohorts. An additional 12 matches were made in the following 2 years (2012 and 2013), for a total of 31 matches to date. We have learned several key lessons from our three cohorts regarding how to structure, implement, and carefully evaluate a peer mentoring program. Informal evaluation of our peer mentoring program noted several challenges for both peer mentors and mentees. Having knowledge of and addressing those challenges may increase the overall quality and effectiveness of peer mentoring programs and, in turn, benefit academic nursing by strengthening the faculty workforce. Findings from development and implementation of a peer mentoring program for gerontological faculty could lead to new and adaptable programs in a variety of clinical and education settings. © 2015 Sigma Theta Tau International.

A World Apart? Bridging the Gap between Theory and Applied Social Gerontology

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Hendricks, Jon; Applebaum, Robert; Kunkel, Suzanne

2010-01-01

This article is based on the premise that there is inadequate attention to the link between theory and applied research in social gerontology. The article contends that applied research studies do not often or effectively employ a theoretical framework and that theory-based articles, including theory-based research, are not often focused on…

Topics in space gerontology: Effects of altered gravity and the problem of biological age

Science.gov (United States)

Economos, A. C.

1982-01-01

The use of altered gravity experimentation as a gerontological research tool is examined and a rationale for a systems approach to the adaptation to spaceflight is presented. The dependence of adaptation capacity on biological age is also discussed.

The State of Gerontological Social Work Education in California: Implications for Curricula Evaluation

Science.gov (United States)

Damron-Rodriguez, JoAnn; Goodman, Catherine; Ranney, Molly; Min, Jong Won; Takahashi, Nancy

2013-01-01

California has actively engaged in the Hartford Geriatric Social Work Initiative. Subsequently, the California Social Work Education Center Aging Initiative conducted a university survey of gerontology education in California graduate social work schools ("N"?=?17). In 2005, students taking aging courses were 12% in comparison to a…

[Chartered specialist training in gerontology and geriatrics. Dissertation Council no. 601.001.01 working practice].

Science.gov (United States)

Kozina, L S

2014-01-01

The article highlights basic facts about the foundation and activity of the Gerontology and Geriatrics Dissertation Council of St. Petersburg Institute of Bioregulation and Gerontology, which took invaluable part in chartered specialist training in this field of science that has actively developed in Russia in recent decades. Over the period from June, 2001 to December, 2013, a total of 41 doctoral dissertations were defended, of which 32 dissertations were on Medicine and 9 on Biological Sciences. Likewise, over the same period, a total of 186 candidate's dissertations were defended, of which 152 dissertations were on Medicine and 34 on Biological Sciences, the defenders coming from various regions of Russia and other countries. The defence-representative trend data acquired over the period of the Dissertation Council activities shows that the number of defended doctoral dissertations was relatively small within the period from 2002 to 2008, but it increased significantly in the years 2009 to 2013. The number of defended candidate's dissertations increased significantly over the same period, too. Among many others considered by the Dissertation Council, there were dissertations dedicated to basic research in the field of gerontology and geriatrics. The priority topics of a large number of dissertations performed in St. Petersburg and other Russian towns are age pathology mechanisms, geroprotective effects of regulatory peptides and effectiveness of their use in clinic.

Advancing the Aging and Technology Agenda in Gerontology.

Science.gov (United States)

Schulz, Richard; Wahl, Hans-Werner; Matthews, Judith T; De Vito Dabbs, Annette; Beach, Scott R; Czaja, Sara J

2015-10-01

Interest in technology for older adults is driven by multiple converging trends: the rapid pace of technological development; the unprecedented growth of the aging population in the United States and worldwide; the increase in the number and survival of persons with disability; the growing and unsustainable costs of caring for the elderly people; and the increasing interest on the part of business, industry, and government agencies in addressing health care needs with technology. These trends have contributed to the strong conviction that technology can play an important role in enhancing quality of life and independence of older individuals with high levels of efficiency, potentially reducing individual and societal costs of caring for the elderly people. The purpose of this "Forum" position article is to integrate what we know about older adults and technology systems in order to provide direction to this vital enterprise. We define what we mean by technology for an aging population, provide a brief history of its development, introduce a taxonomy for characterizing current technology applications to older adults, summarize research in this area, describe existing development and evaluation processes, identify factors important for the acceptance of technology among older individuals, and recommend future directions for research in this area. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Nurturing gerontology students’ intrinsic motivation to cocreate : the design of a powerful learning environment.

NARCIS (Netherlands)

Jukema, Jan S.; Veerman, Mieke; van Alphen, Jacqueline; Visser, Geraldine; Kingma, Tineke

2017-01-01

Professionals such as gerontologists play an important role in the design, development and implementation of age-friendly services. and products, by using working methods and principles of co-creation. A Dutch undergraduate applied gerontology programme aims to train students in the why, how and

Nursing home research: the first International Association of Gerontology and Geriatrics (IAGG) research conference.

Science.gov (United States)

Rolland, Yves; Resnick, Barbara; Katz, Paul R; Little, Milta O; Ouslander, Joseph G; Bonner, Alice; Geary, Carol R; Schumacher, Karen L; Thompson, Sarah; Martin, Finbarr C; Wilbers, Joachim; Zúñiga, Franziska; Ausserhofer, D; Schwendimann, R; Schüssler, S; Dassen, Theo; Lohrmann, Christa; Levy, Cari; Whitfield, Emily; de Souto Barreto, Philipe; Etherton-Beer, Christopher; Dilles, Tinne; Azermai, Majda; Bourgeois, Jolyce; Orrell, Martin; Grossberg, George T; Kergoat, Hélène; Thomas, David R; Visschedijk, Jan; Taylor, Stephanie J C; Handajani, Yvonne S; Widjaja, Nelly T; Turana, Yuda; Rantz, Marilyn J; Skubic, Marjorie; Morley, John E

2014-05-01

The International Association of Gerontology and Geriatrics held its first conference on nursing home research in St Louis, MO, in November 2013. This article provides a summary of the presentations. Copyright © 2014 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

Training Needs in Gerontology. Hearings, Special Committee on Aging, United States Senate. Part 2.

Science.gov (United States)

Congress of the U.S., Washington, DC. Senate Special Committee on Aging.

At the second day of hearings on training needs in gerontology the witnesses were Stephen Kurzman accompanied by Arthur S. Flemming, John Lapp, Gerald D. LaVeck; George Maddox; Elias Cohen; Wilma Donahue; Brin Hawkins with Lettie Graves and Yolanda Owens; and John B. Martin. (MS)

Health information technologies in geriatrics and gerontology: a mixed systematic review.

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Vedel, Isabelle; Akhlaghpour, Saeed; Vaghefi, Isaac; Bergman, Howard; Lapointe, Liette

2013-01-01

To review, categorize, and synthesize findings from the literature about the application of health information technologies in geriatrics and gerontology (GGHIT). This mixed-method systematic review is based on a comprehensive search of Medline, Embase, PsychInfo and ABI/Inform Global. Study selection and coding were performed independently by two researchers and were followed by a narrative synthesis. To move beyond a simple description of the technologies, we employed and adapted the diffusion of innovation theory (DOI). 112 papers were included. Analysis revealed five main types of GGHIT: (1) telecare technologies (representing half of the studies); (2) electronic health records; (3) decision support systems; (4) web-based packages for patients and/or family caregivers; and (5) assistive information technologies. On aggregate, the most consistent finding proves to be the positive outcomes of GGHIT in terms of clinical processes. Although less frequently studied, positive impacts were found on patients' health, productivity, efficiency and costs, clinicians' satisfaction, patients' satisfaction and patients' empowerment. Further efforts should focus on improving the characteristics of such technologies in terms of compatibility and simplicity. Implementation strategies also should be improved as trialability and observability are insufficient. Our results will help organizations in making decisions regarding the choice, planning and diffusion of GGHIT implemented for the care of older adults.

Promoting Careers in Gerontology to Students: What Are Undergraduates Seeking in a Career?

Science.gov (United States)

Eshbaugh, Elaine; Gross, Patricia E.; Hillebrand, Kelsey; Davie, Josie; Henninger, William R.

2013-01-01

The graying of the Baby Boomers has created a shortage of professionals in aging-related careers. However, colleges and universities with gerontology and aging programs face a challenge of recruiting students. The purpose of this study was to determine what students are looking for in a career and whether these attributes are congruent with…

GERONTOLOGÍA EDUCATIVA DESDE LA PERSPECTIVA DE GÉNERO: UNA PRÁCTICA METODOLÓGICA (EDUCATIONAL GERONTOLOGY FROM A PERSPECTIVE OF GENDER: A METHODOLOGICAL PRACTICE

Directory of Open Access Journals (Sweden)

Hernández Sánchez Sonia

2010-08-01

Full Text Available Resumen:En el presente artículo se analiza un grupo de mujeres mayores, de 50 años a 72 años de edad, quienes participan desde el 2008, en un curso de capacitación para enfrentar los cambios y los desafíos de la vejez, asistiendo al Programa de Atención Integral de la Persona Adulta Mayor, de la Sede de Occidente. Ellas re-construyen una estructura de pensamiento acorde con el significado de su propio proceso de envejecimiento y vejez, al que relacionan con formas diferentes de acción e innovación y, con una búsqueda constante de autonomía. De esta manera, hacen una ruptura de ciertas creencias, prejuicios y preconceptos sociales, sobre el envejecimiento femenino, que aún se sostienen en algunos contenidos de la gerontología educativa. En la práctica metodológica del curso, se enfoca el interés en los procesos de interacción social, en “espacios cualitativos”, donde formulan el punto de partida central, para una gerontología educativa con perspectiva de género. En dichos espacios, ellas siempre han expresado grandes deseos de aprender a enfrentar los temores que poseen frente a su propia vejez, ante los cambios que ya están decididas a realizar en esta etapa de la vida y, a proyectar ese re-conocimiento de sí mismas a otras mujeres adultas mayores.Abstract:This article analyzes how a group of elderly women participating in a training course to face their changes and challenges in elderly stages of life, re-build a structure of thought that matches the meaning of their own aging process and of that of elderly age itself. These women relate this process to various forms of action and innovation and to a constant search for autonomy, breaking up with certain beliefs, prejudices, and social preconceptions, regarding female aging, which still remain in some contents of educational gerontology. In developing the methodology of the course, the focus is on the meaning of the processes of social interaction within �

Independent community care gerontological nursing: becoming an entrepreneur.

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Caffrey, Rosalie A

2005-08-01

Few nurses have the experience of developing an independent practice. This ethnographic study explores the process and challenges of becoming an entrepreneur as described by nurses developing independent practices in community care gerontologic nursing. The process included developing a legal contract, marketing strategies, and reimbursement amounts and strategies. Major barriers to implementing this role identified by the nurses included ignorance and confusion by others about their role, financial issues related to an uncertain income, time management, and legal concerns especially around delegation. These were experienced and dedicated nurses who were also risk-takers and enjoyed the independence of practicing nursing because they believed it was meant to be practiced. Suggestions for research, education, and practice are included.

[A new stage of development of gerontology and geriatrics in Russia: Problems o creation of a geriatric care system. Part 2. The structure of the system, scientific approach].

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Anisimov, V N; Serpov, V Yu; Finagentov, A V; Khavinson, V Kh

2017-01-01

The publication is the second part of the analytical review on the new stage of development of gerontology and geriatrics in Russia. Components of social support system for senior citizens and the structure of social-medical care as its crucial components are presented. The problem of positioning of geriatric care within the system of social support for senior citizens, as well as its peculiarities and the algorithm providing geriatric care are discussed. The analysis of this algorithm allowed us to justify the indissoluble link and continuity of individual components of geriatric care and its cost-effectiveness. The position of the Russian Federation Ministry of Health concerning of introduction of geriatric care as an element in the system of medical care for older citizens was looking through. The pilot project «Territory of Care» proposed by the Russian Federation Ministry of Labor and Ministry of Health for establishment of long-term system of medical and social care to citizens of the older generation on the principles of multidisciplinary and interdepartmental interaction was elucidated as well. Some failures of the project have been highlighted and recommendations for its development were stressed. The role of gerontology as a systemic basis for creation of geriatric service in Russia and for the development of an integrated social and medical care to citizens of the older generation was underlined. The main priorities in the field of aging in the forthcoming decade are formulated. The most promising areas of research in the field of gerontology were discussed, the implementation of which will allow to realize the State social policy goals focused on the quality of life of senior citizens. Finally, the position of Gerontological Society of the Russian Academy of Sciences on the creation of mechanisms of scientific support for the renovation of geriatric services, including collaboration with experts in the field of practical medicine, social workers, and

Web-based vs. traditional classroom instruction in gerontology: a pilot study.

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Gallagher, Judith E; Dobrosielski-Vergona, Kathleen A; Wingard, Robin G; Williams, Theresa M

2005-01-01

Numerous studies have documented comparable outcomes from Web-based and traditional classroom instruction. However, there is a paucity of literature comparing these two delivery formats for gerontology courses in dental hygiene curricula. This study examines the effectiveness of alternative methods of course delivery by comparing student profiles and instructional outcomes from a dental hygiene gerontology course offered both on the Web and in a traditional classroom setting. Questionnaires were sent to both groups of students completing the course. The instrument was designed to establish profiles of the participating students. The data collected included familiarity with Web-based instruction, extent of prior computer training, previous interaction with the elderly, and student evaluations of course effectiveness. Traditional instructional outcomes from evaluated course work were compared, as were post-course exam outcomes that assessed retention of course information six months after course completion. The statistical significance of these data was determined using Statistical Package for Social Scientists software (SPSS, Inc., version 12.0, Chicago, IL). A comparison of student characteristics enrolled in the two course formats revealed marked differences. The Web-based group (n=12) included dental hygiene students (67%) and other health care providers (25%). All participants in the traditional classroom format (n=32) were dental hygiene students. Half of the Web-based respondents were over 25 years of age, and the majority (n=8) had previously taken an online course. The majority of traditional classroom students were 25 years of age or younger (n=21) and had never taken a Web-based course (n=20). Statistically significant differences in instructional outcomes were observed between students enrolled in these two formats. Student retention of course material six months after completion of the course was greater in the Web-based format. Students selecting a Web

Características de los trabajos científicos nacionales en geriatría y gerontología.1980-2001

Directory of Open Access Journals (Sweden)

Luis Varela Pinedo

2003-01-01

Full Text Available Objetivo: Describir el estado actual de la Investigación en Geriatría y Gerontología en el Perú y así identificar el amplio campo que aún falta por investigar. Materiales y métodos: El presente es un estudio transversal y descriptivo de las tesis, artículos y publicaciones relativos a geriatría y gerontología realizados a nivel nacional desde 1980 hasta el 2001. Se utilizó una metodología de búsqueda mediante el uso de palabras clave y una selección basada en el cumplimiento de los pasos del proceso metodológico. Resultados: Se encontraron un total de 256 Trabajos de Investigación en Gerontología y Geriatría, 30 trabajos (11.7% de Gerontología y 226 trabajos (88.3% de Geriatría. Una mayor proporción de trabajos fueron realizados en las Universidades Cayetano Heredia (47.9% y San Marcos (23.7% en Lima, seguido de la Universidad San Agustín de Arequipa (19.9%. Se encontró que únicamente un 19.2% de los trabajos se habían publicado. Las tesis de pregrado (69.2% fueron realizadas en mayor número que las de postgrado. Se encontró un mayor porcentaje de trabajos relativos a temas quirúrgicos (12.1%, temas infecciosos (10.2% y temas de enfermería (9.8%. De acuerdo a la clasificación de los estudios, se encontró un alto porcentaje de trabajos de tipo transversal (55.1%, seguidos de los retrospectivos (29.8%. Conclusiones: Los Trabajos de Investigación en Geriatría y Gerontología abarcan fundamentalmente el área clínica, sólo un 19.2% de los trabajos se publica, las tesis de pregrado fueron la principal forma de investigación y la mayor proporción de trabajos fueron descriptivos y de corte transversal. (Rev Med Hered 2003; 14:18-25.

Advocating vaccination of adults aged 60 years and older in Western Europe: statement by the Joint Vaccine Working Group of the European Union Geriatric Medicine Society and the International Association of Gerontology and Geriatrics-European Region.

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Michel, Jean-Pierre; Chidiac, Christian; Grubeck-Loebenstein, Beatrix; Johnson, Robert W; Lambert, Paul Henri; Maggi, Stefania; Moulias, Robert; Nicholson, Karl; Werner, Hans

2009-04-01

Vaccines are an underused public health strategy for healthy aging. Considering the risks of vaccine-preventable diseases and the current low vaccine coverage rates in older European citizens, the two European geriatric and gerontological societies (European Union Geriatric Medicine Society [EUGMS] and International Association of Gerontology and Geriatrics-European Region [IAGG-ER]) convened a Joint Vaccine Working Group to develop a consensus document advocating routine vaccination of aging populations. The mandate of this Working Group was to improve the uptake of routine vaccinations in adults aged 60 years and over. The consensus statement underlines the need to establish, strengthen, and harmonize European policies that continue routine vaccinations to adulthood and that will include older populations. Improved vaccination rates will promote healthy aging by reducing the burden of vaccine-preventable infectious diseases in older populations, a population that is rapidly increasing in Europe.

[A new stage of development of gerontology and geriatrics in Russia: problems of creation of a geriatric care system. Part 1. Relevance, regulatory infrastructure].

Science.gov (United States)

Anisimov, V N; Serpov, V Yu; Finagentov, A V; Khavinson, V Kh

2017-01-01

This article is a 1st part of the analytical review, focused on a new step in development of geriatrics in Russia. Creation of state system geriatric care as important part of state politics in the area of enhancement of quality of life was proved. General aspects of improvement of social support of disable elderly persons in condition of restricted budget and interagency separation was presented. Establishment of unified system of medical social support and gerotechnologies for the elderly was substantiated, as a mechanism facilitated life activity and decreasing of demographic loading on economic status of regions of Russian Federation. Legislative and normative regulations of gerontology and geriatric development were observed as well. Accepted legislative and normative acts were analyzed for period since 1977 to 2014. The necessity of approaches to regulation modernization for elderly was demonstrated. Analytical review on number of legislative state documents issued after meeting of Presidium of State Council of the Russian Federation being in August 2014 was also presented. Applicability of these documents for realization new strategy of gerontology and geriatrics development in Russia was proved.

Job Satisfaction Among Gerontological Social Workers in Ontario, Canada.

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Simons, Kelsey; An, Sofiya

2015-01-01

Little is known about job satisfaction among Canada's social work workforce in aging, although social workers remain a key component of interdisciplinary care in health and social service settings. This study begins to address this gap in knowledge by examining individual, interpersonal, and job-design factors influencing the job satisfaction of gerontological social workers in Ontario. Data were collected via two online surveys with a sample drawn from the Ontario Association of Social Workers' membership list (N = 104). A multiple regression model explained 37% of the variance in job satisfaction, F = 5.47[10, 93], p social work clinicians, and providing educational and clinical supports to clinicians.

Tomorrow Belongs to Those Who Prepare for It Today: Gerontology Doctoral Students Career Aspirations

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Ewen, Heidi H.; Carr, Dawn C.; Reynolds, Courtney

2012-01-01

This research seeks to examine the characteristics and goals of students enrolled in gerontology doctoral education. The authors seek to identify the unique characteristics of scholars enrolled in the interdisciplinary study of aging and elicit discussion on the ways in which these scholars will contribute to the growth and development of the…

The path dependency theory: analytical framework to study institutional integration. The case of France.

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Trouvé, Hélène; Couturier, Yves; Etheridge, Francis; Saint-Jean, Olivier; Somme, Dominique

2010-06-30

The literature on integration indicates the need for an enhanced theorization of institutional integration. This article proposes path dependence as an analytical framework to study the systems in which integration takes place. PRISMA proposes a model for integrating health and social care services for older adults. This model was initially tested in Quebec. The PRISMA France study gave us an opportunity to analyze institutional integration in France. A qualitative approach was used. Analyses were based on semi-structured interviews with actors of all levels of decision-making, observations of advisory board meetings, and administrative documents. Our analyses revealed the complexity and fragmentation of institutional integration. The path dependency theory, which analyzes the change capacity of institutions by taking into account their historic structures, allows analysis of this situation. The path dependency to the Bismarckian system and the incomplete reforms of gerontological policies generate the coexistence and juxtaposition of institutional systems. In such a context, no institution has sufficient ability to determine gerontology policy and build institutional integration by itself. Using path dependence as an analytical framework helps to understand the reasons why institutional integration is critical to organizational and clinical integration, and the complex construction of institutional integration in France.

Activities of the radiobiological institute, the institute for experimental gerontology, and the primate center. Annual report, 1976

International Nuclear Information System (INIS)

1976-01-01

Activities, presented by way of concise articles, cover the following subjects: radiation physics, radiobiology, experimental tumor therapy, tumor induction and tumor biology, immunology, transplantation and immunogenetics, hematology, gerontology, ethology, microbiology and quotobiology, techniques, and animals

Interdisciplinary Collaboration in Gerontology and Geriatrics in Latin America: Conceptual Approaches and Health Care Teams

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Gomez, Fernando; Curcio, Carmen Lucia

2013-01-01

The underlying rationale to support interdisciplinary collaboration in geriatrics and gerontology is based on the complexity of elderly care. The most important characteristic about interdisciplinary health care teams for older people in Latin America is their subjective-basis framework. In other regions, teams are organized according to a…

2008 Kent award lecture: an historian interprets the future of gerontology.

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Achenbaum, W Andrew

2010-04-01

Donald Peterson Kent believed that gerontology would grow through innovative inquiry, effective teaching, and well-evaluated policies and programs that benefited the elderly people. Because advances in research, education, and practice sustain each other, Kent's tripartite agenda continues to be instructive as globalization presents fresh challenges and opportunities for gerontologists to advance our multifaceted, multidisciplinary, multinational enterprise. Donald Kent's vision offers a compelling blueprint for interpreting the field's future as gerontologists engage in theory building, educational trail blazing, and redefining older people's roles in aging societies.

Experiencing aging or demystifying myths? - impact of different "geriatrics and gerontology" teaching strategies in first year medical students.

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Lucchetti, Alessandra Lamas Granero; Lucchetti, Giancarlo; de Oliveira, Isabella Noceli; Moreira-Almeida, Alexander; da Silva Ezequiel, Oscarina

2017-02-08

With the aging of the population comes a greater need for geriatric and gerontology teaching. However, there is currently a dearth of investigations on the impact of different educational methodologies for teaching in this area early in medical courses. The present study aims to determine the impact of two educational strategies on the topic "Geriatrics and Gerontology" ("experiencing aging" and "myths of aging") as compared to a control group (no intervention) on the attitudes, empathy and knowledge of first year medical students. An intervention-based study in education was conducted at the beginning of the first year of a medical course. Students submitted to educational strategies were compared against students with no intervention. The two strategies were: "Experiencing Aging" - also known as the "aging game" (simulation of the disabilities and physiological changes of aging), and "Myths of Aging" - a knowledge discussion based on a "quiz show", questioning common myths about aging. All students were assessed on their attitudes towards older persons (Maxwell-Sullivan, UCLA attitudes), empathy (Maxwell-Sullivan), knowledge on facts and positive view about aging (Palmore), and cognitive knowledge. Data were analysed using Student's t, Chi-squared or ANOVA tests. A total of 230 students were assessed. The "experiencing aging" intervention was associated with improvement in empathy but worsening of attitude. The "myths of aging" intervention was associated with an improved attitude overall and positive view about aging but with no change in empathy towards older persons. Educational strategies can influence the attitudes and empathy of students, leading to different outcomes. These data highlight the importance of assessing the outcomes of educational strategies in medical teaching to ascertain in what manner (how), situations (when) and settings (where) these activities should be introduced.

Elderly patients with Vascular Brain Accident: A gerontogeriatric vision, from a literature review of studies published in the Journal Kairos Gerontology

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Ana Cristina dos Santos Silva

2015-05-01

Full Text Available This research aimed to assess the work published in the journal Kairos Gerontology, from 1998 to 2014, with the theme: elderly affected by cerebrovascular accident. It was intended to be a reflection of the importance of this thematic gerontogeriatria, contributing to the social integration of older persons, from a holistic look. At the end of this survey, we can affirm the importance of respect to reality of these elderly people in its context of life, as well as preventive measures in primary areas, with awareness of the population for the control of various vascular risk factors such as blood pressure, diabetes, cholesterol, triglycerides, heart disease, in addition to the need to refrain from smoking, having a healthy diet and physical exercise.  

[PhD theses on gerontological topics in Russia 1995-2012: scientometric analysis].

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Smol'kin, A A; Makarova, E A

2014-01-01

The paper presents a scientometric analysis of PhD theses on gerontological topics in Russian humanities (excluding economics) for the period from 1995 to 2012. During this period, 253 PhD theses (238 of "candidate dissertations," and 15 of "doctoral dissertations") were defended in Russia. Almost half of them were defended during the boom years (2005-2006; 2009-2010). The number of theses defended in the 2000-s has increased significantly compared to the second half of 1990-s. However for gerontological PhD-s overall as a percentage of all theses defended in Russian humanities, the number hardly changed and remained small (less than 0.3%). The leading discipline in the study of aging (within the humanities) is sociology accounting for more than a third of all defended theses. Though the theses were defended in 48 cities, more than half of them were defended in 3 cities, which are Moscow, St. Petersburg and Saratov. Thematic analysis showed that the leading position was occupied by two topics: "the elderly and the state" (42%) and "(re)socialization/adaptation of the elderly" (25%). 14% of the works are devoted to intergenerational relations and social status of the elderly. Other topics (old man/woman's personality, self-perceptions of aging, violence and crime against the elderly, loneliness, discrimination, etc.) are presented by very few studies.

Learnt and perceived professional roles of a new type of nurse specialized in Gerontology and Geriatrics, a qualitative study.

Science.gov (United States)

Huizenga, Petra; Finnema, Evelyn; Roodbol, Petrie

2016-07-01

To gain insight into a new type of nurse specialized in gerontology and geriatrics, how they find meaning in the care of older persons and how this relates to the seven professional roles derived from the CanMEDS theoretical framework. To promote the quality of care for older persons in the Netherlands, one of the measures taken is the training and deployment of Registered Nurses specialized in Gerontology and Geriatrics. We focus on their professional roles in this study, to gain insight into the extent to which they fulfil their professional standards. A qualitative study, consisting of seven focus group interviews. The study population included 67 Registered Nurses. Data were collected between October 2011-May 2013. Nurses work in all seven CanMEDS roles, but not with all competences associated with these seven roles. The more distant the role is from patient activities, the less frequently competences such as social networks; design; research; innovation of care; legal, financial and organizational frameworks; professional ethics and professional innovation are mentioned. Nurses engage in activities consistent with nursing care for older people; however, despite their training, they are mainly focused on direct-patient care. Their limited awareness of the complete range of professional competences risks the stagnation of their development in professional roles such as health advocate, scholar and professional, which will not lead to an improvement in the care for older persons. © 2016 John Wiley & Sons Ltd.

Shared or Integrated: Which Type of Integration is More Effective Improves Students’ Creativity?

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Mariyam, M.; Kaniawati, I.; Sriyati, S.

2017-09-01

Integrated science learning has various types of integration. This study aims to apply shared and integrated type of integration with project based learning (PjBL) model to improve students’ creativity on waste recycling theme. The research method used is a quasi experiment with the matching-only pre test-post test design. The samples of this study are 108 students consisting of 36 students (experiment class 1st), 35 students (experiment class 2nd) and 37 students (control class 3rd) at one of Junior High School in Tanggamus, Lampung. The results show that there is difference of creativity improvement in the class applied by PjBL model with shared type of integration, integrated type of integration and without any integration in waste recycling theme. Class applied by PjBL model with shared type of integration has the higher creativity improvement than the PjBL model with integrated type of integration and without any integration. Integrated science learning using shared type only combines 2 lessons, hence an intact concept is resulted. So, PjBL model with shared type of integration more effective improves students’ creativity than integrated type.

Implementation of Writing across the Curriculum (WAC) Learning Approaches in Social Work and Sociology Gerontology Courses

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Kolb, Patricia

2013-01-01

This article describes the goals and methods of the international Writing Across the Curriculum (WAC) movement in higher education, and WAC-enriched learning approaches that the author used in teaching a social work gerontology practice course and a sociological theories of aging course. The author's in-class, low-stakes, nongraded writing…

Methodological challenges in measurements of functional ability in gerontological research. A review

DEFF Research Database (Denmark)

Avlund, Kirsten

1997-01-01

This article addresses two important challenges in the measurement of functional ability in gerontological research: the first challenge is to connect measurements to a theoretical frame of reference which enhances our understanding and interpretation of the collected data; the second relates...... procedure, validity, discriminatory power, and responsiveness. In measures of functional ability it is recommended: 1) always to consider the theoretical frame of reference as part of the validation process (e.g., the theory of "The Disablement Process"; 2) always to assess whether the included activities...

Practical theologians’ calling to serve in the field of gerontology

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Petria M. Theron

2013-08-01

Full Text Available The South African demographic statistics echo the global trend of an ageing population. This fact poses challenges to the country’s labour supply, to health care, retirement and intergenerational relations. The elderly are faced with specific challenges such as negative views regarding older people, discrimination and prejudice based on age, changing roles, the loss of a support system when children emigrate, financial problems, abuse and neglect, emotions of fear and depression, and the struggle to find meaning in life and suffering. The field of study that concerns ageing and older adulthood is called gerontology. Joan Erber defines it as ‘the study of the biological, behavioural, and social phenomena that occur from the point of maturity to old age.’ It is an interdisciplinary field where different disciplines seek to address the problems associated with ageing. Biologists focus on the biological processes of ageing, psychologists focus on aspects like mental abilities, personality and behaviour, whilst sociologists study the social roles, group behaviour and status of older people. The question may be asked what is being done regarding the spiritual and emotional needs of the elderly. This is the niche of practical theology, as indicated by one definition of practical theology that it is ‘a place where religious belief, tradition and practice meet contemporary experiences, questions and actions and conducts a dialogue that is mutually enriching, intellectually critical, and practically transforming’ according to Pattison and Woodward. The aims of this exploratory article are (1 to investigate to what extent research in practical theology has addressed the spiritual and emotional needs of the elderly and (2 to identify opportunities where practical theology may provide service in the field of gerontology.

Potential Applications of Smart Multifunctional Wearable Materials to Gerontology.

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Armstrong, David G; Najafi, Bijan; Shahinpoor, Mohsen

2017-01-01

Smart multifunctional materials can play a constructive role in addressing some very important aging-related issues. Aging affects the ability of older adults to continue to live safely and economically in their own residences for as long as possible. Thus, there will be a greater need for preventive, acute, rehabilitative, and long-term health care services for older adults as well as a need for tools to enable them to function independently during daily activities. The objective of this paper is, thus, to present a comprehensive review of some potential smart materials and their areas of applications to gerontology. Thus, brief descriptions of various currently available multifunctional smart materials and their possible applications to aging-related problems are presented. It is concluded that some of the most important applications to geriatrics may be in various sensing scenarios to collect health-related feedback or information and provide personalized care. Further described are the applications of wearable technologies to aging-related needs, including devices for home rehabilitation, remote monitoring, social well-being, frailty monitoring, monitoring of diabetes and wound healing and fall detection or prediction. It is also concluded that wearable technologies, when combined with an appropriate application and with appropriate feedback, may help improve activities and functions of older patients with chronic diseases. Finally, it is noted that methods developed to measure what one collectively manages in this population may provide a foundation to establish new definitions of quality of life. © 2017 S. Karger AG, Basel.

Measuring medical students' attitudes and knowledge about geriatrics and gerontology in Brazilian medical students: A comparison of instruments.

Science.gov (United States)

Lucchetti, Alessandra Lg; da S Ezequiel, Oscarina; Moreira-Almeida, Alexander; Lucchetti, Giancarlo

2018-04-14

To compare instruments available for evaluating attitudes and knowledge about geriatrics and gerontology. This cross-sectional study investigated 83 third-year Brazilian medical students (with exposure to geriatrics and gerontology) and 75 incoming students (with no exposure to this content). We used the University of California at Los Angeles Geriatrics Attitudes Scale, Palmore's Facts on Aging Quiz, modified Maxwell-Sullivan Attitude Survey, Aging Semantic Differential Scale and an instrument assessing their cognitive knowledge in geriatrics. The instruments investigated had moderate-to-high correlations when evaluating similar constructs, had satisfactory or borderline internal consistency for the most part (Cronbach's α: 0.62-0.94) and were capable of discriminating between students exposed or not to practical and theoretical content. Our findings reinforce previous studies that these scales are capable of differentiating students who have or have not had exposure/intervention and, in general, seem to be assessing different constructs. © 2018 AJA Inc.

Considering Accreditation in Gerontology: The Importance of Interprofessional Collaborative Competencies to Ensure Quality Health Care for Older Adults

Science.gov (United States)

Goldberg, Lynette R.; Koontz, Jennifer Scott; Rogers, Nicole; Brickell, Jean

2012-01-01

The health care needs of older adults can be complex and multifaceted. Safe, effective, equitable, and person-centered service provision relies on skilled interprofessional, team-based practice. Too often, students seeking a career specializing in gerontology are not exposed to such interprofessional, team-based learning and practice during their…

[Methodologic developmental principles of standardized surveys within the scope of social gerontologic studies].

Science.gov (United States)

Bansemir, G

1987-01-01

The conception and evaluation of standardized oral or written questioning as quantifying instruments of research orientate by the basic premises of Marxist-Leninist theory of recognition and general scientific logic. In the present contribution the socio-gerontological research process is outlined in extracts. By referring to the intrinsic connection between some of its essential components--problem, formation of hypotheses, obtaining indicators/measurement, preliminary examination, evaluation-as well as to typical errors and (fictitious) examples of practical research, this contribution contrasts the natural, apparently uncomplicated course of structured questioning with its qualitative methodological fundamentals and demands.

The paradoxes of gerotranscendence: The theory of gerotranscendence in a cultural gerontological and post-modernist perspective

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Kirsten Thorsen

2009-10-01

Full Text Available  ABSTRACTThis article presents a theoretical analysis and discussion of the theory of gerotranscendence, formulatedby Lars Tornstam (University of Uppsala, Sweden. The theory is presented as a meta-theory ofageing, as a theory of universal and general ageing processes. Ageing is seen as an urge (a drivetowards a less engaged posititon in the wordly life, moving towards a higher degree of transcendence,with a more cosmic outlook and another definition of reality. In this article the theory is discussed fromanother theoretical position; Ageing seen in a cultural gerontological perspective, as a varied culturallyand historically situated phenomenon – differing in different times and different cultures. The theoreticalperspective underlines that ageing is complex dialectical processes, an intertwined interplay betweenindividual development and cultural change. The varied individual ageing processes are not seenas the result of «drives». In Western post-modern cultures the ageing processes are becoming manifold,often contradictory. Elderly present versions of the selves that are becoming complex, multiplied (multipleselves, acting at different scenes, stamped by varied cultural values, presenting mixed versions ofactivity and passivity, engagement and retractment, wordliness and transcendence.Key words:  Ageing theories; gerotranscendence; cultural gerontology; postmodernism

Continuing interprofessional education in geriatrics and gerontology in medically underserved areas.

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Toner, John A; Ferguson, K Della; Sokal, Regina Davis

2009-01-01

There is a widening gap between the health care needs of older persons and the treatment skills of the health care professionals who serve them. This gap is especially severe in rural areas, where there is a shortage of and inadequate collaboration between health care professionals and poor access to services for older persons. There is also a special opportunity in rural areas, particularly those designated as "medically underserved," for continuing interprofessional education as a vehicle for retaining health care professionals who tend to leave medically underserved areas for more lucrative professional opportunities elsewhere. In collaboration with the Consortium of New York Geriatric Education Centers, the Columbia-New York Geriatric Education Center at the Stroud Center of Columbia University has developed the Program for Outreach to Interprofessional Services and Education (POISE). The purpose of POISE is to develop, implement, evaluate, and sustain interprofessional education and training for health care learners, while emphasizing improved access to health services for the geriatric population in medically underserved areas. The POISE model was designed as an effective approach to teaching the core geriatrics and gerontology curriculum endorsed by the national (U.S. Department of Health and Human Services) network of Geriatric Education Centers to health care learners in medically underserved areas of upstate New York. This article describes the adaptation and implementation of the POISE model.

Zbigniew Wozniak, The Elderly in Social Policy. Towards a New Architecture of Gerontological Programmes (Development in Humanities, Volume 4, Lit Verlag, 2013

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Dianne Campbell

2015-03-01

Full Text Available A review of the following book: Zbigniew Wozniak, The Elderly in Social Policy. Towards a New Architecture of Gerontological Programmes (Development in Humanities, Volume 4, Lit Verlag, 2013

Improving integration for integrated coastal zone management: an eight country study.

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Portman, M E; Esteves, L S; Le, X Q; Khan, A Z

2012-11-15

Integrated coastal zone management (ICZM) is a widely accepted approach for sustainable management of the coastal environment. ICZM emphasizes integration across sectors, levels of government, uses, stakeholders, and spatial and temporal scales. While improving integration is central to progress in ICZM, the role of and the achievement of integration remain understudied. To further study these two points, our research analyzes the performance of specific mechanisms used to support ICZM in eight countries (Belgium, India, Israel, Italy, Portugal, Sweden, UK, and Vietnam). The assessment is based on a qualitative comparative analysis conducted through the use of two surveys. It focuses on five ICZM mechanisms (environmental impact assessment; planning hierarchy; setback lines; marine spatial planning, and regulatory commission) and their role in improving integration. Our findings indicate that certain mechanisms enhance specific types of integration more effectively than others. Environmental impact assessment enhances science-policy integration and can be useful to integrate knowledge across sectors. Planning hierarchy and regulatory commissions are effective mechanisms to integrate policies across government levels, with the latter also promoting public-government integration. Setback lines can be applied to enhance integration across landscape units. Marine spatial planning is a multi-faceted mechanism with the potential to promote all types of integration. Policy-makers should adopt the mechanisms that are suited to the type of integration needed. Results of this study also contribute to evidence-based coastal management by identifying the most common impediments related to the mechanisms of integration in the eight studied countries. Copyright © 2012 Elsevier B.V. All rights reserved.

Learnt and perceived professional roles of a new type of nurse specialized in Gerontology and Geriatrics, a qualitative study

NARCIS (Netherlands)

Huizenga, Petra; Finnema, Evelyn; Roodbol, Petrie

Aim. To gain insight into a new type of nurse specialized in gerontology and geriatrics, how they find meaning in the care of older persons and how this relates to the seven professional roles derived from the CanMEDS theoretical framework. Background. To promote the quality of care for older

The evolution of gerontology and geriatrics in an era of a politics of aging.

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Torres-Gil, Fernando M

2017-01-01

The fields of gerontology and geriatrics are facing unprecedented changes, pressures, and opportunities. The 21st century requires that we utilize contemporary approaches to modernizing these disciplines for new populations, new cohorts and new social, economic and political demands. This article draws on the authors professional, academic, and public policy experiences to suggest initiatives and paradigms that can set a road map to both change the last centuries' notions of longevity and social supports to one that accounts for technology, varied cohorts, a public/private sector divide, and the nexus of aging and diversity.

Inertial sensors as measurement tools of elbow range of motion in gerontology

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Sacco, G; Turpin, JM; Marteu, A; Sakarovitch, C; Teboul, B; Boscher, L; Brocker, P; Robert, P; Guerin, O

2015-01-01

Background and purpose Musculoskeletal system deterioration among the aging is a major reason for loss of autonomy and directly affects the quality of life of the elderly. Articular evaluation is part of physiotherapeutic assessment and helps in establishing a precise diagnosis and deciding appropriate therapy. Reference instruments are valid but not easy to use for some joints. The main goal of our study was to determine reliability and intertester reproducibility of the MP-BV, an inertial sensor (the MotionPod® [MP]) combined with specific software (BioVal [BV]), for elbow passive range-of-motion measurements in geriatrics. Methods This open, monocentric, randomized study compared inertial sensor to inclinometer in patients hospitalized in an acute, post-acute, and long-term-care gerontology unit. Results Seventy-seven patients (mean age 83.5±6.4 years, sex ratio 1.08 [male/female]) were analyzed. The MP-BV was reliable for each of the three measurements (flexion, pronation, and supination) for 24.3% (CI 95% 13.9–32.8) of the patients. Separately, the percentages of reliable measures were 59.7% (49.2–70.5) for flexion, 68.8% (58.4–79.5) for pronation, and 62.3% (51.2–73.1) for supination. The intraclass correlation coefficients were 0.15 (0.07–0.73), 0.46 (0.27–0.98), and 0.50 (0.31–40 0.98) for flexion, pronation, and supination, respectively. Conclusion This study shows the convenience of the MP-BV in terms of ease of use and of export of measured data. However, this instrument seems less reliable and valuable compared to the reference instruments used to measure elbow range of motion in gerontology. PMID:25759568

The zebrafish as a gerontology model in nervous system aging, disease, and repair.

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Van Houcke, Jessie; De Groef, Lies; Dekeyster, Eline; Moons, Lieve

2015-11-01

Considering the increasing number of elderly in the world's population today, developing effective treatments for age-related pathologies is one of the biggest challenges in modern medical research. Age-related neurodegeneration, in particular, significantly impacts important sensory, motor, and cognitive functions, seriously constraining life quality of many patients. Although our understanding of the causal mechanisms of aging has greatly improved in recent years, animal model systems still have much to tell us about this complex process. Zebrafish (Danio rerio) have gained enormous popularity for this research topic over the past decade, since their life span is relatively short but, like humans, they are still subject to gradual aging. In addition, the extensive characterization of its well-conserved molecular and cellular physiology makes the zebrafish an excellent model to unravel the underlying mechanisms of aging, disease, and repair. This review provides a comprehensive overview of the progress made in zebrafish gerontology, with special emphasis on nervous system aging. We review the evidence that classic hallmarks of aging can also be recognized within this small vertebrate, both at the molecular and cellular level. Moreover, we illustrate the high level of similarity with age-associated human pathologies through a survey of the functional deficits that arise as zebrafish age. Copyright © 2015 Elsevier B.V. All rights reserved.

Supporting Family Carers Through Telephone-Mediated Group Programs: Opportunities For Gerontological Social Workers.

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Shanley, Chris

2008-01-01

Telephone-mediated group programs are an important but under-utilized medium for reaching frail or disabled older persons' family carers who are in need of support. The primary purpose and style of group programs can range across a broad spectrum–encompassing educational, supportive and therapeutic types. Gerontological social workers are the members of the multidisciplinary care team whose training, experience and supervision makes them most suitable for facilitating this broad range of group types. Drawing on the experience of training a number of group facilitators, this article provides suggestions for social workers contemplating the use of telephone-mediated groups and highlights groupwork skills peculiar to conducting group programs via the telephone.

Pain Research and Treatment in the Gerontological Context: A Discussion of the Issues

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Margaret C Gibson

1998-01-01

Full Text Available An appreciation of the context in which gerontological health care occurs is crucial to the successful and ethical collection, interpretation and utilization of data on the pain experiences of elderly people. Important contextual considerations for researchers and clinicians who are addressing pain in the elderly are identified. It is argued that topics that are the focus of current attention in the field of pain and ageing, such as the effect of dementia on memory for pain and the responsiveness of the elderly to psychosocial pain treatment, would be clarified by an understanding of the broader sociopolitical context in which ageing occurs.

Improvement attributes in healthcare: implications for integrated care.

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Harnett, Patrick John

2018-04-16

Purpose Healthcare quality improvement is a key concern for policy makers, regulators, carers and service users. Despite a contemporary consensus among policy makers that integrated care represents a means to substantially improve service outcomes, progress has been slow. Difficulties achieving sustained improvement at scale imply that methods employed are not sufficient and that healthcare improvement attributes may be different when compared to prior reference domains. The purpose of this paper is to examine and synthesise key improvement attributes relevant to a complex healthcare change process, specifically integrated care. Design/methodology/approach This study is based on an integrative literature review on systemic improvement in healthcare. Findings A central theme emerging from the literature review indicates that implementing systemic change needs to address the relationship between vision, methods and participant social dynamics. Practical implications Accommodating personal and professional network dynamics is required for systemic improvement, especially among high autonomy individuals. This reinforces the need to recognise the change process as taking place in a complex adaptive system where personal/professional purpose/meaning is central to the process. Originality/value Shared personal/professional narratives are insufficiently recognised as a powerful change force, under-represented in linear and rational empirical improvement approaches.

The built environment and older adults: A literature review and an applied approach to engaging older adults in built environment improvements for health.

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Tuckett, Anthony G; Banchoff, Ann W; Winter, Sandra J; King, Abby C

2018-03-01

This paper presents a review of the literature about the built environment as it impacts the health of older people. It then introduces the gerontological nurse and researcher to the Our Voice framework for engaging older people as citizen scientists in order to empower them as agents of change in improving their local built environment and ultimately advancing community health. Community-level strategies to promote successful ageing in place are critical both to optimising health outcomes and containing healthcare costs. Such strategies must take into account the influence of the built environment both on individual health behaviours and on overall community health. At the same time, the perspectives and experiences of older people themselves ought to inform policies and practices in a systematic way. Integrative literature review. A wide scan of English language articles published in the EMBASE, PubMed and CINAHL bibliographic databases was conducted. Additional articles were sourced by mining relevant reference lists (i.e., snowball sampling). Papers included were published between 2005 and 2016. Three distinct components emerged from the review: the impact of the built environment on health-in particular the health of older persons; citizen science and its applicability for older people research; and the promise of the Our Voice citizen science framework to activate changes in the built environment that improve older peoples' health. The ageing of the world's population brings with it an increased population-level risk of chronic disease and disability. We present the Our Voice framework, developed by researchers at Stanford University, as a promising strategy for engaging and empowering older people as citizen scientists, as a framework to apply to gerontological nursing and improving community health. Gerontology nurses are encouraged to: (i) Recognise the impact of the built environment and other community-level factors on the health of their patients. (ii

APROXIMACIONES DESDE LA GERONTOLOGÍA NARRATIVA: LA MEMORIA AUTOBIOGRÁFICA COMO RECURSO PARA EL DESARROLLO DE LA IDENTIDAD EN LA VEJEZ APROACHES FROM NARRATIVE GERONTOLOGY: AUTOBIOGRAPHICAL MEMORY AS A RESOURCE FOR IDENTITY DEVELOPMENT IN OLDER PEOPLE

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Mónica Salazar Villanea

2015-12-01

Full Text Available En la actualidad, validar la reflexión y la actividad subjetiva en la vejez, tanto como la actividad objetiva externa, es un reto para la Gerontología: no solo se trata de aspirar a envejecer y mantenerse activo en el proceso, sino a reconocer también la relevancia de la actividad subjetiva en cuanto a reflexionar acerca de sí mismo, práctica necesaria para el desarrollo integral y equilibrado de la identidad frente a la demanda externa y progresiva de actividad objetiva y productiva en el sentido material. Una aproximación gerontológica con visión humanista (Baars, Dohmen, Grenier y Phillipson, 2013, en el paradigma ético del cuidado de sí-mismo, reconoce el desarrollo de la identidad en la vejez como un objetivo por encima del desarrollo de espacios de mera actividad productiva, al respecto, la Gerontología narrativa plantea que los seres humanos son seres creadores de sentido y significado (“meaning-making beings”, Kenyon, Bohlmeijer y Randall, 2010, por tanto, parte del potencial que yace en la posibilidad de educar con mejores herramientas a los envejecientes para favorecer los procesos de construcción de esos significados a partir de las propias experiencias vitales. Cabe resaltar, además, que desde dicha perspectiva, la vejez es el momento de la vida en el que más se ha trabajado en las habilidades narrativas. En este trabajo se centra en la descripción de los supuestos y abordajes psicogerontológicos que sustentan la propuesta de intervenciones propias de la Gerontología narrativa, basadas en la actividad del mundo subjetivo a partir de estrategias como la reminiscencia, la revisión de vida y la autobiografía.

