Theory-practice integration in selected clinical situations

Directory of Open Access Journals (Sweden)

M Davhana-Maselesele

2001-09-01

Full Text Available The current changes in health care systems challenge knowledgeable, mature and independent practitioners to integrate theoretical content with practice. The aim of this study was to investigate the problems of integrating theory with practice in selected clinical nursing situations. The study focused on rendering of family planning services to clients as a component of Community Nursing Science. Structured observation schedules were used to observe the theoretical content of the curriculum as well as the practical application of what has been taught in the clinical area. The findings of the study revealed that there was a need for an integrated holistic curriculum, which would address the needs of the community. It was concluded that a problem-based and community-based curriculum, intersectoral collaboration between college and hospital managements and student involvement in all processes of teaching and learning would improve the integration of theory and practice. There also appeared to be a need for tutors to be more involved in clinical teaching and accompaniment.

General practice integration in Australia. Primary health services provider and consumer perceptions of barriers and solutions.

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Appleby, N J; Dunt, D; Southern, D M; Young, D

1999-08-01

To identify practical examples of barriers and possible solutions to improve general practice integration with other health service providers. Twelve focus groups, including one conducted by teleconference, were held across Australia with GPs and non GP primary health service providers between May and September, 1996. Focus groups were embedded within concept mapping sessions, which were used to conceptually explore the meaning of integration in general practice. Data coding, organising and analysis were based on the techniques documented by Huberman and Miles. Barriers to integration were perceived to be principally due to the role and territory disputes between the different levels of government and their services, the manner in which the GP's role is currently defined, and the system of GP remuneration. Suggestions on ways to improve integration involved two types of strategies. The first involves initiatives implemented 'top down' through major government reform to service structures, including the expansion of the role of divisions of general practice, and structural changes to the GP remuneration systems. The second type of strategy suggested involves initiatives implemented from the 'bottom up' involving services such as hospitals (e.g. additional GP liaison positions) and the use of information technology to link services and share appropriate patient data. The findings support the need for further research and evaluation of initiatives aimed at achieving general practice integration at a systems level. There is little evidence to suggest which types of initiatives improve integration. However, general practice has been placed in the centre of the health care debate and is likely to remain central to the success of such initiatives. Clarification of the future role and authority of general practice will therefore be required if such integrative strategies are to be successful at a wider health system level.

Practical impact of group communication theory

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Schiper, A.

2003-01-01

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

Integrating Education: Parekhian Multiculturalism and Good Practice

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McGlynn, Claire

2009-01-01

This paper explores the concept of good practice in integrating education in divided societies. Using Northern Ireland as a case study, the paper draws on data from eight schools (both integrated Catholic and Protestant, and separate) that are identified as exemplifying good practice in response to cultural diversity. Analysis is provided through…

Practices for caring in nursing: Brazilian research groups.

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Erdmann, A L; de Andrade, S R; de Mello, A L Ferreira; Klock, P; do Nascimento, K C; Koerich, M Santos; Backes, D Stein

2011-09-01

The present study considers the production of knowledge and the interactions in the environment of research and their relationships in the system of caring in nursing and health. To elaborate a theoretical model of the organization of the practices used for caring, based on the experiences made by the research groups of administration and management in nursing, in Brazil. The study is based on grounded theory. Twelve leaders of research groups, working as professors in public universities in the south and the south-east of Brazil, distributed in sample groups, were interviewed. The core phenomenon 'research groups of administration and management in nursing: arrangements and interactions in the system of caring in nursing' was derived from the categories: conceptual bases and contexts of the research groups; experiencing interactions in the research groups; functionality of the research groups; and outputs of the research groups. The research groups are integrated in the system of caring in nursing. The activities of the Brazilian administration and management in nursing research groups are process oriented and in a process of constant renovation, socially relevant, operate in a complex scenario and contribute to the advancement of the organizations of the system of caring in nursing through strengthening the connection among academia, service and community. © 2011 The Authors. International Nursing Review © 2011 International Council of Nurses.

Consumer focus can spur group practice turnaround.

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Foreman, M S; Draper, A

2001-06-01

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

42 CFR 411.352 - Group practice.

Science.gov (United States)

2010-10-01

..., verifiable, and documented. (2) The data used to calculate compliance with this substantially all test and... should not be used to calculate whether the group practice has met the substantially all test, regardless... productivity bonuses and profit shares. (1) A physician in the group practice may be paid a share of overall...

An Integrative Professional Theory and Practice Paper: Personal Reflections from the Journey through Clinical Pastoral Education.