Improve data integration performance by employing metadata management utility

Energy Technology Data Exchange (ETDEWEB)

Wei, M.; Sung, A.H. [New Mexico Petroleum Recovery Research Center, Socorro, NM (United States)

2005-07-01

This conference paper explored ways of integrating petroleum and exploration data obtained from different sources in order to provide more comprehensive data for various analysis purposes and to improve the integrity and consistency of integrated data. This paper proposes a methodology to enhance oil and gas industry data integration performance by cooperating data management utilities in Microsoft SQL Server database management system (DBMS) for small scale data integration without support of commercial software. By semi-automatically capturing metadata, data sources are investigated in detail, data quality problems are partially cleansed, and the performance of data integration is improved. 20 refs., 7 tabs., 1 fig.

Aging worlds in contradiction: gerontological observations in the Mediterranean region

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Hans-Joachim von Kondratowitz

2015-12-01

Full Text Available This article discusses the existing and developing aging regimes in the Northern and Southern rim countries of the whole Mediterranean region which are all undergoing considerable social and political transformation processes. It is argued that several eye-opening theoretical interventions for such a gerontological project may lead to some methodological problems and pitfalls, which have to be dealt with productively. Central collective concepts of such an analysis (as the change-oriented "modernization effects" of societal aging and the continuity-oriented gaze at the "unity of the region" have to be reconsidered and ought to be more differentiated in order to allow smaller social entities (such as kinship and community systems and their connectivity to be central orientations for analyzing poverty and care management in old age in the Mediterranean region. How to reconnect such a rather micro-political agenda with large processes and big structures of aging policies in the region however still remains an open question.

Identifying and evaluating electronic learning resources for use in adult-gerontology nurse practitioner education.

Science.gov (United States)

Thompson, Hilaire J; Belza, Basia; Baker, Margaret; Christianson, Phyllis; Doorenbos, Ardith; Nguyen, Huong

2014-01-01

Enhancing existing curricula to meet newly published adult-gerontology advanced practice registered nurse (APRN) competencies in an efficient manner presents a challenge to nurse educators. Incorporating shared, published electronic learning resources (ELRs) in existing or new courses may be appropriate in order to assist students in achieving competencies. The purposes of this project were to (a) identify relevant available ELR for use in enhancing geriatric APRN education and (b) to evaluate the educational utility of identified ELRs based on established criteria. A multilevel search strategy was used. Two independent team members reviewed identified ELR against established criteria to ensure utility. Only resources meeting all criteria were retained. Resources were found for each of the competency areas and included formats such as podcasts, Web casts, case studies, and teaching videos. In many cases, resources were identified using supplemental strategies and not through traditional search or search of existing geriatric repositories. Resources identified have been useful to advanced practice educators in improving lecture and seminar content in a particular topic area and providing students and preceptors with additional self-learning resources. Addressing sustainability within geriatric APRN education is critical for sharing of best practices among educators and for sustainability of teaching and related resources. © 2014.

[Heritages of science history in the gerontological discussion on multidisciplinary and interdisciplinary perspectives].

Science.gov (United States)

von Kondratowitz, Hans-Joachim

2015-04-01

Since the beginning of the nineteenth century, the history of science in modern Germany has been characterized by a development going in opposite directions. The old scientific disciplines with their traditional Gestus of knowledge acquisition are in contrast to new sciences resulting from external pressures, combining and mobilizing different areas of knowledge, which challenge former dominances and help to establish new open disciplines. However, gerontology in Germany is in this respect a clear latecomer and can only cast off the impact of medicine in the twentieth century to some extent. This article describes this process by the superposition of different lines of tradition, which have long-term effects reaching into the history of the early Federal Republic of Germany.

[Gerontology in rural and mountains regions aged people in the country and in mountain regions (author's transl)].

Science.gov (United States)

Gsell, O

1977-04-01

The gerontologic problems of people living in the country and in mountain regions always were neglected in comparison to those of townsmen. In the last decade an important structural change has happened, caused on the one side by the fact that more and more people leave the country for the towns, and by the problem of overaged persons in the country; on the other side this change is a consequence of improvement by modern technical acquisitions (more agricultural machines, silos), living hygiene and the tourism. The living conditions in the past and today in Switzerland are shown, referring to various publications. The ecological change also hits the aged people, financially by revenues, completion of private help organizations, rebuilding of homes for the aged persons in every village and regional nursing home, as well as household helps for those elderly people who still live in the country in their own houses. The qualitative differences between living conditions in the country and in town will in the near future be equalized--which is especially mentionned.

[Report: an analysis of publications by members of the Spanish Geriatrics and Gerontology Society from 2006 to 2011].

Science.gov (United States)

Salvà, Antoni; Domingo, Àlex; Roqué i Figuls, Marta; Serra-Rexach, José Antonio

2013-01-01

Data is presented from the survey conducted by the Sociedad Española de Geriatría y Gerontología (SEGG) (Spanish Society of Geriatrics and Gerontology) among its members in order to assess their scientific production between 2006 and 2011, specifically articles in journals that are indexed in the Science Citation Index. The scientific quality of the publications was quantified using the number of times every article was cited and the journal's impact factor. A total of 162 out of the 2450 members responded (6.6%), reporting a total of 903 individual articles, 335 (37%) of them in geriatrics-specific journals, and 568 (63%) in other journals of other specialties. The number of publications increased yearly from 128 in 2006 to 201 in 2010. The scientific quality could be calculated for 530 articles. On average, publications have been cited 8.2 times (median: 2), with the range of citations being from 0 to 242. The average impact factor was 3.1 (median 2.4), ranging from 0 to 53.5. A number of articles have been published in some of the largest impact factor journals, in those of general-interest, as well as geriatrics-specific and basic science journals. Copyright © 2012 SEGG. Published by Elsevier Espana. All rights reserved.

INTEGRATED COST MODEL FOR IMPROVING THE PRODUCTION IN COMPANIES

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Zuzana Hajduova

2014-12-01

Full Text Available Purpose: All processes in the company play important role in ensuring functional integrated management system. We point out the importance of need for a systematic approach to the use of quantitative, but especially statistical methods for modelling the cost of the improvement activities that are part of an integrated management system. Development of integrated management systems worldwide leads towards building of systematic procedures of implementation maintenance and improvement of all systems according to the requirements of all the sides involved.Methodology: Statistical evaluation of the economic indicators of improvement costs and the need for a systematic approach to their management in terms of integrated management systems have become a key role also in the management of processes in the company Cu Drôt, a.s. The aim of this publication is to highlight the importance of proper implementation of statistical methods in the process of improvement costs management in the integrated management system of current market conditions and document the legitimacy of a systematic approach in the area of monitoring and analysing indicators of improvement with the aim of the efficient process management of company. We provide specific example of the implementation of appropriate statistical methods in the production of copper wire in a company Cu Drôt, a.s. This publication also aims to create a model for the estimation of integrated improvement costs, which through the use of statistical methods in the company Cu Drôt, a.s. is used to support decision-making on improving efficiency.Findings: In the present publication, a method for modelling the improvement process, by an integrated manner, is proposed. It is a method in which the basic attributes of the improvement in quality, safety and environment are considered and synergistically combined in the same improvement project. The work examines the use of sophisticated quantitative, especially

Use of games as a learner-centered strategy in gerontology, geriatrics, and aging-related courses.

Science.gov (United States)

Schmall, Vicki; Grabinski, C Joanne; Bowman, Sally

2008-01-01

Based on their experience as designers and/or users of games as a learner-centered strategy in gerontology, geriatric, and aging-related courses and training programs, the authors note multiple advantages of using games as a learning tool, list six relevant games (including order information), and suggest a variety of ways games can be used. They offer guidelines to apply in selecting appropriate games and discuss key aspects of the instructor or facilitator's role in preparing learners for game playing, monitoring game play, and debriefing students once game play has ended. Outcomes for learners and course instructors are shared.

Gerontology and geriatrics in Dutch medical education.

Science.gov (United States)

Tersmette, W; van Bodegom, D; van Heemst, D; Stott, D; Westendorp, R

2013-01-01

The world population is ageing and healthcare services require trained staff who can address the needs of older patients. In this study we determined how current medical education prepares Dutch students of medicine in the field of Gerontology and Geriatrics (G&G). Using a checklist of the essentials of G&G, we assessed Dutch medical education on three levels. On the national level we analysed the latest National Blueprint for higher medical education (Raamplan artsopleiding 2009). On the faculty level we reviewed medical curricula on the basis of interviews with program directors and inspection of course materials. On the student level we assessed the topics addressed in the questions of the cross-institutional progress test (CIPT). The National Bluepr int contains few specific G&G objectives. Obligatory G&G courses in medical schools on average amount to 2.2% of the total curriculum measured as European Credit Transfer System units (ECTS). Only two out of eight medical schools have practical training during the Master phase in the form of a clerkship in G&G. In the CIPT, on average 1.5% of questions cover G&G. Geriatric education in the Netherlands does not seem to be in line with current demographic trends. The National Blueprint falls short of providing sufficiently detailed objectives for education on the care of older people. The geriatric content offered by medical schools is varied and incomplete, and students are only marginally tested on their knowledge of G&G in the CIPT.

A community-based approach for integrating geriatrics and gerontology into undergraduate medical education.

Science.gov (United States)

Martinez, Iveris L; Mora, Jorge Camilo

2012-01-01

Medical school accreditation requirements require educational opportunities in geriatrics. Twenty-six minimum graduating competencies in geriatrics have recently been identified for medical students. The authors describe how these competencies are being integrated into a new medical curriculum through coursework and community-based experiences. This approach is intended to expose students to older adults from diverse communities and adequately prepare students to address the complex and individual needs of these patients. Initial results indicate proficiency in the minimum geriatric competencies covered. The growth and diversity of the older adult population makes it important to integrate and evaluate geriatrics education in undergraduate medical education.

Performance improvement integration: a whole systems approach.

Science.gov (United States)

Page, C K

1999-02-01

Performance improvement integration in health care organizations is a challenge for health care leaders. Required for accreditation by the Joint Commission on Accreditation of Healthcare Organizations (Joint Commission), performance improvement (PI) can be designed as a sustainable model for performance to survive in a turbulent period. Central Baptist Hospital developed a model for PI that focused on strategy established by the leadership team, delineated responsibility through the organizational structure of shared governance, and accountability for outcomes evidenced through the organization's profitability. Such an approach integrated into the culture of the organization can produce positive financial margins, positive customer satisfaction, and commendations from the Joint Commission.

Gerontology across the professions and the Atlantic: Students' reflective views and voices.

Science.gov (United States)

Liu, Catherine; Balcom, Sarah; Carrigan, Steven; Malloy, Morgan; Mammba, Violet

2017-01-01

Health professions students need to have increasing exposure to interprofessional and international experience in developing the knowledge and skills needed to work with older adults. As students, the authors explore in this article the significant elements of our learning that took place in a blended Gerontology Across the Professions and the Atlantic course for participants from the United States, Canada, and Norway. These factors focus on the following aspects of this course: (1) weekly online topic discussions and learning experiences, (2) group case studies and presentations, (3) international perspectives, (4) interprofessional perspectives, and (5) the final course seminar in Bergen. The authors end their discussion by sharing sidebar stories of their experiences in this course that brought together the powerful, transformative elements of interprofessional and international insights into the challenges of geriatric care in the future.

Musical Memories: translating evidence-based gerontological nursing into a children's picture book.

Science.gov (United States)

Gerdner, Linda A; Buckwalter, Kathleen C

2013-01-01

Individuals with Alzheimer's disease (AD) are often cared for within multigenerational families. More specifically, 26% of family caregivers have children younger than 18 living with them. This article describes an innovative model for translation of an evidence-based intervention into an engaging, realistic picture book that serves as a teaching tool for children and their families. The book, Musical Memories, focuses on the relationship between a granddaughter and her grandmother who has AD. The story applies basic principles of the Progressively Lowered Stress Threshold model to explain the underlying cause of grandmother's behaviors and models the evidence-based guideline "Individualized Music for Elders with Dementia" to empower the granddaughter in maintaining a relationship with her grandmother. Musical Memories is intended to serve as a valuable resource for families and the gerontological nurses who serve them. Copyright 2013, SLACK Incorporated.

Toward the realization of a better aged society: messages from gerontology and geriatrics.

Science.gov (United States)

Arai, Hidenori; Ouchi, Yasuyoshi; Yokode, Masayuki; Ito, Hideki; Uematsu, Hiroshi; Eto, Fumio; Oshima, Shinichi; Ota, Kikuko; Saito, Yasushi; Sasaki, Hidetada; Tsubota, Kazuo; Fukuyama, Hidenao; Honda, Yoshihito; Iguchi, Akihisa; Toba, Kenji; Hosoi, Takayuki; Kita, Toru

2012-01-01

1. Recent medical advancements, and improvements in hygiene and food supply have led to Japan having the longest life expectancy in the world. Over the past 50 years, the percentage of the elderly population has increased fourfold from 5.7% in 1960 to 23.1% in 2010. This change has occurred at the fastest rate in the world. Compared with France, where the percentage of the elderly population has increased just twofold in the past 100 years, Japanese society is aging at an unprecedented rate. In addition, the percentage of the very elderly (aged 75 years and over), comprising more frail people, exceeded 10% of the nation's population in 2008. In such a situation, many elderly Japanese wish to spend their later years healthy, and wish to achieve great accomplishments in their lives. To achieve that, rather than considering an aging population as a negative social phenomenon, we should create a society where elderly people can enjoy a healthy, prosperous life through social participation and contribution. Factors that hamper the elderly from leading a healthy life include various psychological and social problems occurring in older age, as well as a high incidence of diseases. Therefore, gerontology, which focuses on health promotion of the elderly by encompassing the study of social welfare, psychology, environment and social systems; and geriatrics, which focuses on health care of elderly people and carried out research, education and practices to promote health in the elderly, are becoming more important. Furthermore, along with a need for multidisciplinary care to support geriatric medicine, the development of a comprehensive education system for aged-care professionals is awaited. Thus, we should now recognize the importance of gerontology and geriatrics, and a reform of medical-care services should be made in order to cope with the coming aged society. Population aging is a global phenomenon. The actions being taken by Japan, the world's most aged society, have

Improvement of Engineering Work Efficiency through System Integration

International Nuclear Information System (INIS)

Lee, Sangdae; Jo, Sunghan; Hyun, Jinwoo

2016-01-01

This paper presents the concept of developing an integrated engineering system for ER to improve efficiency and utilization of engineering system. Each process including computer system and database was introduced separately by each department at that different time. Each engineering process has a close relation with other engineering processes. The introduction of processes in a different time has caused the several problems such as lack of interrelationship between engineering processes, lack of integration fleet-wide statistical data, lack of the function of data comparison among plants and increase of access time by different access location on internet. These problems have caused inefficiency of engineering system utilization to get proper information and degraded engineering system utilization. KHNP has introduced and conducted advanced engineering processes to maintain equipment effectively in a highly reliable condition since 2000s. But engineering systems for process implementation have been developed in each department at a different time. This has caused the problems of process inefficiency and data discordance. Integrated Engineering System(IES) to integrate dispersed engineering processes will improve work efficiency and utilization of engineering system because integration system would enable engineer to get total engineering information easily and do engineering work efficiently

Improvement of Engineering Work Efficiency through System Integration

Energy Technology Data Exchange (ETDEWEB)

Lee, Sangdae; Jo, Sunghan; Hyun, Jinwoo [KHNP CRI, Daejeon (Korea, Republic of)

2016-10-15

This paper presents the concept of developing an integrated engineering system for ER to improve efficiency and utilization of engineering system. Each process including computer system and database was introduced separately by each department at that different time. Each engineering process has a close relation with other engineering processes. The introduction of processes in a different time has caused the several problems such as lack of interrelationship between engineering processes, lack of integration fleet-wide statistical data, lack of the function of data comparison among plants and increase of access time by different access location on internet. These problems have caused inefficiency of engineering system utilization to get proper information and degraded engineering system utilization. KHNP has introduced and conducted advanced engineering processes to maintain equipment effectively in a highly reliable condition since 2000s. But engineering systems for process implementation have been developed in each department at a different time. This has caused the problems of process inefficiency and data discordance. Integrated Engineering System(IES) to integrate dispersed engineering processes will improve work efficiency and utilization of engineering system because integration system would enable engineer to get total engineering information easily and do engineering work efficiently.

Integrating empowerment evaluation and quality improvement to achieve healthcare improvement outcomes

Science.gov (United States)

Wandersman, Abraham; Alia, Kassandra Ann; Cook, Brittany; Ramaswamy, Rohit

2015-01-01

While the body of evidence-based healthcare interventions grows, the ability of health systems to deliver these interventions effectively and efficiently lags behind. Quality improvement approaches, such as the model for improvement, have demonstrated some success in healthcare but their impact has been lessened by implementation challenges. To help address these challenges, we describe the empowerment evaluation approach that has been developed by programme evaluators and a method for its application (Getting To Outcomes (GTO)). We then describe how GTO can be used to implement healthcare interventions. An illustrative healthcare quality improvement example that compares the model for improvement and the GTO method for reducing hospital admissions through improved diabetes care is described. We conclude with suggestions for integrating GTO and the model for improvement. PMID:26178332

Regional integration, improving women's economic situation, and ...

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

Regional integration, improving women's economic situation, and ... of the West African Economic and Monetary Union on their economic development, the ... production sectors, and commercialization networks affected by regional trade, the ...

AIM: An Integrated Approach to Organizational Improvement

Directory of Open Access Journals (Sweden)

Ronald A. Styron, Jr.

2016-02-01

Full Text Available This concept paper is based on the new problem-solving model of Blended Leadership called Alloy Improvement Model (AIM. This model consists of an integration of change theory, leadership theory, and democratic principles and practices to form a comprehensive problem-solving strategy for organizational leaders. The utilization of AIM will assist leaders in moving from problems to solutions while engaging stakeholders in a comprehensive, efficient, inclusive, informative, integrated and transparent process.

Continuous improvement of the BNFL transport integrated management system

International Nuclear Information System (INIS)

Hale, J.A.

1998-01-01

The integrated Management System of BNFL Transport and Pacific Nuclear Transport Limited (PNTL) is subject to continuous improvement by the application of established improvement techniques adopted by BNFL. The technique currently being used is the application of a Total Quality Management (TQM) philosophy, involving the identification of key processes, benchmarking against existing measures, initiating various improvement projects and applying process changes within the Company. The measurement technique being used is based upon the European Foundation for Quality Management Model (EFQM). A major initiative was started in 1996 to include the requirements of the Environmental Management Systems standard ISO 14001 within the existing integrated management system. This resulted in additional activities added to the system, modification to some existing activities and additional training for personnel. The system was audited by a third party certification organisation, Lloyds Register Quality Assurance (LRQA), during 1997. This paper describes the arrangements to review and update the integrated management system of BNFL Transport and PNTL to include the requirements of the environmental standard ISO 14001 and it also discusses the continuous improvement process adopted by BNFL Transport. (authors)

Improvement of nuclear ship engineering simulation system. Hardware renewal and interface improvement of the integral type reactor

Energy Technology Data Exchange (ETDEWEB)

Takahashi, Hiroki; Kyoya, Masahiko; Shimazaki, Junya [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment; Kano, Tadashi [KCS, Co., Mito, Ibaraki (Japan); Takahashi, Teruo [Energis, Co., Kobe, Hyogo (Japan)

2001-10-01

JAERI had carried out the design study about a lightweight and compact integral type reactor (an advanced marine reactor) with passive safety equipment as a power source for the future nuclear ships, and completed an engineering design. We have developed the simulator for the integral type reactor to confirm the design and operation performance and to utilize the study of automation of the reactor operation. The simulator can be used also for future research and development of a compact reactor. However, the improvement in a performance of hardware and a human machine interface of software of the simulator were needed for future research and development. Therefore, renewal of hardware and improvement of software have been conducted. The operability of the integral-reactor simulator has been improved. Furthermore, this improvement with the hardware and software on the market brought about better versatility, maintainability, extendibility and transfer of the system. This report mainly focuses on contents of the enhancement in a human machine interface, and describes hardware renewal and the interface improvement of the integral type reactor simulator. (author)

Electronics/avionics integrity - Definition, measurement and improvement

Science.gov (United States)

Kolarik, W.; Rasty, J.; Chen, M.; Kim, Y.

The authors report on the results obtained from an extensive, three-fold research project: (1) to search the open quality and reliability literature for documented information relative to electronics/avionics integrity; (2) to interpret and evaluate the literature as to significant concepts, strategies, and tools appropriate for use in electronics/avionics product and process integrity efforts; and (3) to develop a list of critical findings and recommendations that will lead to significant progress in product integrity definition, measurement, modeling, and improvements. The research consisted of examining a broad range of trade journals, scientific journals, and technical reports, as well as face-to-face discussions with reliability professionals. Ten significant recommendations have been supported by the research work.

Integrating Planning, Assessment, and Improvement in Higher Education

Science.gov (United States)

Sherlock, Barbara J.

2009-01-01

Based on Penn State's popular "Innovation Insights" series, this book brings together in one handy reference nearly a decade of tried and true insights into continuous quality improvements in higher education. Their five-step model for integrating planning, assessment, and improvement moves plans off the shelf and into the weekly and daily…

Reflexiones sobre la pertinencia de la educación en el campo de la gerontología en Colombia y en el mundo

Directory of Open Access Journals (Sweden)

Lucelly Ardila Vega

2016-03-01

Full Text Available Este artículo tiene como propósito presentar un cúmulo de reflexiones sobre la pertinencia de la gerontología como carrera profesional, las cuales se sustentan en un conjunto de necesidades y aspectos que tienen resonancia a diferente escala (mundial y nacional tales como: el envejecimiento demográfico y sus consecuencias; la transición epidemiológica; el perfil social de la población vieja; el reto de la dependencia; el rol de las personas mayores en la socialización de generaciones más jóvenes y, en la normatividad en temas relacionados con el envejecimiento y la vejez. Se concluye, con preocupación, que ante el panorama que justifica plenamente la necesidad de formar profesionales en gerontología, hoy exista una muy baja oferta de formación en pregrado en este campo en Colombia, lo cual demuestra la poca visibilización de las profundas transformaciones y consecuencias que, a mediano y largo plazo, trae el proceso de envejecimiento que actualmente vive el mundo y nuestro país.

Communications and Integration Enhancements to Improve Homeland Security

National Research Council Canada - National Science Library

Sando, Terrance W

2007-01-01

.... Homeland Security responses. These technology enhancements and processes combined with the force capabilities that the National Guard has recently created, when integrated with other national capabilities, will greatly improve...

Integrating empowerment evaluation and quality improvement to achieve healthcare improvement outcomes.

Science.gov (United States)

Wandersman, Abraham; Alia, Kassandra Ann; Cook, Brittany; Ramaswamy, Rohit

2015-10-01

While the body of evidence-based healthcare interventions grows, the ability of health systems to deliver these interventions effectively and efficiently lags behind. Quality improvement approaches, such as the model for improvement, have demonstrated some success in healthcare but their impact has been lessened by implementation challenges. To help address these challenges, we describe the empowerment evaluation approach that has been developed by programme evaluators and a method for its application (Getting To Outcomes (GTO)). We then describe how GTO can be used to implement healthcare interventions. An illustrative healthcare quality improvement example that compares the model for improvement and the GTO method for reducing hospital admissions through improved diabetes care is described. We conclude with suggestions for integrating GTO and the model for improvement. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Modelo pedagógico innovador para la enseñanza de la gerontología en enfermería

OpenAIRE

Luna Torres, Leonor

2012-01-01

El propósito de este modelo pedagógico es despertar el interés del estudiante, en la enseñanza de la Gerontología y la Geriatría, como campo de acción del profesional de Enfermería, que ha de familiarizarse con el significado de la vejez y el envejecimiento, sus necesidades, problemas de salud prioritarios, hasta llegar a identificar la especificidad del cuidado que requiere el anciano. Así mismo, entender que el envejecimiento es un proceso continuo en el tiempo, con características ú...

[Intergenerational communication by age-integrating structures? Remarks on on gerontologic utopia].

Science.gov (United States)

Amrhein, L

2002-08-01

In their "aging and society" paradigm Riley and collaborators conceptualize the ideal type of an age-integrated society in which the social segregation of different age groups is removed. They claim that in the future the life-world areas of education, work and leisure will no longer exclusively follow the triple division of the life course but will be visited repeatedly in different phases of life. Therefore, they argue, age barriers would be dissolved in many areas, which would lead to more contact and cooperation and to a greater solidarity between the generations. This conception shall be rejected as an utopia because it contradicts central functional mechanisms of modern societies; at best it might be imagined as a "reflexive modernization" of age-segregated structures. A certain distance and alienation between the generations remains a direct, though unintended product of the modernization process and cannot be reversed without welfare losses. A dialogue of generations as a societal project, therefore, implies that the functional differentiation into age groups and life stages will be accepted without referring to pre-modern idealizations of generational relationships.

Integrating patient satisfaction into performance measurement to meet improvement challenges.

Science.gov (United States)

Smith, J E; Fisher, D L; Endorf-Olson, J J

2000-05-01

A Value Compass has been proposed to guide health care data collection. The "compass corners" represent the four types of data needed to meet health care customer expectations: appropriate clinical outcomes, improved functional status, patient satisfaction, and appropriate costs. Collection of all four types of data is necessary to select processes in need of improvement, guide improvement teams, and monitor the success of improvement efforts. INTEGRATED DATA AT BRYANLGH: BryanLGH Medical Center in Lincoln, Nebraska, has adopted multiple performance measurement systems to collect clinical outcome, financial, and patient satisfaction data into integrated databases. Data integration allows quality professionals at BryanLGH to identify quality issues from multiple perspectives and track the interrelated effects of improvement efforts. A CASE EXAMPLE: Data from the fourth quarter of 1997 indicated the need to improve processes related to cesarean section (C-section) deliveries. An interdisciplinary team was formed, which focused on educating nurses, physicians, and the community about labor support measures. Physicians were given their own rates of C-section deliveries. The C-section rate decreased from 27% to 19%, but per-case cost increased. PickerPLUS+ results indicated that BryanLGH obstetric patients reported fewer problems with receiving information than the Picker norm, but they reported more problems with the involvement of family members and friends. The data collected so far have indicated a decrease in the C-section rate and a need to continue to work on cost and psychosocial issues. A complete analysis of results was facilitated by integrated performance management systems. Successes have been easily tracked over time, and the need for further work on related processes has been clearly identified.

Evaluation of a peer mentoring program for early career gerontological nursing faculty and its potential for application to other fields in nursing and health sciences.

Science.gov (United States)

Brody, Abraham A; Edelman, Linda; Siegel, Elena O; Foster, Victoria; Bailey, Donald E; Bryant, Ashley Leak; Bond, Stewart M

2016-01-01

As the retirement rate of senior nursing faculty increases, the need to implement new models for providing mentorship to early career academics will become key to developing and maintaining an experienced faculty. This evaluation of a peer mentorship program for predoctoral and postdoctoral gerontological nurses examined its efficacy, utility, and potential for improvement. A web-based survey was developed, implemented, and completed by 22 mentees and 17 mentors (71% and 61% response rates, respectively) as part of the evaluation. The peer mentorship program was found to be valuable by both mentors (64.7%) and mentees (72.7%) in helping mentees further develop their careers and networks and providing mentors with supported mentorship experience. The peer mentorship program could serve as a model for other professional organizations, academic institutions, and consortiums to enhance and extend the formal vertical mentorship provided to early academic career individuals. Published by Elsevier Inc.

A review of research on religious and spiritual variables in two primary gerontological nursing journals: 1991 to 1997.

Science.gov (United States)

Weaver, A J; Flannelly, L T; Flannelly, K J

2001-09-01

All articles published between 1991 and 1997 in the Journal of Gerontological Nursing and Geriatric Nursing were classified as qualitative research, quantitative research, or non-research. Of the 784 articles reviewed, 5.1% mentioned religion or spirituality. Research articles (7.7%) were more likely than non-research articles (2.8%) to address religion and spirituality. No statistical difference was found between the percentage of qualitative (10.7%) and quantitative (6.8%) studies addressing religious and spiritual factors. The percentage of quantitative studies including religious and spiritual variables was found to be higher than that found by systematic reviews of the research literature in various health professions.

Case Study: Accelerating Process Improvement by Integrating the TSP and CMMI

National Research Council Canada - National Science Library

Wall, Daniel S; McHale, James; Pomeroy-Huff, Marsha

2005-01-01

.... This case study describes the process improvement efforts of both NAVAIR divisions and how they integrated the two SEI technologies to accelerate process improvement within their organizations...

Ten years of integrated care for the older in France

Directory of Open Access Journals (Sweden)

Dominique Somme

2011-12-01

Full Text Available Background: This paper analyzes progress made toward the integration of the French health care system for the older and chronically ill population. Policies: Over the last ten years, the French health care system has been principally influenced by two competing linkage models that failed to integrate social and health care services: local information and coordination centers, governed by the social field, and the gerontological health networks governed by the health field. In response to this fragmentation, Homes for the Integration and Autonomy for Alzheimer patients (MAIAs is currently being implemented at experimental sites in the French national Alzheimer plan, using an evidence-based model of integrated care. In addition, the state's reforms recently created regional health agencies (ARSs by merging seven strategic institutions to manage the overall delivery of care. Conclusion: The French health care system is moving from a linkage-based model to a more integrated care system. We draw some early lessons from these changes, including the importance of national leadership and governance and a change management strategy that uses both top-down and bottom-up approaches to implement these reforms.

Nutritional status assessment in geriatrics: Consensus declaration by the Spanish Society of Geriatrics and Gerontology Nutrition Work Group.

Science.gov (United States)

Camina-Martín, M Alicia; de Mateo-Silleras, Beatriz; Malafarina, Vincenzo; Lopez-Mongil, Rosa; Niño-Martín, Virtudes; López-Trigo, J Antonio; Redondo-del-Río, M Paz

2015-07-01

Ongoing population ageing is one of the factors influencing the increase in the prevalence of undernutrition, because elderly people are a vulnerable group due to their biological, psychological and social characteristics. Despite its high prevalence, undernutrition is underdiagnosed in the geriatric sphere. For this reason, the aim of this consensus document is to devise a protocol for geriatric nutritional assessment. A multidisciplinary team has been set up within the Spanish Society of Geriatrics and Gerontology (in Spanish Sociedad Española de Geriatría y Gerontología, SEGG) in order to address undernutrition and risk of undernutrition so that they can be diagnosed and treated in an effective manner. The MNA-SF is a practical tool amongst the many validated methods for nutritional screening. Following suspicion of undernutrition or after establishing the presence of undernutrition, a full assessment will include a detailed nutritional history of the patient. The compilation of clinical-nutritional and dietetic histories seeks to aid in identifying the possible risk factors at the root of a patient's undernutrition. Following this, an anthropometric assessment associated to laboratory data, will describe the patient's physical and metabolic changes associated to undernutrition. Currently, the tendency is to further nutritional assessment through the use of non-invasive techniques to study body composition in association with functional status. The latter is an indirect index for nutritional status which is very interesting from a geriatrician's point of view. To conclude, correct nutritional screening is the fundamental basis for an early undernutrition diagnosis and to assess the need for nutritional treatment. In order to achieve this, it is fundamental to foster research in the field of nutritional geriatrics, in order to expand our knowledge base and to increasingly practice evidence-based geriatrics. Copyright © 2015 Elsevier Ireland Ltd. All rights

[Nutritional status assessment in Geriatrics: Consensus declaration by the Spanish Society of Geriatrics and Gerontology NutritionWork Group].

Science.gov (United States)

Camina-Martín, María Alicia; de Mateo-Silleras, Beatriz; Malafarina, Vincenzo; Lopez-Mongil, Rosa; Niño-Martín, Virtudes; López-Trigo, José Antonio; Redondo-Del-Río, María Paz

2016-01-01

Ongoing population ageing is one of the factors influencing the increase in the prevalence of undernutrition, as elderly people are a vulnerable group due to their biological, psychological and social characteristics. Despite its high prevalence, undernutrition is underdiagnosed in the geriatric sphere. For this reason, the aim of this consensus document is to devise a protocol for geriatric nutritional assessment. A multidisciplinary team has been set up within the Spanish Society of Geriatrics and Gerontology (in Spanish Sociedad Española de Geriatría y Gerontología [SEGG]) in order to address undernutrition and risk of undernutrition so that they can be diagnosed and treated in an effective manner. The MNA-SF is a practical tool amongst the many validated methods for nutritional screening. Following suspicion of undernutrition, or after establishing the presence of undernutrition, a full assessment will include a detailed nutritional history of the patient. The compilation of clinical-nutritional and dietetic histories is intended to help in identifying the possible risk factors at the root of a patient's undernutrition. Following this, an anthropometric assessment, combined with laboratory data, will describe the patient's physical and metabolic changes associated to undernutrition. Currently, the tendency is for further nutritional assessment through the use of non-invasive techniques to study body composition in association with functional status. The latter is an indirect index for nutritional status, which is very interesting from a geriatrician's point of view. To conclude, correct nutritional screening is the fundamental basis for an early undernutrition diagnosis and to assess the need for nutritional treatment. In order to achieve this, it is fundamental to foster research in the field of nutritional geriatrics, in order to expand our knowledge base and to increasingly practice evidence-based geriatrics. Copyright © 2015 SEGG. Published by Elsevier

[Effectiveness of teaching gerontology and geriatrics in students of the 1st Faculty of Medicine, Charles University in Prague].

Science.gov (United States)

Mádlová, P; Neuwirth, J; Topinková, E

2006-01-01

Increasing number of seniors in the society requires more university-degree educated professionals--health care professionals, social care workers and managers with basic exposure to and knowledge of gerontology and geriatrics. The aim of our paper was to evaluate the effectiveness of undergraduate training of gerontology and geriatrics among students of the 1st Faculty of Medicine, Charles University in Prague. To get information about knowledge of medical students and students of ergotherapy and physiotherapy and about their attitudes towards senior citizens we conducted a survey using two anonymous questionnaires prepared in our department and piloted earlier. The survey ran during the academic year 2004/2005. Students completed identical questionnaires twice, first time before the start of the clinical rotation and second time after the training end (n=134). Evaluation of knowledge and attitudes confirmed that one to two weeks clinical rotation at Department of Geriatrics was effective and increased knowledge of students in the topic trained. The percentage of correct answers in all three evaluated training programmes increased after the completion of the clinical rotation and reached 83% and more. From 134 participating students, 54.5 % appreciated life experience and wisdom of seniors they met, 98.4 % of students were satisfied with the training programme and 67.2 % of students reported that after training they changed their attitude towards senior population. Our survey confirmed that clinical training in geriatric medicine at 1st Faculty of Medicine, Charles University in Prague, prepared in agreement with current European recommendations is sufficiently effective and well accepted by the students. Therefore we recommend introduction of formal geriatric training for students in all medical faculties in the Czech Republic.

Efficiency improvement for vehicle powertrains using energy integration techniques

OpenAIRE

Dimitrova, Zlatina; Maréchal, François

2016-01-01

The main design criteria for the modern sustainable development of vehicle powertrains are the high energy efficiency of the conversion system, the competitive cost and the lowest possible environmental impacts. The need for efficiency improvement of the vehicle energy system induces the search for an innovative methodology during the design process. In this article the energy services for mobility and comfort are integrated. The energy integration of the mobility and the comfort service is a...

A MODEL FOR INTEGRATED SOFTWARE TO IMPROVE COMMUNICATION POLICY IN DENTAL TECHNICAL LABS

Directory of Open Access Journals (Sweden)

Minko M. Milev

2017-06-01

Full Text Available Introduction: Integrated marketing communications (IMC are all kinds of communications between organisations and customers, partners, other organisations and society. Aim: To develop and present an integrated software model, which can improve the effectiveness of communications in dental technical services. Material and Methods: The model of integrated software is based on recommendations of a total of 700 respondents (students of dental technology, dental physicians, dental technicians and patients of dental technical laboratories in Northeastern Bulgaria. Results and Discussion: We present the benefits of future integrated software to improve the communication policy in the dental technical laboratory that meets the needs of fast cooperation and well-built communicative network between dental physicians, dental technicians, patients and students. Conclusion: The use of integrated communications could be a powerful unified approach to improving the communication policy between all players at the market of dental technical services.

Integrated hospital emergency care improves efficiency.

Science.gov (United States)

Boyle, A A; Robinson, S M; Whitwell, D; Myers, S; Bennett, T J H; Hall, N; Haydock, S; Fritz, Z; Atkinson, P

2008-02-01

There is uncertainty about the most efficient model of emergency care. An attempt has been made to improve the process of emergency care in one hospital by developing an integrated model. The medical admissions unit was relocated into the existing emergency department and came under the 4-hour target. Medical case records were redesigned to provide a common assessment document for all patients presenting as an emergency. Medical, surgical and paediatric short-stay wards were opened next to the emergency department. A clinical decision unit replaced the more traditional observation unit. The process of patient assessment was streamlined so that a patient requiring admission was fully clerked by the first attending doctor to a level suitable for registrar or consultant review. Patients were allocated directly to specialty on arrival. The effectiveness of this approach was measured with routine data over the same 3-month periods in 2005 and 2006. There was a 16.3% decrease in emergency medical admissions and a 3.9% decrease in emergency surgical admissions. The median length of stay for emergency medical patients was reduced from 7 to 5 days. The efficiency of the elective surgical services was also improved. Performance against the 4-hour target declined but was still acceptable. The number of bed days for admitted surgical and medical cases rose slightly. There was an increase in the number of medical outliers on surgical wards, a reduction in the number of incident forms and formal complaints and a reduction in income for the hospital. Integrated emergency care has the ability to use spare capacity within emergency care. It offers significant advantages beyond the emergency department. However, improved efficiency in processing emergency patients placed the hospital at a financial disadvantage.

An improved integrally formed radio frequency quadrupole

Science.gov (United States)

Abbott, S.R.

1987-10-05

An improved radio frequency quadrupole is provided having an elongate housing with an elongate central axis and top, bottom and two side walls symmetrically disposed about the axis, and vanes formed integrally with the walls, the vanes each having a cross-section at right angles to the central axis which tapers inwardly toward the axis to form electrode tips spaced from each other by predetermined distances. Each of the four walls, and the vanes integral therewith, is a separate structural element having a central lengthwise plane passing through the tip of the vane, the walls having flat mounting surfaces at right angles to and parallel to the control plane, respectively, which are butted together to position the walls and vane tips relative to each other. 4 figs.

An integrated approach for prioritized process improvement.

Science.gov (United States)

Vanteddu, Gangaraju; McAllister, Charles D

2014-01-01

The purpose of this paper is to propose an integrated framework to simultaneously identify and improve healthcare processes that are important from the healthcare provider's and patient's perspectives. A modified quality function deployment (QFD) chart is introduced to the field of healthcare quality assurance. A healthcare service example is used to demonstrate the utility of the proposed chart. The proposed framework is versatile and can be used in a wide variety of healthcare quality improvement contexts, wherein, two different perspectives are needed to be considered for identifying and improving critical healthcare processes. The modified QFD chart used in conjunction with the stacked Pareto chart will facilitate the identification of key performance metrics from the patient's and the hospital's perspectives. Subsequently, the chief contributory factors at different levels are identified in a very efficient manner. Healthcare quality improvement professionals will be able to use the proposed modified QFD chart in association with stacked Pareto chart for effective quality assurance.

Inertial sensors as measurement tools of elbow range of motion in gerontology

Directory of Open Access Journals (Sweden)

Sacco G

2015-02-01

Full Text Available G Sacco,1–3,* JM Turpin,3,4,* A Marteu,5 C Sakarovitch,6 B Teboul,2 L Boscher,4,5 P Brocker,4 P Robert,1–3 O Guerin2,3,7 1Memory Center, Claude Pompidou Institut, Department of Geriatrics, University Hospital of Nice, Nice, France; 2Centre d’Innovation et d’Usages en Santé (CIU-S, University Hospital of Nice, Cimiez Hospital, Nice, France; 3CoBTeK Cognition Behaviour Technology EA 7276, Research Center Edmond and Lily Safra, Nice Sophia-Antipolis University, Nice, France; 4Rehabilitation Unit, Department of Geriatrics, University Hospital of Nice, Cimiez Hospital, Nice, France; 5Rehabilitation Unit, Department of Neurosciences, University Hospital of Nice, L’Archet Hospital, Nice, France; 6Department of Clinical Research and Innovation, University Hospital of Nice, Cimiez Hospital, Nice, France; 7Acute Geriatrics Unit, Department of Geriatrics, University Hospital of Nice, Cimiez Hospital, Nice, France *These authors contributed equally to this work Background and purpose: Musculoskeletal system deterioration among the aging is a major reason for loss of autonomy and directly affects the quality of life of the elderly. Articular evaluation is part of physiotherapeutic assessment and helps in establishing a precise diagnosis and deciding appropriate therapy. Reference instruments are valid but not easy to use for some joints. The main goal of our study was to determine reliability and intertester reproducibility of the MP-BV, an inertial sensor (the MotionPod® [MP] combined with specific software (BioVal [BV], for elbow passive range-of-motion measurements in geriatrics. Methods: This open, monocentric, randomized study compared inertial sensor to inclinometer in patients hospitalized in an acute, post-acute, and long-term-care gerontology unit. Results: Seventy-seven patients (mean age 83.5±6.4 years, sex ratio 1.08 [male/female] were analyzed. The MP-BV was reliable for each of the three measurements (flexion, pronation, and

Integrating health promotion with quality improvement in a Swedish hospital.

Science.gov (United States)

Astnell, Sandra; von Thiele Schwarz, Ulrica; Hasson, Henna; Augustsson, Hanna; Stenfors-Hayes, Terese

2016-09-01

Integration of workplace employee health promotion (HP) and occupational health and safety (OHS) work into organizational quality improvement systems is suggested as a way to strengthen HP and OHS activities in an organization. The aim of this article was to study what consequences integration of HP, OHS and a quality improvement system called kaizen has on the frequency and type of HP and OHS activities. A quasi-experimental study design was used where an integration of the three systems for HP, OHS respectively kaizen, was performed at six intervention units at a Swedish hospital. The remaining six units served as controls. Document analysis of all employees' written improvement suggestions (kaizen notes) during 2013 was conducted. The findings show that the intervention group had more suggestions concerning HP and OHS (n = 114) when compared with the control group (n = 78) and a greater variety of HP and OHS suggestions. In addition, only the intervention group had included HP aspects. In both groups, most kaizen notes with health consideration had a preventive focus rather than rehabilitative. The intervention, i.e. the integration of HP, OHS and kaizen work, had a favourable effect on HP and OHS work when compared with the controls. The results of the study support that this system can work in practice at hospitals. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Will Happiness Improve the Psychological Integration of Migrant Workers?

Science.gov (United States)

Li, Tian-Cheng; Chu, Chien-Chi; Meng, Fan-Cun; Li, Qin; Mo, Di; Li, Bin; Tsai, Sang-Bing

2018-05-03

Happiness is a major factor that influences people’s perceptions and behavior. Two-stage least squares regression was applied to investigate the effect of happiness on the psychological integration of migrant workers in China. The data for a total of 1625 individuals were obtained from the 2014 China Labor-force Dynamics Survey (CLDS). This study describes happiness from three main aspects: happiness, life satisfaction, and economic satisfaction. The psychological integration includes two dimensions of settlement willingness, and trust level; these have gone through dimension-reduced processing by using the weighted average method. The empirical evidence shows, first, that happiness has a significantly positive effect on the psychological integration of migrant workers and second, that the sense of life satisfaction in particular plays a more significant role. The acceleration of the social and political integration in migrant workers will enhance their psychological integration. Additionally, social, cultural and economic integration is found to influence migrant workers’ psychological integration by promoting happiness. Happiness between different generations of migrant workers was found to have a noticeably positive impact on their psychological integration; however, the happiness of the younger migrant workers was more perceivable than that of the other generations. Preferential policies should therefore be provided to improve the happiness of migrant workers.

Will Happiness Improve the Psychological Integration of Migrant Workers?

Science.gov (United States)

Li, Qin; Mo, Di; Li, Bin

2018-01-01

Happiness is a major factor that influences people’s perceptions and behavior. Two-stage least squares regression was applied to investigate the effect of happiness on the psychological integration of migrant workers in China. The data for a total of 1625 individuals were obtained from the 2014 China Labor-force Dynamics Survey (CLDS). This study describes happiness from three main aspects: happiness, life satisfaction, and economic satisfaction. The psychological integration includes two dimensions of settlement willingness, and trust level; these have gone through dimension-reduced processing by using the weighted average method. The empirical evidence shows, first, that happiness has a significantly positive effect on the psychological integration of migrant workers and second, that the sense of life satisfaction in particular plays a more significant role. The acceleration of the social and political integration in migrant workers will enhance their psychological integration. Additionally, social, cultural and economic integration is found to influence migrant workers’ psychological integration by promoting happiness. Happiness between different generations of migrant workers was found to have a noticeably positive impact on their psychological integration; however, the happiness of the younger migrant workers was more perceivable than that of the other generations. Preferential policies should therefore be provided to improve the happiness of migrant workers. PMID:29751489

The Role of Standardization in Improving the Effectiveness of Integrated Risk Management

OpenAIRE

Ciocoiu, Carmen Nadia; Dobrea, Razvan Catalin

2010-01-01

The need of standardization in risk management is justified by the efforts to develop and introduce, during the last few years, integrated risk management frameworks inside the organizations. The financial crisis has underscored the fact that significant improvements in risk management organizations and capabilities are required. The business community and also the experts recognize that the risk management standards have an important role in improving the effectiveness of integrated risk man...

Improving Construction Process through Integration and Concurrent Engineering

Directory of Open Access Journals (Sweden)

Malik Khalfan

2012-11-01

Full Text Available In an increasingly competitive business environment, improvedtime-to-market, reduced production cost, quality of the productand customer involvement are rapidly becoming the key successfactors for any product development process. Consequently, mostorganisations are moving towards the adoption of latest technologyand new management concepts and philosophies such as totalquality management and concurrent engineering (CE to bringimprovement in their product development process. This paperdiscusses the adoption of integrated processes and CE withinthe construction industry to enable construction organisations toimprove their project development process. It also discusses aproposed integrated database model for the construction projects,which should enable the construction process to improve, becomemore effective and more efficient.

A gerontologia como campo do conhecimento científico: conceito, interesses e projeto político Gerontology as a field of scientific knowledge: concept, interests and political project

Directory of Open Access Journals (Sweden)

Shirley Donizete Prado

2006-06-01

Full Text Available Discutimos a gerontologia em suas pretensões de constituir-se como a ciência do envelhecimento no Brasil. Consideramos o pensamento de Stengers, que defende a idéia de que o desenvolvimento de um conceito e o despertar de interesses em diferentes setores da sociedade, articulados a um projeto político, constituem-se em pilares fundamentais para o estabelecimento de um campo científico. Identificamos limitações conceituais importantes envolvendo a delimitação da velhice e do envelhecimento, bem como problemas referentes a hierarquias entre domínios internos à gerontologia e a outros campos do conhecimento. A despeito dos importantes interesses suscitados quando a velhice está em questão, a gerontologia parece estar num plano muito limitado como parque científico e como massa crítica para a produção de pesquisas de ponta. Parece-nos que o momento atual de elaboração de um projeto político para a gerontologia está situado no espaço da tentativa de incorporação do discurso epistemológico, a partir de uma perspectiva que nos faz pensar na necessidade do aprofundamento da abordagem teórica acerca do conceito que pretende capturar; sob pena de não avançar na constituição de um importante conjunto de pesquisadores brasileiros de ponta, inseridos no cenário internacional da produção de conhecimento sobre o ser que envelhece.The article discusses gerontology's intention to become the science of aging in Brazil. We considered Stengers's idea that the development of a concept and the emergence of interests in different sectors of society concerned with a political project are the foundations for the establishment of a scientific field. We have identified important conceptual limitations involving old age and ageing delimitations, as well as other problems concerning hierarchies between inner spheres in gerontology and in other knowledge fields. Despite the important interests aroused by old age, gerontology seems to be on a

[Body experience and motion in a biographical context: about the necessity of a body- and motion-related biographical view in gerontology].

Science.gov (United States)

Abraham, Anke

2008-06-01

According to the special view of natural sciences, ageing processes are connected with measurable changes in the body. At the same time we know little about how bodily change is experienced and the subjective acceptance of the body during aging. Therefore a perspective with respect to the body has to be systematically embraced in gerontology. Knowledge perspectives and the view of the body are exemplified in theory and by analysing a case. The knowledge of experience and sense of body and motion in a person's life allows the creation of stimulating offers of growth development and health in age.

Improvement of Students’ Environmental Literacy by Using Integrated Science Teaching Materials

Science.gov (United States)

Suryanti, D.; Sinaga, P.; Surakusumah, W.

2018-02-01

This study aims to determine the improvement of student environmental literacy through the use of integrated science teaching materials on pollution topics. The research is used weak experiment method with the one group pre-test post-test design. The sample of the study were junior high school students in Bandung amounted to 32 people of 7th grade. Data collection in the form of environmental literacy test instrument consist of four components of environmental literacy that is (1) Knowledge, (2) Competencies (Cognitive Skill), (3) Affective and (4) Environmentally Responsible Behavior. The results show that the student’s environmental literacy ability is improved after using integrated science teaching materials. An increase in the medium category is occurring in the knowledge (N-gain=46%) and cognitive skill (N-gain=31%), while the increase in the low category occurs in the affective component (N-gain=25%) and behaviour (N-gain=24%). The conclusions of this study as a whole the improvement of students’ environmental literacy by using integrated science teaching material is in the medium category (N-gain=34%).

An urgent need to improve life conditions of seniors.

Science.gov (United States)

Hebert, R

2010-10-01

In the fall of 2007, the Government of Quebec set up a Public Consultation on Living Conditions of Seniors. Fifty sessions were held in 26 cities across all 17 regions of the province. More than 4000 seniors attended the sessions and 275 briefs were received from scientists and associations. Three themes were identified in the report published in 2008: supporting seniors and their caregivers, reinforcing the place of seniors in society, and preventing problems associated with aging (suicide, abuse, addictions). The main actions that I recommended included: Increasing the Guaranteed Income Supplement to prevent poverty; Modifying pension plans and working conditions to allow for progressive retirement; Making a major investment in home care to provide access to services regardless of place of residence; Introducing an Autonomy Support Benefit and autonomy insurance program for financing services to support people with disabilities; Generalizing an Integrated Service Delivery Network providing services to frail older people; Better training for professionals in gerontology. I also recommended setting up a National Policy on Seniors to align all government departments and agencies, municipalities and the private sector around a vision, objectives and a set of actions for improving the integration of seniors in an aging society. This would contribute to a more equitable, interdependent and wiser society. Unfortunately, the Government did not support these recommendations. It is now time for scientists to get involved in leading policy on seniors and in the political arena.

"Successful aging," gerontological theory and neoliberalism: a qualitative critique.

Science.gov (United States)

Rubinstein, Robert L; de Medeiros, Kate

2015-02-01

This article is a critique of the successful aging (SA) paradigm as described in the Rowe and Kahn book, Successful Aging (1998). The major point of this article is that two key ideas in the book may be understood as consonant with neoliberalism, a social perspective that came into international prominence at the same time the SA paradigm was initially promoted. These two key ideas are (a) the emphasis on individual social action applied to the nature of the aging experience and (b) the failure to provide a detailed policy agenda for the social and cultural change being promoted and, particularly, for older adults who may be left behind by the approach to change the book suggests. The article provides no evidence for a direct connection between SA and neoliberalism, but rather shows how similarities in their approaches to social change characterize both of them. In sum, the article shows (a) how the implicit social theory developed in the book, in a manner similar to neoliberalism, elevates the individual as the main source of any changes that must accompany the SA paradigm and (b) the focus on SA as individual action does not provide for those older adults who do not or will not age "successfully." This, we conclude, implicitly sets up a two-class system of older adults, which may not be an optimal means of addressing the needs of all older adults. The article also reviews a number of studies about SA and shows how these, too, may emphasize its similarities to neoliberalism and other issues that the SA paradigm does not adequately address. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A participatory and integrative approach to improve productivity and ergonomics in assembly

NARCIS (Netherlands)

Looze, M.P. de; Rhijn, J.W. van; Deursen, J. van; Tuinzaad, G.H.; Reijneveld, C.N.

2003-01-01

A participatory and integrative approach was applied to improve the productivity and ergonomics of the assembly lines in two factories, producing magnetic stop valves and office furniture, respectively. Main elements of the approach are the active participation of the company and the integration of

The Geropathology Research Network: An Interdisciplinary Approach for Integrating Pathology Into Research on Aging.

Science.gov (United States)

Ladiges, Warren; Ikeno, Yuji; Niedernhofer, Laura; McIndoe, Richard A; Ciol, Marcia A; Ritchey, Jerry; Liggitt, Denny

2016-04-01

Geropathology is the study of aging and age-related lesions and diseases in the form of whole necropsies/autopsies, surgical biopsies, histology, and molecular biomarkers. It encompasses multiple subspecialties of geriatrics, anatomic pathology, molecular pathology, clinical pathology, and gerontology. In order to increase the consistency and scope of communication in the histologic and molecular pathology assessment of tissues from preclinical and clinical aging studies, a Geropathology Research Network has been established consisting of pathologists and scientists with expertise in the comparative pathology of aging, the design of aging research studies, biostatistical methods for analysis of aging data, and bioinformatics for compiling and annotating large sets of data generated from aging studies. The network provides an environment to promote learning and exchange of scientific information and ideas for the aging research community through a series of symposia, the development of uniform ways of integrating pathology into aging studies, and the statistical analysis of pathology data. The efforts of the network are ultimately expected to lead to a refined set of sentinel biomarkers of molecular and anatomic pathology that could be incorporated into preclinical and clinical aging intervention studies to increase the relevance and productivity of these types of investigations. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

INTEGRATION MECHANISMS OF IMPROVEMENT OF HUMAN RESOURCES MANAGEMENT

Directory of Open Access Journals (Sweden)

Vera A. Akimenko

2013-01-01

Full Text Available In the current economic conditions, the efficiency of business processes of an organization is determined by the quality of the staff. Therefore, actual is the creation and application of new approaches to the management of human re-sources. The article presents a comparative analysis of management practices and their impact on the effectiveness of personnel management, the mechanism of their integration to improve the efficiency of the process.

Integrated approach towards the application of horizontal wells to improve waterflooding performance. Annual report

Energy Technology Data Exchange (ETDEWEB)

Kelkar, M.; Liner, C.; Kerr, D.

1995-05-01

This annual report describes the progress during the second year of the project on Integrated Approach Towards the Application of Horizontal Wells to Improve Waterflooding Performance. This project is funded under the Department of Energy`s Class I program which is targeted towards improving the reservoir performance of mature oil fields located in fluvial-dominated deltaic deposits. The project involves an integrated approach to characterize the reservoir followed by the drilling of horizontal injection wells to improve production performance. The type of data we have integrated include cross bore hole seismic surveys, geological interpretation based on logs and cores, and engineering information. This report covers the second phase of the project which includes a detailed reservoir description of the field by integrating all the available information, followed by flow simulation of the Self Unit under various operating conditions. Based on an examination of the various operating parameters, we observed that the best possible solution to improve the Self Unit performance is to recomplete and stimulate most of the wells followed by an increase in the water injection rate. Drilling of horizontal injection well, although helpful in improving the performance, was not found to be economically feasible. The proposed reservoir management plan will be implemented shortly.

The SUSTAIN Project: A European Study on Improving Integrated Care for Older People Living at Home

Science.gov (United States)

Stoop, Annerieke; Billings, Jenny; Leichsenring, Kai; Ruppe, Georg; Tram, Nhu; Barbaglia, María Gabriela; Ambugo, Eliva A.; Zonneveld, Nick; Paat-Ahi, Gerli; Hoffmann, Henrik; Khan, Usman; Stein, Viktoria; Wistow, Gerald; Lette, Manon; Jansen, Aaltje P.D.; Nijpels, Giel; Baan, Caroline A.

2018-01-01

Introduction: Integrated care programmes are increasingly being put in place to provide care to older people who live at home. Knowledge of how to further develop integrated care and how to transfer successful initiatives to other contexts is still limited. Therefore, a cross-European research project, called Sustainable Tailored Integrated Care for Older People in Europe (SUSTAIN), has been initiated with a twofold objective: 1. to collaborate with local stakeholders to support and monitor improvements to established integrated care initiatives for older people with multiple health and social care needs. Improvements focus on person-centredness, prevention orientation, safety and efficiency; 2. to make these improvements applicable and adaptable to other health and social care systems, and regions in Europe. This paper presents the overall structure and approach of the SUSTAIN project. Methods: SUSTAIN uses a multiple embedded case study design. In three phases, SUSTAIN partners: (i) conduct interviews and workshops with stakeholders from fourteen established integrated care initiatives to understand where they would prefer improvements to existing ways of working; (ii) collaborate with local stakeholders to support the design and implementation of improvement plans, evaluate implementation progress and outcomes per initiative, and carry out overarching analyses to compare the different initiatives, and; (iii) translate knowledge and experience to an online roadmap. Discussion: SUSTAIN aims to generate evidence on how to improve integrated care, and apply and transfer the knowledge gained to other health and social care systems, and regions. Lessons learned will be brought together in practical tools to inform and support policy-makers and decision-makers, as well as other stakeholders involved in integrated care, to manage and improve care for older people living at home. PMID:29632456

Integrated Approach Towards the Application of Horizontal Wells to Improve Waterflooding Performance

Energy Technology Data Exchange (ETDEWEB)

Kelkar, Mohan; Liner, Chris; Kerr, Dennis

1999-10-15

This final report describes the progress during the six year of the project on ''Integrated Approach Towards the Application of Horizontal Wells to Improve Waterflooding Performance.'' This report is funded under the Department of Energy's (DOE's) Class I program which is targeted towards improving the reservoir performance of mature oil fields located in fluvially-dominated deltaic deposits. The project involves using an integrated approach to characterize the reservoir followed by drilling of horizontal injection wells to improve production performance. The project was divided into two budget periods. In the first budget period, many modern technologies were used to develop a detailed reservoir management plan; whereas, in the second budget period, conventional data was used to develop a reservoir management plan. The idea was to determine the cost effectiveness of various technologies in improving the performance of mature oil fields.

Integrated methodology for production related risk management of vehicle electronics (IMPROVE)

OpenAIRE

Geis, Stefan Rafael

2006-01-01

This scientific work is designated to provide an innovative and integrated conceptional approach to improve the assembly quality of automotive electronics. This is achieved by the reduction and elimination of production related risks of automotive electronics and the implementation of a sustainable solution process. The focus is the development and implementation of an integrated technical risk management approach for automotive electronics throughout the vehicle life cycle and the vehicle pr...

Improving method for calculating integral index of personnel security of company

Directory of Open Access Journals (Sweden)

Chjan Khao Yui

2016-06-01

Full Text Available The paper improves the method of calculating the integral index of personnel security of a company. The author has identified four components of personnel security (social and motivational safety, occupational safety, not confliction security, life safety which are characterized by certain indicators. Integral index of personnel security is designed for the enterprises of machine-building sector in Kharkov region, taking into account theweight coefficients j-th component of bj, and weighting factors that determine the degree of contribution of the ith parameter in the integral index aіj as defined by experts.

Improving Outcomes through Transformational Health and Social Care Integration - The Scottish Experience.

Science.gov (United States)

Hendry, Anne; Taylor, Alison; Mercer, Stewart; Knight, Peter

2016-01-01

The Scottish Parliament recently passed legislation on integrating healthcare and social care to improve the quality and outcomes of care and support for people with multiple and complex needs across Scotland. This ambitious legislation provides a national framework to accelerate progress in person-centred and integrated care and support for the growing number of people who have multiple physical and mental health conditions and complex needs. Additional investment and improvement capacity is helping to commission support and services that are designed and delivered with people in local communities and in partnership with housing, community, voluntary and independent sectors.

An Improved Strong Tracking Cubature Kalman Filter for GPS/INS Integrated Navigation Systems.

Science.gov (United States)

Feng, Kaiqiang; Li, Jie; Zhang, Xi; Zhang, Xiaoming; Shen, Chong; Cao, Huiliang; Yang, Yanyu; Liu, Jun

2018-06-12

The cubature Kalman filter (CKF) is widely used in the application of GPS/INS integrated navigation systems. However, its performance may decline in accuracy and even diverge in the presence of process uncertainties. To solve the problem, a new algorithm named improved strong tracking seventh-degree spherical simplex-radial cubature Kalman filter (IST-7thSSRCKF) is proposed in this paper. In the proposed algorithm, the effect of process uncertainty is mitigated by using the improved strong tracking Kalman filter technique, in which the hypothesis testing method is adopted to identify the process uncertainty and the prior state estimate covariance in the CKF is further modified online according to the change in vehicle dynamics. In addition, a new seventh-degree spherical simplex-radial rule is employed to further improve the estimation accuracy of the strong tracking cubature Kalman filter. In this way, the proposed comprehensive algorithm integrates the advantage of 7thSSRCKF’s high accuracy and strong tracking filter’s strong robustness against process uncertainties. The GPS/INS integrated navigation problem with significant dynamic model errors is utilized to validate the performance of proposed IST-7thSSRCKF. Results demonstrate that the improved strong tracking cubature Kalman filter can achieve higher accuracy than the existing CKF and ST-CKF, and is more robust for the GPS/INS integrated navigation system.

Performance Improvement of Receivers Based on Ultra-Tight Integration in GNSS-Challenged Environments

Directory of Open Access Journals (Sweden)

Feng Qin

2013-12-01

Full Text Available Ultra-tight integration was first proposed by Abbott in 2003 with the purpose of integrating a global navigation satellite system (GNSS and an inertial navigation system (INS. This technology can improve the tracking performances of a receiver by reconfiguring the tracking loops in GNSS-challenged environments. In this paper, the models of all error sources known to date in the phase lock loops (PLLs of a standard receiver and an ultra-tightly integrated GNSS/INS receiver are built, respectively. Based on these models, the tracking performances of the two receivers are compared to verify the improvement due to the ultra-tight integration. Meanwhile, the PLL error distributions of the two receivers are also depicted to analyze the error changes of the tracking loops. These results show that the tracking error is significantly reduced in the ultra-tightly integrated GNSS/INS receiver since the receiver’s dynamics are estimated and compensated by an INS. Moreover, the mathematical relationship between the tracking performances of the ultra-tightly integrated GNSS/INS receiver and the quality of the selected inertial measurement unit (IMU is derived from the error models and proved by the error comparisons of four ultra-tightly integrated GNSS/INS receivers aided by different grade IMUs.

Improving Acceptance, Integration, and Health Among LGBT Service Members

Science.gov (United States)

2017-10-01

through multiple rounds of internal testing and quality assurance procedures. Recruitment for the Phase II survey was initiated on August 25, 2017...Award Numbers: W81XWH-15-1-0701 Title: Improving Acceptance, Integration, and Health Among LGBT Service Members Principal Investigators...burden to Department of Defense, Washington Headquarters Services , Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis

Construindo o fazer gerontológico pelas enfermeiras das Unidades de Estratégia Saúde da Família Construcción del quehacer gerontológico por las enfermeras de las unidades de estrategia salud de la familia Building the gerontological performance of nurses in Family Health Programs

Directory of Open Access Journals (Sweden)

Sandra Helena Isse Polaro

2013-02-01

ífica en gerontogeriatría. No obstante, ellas vienen construyendo un quehacer gerontológico peculiar, creando estrategias de acciones integradas, posibles ante situaciones enfrentadas en el proceso laboral, basadas en conocimientos generales de enfermería adquiridos durante su formación general.The goal of this article is to analyze the development of gerontological nurses working in the Family Health Program in a municipal district in Belém, PA. Data have been collected through interviews with 14 nurses between 08/2009 and 02/2010 and have been analyzed using the content analysis method to generate topics. One such topic is the theme of this article: building gerontological work, and the sub-topics are the following: nursing consultation, home visits, family care, and seeking partnerships for integrated actions. According to the results, it may be inferred from nurses performing gerontological tasks that work is hampered primarily by urban violence, the inefficient functional structure of services and poor specific geriatric training. However, nurses have built a special "making of gerontology" by creating strategies of integrated actions according to each new situation that has been presented.

The use of artificial intelligence techniques to improve the multiple payload integration process

Science.gov (United States)

Cutts, Dannie E.; Widgren, Brian K.

1992-01-01

A maximum return of science and products with a minimum expenditure of time and resources is a major goal of mission payload integration. A critical component then, in successful mission payload integration is the acquisition and analysis of experiment requirements from the principal investigator and payload element developer teams. One effort to use artificial intelligence techniques to improve the acquisition and analysis of experiment requirements within the payload integration process is described.

Driving Performance Improvements by Integrating Competencies with Human Resource Practices

Science.gov (United States)

Lee, Jin Gu; Park, Yongho; Yang, Gi Hun

2010-01-01

This study explores the issues in the development and application of a competency model and provides implications for more precise integration of competencies into human resource (HR) functions driving performance improvement. This research is based on a case study from a Korean consumer corporation. This study employed document reviews,…

Improving the Marine Corps Reserve Infantry Battalion: Manning, Training, Integration, and Retention

National Research Council Canada - National Science Library

Parrish, Ross A

2008-01-01

.... Recognizing that all Marine Corps reserve infantry battalions have deployed at least once in support of the GWOT, further improvements in the manning, training, integration, and retention within...

Improving Acceptance, Integration and Health among LGBT Service Members

Science.gov (United States)

2017-10-01

these stressors on LGBT service members is poorly understood, with very little data available on the unique physical and mental health needs of these...Bullying • Overall health • Healthcare utilization • Lost duty days • Sick call visits • Physical health symptoms • Sexual/gender identity disclosure...Award Numbers: W81XWH-15-1-0699 Title: Improving Acceptance, Integration and Health among LGBT Service Members Principal Investigators: Jeremy

Adapting the Quebecois method for assessing implementation to the French National Alzheimer Plan 2008–2012: lessons for gerontological services integration

Directory of Open Access Journals (Sweden)

Dominique Somme

2014-06-01

Full Text Available Introduction: Many countries face ageing-related demographic and epidemiological challenges, notably neurodegenerative disorders, due to the multiple care services they require, thereby pleading for a more integrated system of care. The integrated Quebecois method issued from the Programme of Research to Integrate Services for the Maintenance of Autonomy inspired a French pilot experiment and the National Alzheimer Plan 2008–2012. Programme of Research to Integrate Services for the Maintenance of Autonomy method implementation was rated with an evaluation grid adapted to assess its successive degrees of completion.Discussion: The approaching end of the president's term led to the method's institutionalization (2011–2012, before the implementation study ended. When the government changed, the study was interrupted. The results extracted from that ‘lost’ study (presented herein have, nonetheless, ‘found’ some key lessons.Key lessons/conclusion: It was possible to implement a Quebecois integrated-care method in France. We describe the lessons and pitfalls encountered in adapting this evaluation tool. This process is necessarily multidisciplinary and requires a test phase. A simple tool for quantitative assessment of integration was obtained. The first assessment of the tool was unsatisfactory but requires further studies. In the meantime, we recommend using mixed methodologies to assess the services integration level.

Adapting the Quebecois method for assessing implementation to the French National Alzheimer Plan 2008–2012: lessons for gerontological services integration

Directory of Open Access Journals (Sweden)

Dominique Somme

2014-06-01

Full Text Available Introduction: Many countries face ageing-related demographic and epidemiological challenges, notably neurodegenerative disorders, due to the multiple care services they require, thereby pleading for a more integrated system of care. The integrated Quebecois method issued from the Programme of Research to Integrate Services for the Maintenance of Autonomy inspired a French pilot experiment and the National Alzheimer Plan 2008–2012. Programme of Research to Integrate Services for the Maintenance of Autonomy method implementation was rated with an evaluation grid adapted to assess its successive degrees of completion. Discussion: The approaching end of the president's term led to the method's institutionalization (2011–2012, before the implementation study ended. When the government changed, the study was interrupted. The results extracted from that ‘lost’ study (presented herein have, nonetheless, ‘found’ some key lessons. Key lessons/conclusion: It was possible to implement a Quebecois integrated-care method in France. We describe the lessons and pitfalls encountered in adapting this evaluation tool. This process is necessarily multidisciplinary and requires a test phase. A simple tool for quantitative assessment of integration was obtained. The first assessment of the tool was unsatisfactory but requires further studies. In the meantime, we recommend using mixed methodologies to assess the services integration level.

Validity of the National Center for Geriatrics and Gerontology-Functional Assessment Tool and Mini-Mental State Examination for detecting the incidence of dementia in older Japanese adults.

Science.gov (United States)

Shimada, Hiroyuki; Makizako, Hyuma; Park, Hyuntae; Doi, Takehiko; Lee, Sangyoon

2017-12-01

Numerous neuropsychological tests are implemented in the clinical setting. However, a readily available cognitive test is required to detect the risk of dementia in the community setting. A total of 4151 persons aged ≥65 years participated in the present prospective cohort study. We assessed cognitive performance using the Mini-Mental State Examination and the National Center for Geriatrics and Gerontology-Functional Assessment Tool. The National Center for Geriatrics and Gerontology-Functional Assessment Tool includes tests of story and word list memory, attention and executive function, processing speed, and visuospatial skill to screen for cognitive impairment. All measurements were transformed to Z-scores to compare among the cognitive tests. The incidence of dementia was determined using data collected by the Japanese Health Insurance System over 36 months. After an average of 43 months, 180 (4.3%) participants were diagnosed with dementia. Survival analyses showed that the probability of dementia was significantly associated with all cognitive tests, except for visuospatial skill. The processing speed test showed the highest hazard ratios for the incidence of dementia (Z-score: hazard ratio 0.61, 95% confidence interval 0.50-0.75, P Mini-Mental State Examination, play an important role in detecting the risk of dementia in the community setting. Further analysis is required to identify the risk of dementia in older people without global cognitive impairment. Geriatr Gerontol Int 2017; 17: 2383-2388. © 2017 Japan Geriatrics Society.

Perceived control in the lives of older adults: the influence of Langer and Rodin's work on gerontological theory, policy, and practice.

Science.gov (United States)

Mallers, Melanie H; Claver, Maria; Lares, Lisa A

2014-02-01

A key concept driving the field of both clinical and applied gerontology is that of personal control. Seminal work conducted in the late 1970s to early 1980s by Ellen Langer and Judith Rodin, who examined the effect of choice and enhanced responsibility on older adults, not only contributed to the discussion of the relevance of control in contemporary theories and practices of aging but also aided in the development of today's philosophy of how to serve and care for older adults in ways that are passionate, humanistic, and empowering. In their early research, residents at a nursing home were randomly assigned to 2 groups: 1 group was told they could arrange their furniture as they wanted, go where they wanted, spend time with whom they wanted, and so forth and were given a plant to care for; the other group was told that the staff was there to take care of and help them, including watering a plant given to each of them. During this study, and 18 months later, residents who were given control and personal responsibility had improved health; among those for whom control had not changed, a greater proportion had died. Since these original studies, research has continued to support the need for personal control as we age. This paper presents a brief overview of literature informed by Langer and Rodin's seminal findings, as well as the role of control to theory, policy, and practice.

A modified integrated NDVI for improving estimates of terrestrial net primary production

Science.gov (United States)

Running, Steven W.

1990-01-01

Logic is presented for a time-integrated NDVI that is modified by an AVHRR derived surface evaporation resistance factor sigma, and truncated by temperatures that cause plant dormancy, to improve environmental sensitivity. With this approach, NDVI observed during subfreezing temperatures is not integrated. Water stress-related impairment in plant activity is incorporated by reducing the effective NDVI at each integration with sigma, which is derived from the slope of the surface temperature to NDVI ratio for climatically similar zones of the scene. A comparison of surface resistance before and after an extended drought period for a 1200 sq km region of coniferous forest in Montana is presented.

Urban Gerontological. Challenges of urban planning for the aging population of Mexico / Urbanismo Gerontológico. Retos de la planificación urbana ante el envejecimiento de la población de México

OpenAIRE

Diego Sánchez González

2012-01-01

Book Review: "Urban Gerontology. Population aging and urban facilities. The case of the city of Aguascalientes, "Oscar Narvaez Luis Montoya (2011). Aguascalientes Autonomous University of Aguascalientes. Reseña del libro: “Urbanismo Gerontológico. Envejecimiento demográfico y equipamiento urbano. El caso de la ciudad de Aguascalientes”, de Oscar Luis Narvaez Montoya (2011). Aguascalientes: Universidad Autónoma de Aguascalientes.

Alarm radiation dosimeter with improved integrating pulse ionization chamber and high voltage supply

International Nuclear Information System (INIS)

Borkowski, C.J.; Rochelle, J.M.

1975-01-01

An alarm dosimeter is described which features an improved integrating pulse ionization chamber of the type containing an hermetically sealed gas diode. Improved operation and miniaturization of the chamber are made possible by a ringing choke converter high voltage supply having a ripple-type output that insures discharge of the gas diode. (author)

Numerical Simulation of Antennas with Improved Integral Equation Method

International Nuclear Information System (INIS)

Ma Ji; Fang Guang-You; Lu Wei

2015-01-01

Simulating antennas around a conducting object is a challenge task in computational electromagnetism, which is concerned with the behaviour of electromagnetic fields. To analyze this model efficiently, an improved integral equation-fast Fourier transform (IE-FFT) algorithm is presented in this paper. The proposed scheme employs two Cartesian grids with different size and location to enclose the antenna and the other object, respectively. On the one hand, IE-FFT technique is used to store matrix in a sparse form and accelerate the matrix-vector multiplication for each sub-domain independently. On the other hand, the mutual interaction between sub-domains is taken as the additional exciting voltage in each matrix equation. By updating integral equations several times, the whole electromagnetic system can achieve a stable status. Finally, the validity of the presented method is verified through the analysis of typical antennas in the presence of a conducting object. (paper)

Evaluation of implementation an Integrated Safety and Preventive Maintenance System for Improving of Safety Indexes

Directory of Open Access Journals (Sweden)

I mohammadfam

2014-03-01

Full Text Available Accident analysis shows that one of the main reasons for accidents is non-integration of maintenance units with safety. Merging these two processes through an integrated system can reduce and or eliminate accidents, diseases, and environmental pollution. These issues lead to improvement in organizational performance, as well. The aim of this study is to design and establish an integrated system for obtaining the aforementioned goal. Integration was carried out at Nirou Moharreke Machine Tools Company via Structured System Analysis & Design Method (SSADM. In order to measure the effectiveness of the system, selected indexes were compared using statistical methods prior and after system establishment. Results show that the accident severity index reduced from 135.46 in 2010, to 43.85 in 2012. Moreover, system effectiveness improved equipment reliability and availability (e.g. reliability of the Pfeiffer Milling machine (P (t>50 increased from 0.89 in 2010, to 0.9 in 2012. This system by forecasting various failures, and planning and designing the required operations for preventing occurrence of these failures, plays an important role in improving safety conditions of equipment, and increasing organizational performance, and is capable of presenting an excellent accident prevention program.

A Hyaluronan-Based Injectable Hydrogel Improves the Survival and Integration of Stem Cell Progeny following Transplantation

Directory of Open Access Journals (Sweden)

Brian G. Ballios

2015-06-01

Full Text Available The utility of stem cells and their progeny in adult transplantation models has been limited by poor survival and integration. We designed an injectable and bioresorbable hydrogel blend of hyaluronan and methylcellulose (HAMC and tested it with two cell types in two animal models, thereby gaining an understanding of its general applicability for enhanced cell distribution, survival, integration, and functional repair relative to conventional cell delivery in saline. HAMC improves cell survival and integration of retinal stem cell (RSC-derived rods in the retina. The pro-survival mechanism of HAMC is ascribed to the interaction of the CD44 receptor with HA. Transient disruption of the retinal outer limiting membrane, combined with HAMC delivery, results in significantly improved rod survival and visual function. HAMC also improves the distribution, viability, and functional repair of neural stem and progenitor cells (NSCs. The HAMC delivery system improves cell transplantation efficacy in two CNS models, suggesting broad applicability.

Improving teaching on the basis of student evaluation: integrative teaching consultation.

Science.gov (United States)

Wibbecke, Gerald; Kahmann, Janine; Pignotti, Tanja; Altenberger, Leander; Kadmon, Martina

2015-01-01

Due to the development of medical education in the past decade the role of teachers has changed and requires higher didactic competence. Student evaluation of teaching alone does not lead to considerable improvement of teaching quality. We present the concept of "Integrative Teaching Consultation", which comprises both the teacher's reflection and own objectives to improve their teaching as well as data from students ratings. Teachers in collaboration with a teaching consultant reflect on their teaching ability and set themselves improvement goals. Then the consultant himself observes a teaching session and subsequently analyses the respective student evaluation in order to give meaningful feedback to the teacher. The combination of student feedback with professional consultation elements can initiate and maintain improvements in teaching. Teaching consultation complements existing faculty development programs and increases the benefit of student evaluations.

Development and improvement of the integrated system of management

Directory of Open Access Journals (Sweden)

Lukmanova Inessa Galeevna

2014-07-01

Full Text Available Integrated management system construction can be considered a way that transforms using business processes and information resources into final construction products. Autonomous system of quality management, environmental, health and safety organizations introduction usually lead to the accumulation of duplicate documents, which increase the time spent on processing and analysis as well as increase the financial costs of maintaining the operation of each of them separately. System integration allows reducing these costs and entailing the most obvious benefits: reduced volumes of documents; reduction of time spent on analysis; reducing the cost of audit and certification; involvement of all the employees of the organization; productivity growth; increasing the attractiveness for consumers; reducing the burden on administrative and executive devices; ensuring a high level of flexibility in the organization's management system in case of internal and external changes. Integration of quality management systems, environmental management and safety management systems, production and safety led to the possibility to establish such integrated management system in developing building companies, which allows establishing a unified management system, as an element of management of organization. The main drawback of the currently used standards and specifications is the lack of flexibility of their application, as well as the basic principles and approaches to their implementation. Thus, knowing about what the system should be, but not knowing how to create it, many organizations have to operate without methodological support. Absence of mandatory standards concerning integration of management systems creates opportunities for the existence of multiple options for interaction systems. Economic effects on the integrated management system is formed from three sources: the reduction of production costs by improving product quality and reducing defects and

Improving occupational safety and health by integration into product development

DEFF Research Database (Denmark)

Broberg, Ole

1996-01-01

A cross-sectional case study was performed in a large company producing electro-mechanical products for industrial application. The objectives were: (i) to study the product development process and the role of key actors', (ii) to identify current practice on integrating occupational safety and h...... and studies of documents. A questionnaire regarding product development tasks and occupational safety and health were distributed to 30 design and production engineers. A total of 27 completed the questionnaire corresponding to a response rate of 90 per cent.......A cross-sectional case study was performed in a large company producing electro-mechanical products for industrial application. The objectives were: (i) to study the product development process and the role of key actors', (ii) to identify current practice on integrating occupational safety...... and health into the development process, especially the efforts and attitudes of design and production engineers', and (iii) to identify key actors'reflections on how to improve this integration. The study was based on qualitative as well as quantitative methods including interviews, questionnaires...

Improvement of risk assessment by integrating toxicological and epidemiological approaches: the case of isoflavones

NARCIS (Netherlands)

Islam, M.A.

2015-01-01

Improvement of risk assessment by integrating toxicological and epidemiological approaches: the case of isoflavones

PhD-thesis Mohammed Ariful Islam

This thesis describes the results of a research project that aimed at the improvement of

Efficiencies and improvement potential of building integrated photovoltaic thermal (BIPVT) system

International Nuclear Information System (INIS)

Ibrahim, Adnan; Fudholi, Ahmad; Sopian, Kamaruzzaman; Othman, Mohd Yusof; Ruslan, Mohd Hafidz

2014-01-01

Highlights: • Performances analysis of BIPVT solar collector based on energy and exergy analyses. • A new absorber design of BIPVT solar collector is presented. • BIPVT solar collector is produced primary-energy saving efficiency from about 73% to 81%. • PVT energy efficiency varies between 55% and 62% where as the variation in the PVT exergy efficiency is from 12% to 14%. • The improvement potential is between 98 and 404 W. - Abstract: Building integrated photovoltaic thermal (BIPVT) system has been designed to produce both electricity and hot water and later integrated to building. The hot water is produced at the useful temperatures for the applications in Malaysia such as building integrated heating system and domestic hot water system as well as many industrial including agricultural and commercial applications. The photovoltaic thermal (PVT) system comprises of a high efficiency multicrystal photovoltaic (PV) module and spiral flow absorber for BIPVT application, have been performed and investigated. In this study, it was assumed that the absorber was attached underneath the flat plate single glazing sheet of polycrystalline silicon PV module and water has been used as a heat transfer medium in absorber. Performances analysis of BIPVT system based on energy and exergy analyses. It was based on efficiencies including energy and exergy, and exergetic improvement potential (IP) based on the metrological condition of Malaysia has been carried out. Results show that the hourly variation for BIPVT system, the PVT energy efficiency of 55–62% is higher than the PVT exergy efficiency of 12–14%. The improvement potential increases with increasing solar radiation, it is between 98 and 404 W. On the other hand, BIPVT system was produced primary-energy saving efficiency from about 73% to 81%

CMS Nonpayment Policy, Quality Improvement, and Hospital-Acquired Conditions: An Integrative Review.

Science.gov (United States)

Bae, Sung-Heui

This integrative review synthesized evidence on the consequences of the Centers for Medicare & Medicaid Services (CMS) nonpayment policy on quality improvement initiatives and hospital-acquired conditions. Fourteen articles were included. This review presents strong evidence that the CMS policy has spurred quality improvement initiatives; however, the relationships between the CMS policy and hospital-acquired conditions are inconclusive. In future research, a comprehensive model of implementation of the CMS nonpayment policy would help us understand the effectiveness of this policy.

Improving teaching on the basis of student evaluation: Integrative teaching consultation

Directory of Open Access Journals (Sweden)

Wibbecke, Gerald

2015-02-01

Full Text Available Objective: Due to the development of medical education in the past decade the role of teachers has changed and requires higher didactic competence. Student evaluation of teaching alone does not lead to considerable improvement of teaching quality. We present the concept of "Integrative Teaching Consultation", which comprises both the teacher’s reflection and own objectives to improve their teaching as well as data from students ratings.Methods: Teachers in collaboration with a teaching consultant reflect on their teaching ability and set themselves improvement goals. Then the consultant himself observes a teaching session and subsequently analyses the respective student evaluation in order to give meaningful feedback to the teacher.Results: The combination of student feedback with professional consultation elements can initiate and maintain improvements in teaching. Conclusion: Teaching consultation complements existing faculty development programs and increases the benefit of student evaluations.

An integrated conceptual framework for evaluating and improving 'understanding' in informed consent.

Science.gov (United States)

Bossert, Sabine; Strech, Daniel

2017-10-17

The development of understandable informed consent (IC) documents has proven to be one of the most important challenges in research with humans as well as in healthcare settings. Therefore, evaluating and improving understanding has been of increasing interest for empirical research on IC. However, several conceptual and practical challenges for the development of understandable IC documents remain unresolved. In this paper, we will outline and systematize some of these challenges. On the basis of our own experiences in empirical user testing of IC documents as well as the relevant literature on understanding in IC, we propose an integrated conceptual model for the development of understandable IC documents. The proposed conceptual model integrates different methods for the participatory improvement of written information, including IC, as well as quantitative methods for measuring understanding in IC. In most IC processes, understandable written information is an important prerequisite for valid IC. To improve the quality of IC documents, a conceptual model for participatory procedures of testing, revising, and retesting can be applied. However, the model presented in this paper needs further theoretical and empirical elaboration and clarification of several conceptual and practical challenges.

Exergoeconomic improvement of a complex cogeneration system integrated with a professional process simulator

International Nuclear Information System (INIS)

Vieira, Leonardo S.; Donatelli, Joao L.; Cruz, Manuel E.

2009-01-01

In this paper, the application of an iterative exergoeconomic methodology for improvement of thermal systems to a complex combined-cycle cogeneration plant is presented. The methodology integrates exergoeconomics with a professional process simulator, and represents an alternative to conventional mathematical optimization techniques, because it reduces substantially the number of variables to be considered in the improvement process. By exploiting the computational power of a simulator, the integrated approach permits the optimization routine to ignore the variables associated with the thermodynamic equations, and thus to deal only with the economic equations and objective function. In addition, the methodology combines recent available exergoeconomic techniques with qualitative and quantitative criteria to identify only those decision variables, which matter for the improvement of the system. To demonstrate the strengths of the methodology, it is here applied to a 24-component cogeneration plant, which requires O(10 3 ) variables for its simulation. The results which are obtained, are compared to those reached using a conventional mathematical optimization procedure, also coupled to the process simulator. It is shown that, for engineering purposes, improvement of the system is often more cost effective and less time consuming than optimization of the system.

An experiential approach to improving the integration of knowledge during EIA in transport planning

Energy Technology Data Exchange (ETDEWEB)

Soria-Lara, Julio A., E-mail: julio.soria-lara@ouce.ox.ac.uk [Transport Research Unit, School of Geography and the Environment, University of Oxford, South Parks Road, Oxford OX1 3QY (United Kingdom); Bertolini, Luca, E-mail: l.bertolini@uva.nl [Centre for Urban Studies, University of Amsterdam, Nieuwe Achtergracht 166 1018 WV Amsterdam (Netherlands); Brömmelstroet, Marco te, E-mail: M.C.G.teBrommelstroet@uva.nl [Centre for Urban Studies, University of Amsterdam, Nieuwe Achtergracht 166 1018 WV Amsterdam (Netherlands)

2016-01-15

The integration of knowledge from stakeholders and the public at large is seen as one of the biggest process-related barriers during the scoping phase of EIA application in transport planning. While the academic literature offers abundant analyses, discussions and suggestions how to overcome this problem, the proposed solutions are yet to be adequately tested in practice. In order to address this gap, we test the effectiveness of a set of interventions and trigger mechanisms for improving different aspects of knowledge integration. The interventions are tested in an experiential study with two sequential cases, representing “close-to-real-life” conditions, in the context of two cities in Andalusia, Spain. In general terms, the participants perceived that the integration of knowledge improved during the simulation of the EIA scoping phase. Certain shortcomings were also discussed, fundamentally related to how the time spent during the scoping phase was crucial to lead an effective learning process between the involved people. The study concludes with a reflection on the effectiveness of the tested interventions according to similarities and differences obtained from the two experiential case studies, as well as with a discussion of the potential to generate new knowledge through the use of experiential studies in EIA practice. - Highlights: • It tests a set of interventions and mechanisms to improve the integration of knowledge. • The scoping phase of EIA is simulated to assess the effectiveness of interventions. • Two sequential case studies are used.

An experiential approach to improving the integration of knowledge during EIA in transport planning

International Nuclear Information System (INIS)

Soria-Lara, Julio A.; Bertolini, Luca; Brömmelstroet, Marco te

2016-01-01

The integration of knowledge from stakeholders and the public at large is seen as one of the biggest process-related barriers during the scoping phase of EIA application in transport planning. While the academic literature offers abundant analyses, discussions and suggestions how to overcome this problem, the proposed solutions are yet to be adequately tested in practice. In order to address this gap, we test the effectiveness of a set of interventions and trigger mechanisms for improving different aspects of knowledge integration. The interventions are tested in an experiential study with two sequential cases, representing “close-to-real-life” conditions, in the context of two cities in Andalusia, Spain. In general terms, the participants perceived that the integration of knowledge improved during the simulation of the EIA scoping phase. Certain shortcomings were also discussed, fundamentally related to how the time spent during the scoping phase was crucial to lead an effective learning process between the involved people. The study concludes with a reflection on the effectiveness of the tested interventions according to similarities and differences obtained from the two experiential case studies, as well as with a discussion of the potential to generate new knowledge through the use of experiential studies in EIA practice. - Highlights: • It tests a set of interventions and mechanisms to improve the integration of knowledge. • The scoping phase of EIA is simulated to assess the effectiveness of interventions. • Two sequential case studies are used.

Improved Guideline Adherence With Integrated Sickle Cell Disease and Asthma Care.

Science.gov (United States)

McClain, Brandi L; Ivy, Zalaya K; Bryant, Valencia; Rodeghier, Mark; DeBaun, Michael R

2016-07-01

In children with sickle cell disease (SCD), concomitant asthma is associated with increased morbidity and mortality when compared with children with SCD without asthma. Despite the well-established burden of asthma in children with SCD, no paradigm of care exists for the co-management of these two diseases. To address this gap, an integrated SCD and asthma clinic was created in a community health center that included (1) a dual respiratory therapist/asthma case manager; (2) an SCD nurse practitioner with asthma educator certification; (3) an onsite pulmonary function test laboratory; (4) a pediatric hematologist with expertise in managing SCD and asthma; and (5) application of the National Asthma Education and Prevention Program guidelines. A before (2010-2012) and after (2013-2014) study design was used to assess for improved quality of care with implementation of an integrative care model among 61 children with SCD and asthma followed from 2010 to 2014. Asthma action plan utilization after initial diagnosis increased with the integrative care model (n=16, 56% before, 100% after, p=0.003), as did the use of spirometry in children aged ≥5 years (n=41, 65% before, 95% after, pintegrative care model for SCD and asthma improved evidence-based asthma care, longer follow-up and evaluation will be needed to determine the impact on SCD-related morbidity. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Epidermal Growth Factor Improves Intestinal Integrity and Survival in Murine Sepsis Following Chronic Alcohol Ingestion.

Science.gov (United States)

Klingensmith, Nathan J; Yoseph, Benyam P; Liang, Zhe; Lyons, John D; Burd, Eileen M; Margoles, Lindsay M; Koval, Michael; Ford, Mandy L; Coopersmith, Craig M

2017-02-01

Epidermal growth factor (EGF) is a cytoprotective protein that improves survival in preclinical models of sepsis through its beneficial effects on intestinal integrity. Alcohol use disorder worsens intestinal integrity and is associated with increased morbidity and mortality in critical illness. We sought to determine whether chronic alcohol ingestion alters the host response to systemic administration of EGF in sepsis. Six-week-old FVB/N mice were randomized to receive 20% alcohol or water for 12 weeks. All mice then underwent cecal ligation and puncture to induce polymicrobial sepsis. Mice were then randomized to receive either intraperitoneal injection of EGF (150 μg/kg/day) or normal saline. Water-fed mice given EGF had decreased 7-day mortality compared with water-fed mice (18% vs. 55%). Alcohol-fed mice given EGF also had decreased 7-day mortality compared with alcohol-fed mice (48% vs. 79%). Notably, while systemic EGF improved absolute survival to a similar degree in both water-fed and alcohol-fed mice, mortality was significantly higher in alcohol+EGF mice compared with water+EGF mice. Compared with water-fed septic mice, alcohol-fed septic mice had worsened intestinal integrity with intestinal hyperpermeability, increased intestinal epithelial apoptosis, decreased proliferation and shorter villus length. Systemic administration of EGF to septic alcohol-fed mice decreased intestinal permeability compared with septic alcohol-fed mice given vehicle, with increased levels of the tight junction mediators claudin-5 and JAM-A. Systemic administration of EGF to septic alcohol-fed mice also decreased intestinal apoptosis with an improvement in the Bax/Bcl-2 ratio. EGF also improved both crypt proliferation and villus length in septic alcohol-fed mice. EGF administration resulted in lower levels of both pro- and anti-inflammatory cytokines monocyte chemoattractant protein-1, tumor necrosis factor, and interleukin 10 in alcohol-fed mice. EGF is therefore

Nuclear Regulatory Commission staff approaches to improving the integration of regulatory guidance documents and prelicensing reviews

International Nuclear Information System (INIS)

Johnson, R.L.

1994-01-01

The Nuclear Regulatory Commission staff is conducting numerous activities to improve the integration of its regulatory guidance documents (i.e., License Application Review Plan (LARP) and open-quotes Format and Content for the License Application for the High-Level Waste repositoryclose quotes (FCRG)) and pre-license application (LA) reviews. Those activities related to the regulatory guidance documents consist of: (1) developing an hierarchy of example evaluation findings for LARP; (2) identifying LARP review plan interfaces; (3) conducting an integration review of LARP review strategies; (4) correlating LARP to the ongoing technical program; and (5) revising the FCRG. Some of the more important strategies the staff is using to improve the integration of pre-LA reviews with the LA review include: (1) use of the draft LARP to guide the staff's pre-LA reviews; (2) focus detailed pre-LA reviews on key technical uncertainties; (3) identify and track concerns with DOE's program; and (4) use results of pre-LA reviews in LA reviews. The purpose of this paper is to describe these ongoing activities and strategies and discuss some of the new work that is planned to be included in LARP Revision 1 and the final FCRG, which are scheduled to be issued in late 1994. These activities reflect both the importance the staff has placed on integration and the staff's approach to improving integration in these areas. The staff anticipates that the results of these activities, when incorporated in the FCRG, LARP, and pre-LA reviews, will improve its guidance for DOE's ongoing site characterization program and LA annotated outline development

APPROACH FOR IMPROVING THE INTEGRATED SENSOR ORIENTATION

Directory of Open Access Journals (Sweden)

E. Mitishita

2016-06-01

Full Text Available The direct determination of exterior orientation parameters (EOP of aerial images via integration of the Inertial Measurement Unit (IMU and GPS is often used in photogrammetric mapping nowadays. The accuracies of the EOP depend on the accurate parameters related to sensors mounting when the job is performed (offsets of the IMU relative to the projection centre and the angles of boresigth misalignment between the IMU and the photogrammetric coordinate system. In principle, when the EOP values do not achieve the required accuracies for the photogrammetric application, the approach, known as Integrated Sensor Orientation (ISO, is used to refine the direct EOP. ISO approach requires accurate Interior Orientation Parameters (IOP and standard deviation of the EOP under flight condition. This paper investigates the feasibility of use the in situ camera calibration to obtain these requirements. The camera calibration uses a small sub block of images, extracted from the entire block. A digital Vexcel UltraCam XP camera connected to APPLANIX POS AVTM system was used to get two small blocks of images that were use in this study. The blocks have different flight heights and opposite flight directions. The proposed methodology improved significantly the vertical and horizontal accuracies of the 3D point intersection. Using a minimum set of control points, the horizontal and vertical accuracies achieved nearly one image pixel of resolution on the ground (GSD. The experimental results are shown and discussed.

78 FR 10181 - Global Quality Systems-An Integrated Approach To Improving Medical Product Safety; Public Workshop

Science.gov (United States)

2013-02-13

...] Global Quality Systems--An Integrated Approach To Improving Medical Product Safety; Public Workshop... (AFDO), is announcing a public workshop entitled ``Global Quality Systems--An Integrated Approach to... topics concerning FDA requirements related to the production and marketing of drugs and/or devices...

An Integrated Care Initiative to Improve Patient Outcome in Schizophrenia.

Science.gov (United States)

Mayer-Amberg, Norbert; Woltmann, Rainer; Walther, Stefanie

2015-01-01

The optimal treatment of schizophrenia patients requires integration of medical and psychosocial inputs. In Germany, various health-care service providers and institutions are involved in the treatment process. Early and continuous treatment is important but often not possible because of the fragmented medical care system in Germany. The Integrated Care Initiative Schizophrenia has implemented a networked care concept in the German federal state of Lower Saxony that integrates various stakeholders of the health care system. In this initiative, office-based psychiatrists, specialized nursing staff, psychologists, social workers, hospitals, psychiatric institutional outpatient's departments, and other community-based mental health services work together in an interdisciplinary approach. Much emphasis is placed on psychoeducation. Additional efforts cover socio-therapy, visiting care, and family support. During the period from October 2010 (start of the initiative) to December 2012, first experiences and results of quality indicators were collected of 713 registered patients and summarized in a quality monitoring report. In addition, standardized patient interviews were conducted, and duration of hospital days was recorded in 2013. By the end of 2012, patients had been enrolled for an average of 18.7 months. The overall patient satisfaction measured in a patient survey in June 2013 was high and the duration of hospital days measured in a pre-post analysis in July 2013 was reduced by 44%. Two years earlier than planned, the insurance fund will continue the successfully implemented Integrated Care Initiative and adopt it in the regular care setting. This initiative can serve as a learning case for how to set up and measure integrated care systems that may improve outcomes for patients suffering from schizophrenia.

76 FR 34541 - Child and Adult Care Food Program Improving Management and Program Integrity

Science.gov (United States)

2011-06-13

... 7 CFR Parts 210, 215, 220 et al. Child and Adult Care Food Program Improving Management and Program..., 220, 225, and 226 RIN 0584-AC24 Child and Adult Care Food Program Improving Management and Program... management and integrity in the Child and Adult Care Food Program (CACFP), at 67 FR 43447 (June 27, 2002) and...

Improved parallel solution techniques for the integral transport matrix method

Energy Technology Data Exchange (ETDEWEB)

Zerr, R. Joseph, E-mail: rjz116@psu.edu [Department of Mechanical and Nuclear Engineering, The Pennsylvania State University, University Park, PA (United States); Azmy, Yousry Y., E-mail: yyazmy@ncsu.edu [Department of Nuclear Engineering, North Carolina State University, Burlington Engineering Laboratories, Raleigh, NC (United States)

2011-07-01

Alternative solution strategies to the parallel block Jacobi (PBJ) method for the solution of the global problem with the integral transport matrix method operators have been designed and tested. The most straightforward improvement to the Jacobi iterative method is the Gauss-Seidel alternative. The parallel red-black Gauss-Seidel (PGS) algorithm can improve on the number of iterations and reduce work per iteration by applying an alternating red-black color-set to the subdomains and assigning multiple sub-domains per processor. A parallel GMRES(m) method was implemented as an alternative to stationary iterations. Computational results show that the PGS method can improve on the PBJ method execution time by up to 10´ when eight sub-domains per processor are used. However, compared to traditional source iterations with diffusion synthetic acceleration, it is still approximately an order of magnitude slower. The best-performing cases are optically thick because sub-domains decouple, yielding faster convergence. Further tests revealed that 64 sub-domains per processor was the best performing level of sub-domain division. An acceleration technique that improves the convergence rate would greatly improve the ITMM. The GMRES(m) method with a diagonal block pre conditioner consumes approximately the same time as the PBJ solver but could be improved by an as yet undeveloped, more efficient pre conditioner. (author)

Improved parallel solution techniques for the integral transport matrix method

International Nuclear Information System (INIS)

Zerr, R. Joseph; Azmy, Yousry Y.

2011-01-01

Alternative solution strategies to the parallel block Jacobi (PBJ) method for the solution of the global problem with the integral transport matrix method operators have been designed and tested. The most straightforward improvement to the Jacobi iterative method is the Gauss-Seidel alternative. The parallel red-black Gauss-Seidel (PGS) algorithm can improve on the number of iterations and reduce work per iteration by applying an alternating red-black color-set to the subdomains and assigning multiple sub-domains per processor. A parallel GMRES(m) method was implemented as an alternative to stationary iterations. Computational results show that the PGS method can improve on the PBJ method execution time by up to 10´ when eight sub-domains per processor are used. However, compared to traditional source iterations with diffusion synthetic acceleration, it is still approximately an order of magnitude slower. The best-performing cases are optically thick because sub-domains decouple, yielding faster convergence. Further tests revealed that 64 sub-domains per processor was the best performing level of sub-domain division. An acceleration technique that improves the convergence rate would greatly improve the ITMM. The GMRES(m) method with a diagonal block pre conditioner consumes approximately the same time as the PBJ solver but could be improved by an as yet undeveloped, more efficient pre conditioner. (author)

Converging Technologies for Improving Human Performance: Integrating From the Nanoscale

International Nuclear Information System (INIS)

Roco, M.C.; Bainbridge, W.S.

2002-01-01

In the early decades of the twenty-first century, concentrated efforts can unify science based on the unity of nature, thereby advancing the combination of nanotechnology, biotechnology, information technology, and new humane technologies based in cognitive science. Converging technologies integrated from the nanoscale could determine a tremendous improvement in human abilities and societal outcomes. This is a broad, cross cutting, emerging, and timely opportunity of interest to individuals, society, and humanity in the long term.About eighty scientific leaders, industry experts, and policy makers across a range of fields have contributed to develop a vision for the potential to improve human physical, mental, and social capabilities through the convergence of the four technologies. Six major themes have emerged: (a) The broad potential of converging technologies; (b) Expanding human cognition and communication; (c) Improving human health and physical capabilities; (d) Enhancing group and societal outcomes; (e) National security, and (f) Unifying science and education. This article summarizes the observations, conclusions, and recommendations made in the report (Roco and Bainbridge, eds., 2002. Converging Technologies for Improving Human Performance, NSF-DOC Report, June 2002, Arlington VA, USA)

Self-reported Improvement in Side Effects and Quality of Life With Integrative Medicine in Breast Cancer Patients.

Science.gov (United States)

Hack, Carolin C; Hackl, Janina; Hüttner, Nina B M; Langemann, Hanna; Schwitulla, Judith; Dietzel-Drentwett, Svenja; Fasching, Peter A; Beckmann, Matthias W; Theuser, Anna-Katharin

2018-05-01

Although the demand from patients for integrative medicine is increasing, complementary medicine services are still quite heterogeneous and have not been incorporated into clinical routine. The aim of this study was to systematically evaluate improvements in side effects and quality of life associated with a hospital-based integrative medicine program in the modern breast cancer patient care setting. In a cross-sectional study, integrative health counseling and treatment were evaluated in women with breast cancer. Over a 15-month period, data for 75 patients from an integrative medicine consultancy service with standardized operating procedures were collected at the University Breast Center for Franconia. At baseline, the patients answered a questionnaire on their medical history, symptoms, and the treatment goals they were hoping to achieve with integrative medicine. In the follow-up, patient-reported outcomes related to side effects of conventional cancer treatment and patients' quality of life were analyzed. Among 60 patients with the therapy goal of reducing the side effects of conventional treatment, 46 (76.7%) were successful. Among 57 patients hoping to improve disease-related quality of life, 46 (82%) reported success. Whereas patients with metastatic disease achieved a reduction in the side effects of conventional therapy, quality-of-life improvements were predominantly achieved by patients with a good treatment prognosis. Breast cancer patients benefit from the counseling and treatment provided with integrative medicine in all phases of tumor disease. Integrative treatment services should be included as part of patient care in clinical routine work to offer patients the maximum quality of care and safety with complementary therapies.

An integrated management system to improve the performance of nuclear installations

Energy Technology Data Exchange (ETDEWEB)

Beckmerhagen, I.A.; Berg, H.P. [Bundesamt fur Strahlenschutz, Salzgitter (Germany)

2001-07-01

A integrated management system encompasses all management and assessment activities. The integration of DM, QM, safety management and occupational health into an integrated management system is shown for structures, systems and components of waste repositories because they have to fulfill reliability requirements derived from comprehensive safety assessments, and these structures, systems and components (such as transport vehicles and stacker trucks for the underground emplacement activities) are especially manufactured for this purpose and are not series products. QM institutes a QM system which ensures that there are clearly defined and auditable procedures. The requirements are written down in specifications or operation manuals and/or maintenance manuals. The QM system provides assurance that the installed structures, systems or components meet and continue to meet the prescribed goals with the help of DM and that safety management and occupational health specified requirements are fulfilled. DM focuses on the use of engineering analyses, assessments and methods to improve the design, specification, construction, dependability and operation of important systems, structures and components. (author)

An integrated management system to improve the performance of nuclear installations

International Nuclear Information System (INIS)

Beckmerhagen, I.A.; Berg, H.P.

2001-01-01

A integrated management system encompasses all management and assessment activities. The integration of DM, QM, safety management and occupational health into an integrated management system is shown for structures, systems and components of waste repositories because they have to fulfill reliability requirements derived from comprehensive safety assessments, and these structures, systems and components (such as transport vehicles and stacker trucks for the underground emplacement activities) are especially manufactured for this purpose and are not series products. QM institutes a QM system which ensures that there are clearly defined and auditable procedures. The requirements are written down in specifications or operation manuals and/or maintenance manuals. The QM system provides assurance that the installed structures, systems or components meet and continue to meet the prescribed goals with the help of DM and that safety management and occupational health specified requirements are fulfilled. DM focuses on the use of engineering analyses, assessments and methods to improve the design, specification, construction, dependability and operation of important systems, structures and components. (author)

An Integrated Care Initiative to Improve Patient Outcome in Schizophrenia

Directory of Open Access Journals (Sweden)

Norbert eMayer-Amberg

2016-01-01

Full Text Available The optimal treatment of schizophrenia patients requires integration of medical and psychosocial inputs. In Germany, various healthcare service providers and institutions are involved in the treatment process. Early and continuous treatment is important but often not possible because of the fragmented medical care system in Germany. The current work is a quality monitoring report of a novel care setting, called Integrated Care Initiative Schizophrenia. It has implemented a networked care concept in the German federal state of Lower Saxony that integrates various stakeholders of the health care system. In this initiative, office-based psychiatrists, specialised nursing staff, psychologists, social workers, hospitals, psychiatric institutional outpatient’s departments and other community-based mental health services work together in an interdisciplinary approach. Much emphasis is placed on psychoeducation. Additional efforts cover socio-therapy, visiting care, and family support. During the period from October 2010 (start of the initiative to December 2012, first experiences and results of quality indicators were collected of 713 registered patients and summarised in a quality monitoring report. In addition, standardised patient interviews were conducted, and duration of hospital days was recorded in 2013. By the end of 2012, patients had been enrolled for an average of 18.7 months. The overall patient satisfaction measured in a patient survey in June 2013 was high and the duration of hospital days measured in a pre-post analysis in July 2013 was reduced by 44%. Two years earlier than planned, the insurance fund will continue the successfully implemented integrated care initiative and adopt it in the regular care setting. This initiative can serve as a learning case for how to set up and measure integrated care systems that may improve outcomes for patients suffering from schizophrenia.

Integrating Quality and Safety Competencies to Improve Outcomes: Application in Infusion Therapy Practice.

Science.gov (United States)

Sherwood, Gwen; Nickel, Barbara

Despite intense scrutiny and process improvement initiatives, patient harm continues to occur in health care with alarming frequency. The Quality and Safety Education for Nursing (QSEN) project provides a roadmap to transform nursing by integrating 6 competencies: patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics. As front-line caregivers, nurses encounter inherent risks in their daily work. Infusion therapy is high risk with multiple potential risks for patient harm. This study examines individual and system application of the QSEN competencies and the Infusion Nurses Society's 2016 Infusion Therapy Standards of Practice in the improvement of patient outcomes.

Use of integral experiments to improve neutron propagation and gamma heating calculations

International Nuclear Information System (INIS)

Oceraies, Y.; Caumette, P.; Devillers, C.; Bussac, J.

1979-01-01

1) The studies to define and improve the accuracies of neutron propagation and gamma heating calculations from integral experiments are encompassed in the field of the fast reactor physics program at CEA. 2) A systematic analysis of neutron propagation in Fe-Na clean media, with variable volumic composition between 0 and 100% in sodium, has been performed on the HARMONIE source reactor. Gamma heating traverses in the core, the blankets and several control rods, have been measured in the R Z core program at MASURCA. The experimental techniques, the accuracies and the results obtained are given. The approximations of the calculational methods used to analyse these experiments and to predict the corresponding design parameters are also described. 3) Particular emphasis is given to the methods planned to improve fundamental data used in neutron propagation calculations, using the discrepancies observed between measured and calculated results in clean integral experiments. One of these approaches, similar to the techniques used in core physics, relies upon sensitivity studies and eventually on adjustment techniques applied to neutron propagation. (author)

NASA Remote Sensing Technologies for Improved Integrated Water Resources Management

Science.gov (United States)

Toll, D. L.; Doorn, B.; Searby, N. D.; Entin, J. K.; Lee, C. M.

2014-12-01

This presentation will emphasize NASA's water research, applications, and capacity building activities using satellites and models to contribute to water issues including water availability, transboundary water, flooding and droughts for improved Integrated Water Resources Management (IWRM). NASA's free and open exchange of Earth data observations and products helps engage and improve integrated observation networks and enables national and multi-national regional water cycle research and applications that are especially useful in data sparse regions of most developing countries. NASA satellite and modeling products provide a huge volume of valuable data extending back over 50 years across a broad range of spatial (local to global) and temporal (hourly to decadal) scales and include many products that are available in near real time (see earthdata.nasa.gov). To further accomplish these objectives NASA works to actively partner with public and private groups (e.g. federal agencies, universities, NGO's, and industry) in the U.S. and international community to ensure the broadest use of its satellites and related information and products and to collaborate with regional end users who know the regions and their needs best. Key objectives of this talk will highlight NASA's Water Resources and Capacity Building Programs with their objective to discover and demonstrate innovative uses and practical benefits of NASA's advanced system technologies for improved water management in national and international applications. The event will help demonstrate the strong partnering and the use of satellite data to provide synoptic and repetitive spatial coverage helping water managers' deal with complex issues. The presentation will also demonstrate how NASA is a major contributor to water tasks and activities in GEOSS (Global Earth Observing System of Systems) and GEO (Group on Earth Observations).

Performance improvement based on integrated quality management models : What evidence do we have? A systematic literature review

NARCIS (Netherlands)

Minkman, Mirella; Ahaus, Kees; Huijsman, Robbert

Purpose. Health care organizations have to improve their performance for multiple stakeholders and organize integrated care. To facilitate this, various integrated quality management models can be used. This article reviews the literature on the Malcolm Baldrige Quality Award (MBQA) criteria, the

Performance improvement based on integrated quality management models: What evidence do we have? A systematic literature review

NARCIS (Netherlands)

M.M.N. Minkman (Mirella); C.T.B. Ahaus (Kees); R. Huijsman (Robbert)

2007-01-01

textabstractPurpose. Health care organizations have to improve their performance for multiple stakeholders and organize integrated care. To facilitate this, various integrated quality management models can be used. This article reviews the literature on the Malcolm Baldrige Quality Award (MBQA)

Integrating clinical performance improvement across physician organizations: the PhyCor experience.

Science.gov (United States)

Loeppke, R; Howell, J W

1999-02-01

There is a paucity of literature describing the implementation of clinical performance improvement (CPI) efforts across geographically dispersed multispecialty group practices and independent practice associations. PhyCor, a physician management company based in Nashville, Tennessee, has integrated CPI initiatives into its operating infrastructure. PhyCor CPI INITIATIVES: The strategic framework guiding PhyCor's CPI initiatives is built around a physician-driven, patient-centered model. Physician/administrator leadership teams develop and implement a clinical and financial strategic plan for performance improvement; adopt local clinical and operational performance indicators; and agree on and gain consensus with local physician champions to engage in CPI initiatives. The area/regional leadership councils integrate and coordinate regional medical management and CPI initiatives among local groups and independent practice associations. In addition to these councils and a national leadership council, condition-specific care management councils have also been established. These councils develop condition-specific protocols and outcome measures and lead the implementation of CPI initiatives at their own clinics. Key resources supporting CPI initiatives include information/knowledge management, education and training, and patient education and consumer decision support. Localized efforts in both the asthma care and diabetes management initiatives have led to some preliminary improvements in quality of care indicators. Physician leadership and strategic vision, CPI-oriented organizational infrastructure, broad-based physician involvement in CPI, providing access to performance data, parallel incentives, and creating a sense of urgency for accelerated change are all critical success factors to the implementation of CPI strategies at the local, regional, and national levels.

Intensive care unit nurses' information needs and recommendations for integrated displays to improve nurses' situation awareness.

Science.gov (United States)

Koch, Sven H; Weir, Charlene; Haar, Maral; Staggers, Nancy; Agutter, Jim; Görges, Matthias; Westenskow, Dwayne

2012-01-01

Fatal errors can occur in intensive care units (ICUs). Researchers claim that information integration at the bedside may improve nurses' situation awareness (SA) of patients and decrease errors. However, it is unclear which information should be integrated and in what form. Our research uses the theory of SA to analyze the type of tasks, and their associated information gaps. We aimed to provide recommendations for integrated, consolidated information displays to improve nurses' SA. Systematic observations methods were used to follow 19 ICU nurses for 38 hours in 3 clinical practice settings. Storyboard methods and concept mapping helped to categorize the observed tasks, the associated information needs, and the information gaps of the most frequent tasks by SA level. Consensus and discussion of the research team was used to propose recommendations to improve information displays at the bedside based on information deficits. Nurses performed 46 different tasks at a rate of 23.4 tasks per hour. The information needed to perform the most common tasks was often inaccessible, difficult to see at a distance or located on multiple monitoring devices. Current devices at the ICU bedside do not adequately support a nurse's information-gathering activities. Medication management was the most frequent category of tasks. Information gaps were present at all levels of SA and across most of the tasks. Using a theoretical model to understand information gaps can aid in designing functional requirements. Integrated information that enhances nurses' Situation Awareness may decrease errors and improve patient safety in the future.

A CMOS microdisplay with integrated controller utilizing improved silicon hot carrier luminescent light sources

Science.gov (United States)

Venter, Petrus J.; Alberts, Antonie C.; du Plessis, Monuko; Joubert, Trudi-Heleen; Goosen, Marius E.; Janse van Rensburg, Christo; Rademeyer, Pieter; Fauré, Nicolaas M.

2013-03-01

Microdisplay technology, the miniaturization and integration of small displays for various applications, is predominantly based on OLED and LCoS technologies. Silicon light emission from hot carrier electroluminescence has been shown to emit light visibly perceptible without the aid of any additional intensification, although the electrical to optical conversion efficiency is not as high as the technologies mentioned above. For some applications, this drawback may be traded off against the major cost advantage and superior integration opportunities offered by CMOS microdisplays using integrated silicon light sources. This work introduces an improved version of our previously published microdisplay by making use of new efficiency enhanced CMOS light emitting structures and an increased display resolution. Silicon hot carrier luminescence is often created when reverse biased pn-junctions enter the breakdown regime where impact ionization results in carrier transport across the junction. Avalanche breakdown is typically unwanted in modern CMOS processes. Design rules and process design are generally tailored to prevent breakdown, while the voltages associated with breakdown are too high to directly interact with the rest of the CMOS standard library. This work shows that it is possible to lower the operating voltage of CMOS light sources without compromising the optical output power. This results in more efficient light sources with improved interaction with other standard library components. This work proves that it is possible to create a reasonably high resolution microdisplay while integrating the active matrix controller and drivers on the same integrated circuit die without additional modifications, in a standard CMOS process.

Improved bacteriophage genome data is necessary for integrating viral and bacterial ecology.

Science.gov (United States)

Bibby, Kyle

2014-02-01

The recent rise in "omics"-enabled approaches has lead to improved understanding in many areas of microbial ecology. However, despite the importance that viruses play in a broad microbial ecology context, viral ecology remains largely not integrated into high-throughput microbial ecology studies. A fundamental hindrance to the integration of viral ecology into omics-enabled microbial ecology studies is the lack of suitable reference bacteriophage genomes in reference databases-currently, only 0.001% of bacteriophage diversity is represented in genome sequence databases. This commentary serves to highlight this issue and to promote bacteriophage genome sequencing as a valuable scientific undertaking to both better understand bacteriophage diversity and move towards a more holistic view of microbial ecology.

Improving yeast strains using recyclable integration cassettes, for the production of plant terpenoids

Directory of Open Access Journals (Sweden)

Johnson Christopher B

2011-01-01

Full Text Available Abstract Background Terpenoids constitute a large family of natural products, attracting commercial interest for a variety of uses as flavours, fragrances, drugs and alternative fuels. Saccharomyces cerevisiae offers a versatile cell factory, as the precursors of terpenoid biosynthesis are naturally synthesized by the sterol biosynthetic pathway. Results S. cerevisiae wild type yeast cells, selected for their capacity to produce high sterol levels were targeted for improvement aiming to increase production. Recyclable integration cassettes were developed which enable the unlimited sequential integration of desirable genetic elements (promoters, genes, termination sequence at any desired locus in the yeast genome. The approach was applied on the yeast sterol biosynthetic pathway genes HMG2, ERG20 and IDI1 resulting in several-fold increase in plant monoterpene and sesquiterpene production. The improved strains were robust and could sustain high terpenoid production levels for an extended period. Simultaneous plasmid-driven co-expression of IDI1 and the HMG2 (K6R variant, in the improved strain background, maximized monoterpene production levels. Expression of two terpene synthase enzymes from the sage species Salvia fruticosa and S. pomifera (SfCinS1, SpP330 in the modified yeast cells identified a range of terpenoids which are also present in the plant essential oils. Co-expression of the putative interacting protein HSP90 with cineole synthase 1 (SfCinS1 also improved production levels, pointing to an additional means to improve production. Conclusions Using the developed molecular tools, new yeast strains were generated with increased capacity to produce plant terpenoids. The approach taken and the durability of the strains allow successive rounds of improvement to maximize yields.

Sharing is caring: The potential of the sharing economy to support aging in place.

Science.gov (United States)

Miller, Julie; Ward, Carley; Lee, Chaiwoo; D'Ambrosio, Lisa; Coughlin, Joseph

2018-01-24

This article explores innovative applications of sharing economy services that have the potential to support a population aging in place, especially the "oldest old," aged 85 and older, and their caregivers. A mixed-methods study conducted by the MIT AgeLab examined perceptions of and experiences with sharing economy services, ultimately finding opportunities and barriers to use. Thus, although sharing economy services have potential to support aging in place, to do so successfully will require reconstructing how older adults, family caregivers, aging service professionals, gerontology educators, and gerontology students conceptualize and deliver care to an aging population. We suggest examples for gerontology educators to integrate into their classrooms to further cultivate an appreciation among students of multiple approaches to intervention, including those that leverage sharing economy and technology-enabled platforms to support older adults and their caregivers.

A data-model integration approach toward improved understanding on wetland functions and hydrological benefits at the catchment scale

Science.gov (United States)

Yeo, I. Y.; Lang, M.; Lee, S.; Huang, C.; Jin, H.; McCarty, G.; Sadeghi, A.

2017-12-01

The wetland ecosystem plays crucial roles in improving hydrological function and ecological integrity for the downstream water and the surrounding landscape. However, changing behaviours and functioning of wetland ecosystems are poorly understood and extremely difficult to characterize. Improved understanding on hydrological behaviours of wetlands, considering their interaction with surrounding landscapes and impacts on downstream waters, is an essential first step toward closing the knowledge gap. We present an integrated wetland-catchment modelling study that capitalizes on recently developed inundation maps and other geospatial data. The aim of the data-model integration is to improve spatial prediction of wetland inundation and evaluate cumulative hydrological benefits at the catchment scale. In this paper, we highlight problems arising from data preparation, parameterization, and process representation in simulating wetlands within a distributed catchment model, and report the recent progress on mapping of wetland dynamics (i.e., inundation) using multiple remotely sensed data. We demonstrate the value of spatially explicit inundation information to develop site-specific wetland parameters and to evaluate model prediction at multi-spatial and temporal scales. This spatial data-model integrated framework is tested using Soil and Water Assessment Tool (SWAT) with improved wetland extension, and applied for an agricultural watershed in the Mid-Atlantic Coastal Plain, USA. This study illustrates necessity of spatially distributed information and a data integrated modelling approach to predict inundation of wetlands and hydrologic function at the local landscape scale, where monitoring and conservation decision making take place.

Improving Land Use/Land Cover Classification by Integrating Pixel Unmixing and Decision Tree Methods

Directory of Open Access Journals (Sweden)

Chao Yang

2017-11-01

Full Text Available Decision tree classification is one of the most efficient methods for obtaining land use/land cover (LULC information from remotely sensed imageries. However, traditional decision tree classification methods cannot effectively eliminate the influence of mixed pixels. This study aimed to integrate pixel unmixing and decision tree to improve LULC classification by removing mixed pixel influence. The abundance and minimum noise fraction (MNF results that were obtained from mixed pixel decomposition were added to decision tree multi-features using a three-dimensional (3D Terrain model, which was created using an image fusion digital elevation model (DEM, to select training samples (ROIs, and improve ROI separability. A Landsat-8 OLI image of the Yunlong Reservoir Basin in Kunming was used to test this proposed method. Study results showed that the Kappa coefficient and the overall accuracy of integrated pixel unmixing and decision tree method increased by 0.093% and 10%, respectively, as compared with the original decision tree method. This proposed method could effectively eliminate the influence of mixed pixels and improve the accuracy in complex LULC classifications.

Improved Integral Attacks on SIMON32 and SIMON48 with Dynamic Key-Guessing Techniques

Directory of Open Access Journals (Sweden)

Zhihui Chu

2018-01-01

Full Text Available Dynamic key-guessing techniques, which exploit the property of AND operation, could improve the differential and linear cryptanalytic results by reducing the number of guessed subkey bits and lead to good cryptanalytic results for SIMON. They have only been applied in differential and linear attacks as far as we know. In this paper, dynamic key-guessing techniques are first introduced in integral cryptanalysis. According to the features of integral cryptanalysis, we extend dynamic key-guessing techniques and get better integral cryptanalysis results than before. As a result, we present integral attacks on 24-round SIMON32, 24-round SIMON48/72, and 25-round SIMON48/96. In terms of the number of attacked rounds, our attack on SIMON32 is better than any previously known attacks, and our attacks on SIMON48 are the same as the best attacks.

Biomass pre-extraction, hydrolysis and conversion process improvements fro an integrated biorefinery

Energy Technology Data Exchange (ETDEWEB)

Jansen, Robert [Virdia, Inc., Danville, VA (United States)

2014-12-23

In this project, Virdia will show that it can improve the production of sugars suitable for the conversion into advanced biofuels from a range of woods. Several biomass feedstocks (Pine wood chips & Eucalyptus wood chips) will be tested on this new integrated biorefinery platform. The resultant drop-in biodiesel can be a cost-effective petroleum-replacement that can compete with projected market prices

An integrative conceptual framework of disability. New directions for research.

Science.gov (United States)

Tate, Denise G; Pledger, Constance

2003-04-01

Advances in research on disability and rehabilitation are essential to creating equal opportunity, economic self-sufficiency, and full participation for persons with disabilities. Historically, such initiatives have focused on separate and specific areas, including neuroscience, molecular biology and genetics, gerontology, engineering and physical sciences, and social and behavioral sciences. Research on persons with disabilities should examine the broader context and trends of society that affect the total environment of persons with disabilities. This article examines the various disability paradigms across time, assessing the relative contribution of the socioecological perspective in guiding research designed to improve the lives of persons with disabilities. The authors recommend new research directions that include a focus on life span issues, biomedicine, biotechnology, the efficacy and effectiveness of current interventions, an emphasis on consumer-driven investigations within a socioecological perspective of disability, and the implications for research and practice.

Promoting employee health by integrating health protection, health promotion, and continuous improvement: a longitudinal quasi-experimental intervention study.

Science.gov (United States)

von Thiele Schwarz, Ulrica; Augustsson, Hanna; Hasson, Henna; Stenfors-Hayes, Terese

2015-02-01

To test the effects of integrating health protection and health promotion with a continuous improvement system (Kaizen) on proximal employee outcomes (health promotion, integration, and Kaizen) and distal outcomes (workability, productivity, self-rated health and self-rated sickness absence). Twelve units in a county hospital in Sweden were randomized to control or intervention groups using a quasiexperimental study design. All staff (approximately 500) provided self-ratings in questionnaires at baseline, and a 12- and 24-month follow-up (response rate, 79% to 87.5%). There was a significant increase in the proximal outcomes over time in the intervention group compared with the control group, and a trend toward improvement in the distal outcomes workability and productivity. Integration seems to promote staff engagement in health protection and promotion, as well as to improve their understanding of the link between work and health.

An integrated approach for developing a technology strategy framework for small- to medium-sized furniture manufacturers to improve competitiveness

Directory of Open Access Journals (Sweden)

Lourens, A.S.

2013-05-01

Full Text Available Low-technology firms, such as those found within the furniture manufacturing industry, have no framework or methodology to guide them successfully to acquire and integrate technology that enables them to operate more competitively. The aim of this article is to illustrate the development of a technology strategy framework for small- to medium-sized furniture manufacturers to assist them to improve their competitiveness. More specifically, this article presents an integrated technology strategy framework that enables management to integrate their business strategy with their technology requirements successfully, thus improving competitiveness.

MetaMeta: integrating metagenome analysis tools to improve taxonomic profiling.

Science.gov (United States)

Piro, Vitor C; Matschkowski, Marcel; Renard, Bernhard Y

2017-08-14

Many metagenome analysis tools are presently available to classify sequences and profile environmental samples. In particular, taxonomic profiling and binning methods are commonly used for such tasks. Tools available among these two categories make use of several techniques, e.g., read mapping, k-mer alignment, and composition analysis. Variations on the construction of the corresponding reference sequence databases are also common. In addition, different tools provide good results in different datasets and configurations. All this variation creates a complicated scenario to researchers to decide which methods to use. Installation, configuration and execution can also be difficult especially when dealing with multiple datasets and tools. We propose MetaMeta: a pipeline to execute and integrate results from metagenome analysis tools. MetaMeta provides an easy workflow to run multiple tools with multiple samples, producing a single enhanced output profile for each sample. MetaMeta includes a database generation, pre-processing, execution, and integration steps, allowing easy execution and parallelization. The integration relies on the co-occurrence of organisms from different methods as the main feature to improve community profiling while accounting for differences in their databases. In a controlled case with simulated and real data, we show that the integrated profiles of MetaMeta overcome the best single profile. Using the same input data, it provides more sensitive and reliable results with the presence of each organism being supported by several methods. MetaMeta uses Snakemake and has six pre-configured tools, all available at BioConda channel for easy installation (conda install -c bioconda metameta). The MetaMeta pipeline is open-source and can be downloaded at: https://gitlab.com/rki_bioinformatics .

A strategic approach to quality improvement and patient safety education and resident integration in a general surgery residency.

Science.gov (United States)

O'Heron, Colette T; Jarman, Benjamin T

2014-01-01

To outline a structured approach for general surgery resident integration into institutional quality improvement and patient safety education and development. A strategic plan to address Accreditation Council for Graduate Medical Education (ACGME) Clinical Learning Environment Review assessments for resident integration into Quality Improvement and Patient Safety initiatives is described. Gundersen Lutheran Medical Foundation is an independent academic medical center graduating three categorical residents per year within an integrated multi-specialty health system serving 19 counties over 3 states. The quality improvement and patient safety education program includes a formal lecture series, online didactic sessions, mandatory quality improvement or patient safety projects, institutional committee membership, an opportunity to serve as a designated American College of Surgeons National Surgical Quality Improvement Project and Quality in Training representative, mandatory morbidity and mortality conference attendance and clinical electives in rural surgery and international settings. Structured education regarding and participation in quality improvement and patient safety programs are able to be accomplished during general surgery residency. The long-term outcomes and benefits of these strategies are unknown at this time and will be difficult to measure with objective data. © 2013 Published by Association of Program Directors in Surgery on behalf of Association of Program Directors in Surgery.

An improved PIN photodetector with integrated JFET on high-resistivity silicon

International Nuclear Information System (INIS)

Dalla Betta, Gian-Franco; Piemonte, Claudio; Boscardin, Maurizio; Gregori, Paolo; Zorzi, Nicola; Fazzi, Alberto; Pignatel, Giorgio U.

2006-01-01

We report on a PIN photodetector integrated with a Junction Field Effect Transistor (JFET) on a high-resistivity silicon substrate. Owing to a modified fabrication technology, the electrical and noise characteristics of the JFET transistor have been enhanced with respect to the previous versions of the device, allowing the performance to be significantly improved. In this paper, the main design and technological aspects relevant to the proposed structure are addressed and experimental results from the electrical characterization are discussed

Gerontology across the professions and the Atlantic: Development and evaluation of an interprofessional and international course on aging and health.

Science.gov (United States)

Clark, Phillip G; Weeks, Lori E; van Den Bergh, Graziella; Doucet, Shelley

2017-01-01

The need for interprofessional teamwork and the global challenges for health care systems of dramatically increasing numbers of older adults have received increased recognition in gerontological and geriatrics education. The authors report on the pilot development of a hybrid course on aging and health for graduate-level health professions students from Norway, Canada, and the United States. International faculty from partnering universities developed, taught, and evaluated the course. Course assignments included online forum postings, reflections, and a problem-based learning group assignment and presentation. Directed readings and discussion included topics related to health care systems and services in the three participating countries, teamwork, and patient-centered care. To evaluate the course, quantitative and qualitative data were collected and analyzed. Results indicate a significant impact on student learning outcomes, including understanding of issues in international aging and health, attitudes and skills in teamwork, and application to clinical practice. This course clearly established the importance of developing innovative interprofessional educational experiences that respond to the increasingly universal impacts of aging populations on health and social care systems around the world.

Preparing Future Leaders: An Integrated Quality Improvement Residency Curriculum.

Science.gov (United States)

Potts, Stacy; Shields, Sara; Upshur, Carole

2016-06-01

The Accreditation Council for Graduate Medical Education (ACGME) has recognized the importance of quality improvement (QI) training and requires that accredited residencies in all specialties demonstrate that residents are "integrated and actively participate in interdisciplinary clinical quality improvement and patient safety activities." However, competing demands in residency training may make this difficult to accomplish. The study's objective is to develop and evaluate a longitudinal curriculum that meets the ACGME requirement for QI and patient safety training and links to patient-centered medical home (PCMH) practices. Residents in the Worcester Family Medicine Residency (WFMR) participated in a faculty-developed quality improvement curriculum that included web-based tutorials, quality improvement projects, and small-group sessions across all 3 years of residency. They completed self-evaluations of knowledge and use of curricular activities annually and at graduation, and comparisons were made between two graduating classes, as well as comparison of end of PGY2 to end of PGY3 for one class. Graduating residents who completed the full 3 years of the curriculum rated themselves as significantly more skilled in nine of 15 areas assessed at end of residency compared to after PGY2 and reported confidence in providing future leadership in a focus group. Five areas were also rated significantly higher than prior-year residents. Involving family medicine residents in a longitudinal curriculum with hands-on practice in implementing QI, patient safety, and chronic illness management activities that are inclusive of PCMH goals increased their self-perceived skills and leadership ability to implement these new and emerging evidence-based practices in primary care.

Integrated IoT technology in industrial lasers for the improved user experience

Science.gov (United States)

Ding, Jianwu; Liu, Jinhui

2018-02-01

The end users' biggest concern for any industrial equipment is the reliability and the service down-time. This is especially true for industrial lasers as they are typically used in fully or semi- automated processes. Here we demonstrate how to use the integrated Internet of Things (IoT) technology in industrial lasers to address the reliability and the service down-time so to improve end users' experience.

Clinical and Educational Outcomes of an Integrated Inpatient Quality Improvement Curriculum for Internal Medicine Residents.

Science.gov (United States)

Ogrinc, Greg; Cohen, Emily S; van Aalst, Robertus; Harwood, Beth; Ercolano, Ellyn; Baum, Karyn D; Pattison, Adam J; Jones, Anne C; Davies, Louise; West, Al

2016-10-01

Integrating teaching and hands-on experience in quality improvement (QI) may increase the learning and the impact of resident QI work. We sought to determine the clinical and educational impact of an integrated QI curriculum. This clustered, randomized trial with early and late intervention groups used mixed methods evaluation. For almost 2 years, internal medicine residents from Dartmouth-Hitchcock Medical Center on the inpatient teams at the White River Junction VA participated in the QI curriculum. QI project effectiveness was assessed using statistical process control. Learning outcomes were assessed with the Quality Improvement Knowledge Application Tool-Revised (QIKAT-R) and through self-efficacy, interprofessional care attitudes, and satisfaction of learners. Free text responses by residents and a focus group of nurses who worked with the residents provided information about the acceptability of the intervention. The QI projects improved many clinical processes and outcomes, but not all led to improvements. Educational outcome response rates were 65% (68 of 105) at baseline, 50% (18 of 36) for the early intervention group at midpoint, 67% (24 of 36) for the control group at midpoint, and 53% (42 of 80) for the late intervention group. Composite QIKAT-R scores (range, 0-27) increased from 13.3 at baseline to 15.3 at end point ( P  < .01), as did the self-efficacy composite score ( P  < .05). Satisfaction with the curriculum was rated highly by all participants. Learning and participating in hands-on QI can be integrated into the usual inpatient work of resident physicians.

Action Research for Improving the Effectiveness of Technology Integration in Preservice Teacher Education

Science.gov (United States)

Kuo, Nai-Cheng

2015-01-01

This study aims at exploring how the Technological Pedagogical and Content Knowledge (TPACK) framework can be used to improve the effectiveness of integrating IDEA '04 and Research for Inclusive Settings (IRIS) modules in preservice teacher education. The purposes of this study were to maximize the potential of TPACK at the college and university…

The interrelationship between environmental goals, productivity improvement, and increased energy efficiency in integrated paper and steel plants

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-06-01

This report presents the results of an investigation into the interrelationships between plant-level productivity, energy efficiency, and environmental improvements for integrated pulp and paper mills and integrated steel mills in the US. Integrated paper and steel plants are defined as those facilities that use some form of onsite raw material to produce final products (for example, paper and paperboard or finished steel). Fully integrated pulp and paper mills produce onsite the pulp used to manufacture paper from virgin wood fiber, secondary fiber, or nonwood fiber. Fully integrated steel mills process steel from coal, iron ore, and scrap inputs and have onsite coke oven facilities.

Integrating adaptive management and ecosystem services concepts to improve natural resource management: Challenges and opportunities

Science.gov (United States)

Epanchin-Niell, Rebecca S.; Boyd, James W.; Macauley, Molly K.; Scarlett, Lynn; Shapiro, Carl D.; Williams, Byron K.

2018-05-07

Executive Summary—OverviewNatural resource managers must make decisions that affect broad-scale ecosystem processes involving large spatial areas, complex biophysical interactions, numerous competing stakeholder interests, and highly uncertain outcomes. Natural and social science information and analyses are widely recognized as important for informing effective management. Chief among the systematic approaches for improving the integration of science into natural resource management are two emergent science concepts, adaptive management and ecosystem services. Adaptive management (also referred to as “adaptive decision making”) is a deliberate process of learning by doing that focuses on reducing uncertainties about management outcomes and system responses to improve management over time. Ecosystem services is a conceptual framework that refers to the attributes and outputs of ecosystems (and their components and functions) that have value for humans.This report explores how ecosystem services can be moved from concept into practice through connection to a decision framework—adaptive management—that accounts for inherent uncertainties. Simultaneously, the report examines the value of incorporating ecosystem services framing and concepts into adaptive management efforts.Adaptive management and ecosystem services analyses have not typically been used jointly in decision making. However, as frameworks, they have a natural—but to date underexplored—affinity. Both are policy and decision oriented in that they attempt to represent the consequences of resource management choices on outcomes of interest to stakeholders. Both adaptive management and ecosystem services analysis take an empirical approach to the analysis of ecological systems. This systems orientation is a byproduct of the fact that natural resource actions affect ecosystems—and corresponding societal outcomes—often across large geographic scales. Moreover, because both frameworks focus on

Improved integrability of the gradients of solutions of elliptic equations with variable nonlinearity exponent

International Nuclear Information System (INIS)

Zhikov, Vasilii V; Pastukhova, Svetlana E

2008-01-01

Elliptic equations of p(x)-Laplacian type are investigated. There is a well-known logarithmic condition on the modulus of continuity of the nonlinearity exponent p(x), which ensures that a Laplacian with variable order of nonlinearity inherits many properties of the usual p-Laplacian of constant order. One of these is the so-called improved integrability of the gradient of the solution. It is proved in this paper that this property holds also under a slightly more general condition on the exponent p(x), although then the improvement of integrability is logarithmic rather than power-like. The method put forward is based on a new generalization of Gehring's lemma, which relies upon the reverse Hoelder inequality 'with increased support and exponent on the right-hand side'. A counterexample is constructed that reveals the extent to which the condition on the modulus of continuity obtained is sharp. Bibliography: 28 titles.

Integrated Practice Improvement Solutions-Practical Steps to Operating Room Management.

Science.gov (United States)

Chernov, Mikhail; Pullockaran, Janet; Vick, Angela; Leyvi, Galina; Delphin, Ellise

2016-10-01

Perioperative productivity is a vital concern for surgeons, anesthesiologists, and administrators as the OR is a major source of hospital elective admissions and revenue. Based on elements of existing Practice Improvement Methodologies (PIMs), "Integrated Practice Improvement Solutions" (IPIS) is a practical and simple solution incorporating aspects of multiple management approaches into a single open source framework to increase OR efficiency and productivity by better utilization of existing resources. OR efficiency was measured both before and after IPIS implementation using the total number of cases versus room utilization, OR/anesthesia revenue and staff overtime (OT) costs. Other parameters of efficiency, such as the first case on-time start and the turnover time (TOT) were measured in parallel. IPIS implementation resulted in increased numbers of surgical procedures performed by an average of 10.7%, and OR and anesthesia revenue increases of 18.5% and 6.9%, respectively, with a simultaneous decrease in TOT (15%) and OT for anesthesia staff (26%). The number of perioperative adverse events was stable during the two-year study period which involved a total of 20,378 patients. IPIS, an effective and flexible practice improvement model, was designed to quickly, significantly, and sustainably improve OR efficiency by better utilization of existing resources. Success of its implementation directly correlates with the involvement of and acceptance by the entire OR team and hospital administration.

Study on the Accuracy Improvement of the Second-Kind Fredholm Integral Equations by Using the Buffa-Christiansen Functions with MLFMA

Directory of Open Access Journals (Sweden)

Yue-Qian Wu

2016-01-01

Full Text Available Former works show that the accuracy of the second-kind integral equations can be improved dramatically by using the rotated Buffa-Christiansen (BC functions as the testing functions, and sometimes their accuracy can be even better than the first-kind integral equations. When the rotated BC functions are used as the testing functions, the discretization error of the identity operators involved in the second-kind integral equations can be suppressed significantly. However, the sizes of spherical objects which were analyzed are relatively small. Numerical capability of the method of moments (MoM for solving integral equations with the rotated BC functions is severely limited. Hence, the performance of BC functions for accuracy improvement of electrically large objects is not studied. In this paper, the multilevel fast multipole algorithm (MLFMA is employed to accelerate iterative solution of the magnetic-field integral equation (MFIE. Then a series of numerical experiments are performed to study accuracy improvement of MFIE in perfect electric conductor (PEC cases with the rotated BC as testing functions. Numerical results show that the effect of accuracy improvement by using the rotated BC as the testing functions is greatly different with curvilinear or plane triangular elements but falls off when the size of the object is large.

Improving basic math skills through integrated dynamic representation strategies.

Science.gov (United States)

González-Castro, Paloma; Cueli, Marisol; Cabeza, Lourdes; Álvarez-García, David; Rodríguez, Celestino

2014-01-01

In this paper, we analyze the effectiveness of the Integrated Dynamic Representation strategy (IDR) to develop basic math skills. The study involved 72 students, aged between 6 and 8 years. We compared the development of informal basic skills (numbers, comparison, informal calculation, and informal concepts) and formal (conventionalisms, number facts, formal calculus, and formal concepts) in an experimental group (n = 35) where we applied the IDR strategy and in a Control group (n = 37) in order to identify the impact of the procedure. The experimental group improved significantly in all variables except for number facts and formal calculus. It can therefore be concluded that IDR favors the development of the skills more closely related to applied mathematics than those related to automatic mathematics and mental arithmetic.

Some Improvements of Conformable Fractional Integral Inequalities

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Fuat Usta

2017-07-01

Full Text Available In this study, we wish to set up and present some new conformable fractional integral inequalities of the Gronwall type which have a great variety of implementation area in differential and integral equations.

Learning to Learn: towards a Relational and Transformational Model of Learning for Improved Integrated Care Delivery

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John Diamond

2013-06-01

Full Text Available Health and social care systems are implementing fundamental changes to organizational structures and work practices in an effort to achieve integrated care. While some integration initiatives have produced positive outcomes, many have not. We reframe the concept of integration as a learning process fueled by knowledge exchange across diverse professional and organizational communities. We thus focus on the cognitive and social dynamics of learning in complex adaptive systems, and on learning behaviours and conditions that foster collective learning and improved collaboration. We suggest that the capacity to learn how to learn shapes the extent to which diverse professional groups effectively exchange knowledge and self-organize for integrated care delivery.

Missing Link: Integrated Individual Leadership Development, Employee Engagement, and Customer Value-Added Improvement

Science.gov (United States)

Heldenbrand, Lois; Simms, Michael S.

2012-01-01

Long-term care is a key public issue that affects all of us in some way at some time of our lives. Nowhere is performance improvement and quality management more imperative. Through an 8-month field study and follow-up case study, we discuss how using an integrated approach to individual leadership development, employee engagement, and customer…

Integration of social media with healthcare big data for improved service delivery

Directory of Open Access Journals (Sweden)

Sibulela Mgudlwa

2018-04-01

Full Text Available Background: In the last decade, social media users across the world have crossed 1 billion, making it one of the fastest growing sources of big data. Also, people needing healthcare continue to increase in every society. Through accessibility, communication and interaction between health practitioners and patients, this type of ever-growing, social media subscriber–based platform can be of significant use in improving healthcare delivery to society. However, users encounter serious challenges in their attempts to make use of social media and big data for health-related services. The challenges are primarily caused by factors such as integration, complexity, security and privacy. The challenges are mainly owing to the sensitive nature of the healthcare environment, as a result of personalisation and privacy of information.   Objectives: The objectives of the study were to examine and gain a better understanding of the complexities that are associated with the use of social media and healthcare big data, through influencing factors, and to develop a framework that can be used to improve health-related services to the patients.   Methods: The interpretivist approach was employed, within which qualitative data were collected. This included documents and existing literature in the areas of social media and healthcare big data. To have a good spread of both previous and current state of events within the phenomena being studied, literature published between 2006 and 2016 were gathered. The data were interpretively analysed.   Results: Based on the analysis of the data, factors of influence were found, which were used to develop a model. The model illustrates how the factors of influence can enable and at the same time constrain the use of social media for healthcare services. The factors were interpreted from which a framework was developed. The framework is intended to guide integration of social media with healthcare big data through which

The innovation and practice of management improved by integration management information system in nuclear enterprise

International Nuclear Information System (INIS)

Zhang Fan; Cheng Lihong; Li Qisheng; Ge Zhengfa

2012-01-01

This article expounds that Hunan Taohuajiang Nuclear Power Company generally programs the route of company's core business and implements its integration through referencing the experience of informationization construction of other enterprises at the beginning of the foundation of this company, and summarizes the experience of system construction and analyses the innovation and signification of the integrative management information system to the nu- clear power enterprise management from data unified, resources sharing and business electronic and the management improvement of this company. (authors)

Conceptos básicos de enfermería en la atención gerontológica según el Modelo V. Henderson Basic concepts of nursing in gerontological care following V. Henderson's Model

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Fina Vernet Aguiló

2007-06-01

Full Text Available La atención a la salud de las personas ancianas es actualmente un ámbito extraordinariamente dinámico y cambiante, tanto en lo referente a las necesidades de los clientes, como en los requerimientos profesionales necesarios para dar respuestas adecuadas en un medio extremadamente permeable a los acontecimientos científicos, legales, familiares, sanitarios, políticos, etc. Dentro del equipo multidisciplinar, en los ambitos específicos de atención gerontológica y a la comunidad, la enfermera es el líder indiscutible del equipo, ya que es el único profesional preparado y entrenado para trabajar según un plan de cuidados integral enfocado a la persona. Los modelos de enfermería nos aportan el sistema de valores desde el cual la enfermera afronta su rol, evalúa los problemas de salud y planifica sus objetivos específicos, desde el rol autónomo y desde el rol de colaboración con otros profesionales de la salud. El Modelo Henderson, sus valores y postulados se adaptan muy especialmente a la atención gerontológica y lo hacen comprensible y compatible con los objetivos interdisciplinarios, reforzando el liderazgo de la enfermera dentro del equipo de atención. El objetivo de este trabajo es aportar una visión gerontológica de los conceptos básicos del Modelo Henderson y del proceso de atención de enfermería, basados en la reflexión sobre la práctica clínica.Nowadays, elderly people care has become an extremely dynamic field as it is changing both in the patient's needs and in the professional requests needed to provide the right answers in a modern environment, which is extremely linked to scientific, legal, familiar, health and political changes. Within the multidisciplinary team in the specific fields of gerontology and community care, the nurse is the unquestionable leader, as this is the only qualified professional who is trained to follow a whole care plan aimed at every patient. Nursing models give us the system of values

Integration of solar thermal for improved energy efficiency in low-temperature-pinch industrial processes

International Nuclear Information System (INIS)

Atkins, Martin J.; Walmsley, Michael R.W.; Morrison, Andrew S.

2010-01-01

Solar thermal systems have the potential to provide renewable industrial process heat and are especially suited for low pinch temperature processes such as those in the food, beverage, and textile sectors. When correctly integrated within an industrial process, they can provide significant progress towards both increased energy efficiency and reduction in emissions. However, the integration of renewable solar energy into industrial processes presents a challenge for existing process integration techniques due to the non-continuous nature of the supply. A thorough pinch analysis study of the industrial process, taking in to account non-continuous operating rates, should be performed to evaluate the utility demand profile. Solar collector efficiency data under variable climatic conditions should also be collected for the specific site. A systematic method of combining this information leads to improved design and an optimal operating strategy. This approach has been applied to a New Zealand milk powder plant and benefits of several integration strategies, including mass integration, are investigated. The appropriate placement of the solar heat is analogous to the placement of a hot utility source and an energy penalty will be incurred when the solar thermal system provides heat below the pinch temperature.

Integration of solar thermal for improved energy efficiency in low-temperature-pinch industrial processes

Energy Technology Data Exchange (ETDEWEB)

Atkins, Martin J.; Walmsley, Michael R.W.; Morrison, Andrew S. [Energy Research Group, School of Science and Engineering, University of Waikato, Private Bag 3105, Hamilton 3240 (New Zealand)

2010-05-15

Solar thermal systems have the potential to provide renewable industrial process heat and are especially suited for low pinch temperature processes such as those in the food, beverage, and textile sectors. When correctly integrated within an industrial process, they can provide significant progress towards both increased energy efficiency and reduction in emissions. However, the integration of renewable solar energy into industrial processes presents a challenge for existing process integration techniques due to the non-continuous nature of the supply. A thorough pinch analysis study of the industrial process, taking in to account non-continuous operating rates, should be performed to evaluate the utility demand profile. Solar collector efficiency data under variable climatic conditions should also be collected for the specific site. A systematic method of combining this information leads to improved design and an optimal operating strategy. This approach has been applied to a New Zealand milk powder plant and benefits of several integration strategies, including mass integration, are investigated. The appropriate placement of the solar heat is analogous to the placement of a hot utility source and an energy penalty will be incurred when the solar thermal system provides heat below the pinch temperature. (author)

Sensitivity and fidelity of DNA microarray improved with integration of Amplified Differential Gene Expression (ADGE

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Ile Kristina E

2003-07-01

Full Text Available Abstract Background The ADGE technique is a method designed to magnify the ratios of gene expression before detection. It improves the detection sensitivity to small change of gene expression and requires small amount of starting material. However, the throughput of ADGE is low. We integrated ADGE with DNA microarray (ADGE microarray and compared it with regular microarray. Results When ADGE was integrated with DNA microarray, a quantitative relationship of a power function between detected and input ratios was found. Because of ratio magnification, ADGE microarray was better able to detect small changes in gene expression in a drug resistant model cell line system. The PCR amplification of templates and efficient labeling reduced the requirement of starting material to as little as 125 ng of total RNA for one slide hybridization and enhanced the signal intensity. Integration of ratio magnification, template amplification and efficient labeling in ADGE microarray reduced artifacts in microarray data and improved detection fidelity. The results of ADGE microarray were less variable and more reproducible than those of regular microarray. A gene expression profile generated with ADGE microarray characterized the drug resistant phenotype, particularly with reference to glutathione, proliferation and kinase pathways. Conclusion ADGE microarray magnified the ratios of differential gene expression in a power function, improved the detection sensitivity and fidelity and reduced the requirement for starting material while maintaining high throughput. ADGE microarray generated a more informative expression pattern than regular microarray.

Long Pulse Integrator of Variable Integral Time Constant

International Nuclear Information System (INIS)

Wang Yong; Ji Zhenshan; Du Xiaoying; Wu Yichun; Li Shi; Luo Jiarong

2010-01-01

A kind of new long pulse integrator was designed based on the method of variable integral time constant and deducting integral drift by drift slope. The integral time constant can be changed by choosing different integral resistors, in order to improve the signal-to-noise ratio, and avoid output saturation; the slope of integral drift of a certain period of time can be calculated by digital signal processing, which can be used to deduct the drift of original integral signal in real time to reduce the integral drift. The tests show that this kind of long pulse integrator is good at reducing integral drift, which also can eliminate the effects of changing integral time constant. According to experiments, the integral time constant can be changed by remote control and manual adjustment of integral drift is avoided, which can improve the experiment efficiency greatly and can be used for electromagnetic measurement in Tokamak experiment. (authors)

An Integrated Model of Co-ordinated Community-Based Care.

Science.gov (United States)

Scharlach, Andrew E; Graham, Carrie L; Berridge, Clara

2015-08-01

Co-ordinated approaches to community-based care are a central component of current and proposed efforts to help vulnerable older adults obtain needed services and supports and reduce unnecessary use of health care resources. This study examines ElderHelp Concierge Club, an integrated community-based care model that includes comprehensive personal and environmental assessment, multilevel care co-ordination, a mix of professional and volunteer service providers, and a capitated, income-adjusted fee model. Evaluation includes a retrospective study (n = 96) of service use and perceived program impact, and a prospective study (n = 21) of changes in participant physical and social well-being and health services utilization. Over the period of this study, participants showed greater mobility, greater ability to meet household needs, greater access to health care, reduced social isolation, reduced home hazards, fewer falls, and greater perceived ability to obtain assistance needed to age in place. This study provides preliminary evidence that an integrated multilevel care co-ordination approach may be an effective and efficient model for serving vulnerable community-based elders, especially low and moderate-income elders who otherwise could not afford the cost of care. The findings suggest the need for multisite controlled studies to more rigorously evaluate program impacts and the optimal mix of various program components. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Integrating Quality Improvement and Continuing Professional Development: A Model From the Mental Health Care System.

Science.gov (United States)

Sockalingam, Sanjeev; Tehrani, Hedieh; Lin, Elizabeth; Lieff, Susan; Harris, Ilene; Soklaridis, Sophie

2016-04-01

To explore the perspectives of leaders in psychiatry and continuing professional development (CPD) regarding the relationship, opportunities, and challenges in integrating quality improvement (QI) and CPD. In 2013-2014, the authors interviewed 18 participants in Canada: 10 psychiatrists-in-chief, 6 CPD leaders in psychiatry, and 2 individuals with experience integrating these domains in psychiatry who were identified through snowball sampling. Questions were designed to identify participants' perspectives about the definition, relationship, and integration of QI and CPD in psychiatry. Interviews were recorded and transcribed. An iterative, inductive method was used to thematically analyze the transcripts. To ensure the rigor of the analysis, the authors performed member checking and sampling until theoretical saturation was achieved. Participants defined QI as a concept measured at the individual, hospital, and health care system levels and CPD as a concept measured predominantly at the individual and hospital levels. Four themes related to the relationship between QI and CPD were identified: challenges with QI training, adoption of QI into the mental health care system, implementation of QI in CPD, and practice improvement outcomes. Despite participants describing QI and CPD as mutually beneficial, they expressed uncertainty about the appropriateness of aligning these domains within a mental health care context because of the identified challenges. This study identified challenges with aligning QI and CPD in psychiatry and yielded a framework to inform future integration efforts. Further research is needed to determine the generalizability of this framework to other specialties and health care professions.

Improving power for rare-variant tests by integrating external controls.

Science.gov (United States)

Lee, Seunggeun; Kim, Sehee; Fuchsberger, Christian

2017-11-01

Due to the drop in sequencing cost, the number of sequenced genomes is increasing rapidly. To improve power of rare-variant tests, these sequenced samples could be used as external control samples in addition to control samples from the study itself. However, when using external controls, possible batch effects due to the use of different sequencing platforms or genotype calling pipelines can dramatically increase type I error rates. To address this, we propose novel summary statistics based single and gene- or region-based rare-variant tests that allow the integration of external controls while controlling for type I error. Our approach is based on the insight that batch effects on a given variant can be assessed by comparing odds ratio estimates using internal controls only vs. using combined control samples of internal and external controls. From simulation experiments and the analysis of data from age-related macular degeneration and type 2 diabetes studies, we demonstrate that our method can substantially improve power while controlling for type I error rate. © 2017 WILEY PERIODICALS, INC.

Effectiveness of integrated science instructional material on pressure in daily life theme to improve digital age literacy of students

Science.gov (United States)

Asrizal; Amran, A.; Ananda, A.; Festiyed; Khairani, S.

2018-04-01

Integrated science learning and literacy skills are relevant issues in Indonesian’s education. However, the use of the integrated science learning and the integration of literacy in learning cannot be implemented well. An alternative solution of this problem is to develop integrated science instructional material on pressure in daily life theme by integrating digital age literacy. Purpose of research is to investigate the effectiveness of the use of integrated science instructional material on pressure in daily life theme to improve knowledge competence, attitudes competence and literacy skills of students. This research was a part of development research which has been conducted. In the product testing stage of this research and development was used before and after design of treatment for one sample group. Instruments to collect the data consist of learning outcomes test sheet, attitude observation sheet, and performance assessment sheet of students. Data analysis techniques include descriptive statistics analysis, normality test, homogeneity test, and paired comparison test. Therefore, the important result of research is the use of integrated science instructional material on pressure in daily life theme is effective in scientific approach to improve knowledge competence, attitudes competence, and digital age literacy skills of grade VIII students at 95% confidence level.

Provider perceptions of an integrated primary care quality improvement strategy: The PPAQ toolkit.

Science.gov (United States)

Beehler, Gregory P; Lilienthal, Kaitlin R

2017-02-01

The Primary Care Behavioral Health (PCBH) model of integrated primary care is challenging to implement with high fidelity. The Primary Care Behavioral Health Provider Adherence Questionnaire (PPAQ) was designed to assess provider adherence to essential model components and has recently been adapted into a quality improvement toolkit. The aim of this pilot project was to gather preliminary feedback on providers' perceptions of the acceptability and utility of the PPAQ toolkit for making beneficial practice changes. Twelve mental health providers working in Department of Veterans Affairs integrated primary care clinics participated in semistructured interviews to gather quantitative and qualitative data. Descriptive statistics and qualitative content analysis were used to analyze data. Providers identified several positive features of the PPAQ toolkit organization and structure that resulted in high ratings of acceptability, while also identifying several toolkit components in need of modification to improve usability. Toolkit content was considered highly representative of the (PCBH) model and therefore could be used as a diagnostic self-assessment of model adherence. The toolkit was considered to be high in applicability to providers regardless of their degree of prior professional preparation or current clinical setting. Additionally, providers identified several system-level contextual factors that could impact the usefulness of the toolkit. These findings suggest that frontline mental health providers working in (PCBH) settings may be receptive to using an adherence-focused toolkit for ongoing quality improvement. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Qualitative Study to improve integrity of NET : Perspectives of Peer review and Authorship in research ethics

International Nuclear Information System (INIS)

Kwon, Hyuk; Min, Byung Joo

2007-01-01

After Dr. Hwang's Human embryonic stem cell scandal, research ethics stood out as the hot issue in both Korean scientific circles and general public. Science Publishing Group referred the limitation of peer review system and the absence of responsibility of author to one of the causes for the scandal. In order to prevent a similar fraud, Ministry of Science and Technology(MOST) established guidelines for research ethics and integrity in 2006. The guidelines included fabrication, falsification, and plagiarism(FFP) and unfair authorship. MOST committed the authority of administration and supervision to the society and the institutes of research to preserve the research integrity. The society and institute are charged with overseeing the implementation of enacted ethics guidelines. SCI(Scientific Citation Index) holds the guideline of research ethics and canon of the society which were crafted in order to guaranty the integrity and quality of the research. The publication policy pertains submission of articles, authorship and responsibilities of a reviewer. Societies pay attention to the peer review policy because the quality of articles is strongly dependent on the peer review. Nuclear Engineering and Technology (NET) is the journal of Korea Nuclear Society(KNS). NET is registered with SCIE(Science Citation Index Expanded), recently. In addition to the growth in external circulation, the improvement of quality requires the effort of the society to establish a strict peer review system and a fair authorship. The qualitative study on peer review and authorship of NET was put into force to improve the quality of NET. Based on studies and suggestions, the policy focuses on research ethics to improve the integrity of NET

Qualitative Study to improve integrity of NET : Perspectives of Peer review and Authorship in research ethics

Energy Technology Data Exchange (ETDEWEB)

Kwon, Hyuk; Min, Byung Joo [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

2007-10-15

After Dr. Hwang's Human embryonic stem cell scandal, research ethics stood out as the hot issue in both Korean scientific circles and general public. Science Publishing Group referred the limitation of peer review system and the absence of responsibility of author to one of the causes for the scandal. In order to prevent a similar fraud, Ministry of Science and Technology(MOST) established guidelines for research ethics and integrity in 2006. The guidelines included fabrication, falsification, and plagiarism(FFP) and unfair authorship. MOST committed the authority of administration and supervision to the society and the institutes of research to preserve the research integrity. The society and institute are charged with overseeing the implementation of enacted ethics guidelines. SCI(Scientific Citation Index) holds the guideline of research ethics and canon of the society which were crafted in order to guaranty the integrity and quality of the research. The publication policy pertains submission of articles, authorship and responsibilities of a reviewer. Societies pay attention to the peer review policy because the quality of articles is strongly dependent on the peer review. Nuclear Engineering and Technology (NET) is the journal of Korea Nuclear Society(KNS). NET is registered with SCIE(Science Citation Index Expanded), recently. In addition to the growth in external circulation, the improvement of quality requires the effort of the society to establish a strict peer review system and a fair authorship. The qualitative study on peer review and authorship of NET was put into force to improve the quality of NET. Based on studies and suggestions, the policy focuses on research ethics to improve the integrity of NET.

Numerical integration methods and layout improvements in the context of dynamic RNA visualization.

Science.gov (United States)

Shabash, Boris; Wiese, Kay C

2017-05-30

RNA visualization software tools have traditionally presented a static visualization of RNA molecules with limited ability for users to interact with the resulting image once it is complete. Only a few tools allowed for dynamic structures. One such tool is jViz.RNA. Currently, jViz.RNA employs a unique method for the creation of the RNA molecule layout by mapping the RNA nucleotides into vertexes in a graph, which we call the detailed graph, and then utilizes a Newtonian mechanics inspired system of forces to calculate a layout for the RNA molecule. The work presented here focuses on improvements to jViz.RNA that allow the drawing of RNA secondary structures according to common drawing conventions, as well as dramatic run-time performance improvements. This is done first by presenting an alternative method for mapping the RNA molecule into a graph, which we call the compressed graph, and then employing advanced numerical integration methods for the compressed graph representation. Comparing the compressed graph and detailed graph implementations, we find that the compressed graph produces results more consistent with RNA drawing conventions. However, we also find that employing the compressed graph method requires a more sophisticated initial layout to produce visualizations that would require minimal user interference. Comparing the two numerical integration methods demonstrates the higher stability of the Backward Euler method, and its resulting ability to handle much larger time steps, a high priority feature for any software which entails user interaction. The work in this manuscript presents the preferred use of compressed graphs to detailed ones, as well as the advantages of employing the Backward Euler method over the Forward Euler method. These improvements produce more stable as well as visually aesthetic representations of the RNA secondary structures. The results presented demonstrate that both the compressed graph representation, as well as the Backward

Regulatory Improvements for Effective Integration of Distributed Generation into Electricity Distribution Networks

International Nuclear Information System (INIS)

Scheepers, M.J.J.; Jansen, J.C.; De Joode, J.; Bauknecht, D.; Gomez, T.; Pudjianto, D.; Strbac, G.; Ropenus, S.

2007-11-01

The growth of distributed electricity supply of renewable energy sources (RES-E) and combined heat and power (CHP) - so called distributed generation (DG) - can cause technical problems for electricity distribution networks. These integration problems can be overcome by reinforcing the network. Many European Member States apply network regulation that does not account for the impact of DG growth on the network costs. Passing on network integration costs to the DG-operator who is responsible for these extra costs may result in discrimination between different DG plants and between DG and large power generation. Therefore, in many regulatory systems distribution system operators (DSOs) are not being compensated for the DG integration costs. The DG-GRID project analysed technical and economical barriers for integration of distributed generation into electricity distribution networks. The project looked into the impact of a high DG deployment on the electricity distribution system costs and the impact on the financial position of the DSO. Several ways for improving network regulation in order to compensate DSOs for the increasing DG penetration were identified and tested. The DG-GRID project looked also into stimulating network innovations through economic regulation. The project was co-financed by the European Commission and carried out by nine European universities and research institutes. This report summarises the project results and is based on a number of DG-GRID reports that describe the conducted analyses and their results

Development road of critical care medicine in China: reference, integration and improvement

Directory of Open Access Journals (Sweden)

Hai-tao ZHANG

2013-07-01

Full Text Available Fundamental critical care medicine (FCCM and specialty critical care medicine (SCCM have their own independent developmental itinerary and have made indelible contributions to intensive treatment in the long history of CCM. The experts in FCCM are usually dominant in the cross-sectional study for various severe illnesses, and lay emphases on balancing the relationship among the dysfunctional organs under the guidance of overall treatment concept. SCCM experts emphasize longitudinal in-depth study for a specialized subject or special disease in order to solve the principal problem of the severe illness under the guidance of its own principal. At present, the main challenge of CCM is to avoid the habitual linear thinking. It is necessary for the members of FCCM to learn the knowledge of different problems pertaining to various specialties from SCCM, thus FCCM doctors would be able to take care of patients suffering from derangements of specific organs. SCCM members also need to learn from FCCM for strengthening the concept of overall treatment, optimizing various treatment resources, and improving treatment effects. Members of FCCM and SCCM need to learn from each other, in order to integrate and improve treatment strategies together, so as to complement each other. This will broaden the knowledge of SCCM and deepen that of FCCM. The integration of knowledge and skill will enrich the connotation of the CCM.

A Practical Perspective on the Design and Implementation of Enterprise Integration Solution to improve QoS using SAP NetWeaver Platform

Directory of Open Access Journals (Sweden)

K.Krishna Mohan

2010-06-01

Full Text Available Most of the enterprise operations require information from several systems within and outside the enterprise(s. The past few years have seen explosive growth in direct program to program interaction for application integration, removing manual steps yielding tremendous improvements in reliability and efficiency. This paper addresses the practical approach for the design and implementation of Enterprise Application Integration in a heterogeneous environment with SAP NetWeaver Platform (i.e. Exchange Infrastructure (XI/Process Integration (PI using a Customizable Tool named TEmplate based Functional Requirements for Integration Design (TEFRID developed by the author(s to improve the Quality of Service (QoS and reduce the development time and cost with the end-to-end scenario development.

Improving integrity of on-line grammage measurement with traceable basic calibration.

Science.gov (United States)

Kangasrääsiö, Juha

2010-07-01

The automatic control of grammage (basis weight) in paper and board production is based upon on-line grammage measurement. Furthermore, the automatic control of other quality variables such as moisture, ash content and coat weight, may rely on the grammage measurement. The integrity of Kr-85 based on-line grammage measurement systems was studied, by performing basic calibrations with traceably calibrated plastic reference standards. The calibrations were performed according to the EN ISO/IEC 17025 standard, which is a requirement for calibration laboratories. The observed relative measurement errors were 3.3% in the first time calibrations at the 95% confidence level. With the traceable basic calibration method, however, these errors can be reduced to under 0.5%, thus improving the integrity of on-line grammage measurements. Also a standardised algorithm, based on the experience from the performed calibrations, is proposed to ease the adjustment of the different grammage measurement systems. The calibration technique can basically be applied to all beta-radiation based grammage measurements. 2010 ISA. Published by Elsevier Ltd. All rights reserved.

Improving safety through an integrated approach for advanced control room development

International Nuclear Information System (INIS)

Haugset, K.; Berg, O.; Bologna, S.; Foerdestroemmen, N.T.; Kvalem, J.; Nelson, W.R.; Yamane, N.

1992-01-01

With the fast development of computer technology, the potential exists for improving operational safety of nuclear plants by using advanced operator tools in the control room. Specific systems are being introduced, such as systems for alarm handling, failure detection, disturbance diagnosis, procedural advice and others, often based on process modeling techniques or expert system technology. To ensure a maximum benefit from the new technology, a careful integration of the various systems must, however, take place, resulting in a well coordinated interface between the operator and the process. The OECD Halden Reactor Project has started the development of an Integrated Surveillance And Control System (ISACS). The basis for the activity is the experience at Halden in developing specific Computerized Operator Support Systems (COSSs), and the activity around the experimental control room HAMMLAB where detailed validations of operator tools have been performed for a number of years. The first goal in the ISACS project is to have a first, limited prototype in operation at the end of 1990. Validation experiments will follow. (orig.)

Improving safety through an integrated approach for advanced control room development

International Nuclear Information System (INIS)

Haugset, K.; Berg, O.; Foerdestroemmen, N.T.; Kvalem, J.; Nelson, W.R.

1990-01-01

With the fast development of computer technology, the potential exists for improving operational safety of nuclear plants by using advanced operator tools in the control room. Specific systems are being introduced, such as systems for alarm handling, failure detection, disturbance diagnosis, procedural advice and others, often based on process modeling techniques or expert system technology. To ensure a maximum benefit from the new technology, a careful integration of the various systems must, however, take place, resulting in a well coordinated interface between the operator and the process. The OECD Halden Reactor Project has started the development of an Integrated Surveillance And Control System (ISACS). The basis for the activity is the experience at Halden in developing specific Computerized Operator Support Systems (COSSs), and the activity around the experimental control room HAMMLAB where detailed validations of operator tools have been performed for a number of years. The first goal in the ISACS project is to have a first, limited prototype in operation at the end of 1990. Validation experiments will follow

The effect of science learning integrated with local potential to improve science process skills

Science.gov (United States)

Rahardini, Riris Riezqia Budy; Suryadarma, I. Gusti Putu; Wilujeng, Insih

2017-08-01

This research was aimed to know the effectiveness of science learning that integrated with local potential to improve student`s science process skill. The research was quasi experiment using non-equivalent control group design. The research involved all student of Muhammadiyah Imogiri Junior High School on grade VII as a population. The sample in this research was selected through cluster random sampling, namely VII B (experiment group) and VII C (control group). Instrument that used in this research is a nontest instrument (science process skill observation's form) adapted Desak Megawati's research (2016). The aspect of science process skills were making observation and communication. The data were using univariat (ANOVA) analyzed at 0,05 significance level and normalized gain score for science process skill increase's category. The result is science learning that integrated with local potential was effective to improve science process skills of student (Sig. 0,00). This learning can increase science process skill, shown by a normalized gain score value at 0,63 (medium category) in experiment group and 0,29 (low category) in control group.

Recommendations for Preoperative Management of Frailty from the Society for Perioperative Assessment and Quality Improvement (SPAQI).

Science.gov (United States)

Alvarez-Nebreda, Maria Loreto; Bentov, Nathalie; Urman, Richard D; Setia, Sabeena; Huang, Joe Chin-Sun; Pfeifer, Kurt; Bennett, Katherine; Ong, Thuan D; Richman, Deborah; Gollapudi, Divya; Alec Rooke, G; Javedan, Houman

2018-06-01

Frailty is an age-related, multi-dimensional state of decreased physiologic reserve that results in diminished resiliency and increased vulnerability to stressors. It has proven to be an excellent predictor of unfavorable health outcomes in the older surgical population. There is agreement in recommending that a frailty evaluation should be part of the preoperative assessment in the elderly. However, the consensus is still building with regards to how it should affect perioperative care. The Society for Perioperative Assessment and Quality Improvement (SPAQI) convened experts in the fields of gerontology, anesthesiology and preoperative assessment to outline practical steps for clinicians to assess and address frailty in elderly patients who require elective intermediate or high risk surgery. These recommendations summarize evidence-based principles of measuring and screening for frailty, as well as basic interventions that can help improve patient outcomes. Copyright © 2018 Elsevier Inc. All rights reserved.

Improved Genetic Algorithm-Based Unit Commitment Considering Uncertainty Integration Method

Directory of Open Access Journals (Sweden)

Kyu-Hyung Jo

2018-05-01

Full Text Available In light of the dissemination of renewable energy connected to the power grid, it has become necessary to consider the uncertainty in the generation of renewable energy as a unit commitment (UC problem. A methodology for solving the UC problem is presented by considering various uncertainties, which are assumed to have a normal distribution, by using a Monte Carlo simulation. Based on the constructed scenarios for load, wind, solar, and generator outages, a combination of scenarios is found that meets the reserve requirement to secure the power balance of the power grid. In those scenarios, the uncertainty integration method (UIM identifies the best combination by minimizing the additional reserve requirements caused by the uncertainty of power sources. An integration process for uncertainties is formulated for stochastic unit commitment (SUC problems and optimized by the improved genetic algorithm (IGA. The IGA is composed of five procedures and finds the optimal combination of unit status at the scheduled time, based on the determined source data. According to the number of unit systems, the IGA demonstrates better performance than the other optimization methods by applying reserve repairing and an approximation process. To account for the result of the proposed method, various UC strategies are tested with a modified 24-h UC test system and compared.

Integration of scheduling and discrete event simulation systems to improve production flow planning

Science.gov (United States)

Krenczyk, D.; Paprocka, I.; Kempa, W. M.; Grabowik, C.; Kalinowski, K.

2016-08-01

The increased availability of data and computer-aided technologies such as MRPI/II, ERP and MES system, allowing producers to be more adaptive to market dynamics and to improve production scheduling. Integration of production scheduling and computer modelling, simulation and visualization systems can be useful in the analysis of production system constraints related to the efficiency of manufacturing systems. A integration methodology based on semi-automatic model generation method for eliminating problems associated with complexity of the model and labour-intensive and time-consuming process of simulation model creation is proposed. Data mapping and data transformation techniques for the proposed method have been applied. This approach has been illustrated through examples of practical implementation of the proposed method using KbRS scheduling system and Enterprise Dynamics simulation system.

Developing a revenue integrity improvement plan.

Science.gov (United States)

Banks, Kate

2010-11-01

A revenue integrity plan should address five key areas: Accuracy of patient information. Verification of payer information and policies. Accuracy of documentation. Processing of claims. Accuracy of payment.

Interorganisational Integration

DEFF Research Database (Denmark)

Lyngsø, Anne Marie; Godtfredsen, Nina Skavlan; Frølich, Anne

2016-01-01

INTRODUCTION: Despite many initiatives to improve coordination of patient pathways and intersectoral cooperation, Danish health care is still fragmented, lacking intra- and interorganisational integration. This study explores barriers to and facilitators of interorganisational integration...... at a university hospital in the Capital Region of Denmark. RESULTS AND DISCUSSION: Our results can be grouped into five influencing areas for interorganisational integration: communication/information transfer, committed leadership, patient engagement, the role and competencies of the general practitioner...... and organisational culture. Proposed solutions to barriers in each area hold the potential to improve care integration as experienced by individuals responsible for supporting and facilitating it. Barriers and facilitators to integrating care relate to clinical, professional, functional and normative integration...

Integrated software system for improving medical equipment management.

Science.gov (United States)

Bliznakov, Z; Pappous, G; Bliznakova, K; Pallikarakis, N

2003-01-01

The evolution of biomedical technology has led to an extraordinary use of medical devices in health care delivery. During the last decade, clinical engineering departments (CEDs) turned toward computerization and application of specific software systems for medical equipment management in order to improve their services and monitor outcomes. Recently, much emphasis has been given to patient safety. Through its Medical Device Directives, the European Union has required all member nations to use a vigilance system to prevent the reoccurrence of adverse events that could lead to injuries or death of patients or personnel as a result of equipment malfunction or improper use. The World Health Organization also has made this issue a high priority and has prepared a number of actions and recommendations. In the present workplace, a new integrated, Windows-oriented system is proposed, addressing all tasks of CEDs but also offering a global approach to their management needs, including vigilance. The system architecture is based on a star model, consisting of a central core module and peripheral units. Its development has been based on the integration of 3 software modules, each one addressing specific predefined tasks. The main features of this system include equipment acquisition and replacement management, inventory archiving and monitoring, follow up on scheduled maintenance, corrective maintenance, user training, data analysis, and reports. It also incorporates vigilance monitoring and information exchange for adverse events, together with a specific application for quality-control procedures. The system offers clinical engineers the ability to monitor and evaluate the quality and cost-effectiveness of the service provided by means of quality and cost indicators. Particular emphasis has been placed on the use of harmonized standards with regard to medical device nomenclature and classification. The system's practical applications have been demonstrated through a pilot

Improving Microbial Genome Annotations in an Integrated Database Context

Science.gov (United States)

Chen, I-Min A.; Markowitz, Victor M.; Chu, Ken; Anderson, Iain; Mavromatis, Konstantinos; Kyrpides, Nikos C.; Ivanova, Natalia N.

2013-01-01

Effective comparative analysis of microbial genomes requires a consistent and complete view of biological data. Consistency regards the biological coherence of annotations, while completeness regards the extent and coverage of functional characterization for genomes. We have developed tools that allow scientists to assess and improve the consistency and completeness of microbial genome annotations in the context of the Integrated Microbial Genomes (IMG) family of systems. All publicly available microbial genomes are characterized in IMG using different functional annotation and pathway resources, thus providing a comprehensive framework for identifying and resolving annotation discrepancies. A rule based system for predicting phenotypes in IMG provides a powerful mechanism for validating functional annotations, whereby the phenotypic traits of an organism are inferred based on the presence of certain metabolic reactions and pathways and compared to experimentally observed phenotypes. The IMG family of systems are available at http://img.jgi.doe.gov/. PMID:23424620

Improving microbial genome annotations in an integrated database context.

Directory of Open Access Journals (Sweden)

I-Min A Chen

Full Text Available Effective comparative analysis of microbial genomes requires a consistent and complete view of biological data. Consistency regards the biological coherence of annotations, while completeness regards the extent and coverage of functional characterization for genomes. We have developed tools that allow scientists to assess and improve the consistency and completeness of microbial genome annotations in the context of the Integrated Microbial Genomes (IMG family of systems. All publicly available microbial genomes are characterized in IMG using different functional annotation and pathway resources, thus providing a comprehensive framework for identifying and resolving annotation discrepancies. A rule based system for predicting phenotypes in IMG provides a powerful mechanism for validating functional annotations, whereby the phenotypic traits of an organism are inferred based on the presence of certain metabolic reactions and pathways and compared to experimentally observed phenotypes. The IMG family of systems are available at http://img.jgi.doe.gov/.

Finding a nonlinear lattice with improved integrability using Lie transform perturbation theory

International Nuclear Information System (INIS)

Sonnad, Kiran G.; Cary, John R.

2004-01-01

A condition for improved dynamic aperture for nonlinear, alternating gradient transport systems is derived using Lie transform perturbation theory. The Lie transform perturbation method is used here to perform averaging over fast oscillations by canonically transforming to slowly oscillating variables. This is first demonstrated for a linear sinusoidal focusing system. This method is then employed to average the dynamics over a lattice period for a nonlinear focusing system, provided by the use of higher order poles such as sextupoles and octupoles along with alternate gradient quadrupoles. Unlike the traditional approach, the higher order focusing is not treated as a perturbation. The Lie transform method is particularly advantageous for such a system where the form of the Hamiltonian is complex. This is because the method exploits the property of canonical invariance of Poisson brackets so that the change of variables is accomplished by just replacing the old ones with the new. The analysis shows the existence of a condition in which the system is azimuthally symmetric in the transformed, slowly oscillating frame. Such a symmetry in the time averaged frame renders the system nearly integrable in the laboratory frame. This condition leads to reduced chaos and improved confinement when compared to a system that is not close to integrability. Numerical calculations of single-particle trajectories and phase space projections of the dynamic aperture performed for a lattice with quadrupoles and sextupoles confirm that this is indeed the case

Further Improvement and System Integration of High Temperature Polymer Electrolyte Membrane Fuel Cells

DEFF Research Database (Denmark)

Li, Qingfeng; Jensen, Jens Oluf

The new development in the field of polymer electrolyte membrane fuel cell (PEMFC) is high temperature PEMFC for operation above 100°C, which has been successfully demonstrated through the previous EC Joule III and the 5th framework programme. New challenges are encountered, bottlenecks for the new...... technology have been identified, and new concepts and solutions have been provisionally identified. FURIM is directed at tackling these key issues by concentrating on the further materials development, compatible technologies, and system integration of the high temperature PEMFC. The strategic developments...... of the FURIM are in three steps: (1) further improvement of the high temperature polymer membranes and related materials; (2) development of technological units including fuel cell stack, hydrocarbon reformer and afterburner, that are compatible with the HT-PEMFC; and (3) integration of the HT-PEMFC stack...

Integrated Data for Improved Asset Management

Science.gov (United States)

2016-05-26

The objective of this research is to demonstrate the potential benefits for agency-wide data integration for VDOT asset management. This objective is achieved through an example application that requires information distributed across multiple databa...

Integrated care as a means to improve primary care delivery for adults and adolescents in the developing world: a critical analysis of Integrated Management of Adolescent and Adult Illness (IMAI).

Science.gov (United States)

Vasan, Ashwin; Ellner, Andrew; Lawn, Stephen D; Gove, Sandy; Anatole, Manzi; Gupta, Neil; Drobac, Peter; Nicholson, Tom; Seung, Kwonjune; Mabey, David C; Farmer, Paul E

2014-01-14

More than three decades after the 1978 Declaration of Alma-Ata enshrined the goal of 'health for all', high-quality primary care services remain undelivered to the great majority of the world's poor. This failure to effectively reach the most vulnerable populations has been, in part, a failure to develop and implement appropriate and effective primary care delivery models. This paper examines a root cause of these failures, namely that the inability to achieve clear and practical consensus around the scope and aims of primary care may be contributing to ongoing operational inertia. The present work also examines integrated models of care as a strategy to move beyond conceptual dissonance in primary care and toward implementation. Finally, this paper examines the strengths and weaknesses of a particular model, the World Health Organization's Integrated Management of Adolescent and Adult Illness (IMAI), and its potential as a guidepost toward improving the quality of primary care delivery in poor settings. Integration and integrated care may be an important approach in establishing a new paradigm of primary care delivery, though overall, current evidence is mixed. However, a number of successful specific examples illustrate the potential for clinical and service integration to positively impact patient care in primary care settings. One example deserving of further examination is the IMAI, developed by the World Health Organization as an operational model that integrates discrete vertical interventions into a comprehensive delivery system encompassing triage and screening, basic acute and chronic disease care, basic prevention and treatment services, and follow-up and referral guidelines. IMAI is an integrated model delivered at a single point-of-care using a standard approach to each patient based on the universal patient history and physical examination. The evidence base on IMAI is currently weak, but whether or not IMAI itself ultimately proves useful in

Improving transcriptome construction in non-model organisms: integrating manual and automated gene definition in Emiliania huxleyi.

Science.gov (United States)

Feldmesser, Ester; Rosenwasser, Shilo; Vardi, Assaf; Ben-Dor, Shifra

2014-02-22

The advent of Next Generation Sequencing technologies and corresponding bioinformatics tools allows the definition of transcriptomes in non-model organisms. Non-model organisms are of great ecological and biotechnological significance, and consequently the understanding of their unique metabolic pathways is essential. Several methods that integrate de novo assembly with genome-based assembly have been proposed. Yet, there are many open challenges in defining genes, particularly where genomes are not available or incomplete. Despite the large numbers of transcriptome assemblies that have been performed, quality control of the transcript building process, particularly on the protein level, is rarely performed if ever. To test and improve the quality of the automated transcriptome reconstruction, we used manually defined and curated genes, several of them experimentally validated. Several approaches to transcript construction were utilized, based on the available data: a draft genome, high quality RNAseq reads, and ESTs. In order to maximize the contribution of the various data, we integrated methods including de novo and genome based assembly, as well as EST clustering. After each step a set of manually curated genes was used for quality assessment of the transcripts. The interplay between the automated pipeline and the quality control indicated which additional processes were required to improve the transcriptome reconstruction. We discovered that E. huxleyi has a very high percentage of non-canonical splice junctions, and relatively high rates of intron retention, which caused unique issues with the currently available tools. While individual tools missed genes and artificially joined overlapping transcripts, combining the results of several tools improved the completeness and quality considerably. The final collection, created from the integration of several quality control and improvement rounds, was compared to the manually defined set both on the DNA and

Improved structural integrity through advances in reliable residual stress measurement: the impact of ENGIN-X

Science.gov (United States)

Edwards, L.; Santisteban, J. R.

The determination of accurate reliable residual stresses is critical to many fields of structural integrity. Neutron stress measurement is a non-destructive technique that uniquely provides insights into stress fields deep within engineering components and structures. As such, it has become an increasingly important tool within engineering, leading to improved manufacturing processes to reduce stress and distortion as well as to the definition of more precise lifing procedures. This paper describes the likely impact of the next generation of dedicated engineering stress diffractometers currently being constructed and the utility of the technique using examples of residual stresses both beneficial and detrimental to structural integrity.

Improving service quality of hospital front office using an integrated Kano model and quality function deployment

Directory of Open Access Journals (Sweden)

Anjar Priyono

2017-11-01

Full Text Available Purpose: The aims of this study are twofold: first, it attempts to investigate service attributes in a hospital front office; and second, to identify strategies to improve those service attributes. Design/methodology/approach: This study used integration of Quality Function Deployment and Kano Model. The research instrument, which takes the SERVQUAL model as its starting point, was developed using a comprehensive set of techniques, including a literature review of relevant topics, interviews and focus group discussions. Using a sample of 140 customers of an international hospital situated in Yogyakarta, Indonesia, 14 service attributes required by customers were identified. The attributes, which were further categorised into 5 attractive, 4 one-dimensional and 5 ‘must-be’ attributes, were analysed using the Kano Model. Findings: Using the integrated QFD and Kano Model, the service attributes needed for improvement were identified. The results are different from those when the company used either SERVQUAL or QFD alone. This study also reveals that benchmarking with competitor might produce misleading results. The results are different when the analysis combined a comprehensive method of QFD and Kano Model. Practical implications: Service providers will benefit from the findings of this study, as both the service attributes and technical requirements that require improvement as a priority are identified. Originality/value: It is the first time that front office quality of hospital is examined using integrated method of SERVQUAL, QFD and Kano Model. The recommendations proposed from this comprehensive method offer novel solution that has never been found in existing study.

Integrating Mindfulness Practices into the Elementary Curriculum to Improve Attention-to-Task Behaviors and Social Relations

Science.gov (United States)

Kanagy-Borofka, Lori

2013-01-01

This study examined effects of integrating mindfulness practices into the 5th grade curriculum to improve attention-to-task, including inattention and executive functioning, hyperactivity/impulsivity, and social relations. As academic requirements become more rigorous, students have been expected to demonstrate increased skills in…

Process improvement program evolves into compliance program at an integrated delivery system.

Science.gov (United States)

Tyk, R C; Hylton, P G

1998-09-01

An integrated delivery system discovered questionable practices when it undertook a process-improvement initiative for its revenue-to-cash cycle. These discoveries served as a wake-up call to the organization that it needed to develop a comprehensive corporate compliance program. The organization engaged legal counsel to help it establish such a program. A corporate compliance officer was hired, and a compliance committee was set up. They worked with counsel to develop the structure and substance of the program and establish a corporate code of conduct that became a part of the organization's policies and procedures. Teams were formed in various areas of the organization to review compliance-related activities and suggest improvements. Clinical and nonclinical staff attended mandatory educational sessions about the program. By approaching compliance systematically, the organization has put itself in an excellent position to avoid fraudulent and abusive activities- and the government scrutiny they invite.

Direct integration of intensity-level data from Affymetrix and Illumina microarrays improves statistical power for robust reanalysis

Directory of Open Access Journals (Sweden)

Turnbull Arran K

2012-08-01

Full Text Available Abstract Background Affymetrix GeneChips and Illumina BeadArrays are the most widely used commercial single channel gene expression microarrays. Public data repositories are an extremely valuable resource, providing array-derived gene expression measurements from many thousands of experiments. Unfortunately many of these studies are underpowered and it is desirable to improve power by combining data from more than one study; we sought to determine whether platform-specific bias precludes direct integration of probe intensity signals for combined reanalysis. Results Using Affymetrix and Illumina data from the microarray quality control project, from our own clinical samples, and from additional publicly available datasets we evaluated several approaches to directly integrate intensity level expression data from the two platforms. After mapping probe sequences to Ensembl genes we demonstrate that, ComBat and cross platform normalisation (XPN, significantly outperform mean-centering and distance-weighted discrimination (DWD in terms of minimising inter-platform variance. In particular we observed that DWD, a popular method used in a number of previous studies, removed systematic bias at the expense of genuine biological variability, potentially reducing legitimate biological differences from integrated datasets. Conclusion Normalised and batch-corrected intensity-level data from Affymetrix and Illumina microarrays can be directly combined to generate biologically meaningful results with improved statistical power for robust, integrated reanalysis.

Improvements to Integrated Tradespace Analysis of Communications Architectures (ITACA) Network Loading Analysis Tool

Science.gov (United States)

Lee, Nathaniel; Welch, Bryan W.

2018-01-01

NASA's SCENIC project aims to simplify and reduce the cost of space mission planning by replicating the analysis capabilities of commercially licensed software which are integrated with relevant analysis parameters specific to SCaN assets and SCaN supported user missions. SCENIC differs from current tools that perform similar analyses in that it 1) does not require any licensing fees, 2) will provide an all-in-one package for various analysis capabilities that normally requires add-ons or multiple tools to complete. As part of SCENIC's capabilities, the ITACA network loading analysis tool will be responsible for assessing the loading on a given network architecture and generating a network service schedule. ITACA will allow users to evaluate the quality of service of a given network architecture and determine whether or not the architecture will satisfy the mission's requirements. ITACA is currently under development, and the following improvements were made during the fall of 2017: optimization of runtime, augmentation of network asset pre-service configuration time, augmentation of Brent's method of root finding, augmentation of network asset FOV restrictions, augmentation of mission lifetimes, and the integration of a SCaN link budget calculation tool. The improvements resulted in (a) 25% reduction in runtime, (b) more accurate contact window predictions when compared to STK(Registered Trademark) contact window predictions, and (c) increased fidelity through the use of specific SCaN asset parameters.

Using the Internet for Gerontology Education: Assessing and Improving Wikipedia

Science.gov (United States)

Infeld, Donna Lind; Adams, William C.

2013-01-01

Older adults, students, professionals, and the general public increasingly turn to the Internet and to Wikipedia for information. Wikipedia, the world's sixth most used website, is by far the most widely used open-source information site. Among its nearly four million English-language encyclopedia articles, how thorough is coverage of key…

Clinical performance improvement series. Classic CQI integrated with comprehensive disease management as a model for performance improvement.

Science.gov (United States)

Joshi, M S; Bernard, D B

1999-08-01

In recent years, health and disease management has emerged as an effective means of delivering, integrating, and improving care through a population-based approach. Since 1997 the University of Pennsylvania Health System (UPHS) has utilized the key principles and components of continuous quality improvement (CQI) and disease management to form a model for health care improvement that focuses on designing best practices, using best practices to influence clinical decision making, changing processes and systems to deploy and deliver best practices, and measuring outcomes to improve the process. Experience with 28 programs and more than 14,000 patients indicates significant improvement in outcomes, including high physician satisfaction, increased patient satisfaction, reduced costs, and improved clinical process and outcome measures across multiple diseases. DIABETES DISEASE MANAGEMENT: In three months a UPHS multidisciplinary diabetes disease management team developed a best practice approach for the treatment of all patients with diabetes in the UPHS. After the program was pilot tested in three primary care physician sites, it was then introduced progressively to additional practice sites throughout the health system. The establishment of the role of the diabetes nurse care managers (certified diabetes educators) was central to successful program deployment. Office-based coordinators ensure incorporation of the best practice protocols into routine flow processes. A disease management intranet disseminates programs electronically. Outcomes of the UPHS health and disease management programs so far demonstrate success across multiple dimensions of performance-service, clinical quality, access, and value. The task of health care leadership today is to remove barriers and enable effective implementation of key strategies, such as health and disease management. Substantial effort and resources must be dedicated to gain physician buy-in and achieve compliance. The

Nursing Work in Long-Term Care: An Integrative Review.

Science.gov (United States)

Montayre, Jed; Montayre, Jasmine

2017-11-01

Evidence suggests that delivery of good nursing care in long-term care (LTC) facilities is reflected in nurses' descriptions of the factors and structures that affect their work. Understanding the contemporary nature of nursing work in aged care will influence policies for improving current work structures in this practice setting. The current review aims to present a contemporary perspective of RNs' work in LTC facilities. A comprehensive search and purposeful selection of the literature was conducted using CINAHL, PubMed, Medline, Scopus, and Google Scholar databases. Nine studies were eligible for review. Common themes revealed that nursing work in aged care settings is characterized by RNs providing indirect care tasks-primarily care coordination, engaging in non-nursing activities, and having an expanded and overlapping role. As care providers, aged care RNs do not always provide direct care as part of their nursing work. The scope of RN work beyond its clinical nature or performance of non-nursing tasks adds complexity in clarifying RN work roles in aged care. [Journal of Gerontological Nursing, 43(11), 41-49.]. Copyright 2017, SLACK Incorporated.

Point-of-care technology: integration for improved delivery of care.

Science.gov (United States)

Gregory, Debbie; Buckner, Martha

2014-01-01

The growing complexity of technology, equipment, and devices involved in patient care delivery can be staggering and overwhelming. Technology is intended to be a tool to help clinicians, but it can also be a frustrating hindrance if not thoughtfully planned and strategically aligned. Critical care nurses are key partners in the collaborations needed to improve safety and quality through health information technology (IT). Nurses must advocate for systems that are interoperable and adapted to the context of care experiences. The involvement and collaboration between clinicians, information technology specialists, biomedical engineers, and vendors has never been more relevant and applicable. Working together strategically with a shared vision can effectively provide a seamless clinical workflow, maximize technology investments, and ultimately improve patient care delivery and outcomes. Developing a strategic integrated clinical and IT roadmap is a critical component of today's health care environment. How can technology strategy be aligned from the executive suite to the bedside caregiver? What is the model for using clinical workflows to drive technology adoption? How can the voice of the critical care nurse strengthen this process? How can success be assured from the initial assessment and selection of technology to a sustainable support model? What is the vendor's role as a strategic partner and "co-caregiver"?

Ethical dimensions of quality of life in aging: autonomy vs. collectivism in the United States and Canada.

Science.gov (United States)

Clark, P G

1991-10-01

Ethical concepts lie at the core of how quality of life in aging is defined and enhanced. Although recent American attention has been largely focused on autonomy as an important value for quality of life in old age, there is real danger in emphasizing personal independence at the expense of community or collectivism. This conceptual analysis compares and contrasts these value orientations in the U.S. and Canada and examines their relationship to the concept of quality of life in aging. It also explores implications of the analysis for expanding our understanding of the importance of value dimensions in comparative gerontology, and suggests ways of integrating individualistic and collectivistic ideals in gerontological policies and programs.

Decision-Making for Supply Chain Integration Supply Chain Integration

CERN Document Server

Lettice, Fiona; Durowoju, Olatunde

2012-01-01

Effective supply chain integration, and the tight co-ordination it creates, is an essential pre-requisite for successful supply chain management.  Decision-Making for Supply Chain Integration is a practical reference on recent research in the area of supply chain integration focusing on distributed decision-making problems. Recent applications of various decision-making tools for integrating supply chains are covered including chapters focusing on: •Supplier selection, pricing strategy and inventory decisions in multi-level supply chains, •RFID-enabled distributed decision-making, •Operational risk issues and time-critical decision-making for sensitive logistics nodes, Modelling end to end processes to improve supply chain integration, and •Integrated systems to improve service delivery and optimize resource use. Decision-Making for Supply Chain Integration provides an insight into the tools and methodologies of this field with support from real-life case studies demonstrating successful application ...

Corticospinal tract integrity and lesion volume play different roles in chronic hemiparesis and its improvement through motor practice.

Science.gov (United States)

Sterr, Annette; Dean, Phil J A; Szameitat, Andre J; Conforto, Adriana Bastos; Shen, Shan

2014-05-01

Initial evidence suggests that the integrity of the ipsilesional corticospinal tract (CST) after stroke is strongly related to motor function in the chronic state but not the treatment gain induced by motor rehabilitation. We examined the association of motor status and treatment benefit by testing patients with a wide range of severity of hemiparesis of the left and right upper extremity. Diffusion tensor imaging was performed in 22 patients beyond 12 months after onset of stroke with severe to moderate hemiparesis. Motor function was tested before and after 2 weeks of modified constraint-induced movement therapy. CST integrity, but not lesion volume, correlated with the motor ability measures of the Wolf Motor Function Test and the Motor Activity Log. No differences were found between left and right hemiparesis. Motor performance improved significantly with the treatment regime, and did so equally for patients with left and right arm paresis. However, treatment benefit was not associated with either CST integrity or lesion volume. CST integrity correlated best in this small trial with chronic long-term status but not treatment-induced improvements. The CST may play a different role in the mechanisms mediating long-term outcome compared to those underlying practice-induced gains after a chronic plateau in motor function.

Improved data for integrated modeling of global environmental change

Science.gov (United States)

Lotze-Campen, Hermann

2011-12-01

The assessment of global environmental changes, their impact on human societies, and possible management options requires large-scale, integrated modeling efforts. These models have to link biophysical with socio-economic processes, and they have to take spatial heterogeneity of environmental conditions into account. Land use change and freshwater use are two key research areas where spatial aggregation and the use of regional average numbers may lead to biased results. Useful insights can only be obtained if processes like economic globalization can be consistently linked to local environmental conditions and resource constraints (Lambin and Meyfroidt 2011). Spatially explicit modeling of environmental changes at the global scale has a long tradition in the natural sciences (Woodward et al 1995, Alcamo et al 1996, Leemans et al 1996). Socio-economic models with comparable spatial detail, e.g. on grid-based land use change, are much less common (Heistermann et al 2006), but are increasingly being developed (Popp et al 2011, Schneider et al 2011). Spatially explicit models require spatially explicit input data, which often constrains their development and application at the global scale. The amount and quality of available data on environmental conditions is growing fast—primarily due to improved earth observation methods. Moreover, systematic efforts for collecting and linking these data across sectors are on the way (www.earthobservations.org). This has, among others, also helped to provide consistent databases on different land cover and land use types (Erb et al 2007). However, spatially explicit data on specific anthropogenic driving forces of global environmental change are still scarce—also because these cannot be collected with satellites or other devices. The basic data on socio-economic driving forces, i.e. population density and wealth (measured as gross domestic product per capita), have been prepared for spatially explicit analyses (CIESIN, IFPRI

Valoración integral de adultos mayores en centros gerontológicos de Guayaquil

Directory of Open Access Journals (Sweden)

Reyes, Myriam

2017-08-01

Full Text Available On this study, the health situation of elderly people from Gerontological centers is described through the integral geriatric assessment. An observational, transversal, descriptive study was applied on intentional no probabilistic sample to achieve this objective. The results show that 92% of the population are women, 74% have hypertension, 28% suffers from diabetes mellitus, and 40% have dyslipidemia. The Katz test shows that 94% are functionally independent, Yesavage test establishes that 76% does not have depressive manifestations. Pfeiffer test reveals that 78% does not show cognitive deterioration and 70% have an acceptable social situation. The Mini Nutritional Assessment (MNA shows that the 82% does not present nutritional risk. All the laboratory tests were normal. The cardiovascular evaluation reveals that 90% of the sample are within the normal parameters for age and comorbidities. The abdominal echography shows that 70% have grade 0 of Non Alcoholic Hepatic Steatosis (NASH and 30% have grade 1. Based on these results, it can be concluded that their quality of life is good

INTEGRATED PRACTICE LEARNING MODEL TO IMPROVE WAITER/S’ COMPETENCY ON HOSPITALITY STUDY PROGRAM, POLITEKNIK NEGERI BALI

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I Made Darma Oka

2017-12-01

Full Text Available Hospitality Study Program, Politeknik Negeri Bali (PNB, hadn’t implemented integrated learning practice optimally. The aim of this research was improving the learning process method as an integrated practice learning model involving three courses (Food Production, FB Service, English for Restaurant in the same topic. This study was conducted on the forth semester of Hotel Study Program as the sample used in this research. After the random sampling was selected two classes as research samples, those were IVA class as an experiment group and IVB class as a control. Thus the samples could be determined according to the number of students in each class as many as 26 people. The application of integrated practice learning had an effect on the achievement of student competency in waiter/s occupation at Hotel Studies Program. The result of statistical test showed that there was a significant difference of competency achievement between integrated learning practices with partial practice learning students groups. It’s suggested to the management Hospitality Study Program to encourage and to facilitate the lecturers especially of core subjects to apply integrated learning practices in order to achieve the competency.

Integrating Morbidity and Mortality Core Competencies and Quality Improvement in Otolaryngology.

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Laury, Adrienne M; Bowe, Sarah N; Lospinoso, Joshua

2017-02-01

To date, an otolaryngology-specific morbidity and mortality (M&M) conference has never been reported or evaluated. To propose a novel otolaryngology-specific M&M format and to assess its success using a validated assessment tool. Preintervention and postintervention cohort study spanning 14 months (September 2014 to November 2015), with 32 faculty, residents, and medical students attending the department of otolaryngology M&M conference, conducted at the the San Antonio Uniformed Services Health Education Consortium. A novel quality assurance conference was implemented in the department of otolaryngology at the San Antonio Uniformed Services Health Education Consortium. This conference incorporates patient safety reports, otolaryngology-specific quality metrics, and individual case presentations. The revised format integrates the Accreditation Council for Graduate Medical Education (ACGME) core competencies and Quality Improvement and Patient Safety (QI/PS) system. This format was evaluated by faculty, residents, and medical students every other month for 14 months to assess changes in attitudes regarding the M&M conference as well as changes in presentation quality. Overall, 13 faculty, 12 residents, and 7 medical students completed 232 evaluations. Summary statistics of both resident and faculty attitudes about the success of the M&M format seem to improve over the 14 months between the prequestionnaires and postquestionnaires. General attitudes for both residents and faculty significantly improved from the pretest to posttest (odds ratio, 0.32 per month; 95% CI, 0.29-0.35). In the pretest period, "established presentation format" was considered the most necessary improvement, whereas in the posttest period this changed to "incorporate more QI." For resident presentations evaluated using the situation, background, assessment, and review/recommendations (SBAR) tool, all evaluations, from all participants, improved over time. The M&M conference is an essential

Integrating Customer Intimacy Into Radiology to Improve the Patient Perspective: The Case of Breast Cancer Screening.

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Chhor, Chloe M; Mercado, Cecilia L

2016-02-01

The customer intimacy business model has emerged as a key operational approach for health care organizations as they move toward patient-centered care. The question arises how the customer intimacy approach can be implemented in the clinical setting and whether it can help practitioners address problems and improve quality of care. Breast cancer screening and its emphasis on the patient perspective provides an interesting case study for understanding how the customer intimacy approach can be integrated into radiologic practice to improve the patient experience.

Further Improvement and System Integration of High Temperature Polymer Electrolyte Membrane Fuel Cells

DEFF Research Database (Denmark)

Jensen, Jens Oluf; Li, Qingfeng

Polymer electrolyte membrane fuel cell (PEMFC) technology based on Nafion membranes can operate at temperatures around 80°C. The new development in the field is high temperature PEMFC for operation above 100°C, which has been successfully demonstrated through the previous EC Joule III and the 5th......, and system integration of the high temperature PEMFC. The strategic developments of the FURIM are in three steps: (1) further improvement of the high temperature polymer membranes and related materials; (2) development of technological units including fuel cell stack, hydrocarbon reformer, afterburner...... and power management system, that are compatible with the HT-PEMFC; and (3) integration of the HT-PEMFC stack with these compatible subunits. The main goal of the project is a 2kWel HT-PEMFC stack operating in a temperature range of 120-220°C, with a single cell performance target of 0.7 A/cm² at a cell...

Integrating Quality Improvement and Continuing Professional Development at an Academic Medical Center: A Partnership Between Practice Plan, Hospital, and Medical School.

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Gold, Barbara; England, Dawn; Riley, William; Jacobs-Halsey, Ginny; Webb, Corinne; Daniels, Bobbi

2016-01-01

While quality improvement (QI) initiatives can be a highly effective means for improving health care delivery in academic medical centers (AMCs), many health care professionals are not formally trained in basic QI methodology, engaging clinicians in QI activities can be challenging, and there is often a lack of integration and coordination among QI functions (eg, Departments of Quality and Safety, Continuing Professional Development). In our AMC, we undertook a collaborative approach to achieve better vertical and horizontal integration of our QI education efforts. This article provides a case example describing our organizational context, what was done, and with what effect and makes our example and lessons learned available to others. We developed a new educational QI program that was jointly planned and implemented by a group comprising major QI stakeholders. This project was intended to create horizontal organizational linkages between continuing professional development, clinicians, the hospital, and QI department and produce QI activities that aligned with the strategic objectives of senior management. The group developed and implemented a curriculum based on Lean methodology and concepts from the Institute for Health Care Improvement Model for Improvement. Two cohorts (27 teams) completed the training and planned and implemented QI projects. All projects were aligned with organizational quality, safety, and patient experience goals. The majority of projects met their aim statements. This case description provides an example of successful horizontal integration of an AMCs' QI functions to disseminate knowledge and implement meaningful QI aligned with strategic objectives (vertical integration).

Integrating qualitative research methods into care improvement efforts within a learning health system: addressing antibiotic overuse.

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Munoz-Plaza, Corrine E; Parry, Carla; Hahn, Erin E; Tang, Tania; Nguyen, Huong Q; Gould, Michael K; Kanter, Michael H; Sharp, Adam L

2016-08-15

Despite reports advocating for integration of research into healthcare delivery, scant literature exists describing how this can be accomplished. Examples highlighting application of qualitative research methods embedded into a healthcare system are particularly needed. This article describes the process and value of embedding qualitative research as the second phase of an explanatory, sequential, mixed methods study to improve antibiotic stewardship for acute sinusitis. Purposive sampling of providers for in-depth interviews improved understanding of unwarranted antibiotic prescribing and elicited stakeholder recommendations for improvement. Qualitative data collection, transcription and constant comparative analyses occurred iteratively. Emerging themes and sub-themes identified primary drivers of unwarranted antibiotic prescribing patterns and recommendations for improving practice. These findings informed the design of a health system intervention to improve antibiotic stewardship for acute sinusitis. Core components of the intervention are also described. Qualitative research can be effectively applied in learning healthcare systems to elucidate quantitative results and inform improvement efforts.

Improving Demographic Components of Integrated Assessment Models: The Effect of Changes in Population Composition by Household Characteristics

Energy Technology Data Exchange (ETDEWEB)

Brian C. O' Neill

2006-08-09

This report describes results of the research project on "Improving Demographic Components of Integrated Assessment Models: The Effect of Changes in Population Composition by Household Characteristics". The overall objective of this project was to improve projections of energy demand and associated greenhouse gas emissions by taking into account demographic factors currently not incorporated in Integrated Assessment Models (IAMs) of global climate change. We proposed to examine the potential magnitude of effects on energy demand of changes in the composition of populations by household characteristics for three countries: the U.S., China, and Indonesia. For each country, we planned to analyze household energy use survey data to estimate relationships between household characteristics and energy use; develop a new set of detailed household projections for each country; and combine these analyses to produce new projections of energy demand illustrating the potential importance of consideration of households.

Integrating prevention of mother-to-child HIV transmission programs to improve uptake: a systematic review.

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Lorainne Tudor Car

Full Text Available BACKGROUND: We performed a systematic review to assess the effect of integrated perinatal prevention of mother-to-child transmission of HIV interventions compared to non- or partially integrated services on the uptake in low- and middle-income countries. METHODS: We searched for experimental, quasi-experimental and controlled observational studies in any language from 21 databases and grey literature sources. RESULTS: Out of 28 654 citations retrieved, five studies met our inclusion criteria. A cluster randomized controlled trial reported higher probability of nevirapine uptake at the labor wards implementing HIV testing and structured nevirapine adherence assessment (RRR 1.37, bootstrapped 95% CI, 1.04-1.77. A stepped wedge design study showed marked improvement in antiretroviral therapy (ART enrolment (44.4% versus 25.3%, p<0.001 and initiation (32.9% versus 14.4%, p<0.001 in integrated care, but the median gestational age of ART initiation (27.1 versus 27.7 weeks, p = 0.4, ART duration (10.8 versus 10.0 weeks, p = 0.3 or 90 days ART retention (87.8% versus 91.3%, p = 0.3 did not differ significantly. A cohort study reported no significant difference either in the ART coverage (55% versus 48% versus 47%, p = 0.29 or eight weeks of ART duration before the delivery (50% versus 42% versus 52%; p = 0.96 between integrated, proximal and distal partially integrated care. Two before and after studies assessed the impact of integration on HIV testing uptake in antenatal care. The first study reported that significantly more women received information on PMTCT (92% versus 77%, p<0.001, were tested (76% versus 62%, p<0.001 and learned their HIV status (66% versus 55%, p<0.001 after integration. The second study also reported significant increase in HIV testing uptake after integration (98.8% versus 52.6%, p<0.001. CONCLUSION: Limited, non-generalizable evidence supports the effectiveness of integrated PMTCT programs. More research measuring coverage and

Studies on improved integrated membrane-based chromatographic process for bioseparation

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Xu, Yanke

To improve protein separation and purification directly from a fermentation broth, a novel membrane filtration-cum-chromatography device configuration having a relatively impermeable coated zone near the hollow fiber module outlet has been developed. The integrated membrane filtration-cum-chromatography unit packed with chromatographic beads on the shell side of the hollow fiber unit enjoys the advantages of both membrane filtration and chromatography; it allows one to load the chromatographic media directly from the fermentation broth or lysate and separate the adsorbed proteins through the subsequent elution step in a cyclic process. Interfacial polymerization was carried out to coat the bottom section of the hollow fiber membrane while leaving the rest of the hollow fiber membrane unaffected. Myoglobin (Mb), bovine serum albumin (BSA) and a-lactalbumin (a-LA) were used as model proteins in binary mixtures. Separation behaviors of binary protein mixtures were studied in devices using either an ultrafiltration (UF) membrane or a microfiltration (MF) membrane. Experimental results show that the breakthrough time and the protein loading capacities were dramatically improved after coating in both UF and MF modules. For a synthetic yeast fermentation broth feed, the Mb and a-LA elution profiles for the four consecutive cyclic runs were almost superimposable. Due to the lower transmembrane flux in this device plus the periodical washing-elution during the chromatographic separation, fouling was not a problem as it is in conventional microfiltration. A mathematical model describing the hydrodynamic and protein loading behaviors of the integrated device using UF membrane with a coated zone was developed. The simulation results for the breakthrough agree well with the experimental breakthrough curves. The optimal length of the coated zone was obtained from the simulation. A theoretical analysis of the protein mass transfer was performed using a diffusion-convection model

Faculty Integration of Technology into Instruction and Students' Perceptions of Computer Technology to Improve Student Learning

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Keengwe, Jared

2007-01-01

There has been a remarkable improvement in access and rate of adoption of technology in higher education. Even so, reports indicate that faculty members are not integrating technology into instruction in ways that make a difference in student learning (Cuban, 2001; McCannon & Crews, 2000). To help faculty make informed decisions on student…

Improving the variational path integral approach to the quantum double-well potential

International Nuclear Information System (INIS)

Bao Jingdong; Wang Hongyu

2002-01-01

An improved variational path integral approach is developed and applied to the quantum double-well potential, in which part of the quartic term of the potential is included in the trial action. The expression of the effective classical potential (ECP) under a non-Gaussian expectation is obtained. Here the frequency and fourth-order derivative of the potential are treated as two variational parameters, determined by the minimization of the ECP at each point. We calculate the ECP, the free energy and the level splitting of a symmetrical double-well potential. It is shown that the present results are better than those of the Feynman-Kleinert Gaussian variational method. (author)

Improving integrated waste management at the regional level: the case of Lombardia.

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Rigamonti, Lucia; Falbo, Alida; Grosso, Mario

2013-09-01

The article summarises the main results of the 'Gestione Rifiuti in Lombardia: Analisi del ciclo di vita' (Waste management in Lombardia region: Life cycle assessment; GERLA) project. Life cycle assessment (LCA) has been selected by Regione Lombardia as a strategic decision support tool in the drafting of its new waste management programme. The goal was to use the life cycle thinking approach to assess the current regional situation and thus to give useful strategic indications for the future waste management. The first phase of the study consisted of the LCA of the current management of municipal waste in the Lombardia region (reference year: 2009). The interpretation of such results has allowed the definition of four possible waste management scenarios for the year 2020, with the final goal being to improve the environmental performance of the regional system. The results showed that the current integrated waste management of Lombardia region is already characterised by good energy and environmental performances. However, there is still room for further improvement: actions based, on the one hand, on a further increase in recycling rates and, on the other hand, on a series of technological modifications, especially in food waste and residual waste management, can be undertaken to improve the overall system.

Multimodal user interfaces to improve social integration of elderly and mobility impaired.

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Dias, Miguel Sales; Pires, Carlos Galinho; Pinto, Fernando Miguel; Teixeira, Vítor Duarte; Freitas, João

2012-01-01

Technologies for Human-Computer Interaction (HCI) and Communication have evolved tremendously over the past decades. However, citizens such as mobility impaired or elderly or others, still face many difficulties interacting with communication services, either due to HCI issues or intrinsic design problems with the services. In this paper we start by presenting the results of two user studies, the first one conducted with a group of mobility impaired users, comprising paraplegic and quadriplegic individuals; and the second one with elderly. The study participants carried out a set of tasks with a multimodal (speech, touch, gesture, keyboard and mouse) and multi-platform (mobile, desktop) system, offering an integrated access to communication and entertainment services, such as email, agenda, conferencing, instant messaging and social media, referred to as LHC - Living Home Center. The system was designed to take into account the requirements captured from these users, with the objective of evaluating if the adoption of multimodal interfaces for audio-visual communication and social media services, could improve the interaction with such services. Our study revealed that a multimodal prototype system, offering natural interaction modalities, especially supporting speech and touch, can in fact improve access to the presented services, contributing to the reduction of social isolation of mobility impaired, as well as elderly, and improving their digital inclusion.

Integrating Participatory Design and Health Literacy to Improve Research and Interventions.

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Neuhauser, Linda

2017-01-01

Health communication is an essential health promotion strategy to convert scientific findings into actionable, empowering information for the public. Health communication interventions have shown positive outcomes, but many efforts have been disappointing. A key weakness is that expert-designed health communication is often overly generic and not adequately aligned with the abilities, preferences and life situations of specific audiences. The emergence of the field of health literacy is providing powerful theoretical guidance and practice strategies. Health literacy, in concert with other determinants of health, has greatly advanced understanding of factors that facilitate or hinder health promotion at individual, organizational and community settings. However, health literacy models are incomplete and interventions have shown only modest success to date. A challenge is to move beyond the current focus on individual comprehension and address deeper factors of motivation, self-efficacy and empowerment, as well as socio-environmental influences, and their impact to improve health outcomes and reduce health disparities. Integrating participatory design theory and methods drawn from social sciences and design sciences can significantly improve health literacy models and interventions. Likewise, researchers and practitioners using participatory design can greatly benefit from incorporating health literacy principles into their efforts. Such interventions at multiple levels are showing positive health outcomes and reduction of health disparities, but this approach is complex and not yet widespread. This chapter focuses on research findings about health literacy and participatory design to improve health promotion, and practical guidance and case examples for researchers, practitioners and policymakers.

Tuning them in versus turning them on: how do we interest students in working with older adults?

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Gross, Patricia E; Eshbaugh, Elaine M

2011-01-01

As a nation, we face a shortage of individuals to serve our aging population. Therefore, the recruitment of undergraduate students into gerontology programs is an important, although challenging task. The purpose of this study was to determine if students who do not choose to major in gerontology do so because they simply are unaware of the opportunities or because they are uninterested. College students who were not gerontology majors (N = 226) were surveyed to determine whether they were aware of a gerontology major at their university, whether they could define gerontology, and their reasons for not pursuing gerontology. Results suggest that a lack of awareness, rather than a lack of interest, may be responsible for the challenges of recruiting college students into the field of gerontology. This implies that the most efficient path to bolstering our gerontology workforce may be to make students aware of the diverse and rewarding career opportunities in the field of aging.

Integrating quantitative thinking into an introductory biology course improves students' mathematical reasoning in biological contexts.

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Hester, Susan; Buxner, Sanlyn; Elfring, Lisa; Nagy, Lisa

2014-01-01

Recent calls for improving undergraduate biology education have emphasized the importance of students learning to apply quantitative skills to biological problems. Motivated by students' apparent inability to transfer their existing quantitative skills to biological contexts, we designed and taught an introductory molecular and cell biology course in which we integrated application of prerequisite mathematical skills with biology content and reasoning throughout all aspects of the course. In this paper, we describe the principles of our course design and present illustrative examples of course materials integrating mathematics and biology. We also designed an outcome assessment made up of items testing students' understanding of biology concepts and their ability to apply mathematical skills in biological contexts and administered it as a pre/postcourse test to students in the experimental section and other sections of the same course. Precourse results confirmed students' inability to spontaneously transfer their prerequisite mathematics skills to biological problems. Pre/postcourse outcome assessment comparisons showed that, compared with students in other sections, students in the experimental section made greater gains on integrated math/biology items. They also made comparable gains on biology items, indicating that integrating quantitative skills into an introductory biology course does not have a deleterious effect on students' biology learning.

Integrating Quantitative Thinking into an Introductory Biology Course Improves Students’ Mathematical Reasoning in Biological Contexts

Science.gov (United States)

Hester, Susan; Buxner, Sanlyn; Elfring, Lisa; Nagy, Lisa

2014-01-01

Recent calls for improving undergraduate biology education have emphasized the importance of students learning to apply quantitative skills to biological problems. Motivated by students’ apparent inability to transfer their existing quantitative skills to biological contexts, we designed and taught an introductory molecular and cell biology course in which we integrated application of prerequisite mathematical skills with biology content and reasoning throughout all aspects of the course. In this paper, we describe the principles of our course design and present illustrative examples of course materials integrating mathematics and biology. We also designed an outcome assessment made up of items testing students’ understanding of biology concepts and their ability to apply mathematical skills in biological contexts and administered it as a pre/postcourse test to students in the experimental section and other sections of the same course. Precourse results confirmed students’ inability to spontaneously transfer their prerequisite mathematics skills to biological problems. Pre/postcourse outcome assessment comparisons showed that, compared with students in other sections, students in the experimental section made greater gains on integrated math/biology items. They also made comparable gains on biology items, indicating that integrating quantitative skills into an introductory biology course does not have a deleterious effect on students’ biology learning. PMID:24591504

Integrating rapid diagnostics and antimicrobial stewardship improves outcomes in patients with antibiotic-resistant Gram-negative bacteremia.

Science.gov (United States)

Perez, Katherine K; Olsen, Randall J; Musick, William L; Cernoch, Patricia L; Davis, James R; Peterson, Leif E; Musser, James M

2014-09-01

An intervention for Gram-negative bloodstream infections that integrated mass spectrometry technology for rapid diagnosis with antimicrobial stewardship oversight significantly improved patient outcomes and reduced hospital costs. As antibiotic resistance rates continue to grow at an alarming speed, the current study was undertaken to assess the impact of this intervention in a challenging patient population with bloodstream infections caused by antibiotic-resistant Gram-negative bacteria. A total of 153 patients with antibiotic-resistant Gram-negative bacteremia hospitalized prior to the study intervention were compared to 112 patients treated post-implementation. Outcomes assessed included time to optimal antibiotic therapy, time to active treatment when inactive, hospital and intensive care unit length of stay, all-cause 30-day mortality, and total hospital expenditures. Integrating rapid diagnostics with antimicrobial stewardship improved time to optimal antibiotic therapy (80.9 h in the pre-intervention period versus 23.2 h in the intervention period, P Gram-negatives. The intervention decreased hospital and intensive care unit length of stay, total hospital costs, and reduced all-cause 30-day mortality. Copyright © 2014. Published by Elsevier Ltd.

Reporting quality of conference abstracts on randomised controlled trials in gerontology and geriatrics: a cross-sectional investigation.

Science.gov (United States)

Mann, Eva; Meyer, Gabriele

2011-01-01

Without transparent reporting of how a randomised controlled trial was designed and conducted and of the methods used, its internal validity cannot be assessed by the reader. A congress abstract is often the only source providing information about a trial. In January 2008, an extended CONSORT statement on abstract reporting was published. Its impact has yet to be evaluated. Using a slightly modified CONSORT checklist comprising 17 items, we thus investigated the reporting quality of randomised controlled trials published in the book of abstracts presented at the World Congress of Geriatrics and Gerontology in Paris in July 2009. A total of n=4,416 abstracts was screened for inclusion; n=129 met the inclusion criteria. The overall quality of the abstracts was remarkably poor. The primary outcome was mentioned in 34/129 abstracts (26%), none of the abstracts reported on the procedure of random allocation of participants or clusters, 21/129 abstracts (16%) reported some kind of blinding, and the attrition rate was mentioned in only 12/129 abstracts (9%). The majority of abstracts fulfilled two items: description of intended intervention for each group (102/129; 79%) and general interpretation of results (107/129; 83%). Trial status was reported in all abstracts. Both journal editors and committees organising congresses are requested to define the use of the CONSORT statement as a prerequisite in their guidelines for authors and to instruct reviewers to conduct compliance checks. Medical associations should finally endorse the indispensability of the CONSORT statement and publish it in their journals. Otherwise the intended benefits cannot be fully generated. Copyright © 2010. Published by Elsevier GmbH.

Promoting access to innovation for frail old persons. IAGG (International Association of Gerontology and Geriatrics), WHO (World Health Organization) and SFGG (Société Française de Gériatrie et de Gérontologie) Workshop--Athens January 20-21, 2012.

Science.gov (United States)

Berrut, G; Andrieu, S; Araujo de Carvalho, I; Baeyens, J P; Bergman, H; Cassim, B; Cerreta, F; Cesari, M; Cha, H B; Chen, L K; Cherubini, A; Chou, M Y; Cruz-Jentoft, A J; De Decker, L; Du, P; Forette, B; Forette, F; Franco, A; Guimaraes, R; Guttierrez-Robledo, L M; Jauregui, J; Khavinson, V; Lee, W J; Peng, L N; Perret-Guillaume, C; Petrovic, M; Retornaz, F; Rockwood, K; Rodriguez-Manas, L; Sieber, C; Spatharakis, G; Theou, O; Topinkova, E; Vellas, B; Benetos, A

2013-01-01

Frailty tends to be considered as a major risk for adverse outcomes in older persons, but some important aspects remain matter of debate. The purpose of this paper is to present expert's positions on the main aspects of the frailty syndrome in the older persons. Workshop organized by International Association of Gerontology and Geriatrics (IAGG), World Health Organization (WHO) and Société Française de Gériatrie et de Gérontologie (SFGG). Frailty is widely recognized as an important risk factor for adverse health outcomes in older persons. This can be of particular value in evaluating non-disabled older persons with chronic diseases but today no operational definition has been established. Nutritional status, mobility, activity, strength, endurance, cognition, and mood have been proposed as markers of frailty. Another approach calculates a multidimensional score ranging from "very fit" to "severely frail", but it is difficult to apply into the medical practice. Frailty appears to be secondary to multiple conditions using multiple pathways leading to a vulnerability to a stressor. Biological (inflammation, loss of hormones), clinical (sarcopenia, osteoporosis etc.), as well as social factors (isolation, financial situation) are involved in the vulnerability process. In clinical practice, detection of frailty is of major interest in oncology because of the high prevalence of cancer in older persons and the bad tolerance of the drug therapies. Presence of frailty should also be taken into account in the definition of the cardiovascular risks in the older population. The experts of the workshop have listed the points reached an agreement and those must to be a priority for improving understanding and use of frailty syndrome in practice. Frailty in older adults is a syndrome corresponding to a vulnerability to a stressor. Diagnostic tools have been developed but none can integrate at the same time the large spectrum of factors and the simplicity asked by the

Integrated respiratory and palliative care may improve outcomes in advanced lung disease

Directory of Open Access Journals (Sweden)

Natasha Smallwood

2018-02-01

Full Text Available The unaddressed palliative care needs of patients with advanced, nonmalignant, lung disease highlight the urgent requirement for new models of care. This study describes a new integrated respiratory and palliative care service and examines outcomes from this service. The Advanced Lung Disease Service (ALDS is a long-term, multidisciplinary, integrated service. In this single-group cohort study, demographic and prospective outcome data were collected over 4 years, with retrospective evaluation of unscheduled healthcare usage. Of 171 patients included, 97 (56.7% were male with mean age 75.9 years and 142 (83.0% had chronic obstructive pulmonary disease. ALDS patients had severely reduced pulmonary function (median (interquartile range (IQR forced expiratory volume in 1 s 0.8 (0.6–1.1 L and diffusing capacity of the lung for carbon monoxide 37.5 (29.0–48.0 % pred and severe breathlessness. All patients received nonpharmacological breathlessness management education and 74 (43.3% were prescribed morphine for breathlessness (median dose 9 mg·day−1. There was a 52.4% reduction in the mean number of emergency department respiratory presentations in the year after ALDS care commenced (p=0.007. 145 patients (84.8% discussed and/or completed an advance care plan. 61 patients died, of whom only 15 (24.6% died in an acute hospital bed. While this was a single-group cohort study, integrated respiratory and palliative care was associated with improved end-of-life care and reduced unscheduled healthcare usage.

Advances in Integrative Nanomedicine for Improving Infectious Disease Treatment in Public Health.

Science.gov (United States)

Bell, Iris R; Schwartz, Gary E; Boyer, Nancy N; Koithan, Mary; Brooks, Audrey J

2013-04-01

Infectious diseases present public health challenges worldwide. An emerging integrative approach to treating infectious diseases is using nanoparticle (NP) forms of traditional and alternative medicines. Advantages of nanomedicine delivery methods include better disease targeting, especially for intracellular pathogens, ability to cross membranes and enter cells, longer duration drug action, reduced side effects, and cost savings from lower doses. We searched Pubmed articles in English with keywords related to nanoparticles and nanomedicine. Nanotechnology terms were also combined with keywords for drug delivery, infectious diseases, herbs, antioxidants, homeopathy, and adaptation. NPs are very small forms of material substances, measuring 1-100 nanometers along at least one dimension. Compared with bulk forms, NPs' large ratio of surface-area-to-volume confers increased reactivity and adsorptive capacity, with unique electromagnetic, chemical, biological, and quantum properties. Nanotechnology uses natural botanical agents for green manufacturing of less toxic NPs. Nanoparticle herbs and nutriceuticals can treat infections via improved bioavailability and antiinflammatory, antioxidant, and immunomodulatory effects. Recent studies demonstrate that homeopathic medicines may contain source and/or silica nanoparticles because of their traditional manufacturing processes. Homeopathy, as a form of nanomedicine, has a promising history of treating epidemic infectious diseases, including malaria, leptospirosis and HIV/AIDS, in addition to acute upper respiratory infections. Adaptive changes in the host's complex networks underlie effects. Nanomedicine is integrative, blending modern technology with natural products to reduce toxicity and support immune function. Nanomedicine using traditional agents from alternative systems of medicine can facilitate progress in integrative public health approaches to infectious diseases.

Neighborhood built environment and physical activity of Japanese older adults: results from the Aichi Gerontological Evaluation Study (AGES

Directory of Open Access Journals (Sweden)

Hirai Hiroshi

2011-08-01

Full Text Available Abstract Background Although many studies have reported the association between neighborhood built environment (BE and physical activity (PA, less is known about the associations for older populations or in countries besides the US and Australia. The aim of this paper is to examine the associations for older adult populations in Japan. Methods Our analyses were based on cross-sectional data from the Aichi Gerontological Evaluation Study (AGES, conducted in 2003. The respondents were older adults, aged 65 years or over (n = 9,414, from 8 municipalities across urban, suburban, and rural areas. The frequency of leisure time sports activity and total walking time were used as the outcome variables. Using geographic information systems (GIS, we measured residential density, street connectivity, number of local destinations, access to recreational spaces, and land slope of the respondents' neighborhoods, based on network distances with multiple radii (250 m, 500 m, 1,000 m. An ordinal logistic regression model was used to analyze the association between PA and BE measures. Results Population density and presence of parks or green spaces had positive associations with the frequency of sports activity, regardless of the selected buffer zone. The analysis of total walking time, however, showed only a few associations. Conclusions Our findings provide mixed support for the association between PA and the characteristics of BE measures, previously used in Western settings. Some characteristics of the neighborhood built environment may facilitate leisure time sports activity, but not increase the total walking time for Japanese older adults.

Integrated care for patients with a stroke in the Netherlands: results and experiences from a national Breakthrough Collaborative Improvement project

Directory of Open Access Journals (Sweden)

M.M.N. Minkman

2005-03-01

Full Text Available Purpose: This article considers the question if measurable improvements are achieved in the quality of care in stroke services by using a Breakthrough collaborative quality improvement model. Context of case: Despite the availability of explicit criteria, evidence based guidelines, national protocols and examples of best practices; stroke care in the Netherlands did not improve substantially yet. For that reason a national collaborative started in 2002 to improve integrated stroke care in 23 self selected stroke services. Data sources: Characteristics of sites, teams, aims and changes were assessed by using a questionnaire and monthly self-reports of teams. Progress in achieving significant quality improvement has been assessed on a five point Likert scale (IHI score. Case description: The stroke services (n=23 formed multidisciplinary teams, which worked together in a collaborative based on the IHI Breakthrough Series Model. Teams received instruction in quality improvement, reviewed self reported performance data, identified bottlenecks and improvement goals, and implemented “potentially better practices” based on criteria from the Edisse study, evidence based guidelines, own ideas and expert opinion. Conclusion and discussion: Quality of care has been improved in most participating stroke services. Eighty-seven percent of the teams have improved their care significantly on at least one topic. About 34% of the teams have achieved significant improvement on all aims within the time frame of the project. The project has contributed to the further development and spread of integrated stroke care in the Netherlands.

At the Nexus of History, Ecology, and Hydrobiogeochemistry: Improved Predictions across Scales through Integration.

Science.gov (United States)

Stegen, James C

2018-01-01

To improve predictions of ecosystem function in future environments, we need to integrate the ecological and environmental histories experienced by microbial communities with hydrobiogeochemistry across scales. A key issue is whether we can derive generalizable scaling relationships that describe this multiscale integration. There is a strong foundation for addressing these challenges. We have the ability to infer ecological history with null models and reveal impacts of environmental history through laboratory and field experimentation. Recent developments also provide opportunities to inform ecosystem models with targeted omics data. A major next step is coupling knowledge derived from such studies with multiscale modeling frameworks that are predictive under non-steady-state conditions. This is particularly true for systems spanning dynamic interfaces, which are often hot spots of hydrobiogeochemical function. We can advance predictive capabilities through a holistic perspective focused on the nexus of history, ecology, and hydrobiogeochemistry.

Engaging Clinicians to lead improvement of care integration

OpenAIRE

White, Sharyn Ann; Ewald, Dan; Wilson, Catriona; Rose, Vicki

2017-01-01

Introduction: Health systems are complex and the outcomes of a given action are not easily predictable. While the International experience provides principles for successful integration, these require local adaptation to be effective in the context of a regional area of Northern NSW.At an organisational level health jurisdictions in the region have been working in partnership, building trust and developing a shared vision for Integration (top-down) but we needed to learn what could be done at...

Pursuing Improvement in Clinical Reasoning: The Integrated Clinical Education Theory.

Science.gov (United States)

Jessee, Mary Ann

2018-01-01

The link between clinical education and development of clinical reasoning is not well supported by one theoretical perspective. Learning to reason during clinical education may be best achieved in a supportive sociocultural context of nursing practice that maximizes reasoning opportunities and facilitates discourse and meaningful feedback. Prelicensure clinical education seldom incorporates these critical components and thus may fail to directly promote clinical reasoning skill. Theoretical frameworks supporting the development of clinical reasoning during clinical education were evaluated. Analysis of strengths and gaps in each framework's support of clinical reasoning development was conducted. Commensurability of philosophical underpinnings was confirmed, and complex relationships among key concepts were elucidated. Six key concepts and three tenets comprise an explanatory predictive theory-the integrated clinical education theory (ICET). ICET provides critical theoretical support for inquiry and action to promote clinical education that improves development of clinical reasoning skill. [J Nurs Educ. 2018;57(1):7-13.]. Copyright 2018, SLACK Incorporated.

The Work Compatibility Improvement Framework: an integrated perspective of the human-at-work system.

Science.gov (United States)

Genaidy, Ash; Salem, Sam; Karwowski, Waldemar; Paez, Omar; Tuncel, Setenay

2007-01-15

The industrial revolution demonstrated the limitations of a pure mechanistic approach towards work design. Human work is now seen as a complex entity that involves different scientific branches and blurs the line between mental and physical activities. Job design has been a traditional concern of applied psychology, which has provided insight into the interaction between the individual and the work environment. The goal of this paper is to introduce the human-at-work system as a holistic approach to organizational design. It postulates that the well-being of workers and work outcomes are issues that need to be addressed jointly, moving beyond traditional concepts of job satisfaction and work stress. The work compatibility model (WCM) is introduced as an engineering approach that seeks to integrate previous constructs of job and organizational design. The WCM seeks a balance between energy expenditure and replenishment. The implementation of the WCM in industrial settings is described within the context of the Work Compatibility Improvement Framework. A sample review of six models (motivation-hygiene theory; job characteristics theory; person-environment fit; demand-control model; and balance theory) provides the foundation for the interaction between the individual and the work environment. A review of three workload assessment methods (position analysis questionnaire, job task analysis and NASA task load index) gives an example of the foundation for the taxonomy of work environment domains. Previous models have sought to identify a balance state for the human-at-work system. They differentiated between the objective and subjective effects of the environment and the worker. An imbalance between the person and the environment has been proven to increase health risks. The WCM works with a taxonomy of 12 work domains classified in terms of the direct (acting) or indirect (experienced) effect on the worker. In terms of measurement, two quantitative methods are proposed

Integrating Science-Based Co-management, Partnerships, Participatory Processes and Stewardship Incentives to Improve the Performance of Small-Scale Fisheries

Directory of Open Access Journals (Sweden)

Kendra A. Karr

2017-10-01

Full Text Available Small scale fisheries are critically important for the provision of food security, livelihoods, and economic development for billions of people. Yet, most of these fisheries appear to not be achieving either fisheries or conservation goals, with respect to creating healthier oceans that support more fish, feed more people and improve livelihoods. Research and practical experience have elucidated many insights into how to improve the performance of small-scale fisheries. Here, we present lessons learned from five case studies of small-scale fisheries in Cuba, Mexico, the Philippines, and Belize. The major lessons that arise from these cases are: (1 participatory processes empower fishers, increase compliance, and support integration of local and scientific knowledge; (2 partnership across sectors improves communication and community buy-in; (3 scientific analysis can lead fishery reform and be directly applicable to co-management structures. These case studies suggest that a fully integrated approach that implements a participatory process to generate a scientific basis for fishery management (e.g., data collection, analysis, design and to design management measures among stakeholders will increase the probability that small-scale fisheries will implement science-based management and improve their performance.

Factors Associated with Falls in Community-Dwelling Older People with Focus on Participation in Sport Organizations: The Japan Gerontological Evaluation Study Project

Directory of Open Access Journals (Sweden)

Takahiro Hayashi

2014-01-01

Full Text Available Objective. Promoting participation in sport organizations may be a population strategy for preventing falls in older people. In this study, we examined whether participation in sport organizations is associated with fewer falls in older people even after adjusting for multiple individual and environmental factors. Methods. We used the Japan Gerontological Evaluation Study data of 90,610 people (31 municipalities who were not eligible for public long-term care. Logistic regression analysis was performed, with multiple falls over the past year as the dependent variable and participation in a sport organization as the independent variable, controlling for 13 factors. These included individual factors related to falls, such as age and sex, and environmental factors such as population density of the habitable area. Results. A total of 6,391 subjects (7.1% had a history of multiple falls. Despite controlling for 13 variables, those who participated in a sport organization at least once a week were approximately ≥20% less likely to fall than those who did not participate at all (once a week; odds ratio = 0.82 and 95% confidence interval = 0.72–0.95. Conclusion. Participation in a sport organization at least once per week might help prevent falls in the community-dwelling older people.

Multilevel examination of facility characteristics, social integration, and health for older adults living in nursing homes.

Science.gov (United States)

Leedahl, Skye N; Chapin, Rosemary K; Little, Todd D

2015-01-01

Testing a model based on past research and theory, this study assessed relationships between facility characteristics (i.e., culture change efforts, social workers) and residents' social networks and social support across nursing homes; and examined relationships between multiple aspects of social integration (i.e., social networks, social capital, social engagement, social support) and mental and functional health for older adults in nursing homes. Data were collected at nursing homes using a planned missing data design with random sampling techniques. Data collection occurred at the individual-level through in-person structured interviews with older adult nursing home residents (N = 140) and at the facility-level (N = 30) with nursing home staff. The best fitting multilevel structural equation model indicated that the culture change subscale for relationships significantly predicted differences in residents' social networks. Additionally, social networks had a positive indirect relationship with mental and functional health among residents primarily via social engagement. Social capital had a positive direct relationship with both health outcomes. To predict better social integration and mental and functional health outcomes for nursing homes residents, study findings support prioritizing that close relationships exist among staff, residents, and the community as well as increased resident social engagement and social trust. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Improving lactic acid productivity from wheat straw hydrolysates by membrane integrated repeated batch fermentation under non-sterilized conditions

DEFF Research Database (Denmark)

Zhang, Yuming; Chen, Xiangrong; Qi, Benkun

2014-01-01

to eliminate the sequential utilization of mixed sugar and feedback inhibition during batch fermentation, membrane integrated repeated batch fermentation (MIRB) was used to improve LA productivity. With MIRB, a high cell density was obtained and the simultaneous fermentation of glucose, xylose and arabinose...

Moderate-intensity endurance training improves endothelial glycocalyx layer integrity in healthy young men.

Science.gov (United States)

Majerczak, Joanna; Grandys, Marcin; Duda, Krzysztof; Zakrzewska, Agnieszka; Balcerczyk, Aneta; Kolodziejski, Leszek; Szymoniak-Chochol, Dorota; Smolenski, Ryszard T; Bartosz, Grzegorz; Chlopicki, Stefan; Zoladz, Jerzy A

2017-01-01

What is the central question of this study? The main aim of the present study was to determine the effect of prolonged moderate-intensity endurance training on the endothelial glycocalyx layer integrity in relationship to the training-induced changes in oxidative stress and antioxidant defence in humans. What is the main finding and its importance? We have shown, for the first time, a protective effect of prolonged moderate-intensity endurance training on endothelial glycocalyx layer integrity, as judged by significantly lower basal and end-exercise serum concentrations of glycocalyx damage markers, i.e. syndecan-1 and heparan sulfate, accompanied by attenuation of oxidative stress and enhancement of antioxidant defence after training in previously untrained healthy young men. In this study, we evaluated the effect of 20 weeks of moderate-intensity endurance training (ET) on the endothelial glycocalyx layer integrity in relationship to the training-induced changes in antioxidant defence. Eleven healthy young, untrained men performed an incremental cycling exercise bout until exhaustion before and after 20 weeks of ET. Endurance training consisted of 40 min sessions, mainly of moderate intensity (∼50% of maximal oxygen uptake), performed four times per week. Venous blood samples were taken at rest and at the end of the maximal exercise test. Muscle biopsies from vastus lateralis were taken before and after the training. Endurance training resulted in a significant increase in physical capacity (P  0.05). Moderate-intensity ET exerts a pronounced protective effect on endothelial glycocalyx integrity at rest and during exercise, probably through an improvement of antioxidant defence that may represent the vasoprotective mechanisms highly responsive to moderate-intensity endurance training. © 2016 The Authors. Experimental Physiology © 2016 The Physiological Society.

Towards Integrated Health Technology Assessment for Improving Decision Making in Selected Countries.

Science.gov (United States)

Oortwijn, Wija; Determann, Domino; Schiffers, Krijn; Tan, Siok Swan; van der Tuin, Jeroen

2017-09-01

To assess the level of comprehensiveness of health technology assessment (HTA) practices around the globe and to formulate recommendations for enhancing legitimacy and fairness of related decision-making processes. To identify best practices, we developed an evaluation framework consisting of 13 criteria on the basis of the INTEGRATE-HTA model (integrative perspective on assessing health technologies) and the Accountability for Reasonableness framework (deliberative appraisal process). We examined different HTA systems in middle-income countries (Argentina, Brazil, and Thailand) and high-income countries (Australia, Canada, England, France, Germany, Scotland, and South Korea). For this purpose, desk research and structured interviews with relevant key stakeholders (N = 32) in the selected countries were conducted. HTA systems in Canada, England, and Scotland appear relatively well aligned with our framework, followed by Australia, Germany, and France. Argentina and South Korea are at an early stage, whereas Brazil and Thailand are at an intermediate level. Both desk research and interviews revealed that scoping is often not part of the HTA process. In contrast, providing evidence reports for assessment is well established. Indirect and unintended outcomes are increasingly considered, but there is room for improvement. Monitoring and evaluation of the HTA process is not well established across countries. Finally, adopting transparent and robust processes, including stakeholder consultation, takes time. This study presents a framework for assessing the level of comprehensiveness of the HTA process in a country. On the basis of applying the framework, we formulate recommendations on how the HTA community can move toward a more integrated decision-making process using HTA. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Use of a Hands Free, Instantaneous, Closed-Loop Communication Device Improves Perception of Communication and Workflow Integration in an Academic Teaching Hospital: A Pilot Study.

Science.gov (United States)

Fang, Daniel Z; Patil, Teja; Belitskaya-Levy, Ilana; Yeung, Marianne; Posley, Keith; Allaudeen, Nazima

2017-11-17

Efficient and effective communication between providers is critical to quality patient care within a hospital system. Hands free communication devices (HFCD) allow instantaneous, closed-loop communication between physicians and other members of a multidisciplinary team, providing a communication advantage over traditional pager systems. HFCD have been shown to decrease emergency room interruptions, improve nursing communication, improve speed of information flow, and eliminate health care waste. We evaluated the integration of an HFCD with an existing alphanumeric paging system on an acute inpatient medicine service. We conducted a prospective, observational, survey-based study over twenty-four weeks in an academic tertiary care center with attending physicians and residents. Our intervention involved the implementation of an HFCD alongside the existing paging system. Fifty-six pre and post surveys evaluated the perception of improvement in communication and the integration of the HFCD into existing workflow. We saw significant improvements in the ability of an HFCD to help physicians communicate thoughts clearly, communicate thoughts effectively, reach team members, reach ancillary staff, and stay informed about patients. Physicians also reported better workflow integration during admissions, rounds, discharge, and teaching sessions. Qualitative data from post surveys demonstrated that the greatest strengths of the HFCD included the ability to reach colleagues and staff quickly, provide instant access to individuals of the care team, and improve overall communication. Integration of an instantaneous, hands free, closed loop communication system alongside the existing pager system can provide improvements in the perceptions of communication and workflow integration in an academic medicine service. Future studies are needed to correlate these subjective findings with objective measures of quality and safety.

France's Financial (Eco)system. Improving the integration of sustainability factors

International Nuclear Information System (INIS)

Morel, Romain; Cochran, Ian; Robins, Nick

2015-11-01

In the run-up of the COP21, much international attention is focused on France. While mainly related to climate change negotiations, this creates an opportunity to take a broader look at French domestic policies and practices on sustainability. This report presents the French financial system and draws lessons from the French ongoing experience in improving the integration of sustainability issues that could be shared with other countries. The present report summarizes and analyses the key initiatives and dynamics at stake in France. It focuses on both the climate-related issues that have recently received significant attention and the development of broader Environmental, Social and Governance (ESG) issues over the past twenty years. The dynamics that have shaped the last two decades have both led to and been influenced by the emergence of an 'ecosystem' of commercial, public and non-profit actors and experts involved in the appropriation and integration of sustainability issues across the sector. Using the framework of analysis presented in the UNEP Inquiry global report, this case study examines the landscape of actors, private initiatives and public policy that has driven the emergence of this ecosystem and helped foster capacity building and the acquisition of expertise among sectoral actors. (authors)

Technical integrity and continuous improvement: Key to survival beyond the nineties

International Nuclear Information System (INIS)

Thorogood, J.L.

1994-01-01

Drilling decisions made before a rig reaches location make a significant contribution to an oil company's financial success. Of value to the company is not the ability to drill wells, but the ability to plan with confidence in the knowledge of what is possible. In spite of this, operators have tended to over-work day to day decisions about drilling out of proportion to their significance. Recognition of this fact has resulted in the present wave of contracting initiatives. A major challenge for the industry is to achieve the necessary transfer of responsibility without compromising the operator's license to operate. These changes will compel the service sector to develop a new culture of technical integrity and continuous improvement. To operate safely, measure performance and manage drilling risk, the transformation will oblige the service sector to adopt many technologies presently owned by oil companies

Improving integrative searching of systems chemical biology data using semantic annotation.

Science.gov (United States)

Chen, Bin; Ding, Ying; Wild, David J

2012-03-08

Systems chemical biology and chemogenomics are considered critical, integrative disciplines in modern biomedical research, but require data mining of large, integrated, heterogeneous datasets from chemistry and biology. We previously developed an RDF-based resource called Chem2Bio2RDF that enabled querying of such data using the SPARQL query language. Whilst this work has proved useful in its own right as one of the first major resources in these disciplines, its utility could be greatly improved by the application of an ontology for annotation of the nodes and edges in the RDF graph, enabling a much richer range of semantic queries to be issued. We developed a generalized chemogenomics and systems chemical biology OWL ontology called Chem2Bio2OWL that describes the semantics of chemical compounds, drugs, protein targets, pathways, genes, diseases and side-effects, and the relationships between them. The ontology also includes data provenance. We used it to annotate our Chem2Bio2RDF dataset, making it a rich semantic resource. Through a series of scientific case studies we demonstrate how this (i) simplifies the process of building SPARQL queries, (ii) enables useful new kinds of queries on the data and (iii) makes possible intelligent reasoning and semantic graph mining in chemogenomics and systems chemical biology. Chem2Bio2OWL is available at http://chem2bio2rdf.org/owl. The document is available at http://chem2bio2owl.wikispaces.com.

Conceptualizing physical activity behavior of older Korean-Americans: an integration of Korean culture and social cognitive theory.

Science.gov (United States)

Lim, Kyung-Choon; Waters, Catherine M; Froelicher, Erika S; Kayser-Jones, Jeanie S

2008-01-01

People can live longer and healthier lives by engaging in physical activity (PA). The purpose of this article is to assess the social cognitive theory (SCT) in relation to its relevance to produce cultural-specific directions for gerontological nursing practice in order to guide the design of PA interventions for Korean-American elders. SCT is compared to the Korean cultural, social, and health belief system and is analyzed and evaluated based on 3 criteria: assumptions of the theory, completeness and consistency, and essence of nursing. Within the Korean culture, as presumed in the SCT and the nursing paradigm, health-promoting behavior, such as PA, is conceptualized as the desire for a higher level of health rather than a fear of disease as is proposed by other health behavior theories. SCT with the integration of Korean culture recognizes cultural, developmental, societal, and other external constraints that may help in formulating interventions and better understanding of the limits faced by older Korean-Americans (OKAs) in their pursuit of routine PA.

Metformin reduces hyper-reactivity of platelets from patients with polycystic ovary syndrome by improving mitochondrial integrity.

Science.gov (United States)

Randriamboavonjy, Voahanginirina; Mann, W Alexander; Elgheznawy, Amro; Popp, Rüdiger; Rogowski, Paul; Dornauf, Imke; Dröse, Stefan; Fleming, Ingrid

2015-08-31

Polycystic ovary syndrome (PCOS) is associated with decreased fertility, insulin resistance and an increased risk of developing cardiovascular disease. Treating PCOS patients with metformin improves fertility and decreases cardiovascular complications. Given that platelet activation contributes to both infertility and cardiovascular disease development, we assessed platelet reactivity in PCOS patients and the consequences of metformin treatment. Compared to washed platelets from healthy donors, platelets from PCOS patients demonstrated enhanced reactivity and impaired activation of the AMP-activated kinase (AMPK). PCOS platelets also demonstrated enhanced expression of mitochondrial proteins such as the cytochrome c reductase, ATP synthase and the voltage-dependent anion channel-1. However, mitochondrial function was impaired as demonstrated by a decreased respiration rate. In parallel, the phosphorylation of dynamin-related protein-1 (Drp-1) on Ser616 was increased while that on Ser637 decreased. The latter changes were accompanied by decreased mitochondrial size. In insulin-resistant PCOS patients (HOMA-IR> 2) metformin treatment (1.7 g per day for 4 weeks to 6 months) improved insulin sensitivity, restored mitochondrial integrity and function and normalised platelet aggregation. Treatment was without effect in PCOS patients with HOMA-IRtreatment of megakaryocytes with metformin enhanced mitochondrial content and in the same cells metformin enhanced the phosphorylation of the Drp-1 on Ser637 via an AMPKα1-dependent mechanism. In conclusion, the improvement of mitochondrial integrity and platelet reactivity may contribute to the beneficial effects of metformin on cardiovascular disease.

Smart Microgrid Energy Management Controls for Improved Energy Efficiency and Renewables Integration at DoD Installations

Science.gov (United States)

2013-05-01

reduced greenhouse gas (GHG) emissions; 2. Increased energy efficiency; and 3. Increased energy surety. This demonstration will also directly impact ...megawatt (MW), as well as a gas-fired cogeneration plant in excess of 7 MW. In the future, additional solar PV, fuel cells and advanced energy storage... Energy Management Controls for Improved Energy Efficiency and Renewables Integration at DoD Installations May 2013 Report Documentation Page Form

Decision Support For Digester Algae Integration For Improved Environmental And Economic Sustainability

Energy Technology Data Exchange (ETDEWEB)

2017-06-28

The Idaho National Laboratory (INL) has teamed with University of Idaho and Boise State University to make the use of ADs more attractive by implementing a two-stage AD and coupling additional processes to the system. The addition of a polyhydroxyalkanoate (PHA) reactor, algae cultivation system, and a biomass treatment system such as fast-pyrolysis or hydrothermal liquefaction (HTL) would further sequester carbon and nutrients, as well as add valuable products that can be sold or used on-site to mitigate costs. The Decision-support for Digester-Algae IntegRation for Improved Environmental and Economic Sustainability (DAIRIEES) technoeconomic model will play a key role in evaluating the effectiveness and viability of this system to achieve economic and environmental sustainability by the dairy industry.

Three silver linings in the cloud of old age: an autobiographical perspective.

Science.gov (United States)

Haber, David

2014-01-01

Through the author's experiences as a gerontological social worker, graduate student in gerontology, and gerontology professor, the author discovered not only the cloud of old age, but three silver linings.

Integrated Management System in construction company-effective tool of quality, environment and safety level improving

OpenAIRE

Gašparík, Jozef

2009-01-01

Contribution Presents the struCture of integrated M anageMent systeM ( iMs) according to international standards ISO 9001:2008, ISO 14001:2004 and STN OHSAS 18001:2009, which consists of 3 management systems focused to quality, environment and safety of building processes. The purpose of paper is to describe basic steps concerning the development of IMS. Paper analises basic processes of IMS like company vision, IMS planning, implementing, monitoring, revive and improving. The paper presents ...

Fellowship Program in Health System Improvement: A novel approach integrating leadership development and patient-centred health system transformation.

Science.gov (United States)

Philippon, Donald J; Montesanti, Stephanie; Stafinski, Tania

2018-03-01

This article highlights a novel approach to professional development, integrating leadership, development and patient-centred health system transformation in the new Fellowship Program in Health System Improvement offered by the School of Public Health at the University of Alberta. Early assessment of the program is also provided.

Measuring the degree of integration for an integrated service network

Directory of Open Access Journals (Sweden)

Chenglin Ye

2012-09-01

Full Text Available Background: Integration involves the coordination of services provided by autonomous agencies and improves the organization and delivery of multiple services for target patients. Current measures generally do not distinguish between agencies' perception and expectation. We propose a method for quantifying the agencies' service integration. Using the data from the Children's Treatment Network (CTN, we aimed to measure the degree of integration for the CTN agencies in York and Simcoe.  Theory and Methods: We quantified the integration by the agreement between perceived and expected levels of involvement and calculated four scores from different perspectives for each agency. We used the average score to measure the global network integration and examined the sensitivity of the global score.  Results: Most agencies' integration scores were less than 65%. As measured by the agreement between every other agency's perception and expectation, the overall integration of CTN in Simcoe and York was 44% (95% CI: 39% - 49% and 52% (95% CI: 48% - 56%, respectively. The sensitivity analysis showed that the global scores were robust.  Conclusion: Our method extends existing measures of integration and possesses a good extent of validity. We can also apply the method in monitoring improvement and linking integration with other outcomes.

Measuring the degree of integration for an integrated service network

Directory of Open Access Journals (Sweden)

Chenglin Ye

2012-09-01

Full Text Available Background: Integration involves the coordination of services provided by autonomous agencies and improves the organization and delivery of multiple services for target patients. Current measures generally do not distinguish between agencies' perception and expectation. We propose a method for quantifying the agencies' service integration. Using the data from the Children's Treatment Network (CTN, we aimed to measure the degree of integration for the CTN agencies in York and Simcoe. Theory and Methods: We quantified the integration by the agreement between perceived and expected levels of involvement and calculated four scores from different perspectives for each agency. We used the average score to measure the global network integration and examined the sensitivity of the global score. Results: Most agencies' integration scores were less than 65%. As measured by the agreement between every other agency's perception and expectation, the overall integration of CTN in Simcoe and York was 44% (95% CI: 39% - 49% and 52% (95% CI: 48% - 56%, respectively. The sensitivity analysis showed that the global scores were robust. Conclusion: Our method extends existing measures of integration and possesses a good extent of validity. We can also apply the method in monitoring improvement and linking integration with other outcomes. 

Neighborhood food environment and body mass index among Japanese older adults: results from the Aichi Gerontological Evaluation Study (AGES

Directory of Open Access Journals (Sweden)

Hirai Hiroshi

2011-07-01

Full Text Available Abstract Background The majority of studies of the local food environment in relation to obesity risk have been conducted in the US, UK, and Australia. The evidence remains limited to western societies. The aim of this paper is to examine the association of local food environment to body mass index (BMI in a study of older Japanese individuals. Methods The analysis was based on 12,595 respondents from cross-sectional data of the Aichi Gerontological Evaluation Study (AGES, conducted in 2006 and 2007. Using Geographic Information Systems (GIS, we mapped respondents' access to supermarkets, convenience stores, and fast food outlets, based on a street network (both the distance to the nearest stores and the number of stores within 500 m of the respondents' home. Multiple linear regression and logistic regression analyses were performed to examine the association between food environment and BMI. Results In contrast to previous reports, we found that better access to supermarkets was related to higher BMI. Better access to fast food outlets or convenience stores was also associated with higher BMI, but only among those living alone. The logistic regression analysis, using categorized BMI, showed that the access to supermarkets was only related to being overweight or obese, but not related to being underweight. Conclusions Our findings provide mixed support for the types of food environment measures previously used in western settings. Importantly, our results suggest the need to develop culture-specific approaches to characterizing neighborhood contexts when hypotheses are extrapolated across national borders.

Further Improvement and System Integration of High Temperature Polymer Electrolyte Membrane Fuel Cells

DEFF Research Database (Denmark)

Li, Qingfeng; Jensen, Jens Oluf

The strategic developments of the FURIM are in three steps: (1) further improvement of the high temperature polymer membranes and related materials; (2) development of technological units including fuel cell stack, hydrocarbon reformer and afterburner, that are compatible with the HT-PEMFC; and (3......) integration of the HT-PEMFC stack with these compatible subunits. The main goal of the project is a 2kWel HT-PEMFC stack operating in a temperature range of 150-200°C, with a single cell performance target of 0.7 A/cm² at a cell voltage around 0.6 V. The target durability is more than 5,000 hours...

Does interprofessional collaboration between care levels improve following the creation of an integrated delivery organisation? The Bidasoa case in the Basque Country

Directory of Open Access Journals (Sweden)

Roberto Nuño Solinís

2013-09-01

Full Text Available Introduction: This article explores the impact of the creation of a new integrated delivery organisation on the evolution of interprofessional collaboration between primary and secondary care levels. In particular, the case of the Bidasoa Integrated Healthcare Organisation is analysed.Theory and methods: The evolution of interprofessional collaboration is measured through a validated Spanish questionnaire, with 10 items and a 5-point Likert scale, based on the D’Amour’s model of collaboration [20]. The final sample included 146 observations (doctors and nurses.   Results: The questionnaire identified a significant improvement on the mean scores for interprofessional collaboration of 0.57 points before and after the intervention. A significant improvement was also found in the two dimensions of the measure of interprofessional collaboration used, with the size of the change being higher for the dimension related to the organisational setting (0.63 than for interpersonal relationships (0.47.Conclusions: Before and after the creation of the Bidasoa Integrated Healthcare Organisation, an improvement in the perceived degree of interprofessional collaboration between primary and secondary care levels was observed. This finding supports the benefit of a multilevel and multidimensional approach to integration, as in the described Bidasoa case.Discussion: Results on the two dimensions of the measure of interprofessional collaboration used, seem to point to the longer time required for interpersonal relationships to change, compared to the organisational setting.

Does interprofessional collaboration between care levels improve following the creation of an integrated delivery organisation? The Bidasoa case in the Basque Country

Directory of Open Access Journals (Sweden)

Roberto Nuño Solinís

2013-09-01

Full Text Available Introduction: This article explores the impact of the creation of a new integrated delivery organisation on the evolution of interprofessional collaboration between primary and secondary care levels. In particular, the case of the Bidasoa Integrated Healthcare Organisation is analysed. Theory and methods: The evolution of interprofessional collaboration is measured through a validated Spanish questionnaire, with 10 items and a 5-point Likert scale, based on the D’Amour’s model of collaboration [20]. The final sample included 146 observations (doctors and nurses.    Results: The questionnaire identified a significant improvement on the mean scores for interprofessional collaboration of 0.57 points before and after the intervention. A significant improvement was also found in the two dimensions of the measure of interprofessional collaboration used, with the size of the change being higher for the dimension related to the organisational setting (0.63 than for interpersonal relationships (0.47. Conclusions: Before and after the creation of the Bidasoa Integrated Healthcare Organisation, an improvement in the perceived degree of interprofessional collaboration between primary and secondary care levels was observed. This finding supports the benefit of a multilevel and multidimensional approach to integration, as in the described Bidasoa case. Discussion: Results on the two dimensions of the measure of interprofessional collaboration used, seem to point to the longer time required for interpersonal relationships to change, compared to the organisational setting.

Improving Maladaptive Behaviors Using Sensory Integration Techniques.

Science.gov (United States)

Shuman, Theresa

A study examined the use of sensory integration techniques to reduce the maladaptive behaviors that interfered with the learning of nine high school students with mental impairments attending a special school. Maladaptive behaviors identified included rocking, toe walking, echolalia, resistance to change, compulsive behaviors, aggression,…

Improved double integral sliding mode MPPT controller based parameter estimation for a stand-alone photovoltaic system

International Nuclear Information System (INIS)

Chatrenour, Nasrin; Razmi, Hadi; Doagou-Mojarrad, Hasan

2017-01-01

Highlights: • IDISMC based MPPT algorithm is introduced. • Hurwitz stability theorem is used for switching surface coefficients computation. • GA approach is presented for parameter estimation of the stand-alone PV system. - Abstract: In this paper, an Improved Double Integral Sliding Mode MPPT Controller (IDISMC) for a stand-alone photovoltaic (PV) system is proposed. Performance of a sliding mode controller (SMC) is greatly influenced by the choice of the sliding surface. Switching surface coefficients were selected by the use of Hurwitz stability theorem. The IDISMC not only is robust against parametric and non-parametric uncertainties, but also has a very small steady-state error, thanks to the use of double integral of tracking voltage error in the definition of its sliding surface. For realistic simulation, Genetic Algorithm (GA) method was used to estimate parameters of solar panels model. The validity of the proposed double integral SMC in maximum power point tracking was approved by comparing the simulation results obtained for a sample PV system with the results of other methods.

Improved efficiency in clinical workflow of reporting measured oncology lesions via PACS-integrated lesion tracking tool.

Science.gov (United States)

Sevenster, Merlijn; Travis, Adam R; Ganesh, Rajiv K; Liu, Peng; Kose, Ursula; Peters, Joost; Chang, Paul J

2015-03-01

OBJECTIVE. Imaging provides evidence for the response to oncology treatment by the serial measurement of reference lesions. Unfortunately, the identification, comparison, measurement, and documentation of several reference lesions can be an inefficient process. We tested the hypothesis that optimized workflow orchestration and tight integration of a lesion tracking tool into the PACS and speech recognition system can result in improvements in oncologic lesion measurement efficiency. SUBJECTS AND METHODS. A lesion management tool tightly integrated into the PACS workflow was developed. We evaluated the effect of the use of the tool on measurement reporting time by means of a prospective time-motion study on 86 body CT examinations with 241 measureable oncologic lesions with four radiologists. RESULTS. Aggregated measurement reporting time per lesion was 11.64 seconds in standard workflow, 16.67 seconds if readers had to register measurements de novo, and 6.36 seconds for each subsequent follow-up study. Differences were statistically significant (p workflow-integrated lesion management tool, especially for patients with multiple follow-up examinations, reversing the onetime efficiency penalty at baseline registration.

System integration for radiation records

International Nuclear Information System (INIS)

Lawson, B.J.; Farrell, L.; Meacham, C.; Tapio, J.

1994-01-01

System integration is the process where through networking and/or software development, necessary business information is available in a common computing environment. System integration is becoming an important objective for many businesses. System integration can improve productivity and efficiency, reduce redundant stored information and errors, and improve availability of information. This paper will discuss the information flow in a radiation health environment, and how system integration can help. Information handled includes external dosimetry and internal dosimetry. The paper will focus on an ORACLE based system integration software product

Integrating enzyme immobilization and protein engineering: An alternative path for the development of novel and improved industrial biocatalysts.

Science.gov (United States)

Bernal, Claudia; Rodríguez, Karen; Martínez, Ronny

2018-06-09

Enzyme immobilization often achieves reusable biocatalysts with improved operational stability and solvent resistance. However, these modifications are generally associated with a decrease in activity or detrimental modifications in catalytic properties. On the other hand, protein engineering aims to generate enzymes with increased performance at specific conditions by means of genetic manipulation, directed evolution and rational design. However, the achieved biocatalysts are generally generated as soluble enzymes, -thus not reusable- and their performance under real operational conditions is uncertain. Combined protein engineering and enzyme immobilization approaches have been employed as parallel or consecutive strategies for improving an enzyme of interest. Recent reports show efforts on simultaneously improving both enzymatic and immobilization components through genetic modification of enzymes and optimizing binding chemistry for site-specific and oriented immobilization. Nonetheless, enzyme engineering and immobilization are usually performed as separate workflows to achieve improved biocatalysts. In this review, we summarize and discuss recent research aiming to integrate enzyme immobilization and protein engineering and propose strategies to further converge protein engineering and enzyme immobilization efforts into a novel "immobilized biocatalyst engineering" research field. We believe that through the integration of both enzyme engineering and enzyme immobilization strategies, novel biocatalysts can be obtained, not only as the sum of independently improved intrinsic and operational properties of enzymes, but ultimately tailored specifically for increased performance as immobilized biocatalysts, potentially paving the way for a qualitative jump in the development of efficient, stable biocatalysts with greater real-world potential in challenging bioprocess applications. Copyright © 2018. Published by Elsevier Inc.

Complete integration of technology for improved reproduction of auricular prostheses.

Science.gov (United States)

Watson, Jason; Hatamleh, Muhanad M

2014-05-01

The accurate reproduction of the form and surface details of missing body structures is an essential part of any successful prosthetic rehabilitation. It helps mask the prosthesis and gives confidence to the patient. This clinical report details the integration of multiple in-house digital technologies of laser scanning, rapid prototyping, and digital color scanning and formulating to improve the shape, texture, orientation, and color of auricular prostheses for 3 patients with missing unilateral ears. A structured light laser scanner was used to digitize the patient's nondefect ear. The digitized data were then manipulated in specialist software and mirrored to reflect the opposing side. A rapid prototyping machine was used to manufacture a 3-dimensional (3D) model of the soft tissue required. This 3D mirrored ear model allowed the accurate reproduction of missing soft tissue. A color spectrometer was used to accurately reproduce the skin tones digitally and physically. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

An integrated CRISPR Bombyx mori genome editing system with improved efficiency and expanded target sites.

Science.gov (United States)

Ma, Sanyuan; Liu, Yue; Liu, Yuanyuan; Chang, Jiasong; Zhang, Tong; Wang, Xiaogang; Shi, Run; Lu, Wei; Xia, Xiaojuan; Zhao, Ping; Xia, Qingyou

2017-04-01

Genome editing enabled unprecedented new opportunities for targeted genomic engineering of a wide variety of organisms ranging from microbes, plants, animals and even human embryos. The serial establishing and rapid applications of genome editing tools significantly accelerated Bombyx mori (B. mori) research during the past years. However, the only CRISPR system in B. mori was the commonly used SpCas9, which only recognize target sites containing NGG PAM sequence. In the present study, we first improve the efficiency of our previous established SpCas9 system by 3.5 folds. The improved high efficiency was also observed at several loci in both BmNs cells and B. mori embryos. Then to expand the target sites, we showed that two newly discovered CRISPR system, SaCas9 and AsCpf1, could also induce highly efficient site-specific genome editing in BmNs cells, and constructed an integrated CRISPR system. Genome-wide analysis of targetable sites was further conducted and showed that the integrated system cover 69,144,399 sites in B. mori genome, and one site could be found in every 6.5 bp. The efficiency and resolution of this CRISPR platform will probably accelerate both fundamental researches and applicable studies in B. mori, and perhaps other insects. Copyright © 2017 Elsevier Ltd. All rights reserved.

INTEGRATING ROUNDTABLE BRAINSTORMING INTO TEAM PAIR SOLO TECHNIQUE FOR IMPROVING STUDENTS’ PARTICIPATION IN WRITING OF DESCRIPTIVE TEXTS

Directory of Open Access Journals (Sweden)

author Sutarno

2015-01-01

Full Text Available The objectives of the study are to find out the application of integration of roundtable brainstorming into team pair solo technique in writing of descriptive texts and to investigate the improvement of students’ participation and achievement after taught by using the integration of the techniques. This study was an action research which was carried out through a preliminary study, first and second cycle activities. The subjects of this study were VII grade students of State Junior High School no.1 Semaka, Tanggamus, Lampung consisting of thirty two students. To collect the data, the researcher used instruments inform of interview, observation sheets, writing tests, and questionnaires. The findings of the research showed that students’ participation improved from the preliminary study, first and second cycle. In the preliminary study there were twenty six students classified as poor, six students classified as fair and no student classified as good in participation. While in the first cycle there were three students classified as fair and twenty nine students classified as good in participation and in the second cycle all students were classified as good in participation. The students’ writing also improved. The average score of students writing in the preliminary study was 53.31, first cycle was 64.41, and second cycle was 72.56.Key words: Roundtable Brainstorming, Team Pair Solo Technique, Students’ Participation, Writing Descriptive Texts

Integrating family planning into postpartum care through modern quality improvement: experience from Afghanistan.

Science.gov (United States)

Tawfik, Youssef; Rahimzai, Mirwais; Ahmadzai, Malalah; Clark, Phyllis Annie; Kamgang, Evelyn

2014-05-01

To address low contraceptive use in Afghanistan, we supported 2 large public maternity hospitals and 3 private hospitals in Kabul to use modern quality improvement (QI) methods to integrate family planning into postpartum care. In 2012, QI teams comprising hospital staff applied root cause analysis to identify barriers to integrated postpartum family planning (PPFP) services and to develop solutions for how to integrate services. Changes made to service provision to address identified barriers included creating a private counseling space near the postpartum ward, providing PPFP counseling training and job aids to staff, and involving husbands and mothers-in-law in counseling in person or via mobile phones. After 10 months, the proportion of postpartum women who received family planning counseling before discharge in the 5 hospitals increased from 36% to 55%, and the proportion of women who received family planning counseling with their husbands rose from 18% to 90%. In addition, the proportion of postpartum women who agreed to use family planning and left the hospital with their preferred method increased from 12% to 95%. Follow-up telephone surveys with a random sample of women who had received PPFP services in the 2 public hospitals and a control group of postpartum women who had received routine hospital services found significant differences in the proportion of women with self-reported pregnancies: 3% vs. 15%, respectively, 6 months after discharge; 6% vs. 22% at 12 months; and 14% vs. 35% at 18 months (P family planning and postpartum services by testing changes they deemed feasible.

Improving the Level and Quality of Ethics Review in Chinese Medicine and Integrative Medicine.

Science.gov (United States)

Zhang, Cheng-Bin; Li, En-Chang

2018-04-01

Three features of ethics review in Chinese medicine (CM) and integrative medicine (IM) were put forward in this paper. It is consistent with the principles of ethical review in Western medicine; it has to be compliant with the laws of CM and IM; emphasis should be laid on the review of clinical practice facts and experience. Three problems were pointed out. The characteristics of CM and IM are not distinctive enough, operation procedures need to be refined and effectiveness remains to be improved. Based on the mentioned above, seven measures were proposed to improve the level and quality of ethics review in CM and IM, including better brand awareness, considerable tolerance, treatment based on disease differentiation and syndrome differentiation, scientific review and toxicity and side effects of CM, perfection of the ethics review system, reasonable procedures of ethics review and more specialized ethics review workers.

Integration of research and practice to improve public health and healthcare delivery through a collaborative 'Health Integration Team' model - a qualitative investigation.

Science.gov (United States)

Redwood, Sabi; Brangan, Emer; Leach, Verity; Horwood, Jeremy; Donovan, Jenny L

2016-06-22

Economic considerations and the requirement to ensure the quality, safety and integration of research with health and social care provision have given rise to local developments of collaborative organisational forms and strategies to span the translational gaps. One such model - the Health Integration Team (HIT) model in Bristol in the United Kingdom (UK) - brings together National Health Service (NHS) organisations, universities, local authorities, patients and the public to facilitate the systematic application of evidence to promote integration across healthcare pathways. This study aimed to (1) provide empirical evidence documenting the evolution of the model; (2) to identify the social and organisational processes and theory of change underlying healthcare knowledge and practice; and (3) elucidate the key aspects of the HIT model for future development and translation to other localities. Contemporaneous documents were analysed, using procedures associated with Framework Analysis to produce summarised data for descriptive accounts. In-depth interviews were undertaken with key informants and analysed thematically. Comparative methods were applied to further analyse the two data sets. One hundred forty documents were analysed and 10 interviews conducted with individuals in leadership positions in the universities, NHS commissioning and provider organisations involved in the design and implementation of the HIT model. Data coalesced around four overarching themes: 'Whole system' engagement, requiring the active recruitment of all those who have a stake in the area of practice being considered, and 'collaboration' to enable coproduction were identified as 'process' themes. System-level integration and innovation were identified as potential 'outcomes' with far-reaching impacts on population health and service delivery. The HIT model emerged as a particular response to the perceived need for integration of research and practice to improve public health and

On the use of small integrating spheres to improve the linearity range of RASNIKS systems

International Nuclear Information System (INIS)

Alberdi, J.; Burgos, C.; Ferrando, A.; Molinero, A.; Schvachkin, V.; Figueroa, C.F.; Matorras, F.; Rodrigo, T.; Ruiz, A.; Vila, I.

1997-10-01

Rasniks elements will be used in the CMS alignment system. The large displacements of the different sub detectors expected in the CMS experiment demands large linearity response of this system. By the use of a small integrating sphere we have optimized the source definition such that a factor three improvement in the linearity range with respect to conventional Rasniks configurations is obtained. The response range reached coincides with the maximum one can get with the components used in the test

Integrated risk reduction framework to improve railway hazardous materials transportation safety

Energy Technology Data Exchange (ETDEWEB)

Liu, Xiang, E-mail: liu94@illinois.edu; Saat, M. Rapik, E-mail: mohdsaat@illinois.edu; Barkan, Christopher P.L., E-mail: cbarkan@illinois.edu

2013-09-15

Highlights: • An integrated framework is developed to optimize risk reduction. • A negative binomial regression model is developed to analyze accident-cause-specific railcar derailment probability. • A Pareto-optimality technique is applied to determine the lowest risk given any level of resource. • A multi-attribute decision model is developed to determine the optimal amount of investment for risk reduction. • The models could aid the government and rail industry in developing cost-efficient risk reduction policy and practice. -- Abstract: Rail transportation plays a critical role to safely and efficiently transport hazardous materials. A number of strategies have been implemented or are being developed to reduce the risk of hazardous materials release from train accidents. Each of these risk reduction strategies has its safety benefit and corresponding implementation cost. However, the cost effectiveness of the integration of different risk reduction strategies is not well understood. Meanwhile, there has been growing interest in the U.S. rail industry and government to best allocate resources for improving hazardous materials transportation safety. This paper presents an optimization model that considers the combination of two types of risk reduction strategies, broken rail prevention and tank car safety design enhancement. A Pareto-optimality technique is used to maximize risk reduction at a given level of investment. The framework presented in this paper can be adapted to address a broader set of risk reduction strategies and is intended to assist decision makers for local, regional and system-wide risk management of rail hazardous materials transportation.

Improving integrative searching of systems chemical biology data using semantic annotation

Directory of Open Access Journals (Sweden)

Chen Bin

2012-03-01

Full Text Available Abstract Background Systems chemical biology and chemogenomics are considered critical, integrative disciplines in modern biomedical research, but require data mining of large, integrated, heterogeneous datasets from chemistry and biology. We previously developed an RDF-based resource called Chem2Bio2RDF that enabled querying of such data using the SPARQL query language. Whilst this work has proved useful in its own right as one of the first major resources in these disciplines, its utility could be greatly improved by the application of an ontology for annotation of the nodes and edges in the RDF graph, enabling a much richer range of semantic queries to be issued. Results We developed a generalized chemogenomics and systems chemical biology OWL ontology called Chem2Bio2OWL that describes the semantics of chemical compounds, drugs, protein targets, pathways, genes, diseases and side-effects, and the relationships between them. The ontology also includes data provenance. We used it to annotate our Chem2Bio2RDF dataset, making it a rich semantic resource. Through a series of scientific case studies we demonstrate how this (i simplifies the process of building SPARQL queries, (ii enables useful new kinds of queries on the data and (iii makes possible intelligent reasoning and semantic graph mining in chemogenomics and systems chemical biology. Availability Chem2Bio2OWL is available at http://chem2bio2rdf.org/owl. The document is available at http://chem2bio2owl.wikispaces.com.

Teaching retirement financial literacy in an undergraduate gerontology classroom: broadening the concept of the tripod or three-legged stool of retirement income utilizing active learning.

Science.gov (United States)

Baker, Hallie E; Brown, Pamela Pitman

2015-01-01

The three-legged stool concept is widely used in gerontological and geriatric education as an explanation on how one should fiscally approach his or her retirement. Financial managers, planners, retirees, business owners, even the Social Security Administration uses this metaphor of fiscal soundness in retirement planning. Gerontologists are moving away from the "tripod of retirement income" and "three-legged stool" term, as more often market work is needed for financial security. This activity focuses on the tripod or three-legged stool concepts of retirement planning using active learning, allowing the students to work collaboratively in a group, reflect upon the activity, and most importantly have fun. The game also allows for an expansion of the tripod concepts into the four pillars of economic security, broaching the use of personal assets and the possible need for longer employment. Game scenarios also emphasize macro- and microlevel forces, such as race, gender, health status, education, or marital status, which can influence timing of retirement or the level of retirement income available. The authors include instructions on how to set up the learning experience including worksheets, as well as reflection questions posed throughout the process.

An integrated methodology for process improvement and delivery system visualization at a multidisciplinary cancer center.

Science.gov (United States)

Singprasong, Rachanee; Eldabi, Tillal

2013-01-01

Multidisciplinary cancer centers require an integrated, collaborative, and stream-lined workflow in order to provide high quality of patient care. Due to the complex nature of cancer care and continuing changes to treatment techniques and technologies, it is a constant struggle for centers to obtain a systemic and holistic view of treatment workflow for improving the delivery systems. Project management techniques, Responsibility matrix and a swim-lane activity diagram representing sequence of activities can be combined for data collection, presentation, and evaluation of the patient care. This paper presents this integrated methodology using multidisciplinary meetings and walking the route approach for data collection, integrated responsibility matrix and swim-lane activity diagram with activity time for data representation and 5-why and gap analysis approach for data analysis. This enables collection of right detail of information in a shorter time frame by identifying process flaws and deficiencies while being independent of the nature of the patient's disease or treatment techniques. A case study of a multidisciplinary regional cancer centre is used to illustrate effectiveness of the proposed methodology and demonstrates that the methodology is simple to understand, allowing for minimal training of staff and rapid implementation. © 2011 National Association for Healthcare Quality.

Review, modeling, Heat Integration, and improved schemes of Rectisol®-based processes for CO2 capture

International Nuclear Information System (INIS)

Gatti, Manuele; Martelli, Emanuele; Marechal, François; Consonni, Stefano

2014-01-01

The paper evaluates the thermodynamic performances and the energy integration of alternative schemes of a methanol absorption based acid gas removal process designed for CO 2 Capture and Storage. More precisely, this work focuses the attention on the Rectisol ® process specifically designed for the selective removal of H 2 S and CO 2 from syngas produced by coal gasification. The study addresses the following issues: (i) perform a review of the Rectisol ® schemes proposed by engineers and researchers with the purpose of determining the best one for CO 2 capture and storage; (ii) calibrate the PC-SAFT equation of state for CH 3 OH–CO 2 –H 2 S–H 2 –CO mixtures at conditions relevant to the Rectisol ® process; (iii) evaluate the thermodynamic performances and optimize the energy integration of a “Reference” scheme derived from those available in the literature; (iv) identify and assess alternative Rectisol ® schemes with optimized performance for CO 2 Capture and Storage and Heat Integration with utilities. On the basis of the analysis of the Composite Curves of the integrated process, we propose some possible improvements at the level of the process configuration, like the introduction of mechanical vapor recompression and the development of a two stage regeneration arrangement. - Highlights: • Comprehensive review of the Rectisol ® process configurations and applications. • Calibration of PC-SAFT equation of state for Rectisol ® -relevant mixtures. • Detailed process simulation and optimized Heat Integration, and utility design. • Development of alternative Rectisol ® schemes optimized for CO 2 Capture

An Integrated Mobile Application to Improve the Watershed Management in Taiwan

Science.gov (United States)

Chou, T. Y.; Chen, M. H.; Lee, C. Y.

2015-12-01

This study aims to focus on the application of information technology on the reservoir watershed management. For the civil and commercial water usage, reservoirs and its upstream plays a significant role due to water scarcity and inequality, especially in Taiwan. Due to the progress of information technology, apply it can improve the efficiency and accuracy of daily affairs significantly which already proved by previous researches. Taipei Water Resource District (TWRD) is selected as study area for this study, it is the first reservoir watershed which authorized as special protection district by urban planning act. This study has designed a framework of mobile application, which addressed three types of public affairs relate to watershed management, includes building management, illegal land-use investigation, and a dashboard of real time stream information. This mobile application integrated a dis-connected map and interactive interface to collect, record and calculate field information which helps the authority manage the public affairs more efficiency.

Multidisciplinary integration in the context of integrated care – results from the North West London Integrated Care Pilot

Directory of Open Access Journals (Sweden)

Matthew Harris

2013-10-01

Full Text Available Background: In the context of integrated care, Multidisciplinary Group (MDG meetings involve participants from diverse professional groups and organizations and are potential vehicles to advance efficiency improvements within the local health economy.  We advance a novel method to evaluate the effectiveness of MDGs by measuring the extent to which participants integrate within MDG meetings and whether this integration leads to improved working. Methods: We purposively selected four MDG meetings, and conducted a content analysis of audio-recorded and transcribed case discussions. Two coders independently coded utterances according to their ‘integrative intensity’ which was defined against three a priori independent domains – the Level (i.e. Individual, Collective and Systems; the Valence (Problem, Information and Solution; the Focus (Concrete and Abstract. Inter- and intra-rater reliability was tested with Kappa scores on one randomly selected Case Discussion.  Standardized weighted mean integration scores were calculated for Case Discussions across utterance deciles, indicating how integrative intensity changed during the conversations. Results: Twenty-three Case Discussions in four different MDG groups were transcribed and coded. Inter- and intra-rater reliability was good as shown by the Prevalence and Bias Adjusted Kappa Scores for one randomly selected Case Discussion.  There were differences in the proportion of utterances per participant type (Consultant 14.6%; Presenting GP 38.75%; Chair 7.8%; Non-Presenting GP 2.25%; Allied Health Professional 4.8%. Utterances were predominantly coded at low levels of integrative intensity; however there was a gradual increase (R2=0.66 in integrative intensity during the Case Discussions.  Based on analysis of the minutes and action points arising from the Case Discussions, this improved integration did not translate into actions moving forward. Interpretation: We characterize the MDGs as

Integrating utilization-focused evaluation with business process modeling for clinical research improvement.

Science.gov (United States)

Kagan, Jonathan M; Rosas, Scott; Trochim, William M K

2010-10-01

New discoveries in basic science are creating extraordinary opportunities to design novel biomedical preventions and therapeutics for human disease. But the clinical evaluation of these new interventions is, in many instances, being hindered by a variety of legal, regulatory, policy and operational factors, few of which enhance research quality, the safety of study participants or research ethics. With the goal of helping increase the efficiency and effectiveness of clinical research, we have examined how the integration of utilization-focused evaluation with elements of business process modeling can reveal opportunities for systematic improvements in clinical research. Using data from the NIH global HIV/AIDS clinical trials networks, we analyzed the absolute and relative times required to traverse defined phases associated with specific activities within the clinical protocol lifecycle. Using simple median duration and Kaplan-Meyer survival analysis, we show how such time-based analyses can provide a rationale for the prioritization of research process analysis and re-engineering, as well as a means for statistically assessing the impact of policy modifications, resource utilization, re-engineered processes and best practices. Successfully applied, this approach can help researchers be more efficient in capitalizing on new science to speed the development of improved interventions for human disease.

Recommendations and Improvements for the Evaluation of Integrated Community-Wide Interventions Approaches

Directory of Open Access Journals (Sweden)

Tessa M. van Koperen

2016-01-01

Full Text Available Background. Integrated community-wide intervention approaches (ICIAs are implemented to prevent childhood obesity. Programme evaluation improves these ICIAs, but professionals involved often struggle with performance. Evaluation tools have been developed to support Dutch professionals involved in ICIAs. It is unclear how useful these tools are to intended users. We therefore researched the facilitators of and barriers to ICIA programme evaluation as perceived by professionals and their experiences of the evaluation tools. Methods. Focus groups and interviews with 33 public health professionals. Data were analysed using a thematic content approach. Findings. Evaluation is hampered by insufficient time, budget, and experience with ICIAs, lack of leadership, and limited advocacy for evaluation. Epidemiologists are regarded as responsible for evaluation but feel incompetent to perform evaluation or advocate its need in a political environment. Managers did not prioritise process evaluations, involvement of stakeholders, and capacity building. The evaluation tools are perceived as valuable but too comprehensive considering limited resources. Conclusion. Evaluating ICIAs is important but most professionals are unfamiliar with it and management does not prioritise process evaluation nor incentivize professionals to evaluate. To optimise programme evaluation, more resources and coaching are required to improve professionals’ evaluation capabilities and specifically the use of evaluation.

A NEW FAMILY OF MULTISTEP METHODS WITH IMPROVED PHASE-LAG CHARACTERISTICS FOR THE INTEGRATION OF ORBITAL PROBLEMS

International Nuclear Information System (INIS)

Vlachos, D. S.; Anastassi, Z. A.; Simos, T. E.

2009-01-01

In this paper, we introduce a new family of 10-step linear multistep methods for the integration of orbital problems. The new methods are constructed by adopting a new methodology which improves the phase-lag characteristics by vanishing both the phase-lag function and its first derivatives at a specific frequency. The efficiency of the new family of methods is proved via error analysis and numerical applications.

Development of Improved Caprock Integrity and Risk Assessment Techniques

Energy Technology Data Exchange (ETDEWEB)

Bruno, Michael [Geomechanics Technologies, Incorporated, Monrovia, CA (United States)

2014-09-30

GeoMechanics Technologies has completed a geomechanical caprock integrity analysis and risk assessment study funded through the US Department of Energy. The project included: a detailed review of historical caprock integrity problems experienced in the natural gas storage industry; a theoretical description and documentation of caprock integrity issues; advanced coupled transport flow modelling and geomechanical simulation of three large-scale potential geologic sequestration sites to estimate geomechanical effects from CO₂ injection; development of a quantitative risk and decision analysis tool to assess caprock integrity risks; and, ultimately the development of recommendations and guidelines for caprock characterization and CO₂ injection operating practices. Historical data from gas storage operations and CO₂ sequestration projects suggest that leakage and containment incident risks are on the order of 10-1 to 10-2, which is higher risk than some previous studies have suggested for CO₂. Geomechanical analysis, as described herein, can be applied to quantify risks and to provide operating guidelines to reduce risks. The risk assessment tool developed for this project has been applied to five areas: The Wilmington Graben offshore Southern California, Kevin Dome in Montana, the Louden Field in Illinois, the Sleipner CO₂ sequestration operation in the North Sea, and the In Salah CO₂ sequestration operation in North Africa. Of these five, the Wilmington Graben area represents the highest relative risk while the Kevin Dome area represents the lowest relative risk.

Improving bioethanol production from sugarcane: evaluation of distillation, thermal integration and cogeneration systems

International Nuclear Information System (INIS)

Dias, Marina O.S.; Modesto, Marcelo; Ensinas, Adriano V.; Nebra, Silvia A.; Filho, Rubens Maciel; Rossell, Carlos E.V.

2011-01-01

Demand for bioethanol has grown considerably over the last years. Even though Brazil has been producing ethanol from sugarcane on a large scale for decades, this industry is characterized by low energy efficiency, using a large fraction of the bagasse produced as fuel in the cogeneration system to supply the process energy requirements. The possibility of selling surplus electricity to the grid or using surplus bagasse as raw material of other processes has motivated investments on more efficient cogeneration systems and process thermal integration. In this work simulations of an autonomous distillery were carried out, along with utilities demand optimization using Pinch Analysis concepts. Different cogeneration systems were analyzed: a traditional Rankine Cycle, with steam of high temperature and pressure (80 bar, 510 o C) and back pressure and condensing steam turbines configuration, and a BIGCC (Biomass Integrated Gasification Combined Cycle), comprised by a gas turbine set operating with biomass gas produced in a gasifier that uses sugarcane bagasse as raw material. Thermoeconomic analyses determining exergy-based costs of electricity and ethanol for both cases were carried out. The main objective is to show the impact that these process improvements can produce in industrial systems, compared to the current situation.

Integrated system of Supervision of Centrals (SISC): results, anticipated self-evaluation and improvements, cross-sectional subjects

International Nuclear Information System (INIS)

Zarzuela, J.

2008-01-01

The integrated System for Plan Oversight was already implemented in 2007 in full scope i.e., including public information of its results. At the moment, the first self-assessment if the system is being implemented and, consequently, it is expected to trigger changes for improvement. Specifically, the management of cross cutting issues will be reviewed in depth, so that the causes of inspection findings will be analysed deeper and closer attention devoted to their correction. (Author)

Six elements of integrated primary healthcare.

Science.gov (United States)

Brown, Lynsey J; Oliver-Baxter, Jodie

2016-03-01

Integrated care has the potential to deliver efficiencies and improvements in patient experiences and health outcomes. Efforts towards integrated care, especially at the primary and community health levels, have increasingly been under focus, both nationally and internationally. In Australia, regional integration is a priority, and integration of care is a task for meso-level organisations such as Primary Health Networks (PHNs). This paper seeks to provide a list of elements and questions for consideration by organisations working across primary healthcare settings, looking to enact and improve the delivery of integrated care. Six elements that consistently emerged during the development of a series of rapid reviews on integrated primary healthcare in Australia are presented in this paper. The elements identified are context, governance and leadership, infrastructure, financing, engagement, and communication. They offer a starting point for reflection in the planning and practices of organisations in their drive for continuous improvements in integrated care.

The utah beacon experience: integrating quality improvement, health information technology, and practice facilitation to improve diabetes outcomes in small health care facilities.

Science.gov (United States)

Tennison, Janet; Rajeev, Deepthi; Woolsey, Sarah; Black, Jeff; Oostema, Steven J; North, Christie

2014-01-01

The Utah Improving Care through Connectivity and Collaboration (IC3) Beacon community (2010-2013) was spearheaded by HealthInsight, a nonprofit, community-based organization. One of the main objectives of IC(3) was to improve health care provided to patients with diabetes in three Utah counties, collaborating with 21 independent smaller clinics and two large health care enterprises. This paper will focus on the use of health information technology (HIT) and practice facilitation to develop and implement new care processes to improve clinic workflow and ultimately improve patients' diabetes outcomes at 21 participating smaller, independent clinics. Early in the project, we learned that most of the 21 clinics did not have the resources needed to successfully implement quality improvement (QI) initiatives. IC(3) helped clinics effectively use data generated from their electronic health records (EHRs) to design and implement interventions to improve patients' diabetes outcomes. This close coupling of HIT, expert practice facilitation, and Learning Collaboratives was found to be especially valuable in clinics with limited resources. Through this process we learned that (1) an extensive readiness assessment improved clinic retention, (2) clinic champions were important for a successful collaboration, and (3) current EHR systems have limited functionality to assist in QI initiatives. In general, smaller, independent clinics lack knowledge and experience with QI and have limited HIT experience to improve patient care using electronic clinical data. Additionally, future projects like IC(3) Beacon will be instrumental in changing clinic culture so that QI is integrated into routine workflow. Our efforts led to significant changes in how practice staff optimized their EHRs to manage and improve diabetes care, while establishing the framework for sustainability. Some of the IC(3) Beacon practices are currently smoothly transitioning to new models of care such as Patient

Organizational Context and Capabilities for Integrating Care: A Framework for Improvement

Directory of Open Access Journals (Sweden)

Jenna M. Evans

2016-08-01

Full Text Available Background: Interventions aimed at integrating care have become widespread in healthcare; however, there is significant variability in their success. Differences in organizational contexts and associated capabilities may be responsible for some of this variability. Purpose: This study develops and validates a conceptual framework of organizational capabilities for integrating care, identifies which of these capabilities may be most important, and explores the mechanisms by which they influence integrated care efforts.  Methods: The Context and Capabilities for Integrating Care (CCIC Framework was developed through a literature review, and revised and validated through interviews with leaders and care providers engaged in integrated care networks in Ontario, Canada. Interviews involved open-ended questions and graphic elicitation. Quantitative content analysis was used to summarize the data.  Results: The CCIC Framework consists of eighteen organizational factors in three categories: Basic Structures, People and Values, and Key Processes. The three most important capabilities shaping the capacity of organizations to implement integrated care interventions include Leadership Approach, Clinician Engagement and Leadership, and Readiness for Change. The majority of hypothesized relationships among organizational capabilities involved Readiness for Change and Partnering, emphasizing the complexity, interrelatedness and importance of these two factors to integrated care efforts.  Conclusions: Organizational leaders can use the framework to determine readiness to integrate care, develop targeted change management strategies, and select appropriate partners with overlapping or complementary profiles on key capabilities. Researchers may use the results to test and refine the proposed framework, with a focus on the hypothesized relationships among organizational capabilities and between organizational capabilities and performance outcomes.

Organizational Context and Capabilities for Integrating Care: A Framework for Improvement

Science.gov (United States)

Grudniewicz, Agnes; Baker, G. Ross; Wodchis, Walter P.

2016-01-01

Background: Interventions aimed at integrating care have become widespread in healthcare; however, there is significant variability in their success. Differences in organizational contexts and associated capabilities may be responsible for some of this variability. Purpose: This study develops and validates a conceptual framework of organizational capabilities for integrating care, identifies which of these capabilities may be most important, and explores the mechanisms by which they influence integrated care efforts. Methods: The Context and Capabilities for Integrating Care (CCIC) Framework was developed through a literature review, and revised and validated through interviews with leaders and care providers engaged in integrated care networks in Ontario, Canada. Interviews involved open-ended questions and graphic elicitation. Quantitative content analysis was used to summarize the data. Results: The CCIC Framework consists of eighteen organizational factors in three categories: Basic Structures, People and Values, and Key Processes. The three most important capabilities shaping the capacity of organizations to implement integrated care interventions include Leadership Approach, Clinician Engagement and Leadership, and Readiness for Change. The majority of hypothesized relationships among organizational capabilities involved Readiness for Change and Partnering, emphasizing the complexity, interrelatedness and importance of these two factors to integrated care efforts. Conclusions: Organizational leaders can use the framework to determine readiness to integrate care, develop targeted change management strategies, and select appropriate partners with overlapping or complementary profiles on key capabilities. Researchers may use the results to test and refine the proposed framework, with a focus on the hypothesized relationships among organizational capabilities and between organizational capabilities and performance outcomes. PMID:28413366

Educational system factors that engage resident physicians in an integrated quality improvement curriculum at a VA hospital: a realist evaluation.

Science.gov (United States)

Ogrinc, Greg; Ercolano, Ellyn; Cohen, Emily S; Harwood, Beth; Baum, Karyn; van Aalst, Robertus; Jones, Anne C; Davies, Louise

2014-10-01

Learning about quality improvement (QI) in resident physician training is often relegated to elective or noncore clinical activities. The authors integrated teaching, learning, and doing QI into the routine clinical work of inpatient internal medicine teams at a Veterans Affairs (VA) hospital. This study describes the design factors that facilitated and inhibited the integration of a QI curriculum-including real QI work-into the routine work of inpatient internal medicine teams. A realist evaluation framework used three data sources: field notes from QI faculty; semistructured interviews with resident physicians; and a group interview with QI faculty and staff. From April 2011 to July 2012, resident physician teams at the White River Junction VA Medical Center used the Model for Improvement for their QI work and analyzed data using statistical process control charts. Three domains affected the delivery of the QI curriculum and engagement of residents in QI work: setting, learner, and teacher. The constant presence of the QI material on a public space in the team workroom was a facilitating mechanism in the setting. Explicit sign-out of QI work to the next resident team formalized the handoff in the learner domain. QI teachers who were respected clinical leaders with QI expertise provided role modeling and local system knowledge. Integrating QI teaching into the routine clinical and educational systems of an inpatient service is challenging. Identifiable, concrete strategies in the setting, learner, and teacher domains helped integrate QI into the clinical and educational systems.

Developing positive attitudes toward geriatric nursing among Millennials and Generation Xers.

Science.gov (United States)

Heise, Barbara A; Johnsen, Vickie; Himes, Deborah; Wing, Debra

2012-01-01

Despite the increase of the older adult population, there exists a shortage of health care professionals trained to help this population remain independent as long as possible. Ageism, common among younger adults, affects the capacity building of health care for older adults. Research has indicated that increased knowledge about older adults, as well as exposure to the elderly, may alter nursing students' attitudes regarding careers in gerontological nursing. However, questions remain as to what are the most effective ways to provide gerontological content in nursing programs and enhance attitudes toward older adults.With the understanding that younger adults see a need to balance work and play, a baccalaureate nursing program provides examples of ways to accomplish this through integration of courses, simulations, positive images of aging, and learning activities that enhance empathy for both frail and healthy older adults.

Improving Music Genre Classification by Short-Time Feature Integration

DEFF Research Database (Denmark)

Meng, Anders; Ahrendt, Peter; Larsen, Jan

2005-01-01

Many different short-time features, using time windows in the size of 10-30 ms, have been proposed for music segmentation, retrieval and genre classification. However, often the available time frame of the music to make the actual decision or comparison (the decision time horizon) is in the range...... of seconds instead of milliseconds. The problem of making new features on the larger time scale from the short-time features (feature integration) has only received little attention. This paper investigates different methods for feature integration and late information fusion for music genre classification...

Improvement of the grid-connect current quality using novel proportional-integral controller for photovoltaic inverters.

Science.gov (United States)

Cheng, Yuhua; Chen, Kai; Bai, Libing; Yang, Jing

2014-02-01

Precise control of the grid-connected current is a challenge in photovoltaic inverter research. Traditional Proportional-Integral (PI) control technology cannot eliminate steady-state error when tracking the sinusoidal signal from the grid, which results in a very high total harmonic distortion in the grid-connected current. A novel PI controller has been developed in this paper, in which the sinusoidal wave is discretized into an N-step input signal that is decided by the control frequency to eliminate the steady state error of the system. The effect of periodical error caused by the dead zone of the power switch and conduction voltage drop can be avoided; the current tracking accuracy and current harmonic content can also be improved. Based on the proposed PI controller, a 700 W photovoltaic grid-connected inverter is developed and validated. The improvement has been demonstrated through experimental results.

SYSTEMS FOR IMPROVEMENT OF BUSINESS INTEGRATED MANAGEMENT PROCESSES IN PORTS

Directory of Open Access Journals (Sweden)

Pavle Popovic

2017-03-01

Full Text Available Based on test results obtained so far, the objective relating to modern scientific methods and approaches has been defined with the intention to develop model which defines new management system integration model, by adopting necessary practical terms of real systems that most frequently circulate in maritime practice in the field of integrated management systems (IMS in terms of safety and security of vessels and ports. The subject of research is maritime, particularly port services, by way of defining internal and external advantages through adopting integrated management systems. The research will be conducted through theoretical and applied assessments of case study analyses using example of the Port of Kotor H.Co.

The integration of improved Monte Carlo compton scattering algorithms into the Integrated TIGER Series

International Nuclear Information System (INIS)

Quirk, Thomas J. IV

2004-01-01

The Integrated TIGER Series (ITS) is a software package that solves coupled electron-photon transport problems. ITS performs analog photon tracking for energies between 1 keV and 1 GeV. Unlike its deterministic counterpart, the Monte Carlo calculations of ITS do not require a memory-intensive meshing of phase space; however, its solutions carry statistical variations. Reducing these variations is heavily dependent on runtime. Monte Carlo simulations must therefore be both physically accurate and computationally efficient. Compton scattering is the dominant photon interaction above 100 keV and below 5-10 MeV, with higher cutoffs occurring in lighter atoms. In its current model of Compton scattering, ITS corrects the differential Klein-Nishina cross sections (which assumes a stationary, free electron) with the incoherent scattering function, a function dependent on both the momentum transfer and the atomic number of the scattering medium. While this technique accounts for binding effects on the scattering angle, it excludes the Doppler broadening the Compton line undergoes because of the momentum distribution in each bound state. To correct for these effects, Ribbefor's relativistic impulse approximation (IA) will be employed to create scattering cross section differential in both energy and angle for each element. Using the parameterizations suggested by Brusa et al., scattered photon energies and angle can be accurately sampled at a high efficiency with minimal physical data. Two-body kinematics then dictates the electron's scattered direction and energy. Finally, the atomic ionization is relaxed via Auger emission or fluorescence. Future work will extend these improvements in incoherent scattering to compounds and to adjoint calculations.

Integrated risk reduction framework to improve railway hazardous materials transportation safety.

Science.gov (United States)

Liu, Xiang; Saat, M Rapik; Barkan, Christopher P L

2013-09-15

Rail transportation plays a critical role to safely and efficiently transport hazardous materials. A number of strategies have been implemented or are being developed to reduce the risk of hazardous materials release from train accidents. Each of these risk reduction strategies has its safety benefit and corresponding implementation cost. However, the cost effectiveness of the integration of different risk reduction strategies is not well understood. Meanwhile, there has been growing interest in the U.S. rail industry and government to best allocate resources for improving hazardous materials transportation safety. This paper presents an optimization model that considers the combination of two types of risk reduction strategies, broken rail prevention and tank car safety design enhancement. A Pareto-optimality technique is used to maximize risk reduction at a given level of investment. The framework presented in this paper can be adapted to address a broader set of risk reduction strategies and is intended to assist decision makers for local, regional and system-wide risk management of rail hazardous materials transportation. Copyright © 2013 Elsevier B.V. All rights reserved.

Integrated traction control strategy for distributed drive electric vehicles with improvement of economy and longitudinal driving stability

OpenAIRE

Zhang, Xudong; Göhlich, Dietmar

2017-01-01

This paper presents an integrated traction control strategy (ITCS) for distributed drive electric vehicles. The purpose of the proposed strategy is to improve vehicle economy and longitudinal driving stability. On high adhesion roads, economy optimization algorithm is applied to maximize motors efficiency by means of the optimized torque distribution. On low adhesion roads, a sliding mode control (SMC) algorithm is implemented to guarantee the wheel slip ratio around the optimal slip ratio po...

Design safety improvements of Kozloduy NPP

International Nuclear Information System (INIS)

Hinovski, I.

1999-01-01

Design safety improvements of Kozloduy NPP, discussed in detail, are concerned with: primary circuit integrity; reactor pressure vessel integrity; primary coolant piping integrity; primary coolant overpressure protection; leak before break status; design basis accidents and transients; severe accident analysis; improvements of safety and support systems; containment/confinement leak tightness and strength; seismic safety improvements; WWER-1000 control rod insertion; upgrading and modernization of Units 5 and 6; Year 2000 problem

Integrating Environmental Management of Asthma into Pediatric Health Care: What Worked and What Still Needs Improvement?

Science.gov (United States)

Roberts, James R; Newman, Nicholas; McCurdy, Leyla E; Chang, Jane S; Salas, Mauro A; Eskridge, Bernard; De Ybarrondo, Lisa; Sandel, Megan; Mazur, Lynnette; Karr, Catherine J

2016-12-01

The National Environmental Education Foundation (NEEF) launched an initiative in 2005 to integrate environmental management of asthma into pediatric health care. This study, a follow-up to a 2013 study, evaluated the program's impact and assessed training results by 5 new faculty champions. We surveyed attendees at training sessions to measure knowledge and the likelihood of asking about and managing environmental triggers of asthma. To conduct the program evaluation, a workshop was held with the faculty champions and NEEF staff in which we identified major program benefits, as well as challenges and suggestions for the future. Trainee baseline knowledge of environmental triggers was low, but they reported robust improvement in environmental triggers knowledge and intention to recommend environmental management. The program has a broad, national scope, reaching more than 12 000 physicians, health care providers, and students, and some faculty champions successfully integrated materials into health record. Program barriers and future endeavors were identified.

Health coaching to improve healthy lifestyle behaviors: an integrative review.

Science.gov (United States)

Olsen, Jeanette M; Nesbitt, Bonnie J

2010-01-01

Chronic diseases account for 70% of U.S. deaths. Health coaching may help patients adopt healthy lifestyle behaviors that prevent and control diseases. This integrative review analyzed health coaching studies for evidence of effectiveness and to identify key program features. Multiple electronic databases were utilized, yielding a final sample of 15 documents. The search was limited to peer-reviewed research articles published between 1999 and 2008. Studies were further analyzed if they (1) specifically cited coaching as a program intervention, and (2) applied the intervention to research. Articles describing various quantitative and qualitative methodologies were critically analyzed using a systematic method. Data were synthesized using a matrix format according to purpose, method, intervention, findings, critique, and quality rating. All 15 studies utilized nonprobability sampling, 7 (47%) with randomized intervention and control groups. Significant improvements in one or more of the behaviors of nutrition, physical activity, weight management, or medication adherence were identified in six (40%) of the studies. Common features of effective programs were goal setting (73%), motivational interviewing (27%), and collaboration with health care providers (20%). Health coaching studies with well-specified methodologies and more rigorous designs are needed to strengthen findings; however, this behavioral change intervention suggests promise.

Interventions to improve the compliance of health care professionals to hand washing: an integrative review

Directory of Open Access Journals (Sweden)

Adriana Cristina de Oliveira

2013-12-01

Full Text Available The objective of this study was to identify the main strategies used to improve the compliance of health care professionals to hand washing. This is an integrative literature review, which search included journals in English, Spanish and Portuguese. Twenty—three articles were included. An electronic tool was developed on Microsoft Office Excel and the main results were submitted to descriptive analysis. Of the total studies, 87.1% had before and after designs and several methods were used to monitor compliance rate (direct observation, supply use and self-reported rates. Multimodal interventions were used in 87.0%, and the most often employed were: education, feedback, alcohol being available and posters. The largest challenge identified was not only improving the compliance rates to hand washing, but, most of all, keeping them high. It was observed there is a need to use multimodal strategies that contribute to behavior change considering the local setting. Descriptors: Hand Disinfection; Health Personnel; Cross Infection; Nursing.

Students' Knowledge of Aging and Career Preferences

Science.gov (United States)

Lun, Man Wai

2012-01-01

The increased number of older adults attributes to a rising need for future professionals to work in gerontology. Understanding the influence of students' career choices is important. A qualitative study was conducted after students' taking a gerontology course to explore students' knowledge and career preference in gerontology. The results were…

Community integration after burn injuries.

Science.gov (United States)

Esselman, P C; Ptacek, J T; Kowalske, K; Cromes, G F; deLateur, B J; Engrav, L H

2001-01-01

Evaluation of community integration is a meaningful outcome criterion after major burn injury. The Community Integration Questionnaire (CIQ) was administered to 463 individuals with major burn injuries. The CIQ results in Total, Home Integration, Social Integration, and Productivity scores. The purposes of this study were to determine change in CIQ scores over time and what burn injury and demographic factors predict CIQ scores. The CIQ scores did not change significantly from 6 to 12 to 24 months postburn injury. Home integration scores were best predicted by sex and living situation; Social Integration scores by marital status; and Productivity scores by functional outcome, burn severity, age, and preburn work factors. The data demonstrate that individuals with burn injuries have significant difficulties with community integration due to burn and nonburn related factors. CIQ scores did not improve over time but improvement may have occurred before the initial 6-month postburn injury follow-up in this study.

Multidisciplinary group performance – measuring integration intensity in the context of the North West London Integrated Care Pilot

Directory of Open Access Journals (Sweden)

Matthew Harris

2013-02-01

Full Text Available Introduction: Multidisciplinary Group meeting (MDGs are seen as key facilitators of integration, moving from individual to multi-disciplinary decision making, and from a focus on individual patients to a focus on patient groups.  We have developed a method for coding MDG transcripts to identify whether they are or are not vehicles for delivering the anticipated efficiency improvements across various providers and apply it to a test case in the North West London Integrated Care Pilot.  Methods:  We defined 'integrating' as the process within the MDG meeting that enables or promotes an improved collaboration, improved understanding, and improved awareness of self and others within the local healthcare economy such that efficiency improvements could be identified and action taken.  Utterances within the MDGs are coded according to three distinct domains grounded in concepts from communication, group decision-making, and integrated care literatures - the Valence, the Focus, and the Level.  Standardized weighted integrative intensity scores are calculated across ten time deciles in the Case Discussion providing a graphical representation of its integrative intensity. Results: Intra- and Inter-rater reliability of the coding scheme was very good as measured by the Prevalence and Bias-adjusted Kappa Score.  Standardized Weighted Integrative Intensity graph mirrored closely the verbatim transcript and is a convenient representation of complex communication dynamics. Trend in integrative intensity can be calculated and the characteristics of the MDG can be pragmatically described. Conclusion: This is a novel and potentially useful method for researchers, managers and practitioners to better understand MDG dynamics and to identify whether participants are integrating.  The degree to which participants use MDG meetings to develop an integrated way of working is likely to require management, leadership and shared values.

Multidisciplinary group performance – measuring integration intensity in the context of the North West London Integrated Care Pilot

Directory of Open Access Journals (Sweden)

Matthew Harris

2013-02-01

Full Text Available Introduction: Multidisciplinary Group meeting (MDGs are seen as key facilitators of integration, moving from individual to multi-disciplinary decision making, and from a focus on individual patients to a focus on patient groups.  We have developed a method for coding MDG transcripts to identify whether they are or are not vehicles for delivering the anticipated efficiency improvements across various providers and apply it to a test case in the North West London Integrated Care Pilot. Methods:  We defined 'integrating' as the process within the MDG meeting that enables or promotes an improved collaboration, improved understanding, and improved awareness of self and others within the local healthcare economy such that efficiency improvements could be identified and action taken.  Utterances within the MDGs are coded according to three distinct domains grounded in concepts from communication, group decision-making, and integrated care literatures - the Valence, the Focus, and the Level.  Standardized weighted integrative intensity scores are calculated across ten time deciles in the Case Discussion providing a graphical representation of its integrative intensity.Results: Intra- and Inter-rater reliability of the coding scheme was very good as measured by the Prevalence and Bias-adjusted Kappa Score.  Standardized Weighted Integrative Intensity graph mirrored closely the verbatim transcript and is a convenient representation of complex communication dynamics. Trend in integrative intensity can be calculated and the characteristics of the MDG can be pragmatically described.Conclusion: This is a novel and potentially useful method for researchers, managers and practitioners to better understand MDG dynamics and to identify whether participants are integrating.  The degree to which participants use MDG meetings to develop an integrated way of working is likely to require management, leadership and shared values.

Improving the integration of recreation management with management of other natural resources by applying concepts of scale from ecology

Science.gov (United States)

Wayde c. Morse; Troy E. Hall; Linda E. Kruger

2008-01-01

In this article, we examine how issues of scale affect the integration of recreation management with the management of other natural resources on public lands. We present two theories used to address scale issues in ecology and explore how they can improve the two most widely applied recreation-planning frameworks. The theory of patch dynamics and hierarchy theory are...

An Integrated Care Initiative to Improve Patient Outcome in Schizophrenia

OpenAIRE

Mayer-Amberg, Norbert; Woltmann, Rainer; Walther, Stefanie

2016-01-01

The optimal treatment of schizophrenia patients requires integration of medical and psychosocial inputs. In Germany, various healthcare service providers and institutions are involved in the treatment process. Early and continuous treatment is important but often not possible because of the fragmented medical care system in Germany. The current work is a quality monitoring report of a novel care setting, called Integrated Care Initiative Schizophrenia. It has implemented a networked care con...

Integrated double mulching practices optimizes soil temperature and improves soil water utilization in arid environments

Science.gov (United States)

Yin, Wen; Feng, Fuxue; Zhao, Cai; Yu, Aizhong; Hu, Falong; Chai, Qiang; Gan, Yantai; Guo, Yao

2016-09-01

Water shortage threatens agricultural sustainability in many arid and semiarid areas of the world. It is unknown whether improved water conservation practices can be developed to alleviate this issue while increasing crop productivity. In this study, we developed a "double mulching" system, i.e., plastic film coupled with straw mulch, integrated together with intensified strip intercropping. We determined (i) the responses of soil evaporation and moisture conservation to the integrated double mulching system and (ii) the change of soil temperature during key plant growth stages under the integrated systems. Experiments were carried out in northwest China in 2009 to 2011. Results show that wheat-maize strip intercropping in combination with plastic film and straw covering on the soil surface increased soil moisture (mm) by an average of 3.8 % before sowing, 5.3 % during the wheat and maize co-growth period, 4.4 % after wheat harvest, and 4.9 % after maize harvest, compared to conventional practice (control). The double mulching decreased total evapotranspiration of the two intercrops by an average of 4.6 % ( P < 0.05), compared to control. An added feature was that the double mulching system decreased soil temperature in the top 10-cm depth by 1.26 to 1.31 °C in the strips of the cool-season wheat, and by 1.31 to 1.51 °C in the strips of the warm-season maize through the 2 years. Soil temperature of maize strips higher as 1.25 to 1.94 °C than that of wheat strips in the top 10-cm soil depth under intercropping with the double mulching system; especially higher as 1.58 to 2.11 °C under intercropping with the conventional tillage; this allows the two intercrops to grow in a well "collaborative" status under the double mulching system during their co-growth period. The improvement of soil moisture and the optimization of soil temperature for the two intercrops allow us to conclude that wheat-maize intensification with the double mulching system can be used as an

Towards an Improved Integration of Sustainability in Finance - The French (eco)system. Executive summary

International Nuclear Information System (INIS)

Morel, Romain; Cochran, Ian; Robins, Nick

2015-11-01

In the run-up of the COP21, much international attention is focused on France. While mainly related to climate change negotiations, this creates an opportunity to take a broader look at French domestic policies and practices on sustainability. This report presents the French financial system and draws lessons from the French ongoing experience in improving the integration of sustainability issues that could be shared with other countries. The present report summarizes and analyses the key initiatives and dynamics at stake in France. It focuses on both the climate-related issues that have recently received significant attention and the development of broader Environmental, Social and Governance (ESG) issues over the past twenty years. The dynamics that have shaped the last two decades have both led to and been influenced by the emergence of an 'ecosystem' of commercial, public and non-profit actors and experts involved in the appropriation and integration of sustainability issues across the sector. Using the framework of analysis presented in the UNEP Inquiry global report, this case study examines the landscape of actors, private initiatives and public policy that has driven the emergence of this ecosystem and helped foster capacity building and the acquisition of expertise among sectoral actors. (authors)

Integrating Flow, Form, and Function for Improved Environmental Water Management

Science.gov (United States)

Albin Lane, Belize Arela

Rivers are complex, dynamic natural systems. The performance of river ecosystem functions, such as habitat availability and sediment transport, depends on the interplay of hydrologic dynamics (flow) and geomorphic settings (form). However, most river restoration studies evaluate the role of either flow or form without regard for their dynamic interactions. Despite substantial recent interest in quantifying environmental water requirements to support integrated water management efforts, the absence of quantitative, transferable relationships between river flow, form, and ecosystem functions remains a major limitation. This research proposes a novel, process-driven methodology for evaluating river flow-form-function linkages in support of basin-scale environmental water management. This methodology utilizes publically available geospatial and time-series data and targeted field data collection to improve basic understanding of river systems with limited data and resource requirements. First, a hydrologic classification system is developed to characterize natural hydrologic variability across a highly altered, physio-climatically diverse landscape. Next, a statistical analysis is used to characterize reach-scale geomorphic variability and to investigate the utility of topographic variability attributes (TVAs, subreach-scale undulations in channel width and depth), alongside traditional reach-averaged attributes, for distinguishing dominant geomorphic forms and processes across a hydroscape. Finally, the interacting roles of flow (hydrologic regime, water year type, and hydrologic impairment) and form (channel morphology) are quantitatively evaluated with respect to ecosystem functions related to hydrogeomorphic processes, aquatic habitat, and riparian habitat. Synthetic river corridor generation is used to evaluate and isolate the role of distinct geomorphic attributes without the need for intensive topographic surveying. This three-part methodology was successfully

The implementation of integrated science teaching materials based socio-scientific issues to improve students scientific literacy for environmental pollution theme

Science.gov (United States)

Yenni, Rita; Hernani, Widodo, Ari

2017-05-01

The study aims to determine the increasing of students' science literacy skills on content aspects and competency of science by using Integrated Science teaching materials based Socio-scientific Issues (SSI) for environmental pollution theme. The method used in the study is quasi-experiment with nonequivalent pretest and posttest control group design. The students of experimental class used teaching materials based SSI, whereas the students of control class were still using the usual textbooks. The result of this study showed a significant difference between the value of N-gain of experimental class and control class, whichalso occurred in every indicator of content aspects and competency of science. This result indicates that using of Integrated Science teaching materials based SSI can improve content aspect and competency of science and can be used as teaching materials alternative in teaching of Integrated Science.

Transcranial infrared laser stimulation improves rule-based, but not information-integration, category learning in humans.

Science.gov (United States)

Blanco, Nathaniel J; Saucedo, Celeste L; Gonzalez-Lima, F

2017-03-01

This is the first randomized, controlled study comparing the cognitive effects of transcranial laser stimulation on category learning tasks. Transcranial infrared laser stimulation is a new non-invasive form of brain stimulation that shows promise for wide-ranging experimental and neuropsychological applications. It involves using infrared laser to enhance cerebral oxygenation and energy metabolism through upregulation of the respiratory enzyme cytochrome oxidase, the primary infrared photon acceptor in cells. Previous research found that transcranial infrared laser stimulation aimed at the prefrontal cortex can improve sustained attention, short-term memory, and executive function. In this study, we directly investigated the influence of transcranial infrared laser stimulation on two neurobiologically dissociable systems of category learning: a prefrontal cortex mediated reflective system that learns categories using explicit rules, and a striatally mediated reflexive learning system that forms gradual stimulus-response associations. Participants (n=118) received either active infrared laser to the lateral prefrontal cortex or sham (placebo) stimulation, and then learned one of two category structures-a rule-based structure optimally learned by the reflective system, or an information-integration structure optimally learned by the reflexive system. We found that prefrontal rule-based learning was substantially improved following transcranial infrared laser stimulation as compared to placebo (treatment X block interaction: F(1, 298)=5.117, p=0.024), while information-integration learning did not show significant group differences (treatment X block interaction: F(1, 288)=1.633, p=0.202). These results highlight the exciting potential of transcranial infrared laser stimulation for cognitive enhancement and provide insight into the neurobiological underpinnings of category learning. Copyright © 2017 Elsevier Inc. All rights reserved.

Improved Mapping of Human Population and Settlements through Integration of Remote Sensing and Socioeconomic Data

Science.gov (United States)

de Sherbinin, A. M.; Yetman, G.; MacManus, K.; Vinay, S.

2017-12-01

The diversity of data on human settlements, infrastructure, and population continues to grow rapidly, with recent releases of data products based on a range of different remote sensing data sources as well as census and administrative data. We report here on recent improvements in data from the NASA Socioeconomic Data and Applications Center (SEDAC) and partner organizations, aimed at supporting both interdisciplinary research and real-world applications. The fourth version of SEDAC's Gridded Population of the World (GPWv4) now includes variables for age categories, gender, and urban/rural location, and has also been integrated with the Global Human Settlements (GHS) data developed by the Joint Research Centre of the European Commission to produce a GHS-POP grid for the years 1975, 1990, 2000 and 2015. Through a collaboration between Facebook's Connectivity Lab and the Center for International Earth Science Information Network (CIESIN), High Resolution Settlement Layer (HRSL) data derived from 50-cm DigitalGlobe imagery are now available for selected developing countries at 30-m resolution. SEDAC is also developing interactive mapping and analysis tools to facilitate visualization and access to these often large and complex data products. For example, SEDAC has collaborated with scientists from NASA's Goddard Space Flight Center to release the Global Man-made Impervious Surfaces & Settlement Extents from Landsat data at 30-m resolution through an innovative map interface. We also summarize recent progress in developing an international data collective that is bringing together both data developers and data users from the public and private sectors to collaborate on expanding data access and use, improving data quality and documentation, facilitating data intercomparison and integration, and sharing of resources and capabilities.

Integration of virtual and real scenes within an integral 3D imaging environment

Science.gov (United States)

Ren, Jinsong; Aggoun, Amar; McCormick, Malcolm

2002-11-01

The Imaging Technologies group at De Montfort University has developed an integral 3D imaging system, which is seen as the most likely vehicle for 3D television avoiding psychological effects. To create real fascinating three-dimensional television programs, a virtual studio that performs the task of generating, editing and integrating the 3D contents involving virtual and real scenes is required. The paper presents, for the first time, the procedures, factors and methods of integrating computer-generated virtual scenes with real objects captured using the 3D integral imaging camera system. The method of computer generation of 3D integral images, where the lens array is modelled instead of the physical camera is described. In the model each micro-lens that captures different elemental images of the virtual scene is treated as an extended pinhole camera. An integration process named integrated rendering is illustrated. Detailed discussion and deep investigation are focused on depth extraction from captured integral 3D images. The depth calculation method from the disparity and the multiple baseline method that is used to improve the precision of depth estimation are also presented. The concept of colour SSD and its further improvement in the precision is proposed and verified.

Virtual Reality-Based Wii Fit Training in Improving Muscle Strength, Sensory Integration Ability, and Walking Abilities in Patients with Parkinson's Disease: A Randomized Control Trial

Directory of Open Access Journals (Sweden)

Ying-Yi Liao

2015-12-01

Conclusion: VRWii training is as beneficial as TE in improving walking abilities, sensory integration ability, and muscle strength in patients with PD, and such improvements persisted for at least for 1 month. VRWii training is thus suggested to be implemented in patients with PD.

Integrating Disciplines, Sectors, and Societies to Improve the Definition and Implementation of Environmental Flows for Dammed Amazonian Rivers

Science.gov (United States)

Kaplan, D. A.; Livino, A.; Arias, M. E.; Crouch, T. D.; Anderson, E.; Marques, E.; Dutka-Gianelli, J.

2017-12-01

The Amazon River watershed is the world's largest river basin and provides US$30 billion/yr in ecosystem services to local populations, national societies, and humanity at large. The Amazon is also a relatively untapped source of hydroelectricity for Latin America, and construction of >30 large hydroelectric dams and >170 small dams is currently underway. Hydropower development will have a cascade of physical, ecological, and social effects at local to global scales. While Brazil has well-defined environmental impact assessment and mitigation programs, these efforts often fail to integrate data and knowledge across disciplines, sectors, and societies throughout the dam planning process. Resulting failures of science, policy, and management have had widespread environmental, economic, and social consequences, highlighting the need for an improved theoretical and practical framework for understanding the impacts of Amazon dams and guiding improved management that respects the needs and knowledge of diverse set of stakeholders. We present a conceptual framework that links four central goals: 1) connecting research in different disciplines (interdisciplinarity); 2) incorporating new knowledge into decision making (adaptive management); 3) including perspectives and participation of non-academic participants in knowledge generation (transdisciplinarity); and 4) extending the idea of environmental flows ("how much water does a river need?") to better consider human uses and users through the concept of fluvial anthropology ("how much water does a society need?"). We use this framework to identify opportunities for improved integration strategies within the (Brazilian) hydroelectric power plant planning and implementation "lifecycle." We applied this approach to the contentious Belo Monte dam, where compliance with regulatory requirements, including monitoring for environmental flows, exemplifies the opportunity for applying adaptive management, but also highlights an

A Comprehensive Theory of Integration.

Science.gov (United States)

Singer, Sara J; Kerrissey, Michaela; Friedberg, Mark; Phillips, Russell

2018-03-01

Efforts to transform health care delivery to improve care have increasingly focused on care integration. However, variation in how integration is defined has complicated efforts to design, synthesize, and compare studies of integration in health care. Evaluations of integration initiatives would be enhanced by describing them according to clear definitions of integration and specifying which empirical relationships they seek to test-whether among types of integration or between integration and outcomes of care. Drawing on previous work, we present a comprehensive theoretical model of relationships between types of integration and propose how to measure them.

A "next generation" ethics committee. St. Joseph Health system has integrated performance-improvement features into its ethics work.

Science.gov (United States)

Murphy, Kevin

2006-01-01

Understanding the limitations that accompany the traditional model of ethics committees, St. Joseph Health System (SJHS), Orange, CA, has been working to integrate ethics expertise and quality-improvement methodology into its "Next Generation Model" (NG Model) for such committees. However, moving from a traditional structure to the NG Model (introduced to SJHS facilities in 1999) brought some challenges, not the least of which was a deep-rooted culture of resistance to change. Following a 2004 audit of how the NG model was working, some common challenges were identified. To deal with those challenges, SJHS developed some tools and techniques that have helped ease the ongoing transition. These tools have helped the system's ethics committees address such issues as collaboration for the sake of organizational integration, setting goals, and measuring performance of various ethics roles.

Management systems for high reliability organizations. Integration and effectiveness; Managementsysteme fuer Hochzuverlaessigkeitsorganisationen. Integration und Wirksamkeit

Energy Technology Data Exchange (ETDEWEB)

Mayer, Michael

2015-03-09

The scope of the thesis is the development of a method for improvement of efficient integrated management systems for high reliability organizations (HRO). A comprehensive analysis of severe accident prevention is performed. Severe accident management, mitigation measures and business continuity management are not included. High reliability organizations are complex and potentially dynamic organization forms that can be inherently dangerous like nuclear power plants, offshore platforms, chemical facilities, large ships or large aircrafts. A recursive generic management system model (RGM) was development based on the following factors: systemic and cybernetic Asepcts; integration of different management fields, high decision quality, integration of efficient methods of safety and risk analysis, integration of human reliability aspects, effectiveness evaluation and improvement.

Integration of transportation for improved mobility.

Science.gov (United States)

2017-07-04

Mobility management and improvement have become the focal point of the federal, state, and local transportation agencies over the last decade. Even with decreasing vehicle-miles-traveled (VMT) over the same time span, the congestion and delays have n...

Care Plan Improvement in Nursing Homes: An Integrative Review.