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McLean, Gillian

2015-12-01

CPE is an experience-based approach to learning spiritual care which combines clinical care with qualified supervision, in-class education and group reflection (CASC--http://www.spiritualcare.ca/). Through didactic seminars, group presentations and personal reading there is opportunity for the student to acquire, apply and integrate relevant theoretical information into their practice. Written for my CPE Specialist application, this paper describes how, through the course of advanced CPE education, I learn to utilize and integrate theory into my clinical work. Beginning with three strands--authenticity, listening and storytelling--I then discuss how the behavioural sciences and theology inform my practice. Focusing on empathy, I speak of the application of disclosure, the use of counter-transference as a diagnostic tool, and the place of therapeutic termination. Group theory, family systems theory, theological reflection, liturgical ministry, and multi-faith practices are considered. © The Author(s) 2015.

Meeting the challenge of a group practice turnaround.

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Porn, L M

2001-03-01

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

Advancing nursing practice: redefining the theoretical and practical integration of knowledge.

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Christensen, Martin

2011-03-01

The aim of this paper is to offer an alternative knowing-how knowing-that framework of nursing knowledge, which in the past has been accepted as the provenance of advanced practice. The concept of advancing practice is central to the development of nursing practice and has been seen to take on many different forms depending on its use in context. To many it has become synonymous with the work of the advanced or expert practitioner; others have viewed it as a process of continuing professional development and skills acquisition. Moreover, it is becoming closely linked with practice development. However, there is much discussion as to what constitutes the knowledge necessary for advancing and advanced practice, and it has been suggested that theoretical and practical knowledge form the cornerstone of advanced knowledge. The design of this article takes a discursive approach as to the meaning and integration of knowledge within the context of advancing nursing practice. A thematic analysis of the current discourse relating to knowledge integration models in an advancing and advanced practice arena was used to identify concurrent themes relating to the knowing-how knowing-that framework which commonly used to classify the knowledge necessary for advanced nursing practice. There is a dichotomy as to what constitutes knowledge for advanced and advancing practice. Several authors have offered a variety of differing models, yet it is the application and integration of theoretical and practical knowledge that defines and develops the advancement of nursing practice. An alternative framework offered here may allow differences in the way that nursing knowledge important for advancing practice is perceived, developed and coordinated. What has inevitably been neglected is that there are various other variables which when transposed into the existing knowing-how knowing-that framework allows for advanced knowledge to be better defined. One of the more notable variables is

Writing a group practice business plan.

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Reiboldt, J M

1999-07-01

A business plan offers group practices a blueprint to accomplish a variety of goals, such as securing capital, marketing the practice's services, recruiting new employees, developing a strategic plan or a budget, or planning for growth. A business plan should be informative, specific, and visionary. Elements that every business plan should address are a mission statement, strategy, planning, management information, and action scheme. A business plan should include certain information in a prescribed order. By writing a realistic business plan, group practices can work more efficiently and minimize the risk of not meeting their financial projections.

Implementation of integrated services networks in Quebec and nursing practice transformation: convergence or divergence?

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Longpré, Caroline; Dubois, Carl-Ardy

2015-03-03

Even though nurses are expected to play a key role in implementing integrated services networks, up to now their practice in this regard has received very little research attention. The aim of this study is to describe the extent to which the evolution of nursing practice in Quebec in recent years has converged with the requirements and efforts involved in services integration. This descriptive study was carried out with 107 nurses working an integrated network of healthcare services in Quebec in four different care pathways: chronic obstructive pulmonary disease, autonomy support for the elderly, palliative oncology care, and mental health. Development model for integrated care (DMIC) was used, first, to examine the prevalence in each pathway of integrative activities, grouped into nine practice dimensions, and then to position each pathway in relation to the four phases of development for any integration process, as defined by the DMIC. Only one pathway had reached Phase 3, which involves expansion and monitoring of integration, whereas the others were still in the preliminary Phases 1 and 2 characterized by initiative and experimentation. Only two dimensions out of nine ('quality of care' and 'interprofessional teamwork') were prevalent in all the pathways; two others ('transparent entrepreneurship' and 'performance management') were in none of the pathways, and the remaining five ('patient-family centered care', 'result-focused learning', 'delivery system', 'commitment', 'roles and tasks') were present to varying degrees. These results suggest that particular efforts should be made to bridge the significant gap between the pace of nursing practice transformation and the objectives of service integration. These efforts should focus, among other things, on the deployment of organizational, clinical, human, and material resources to support practice renewal and continuing education for nurses to prepare them for the requirements of integration.

Health promotion practices in primary care groups.

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Heidemann, Ivonete Teresinha Schulter Buss; Alonso da Costa, Maria Fernanda Baeta Neves; Hermida, Patrícia Madalena Vieira; Marçal, Cláudia Cossentino Bruck; Antonini, Fabiano Oliveira; Cypriano, Camilla Costa

2018-04-01

This is a descriptive-exploratory study using a qualitative approach, conducted in ten municipalities in southern Brazil. Data were obtained by talking to 21 nurses from February to November 2012, through semi-structured interviews using questions to probe their health promotion practices. Data were analyzed through thematic analysis focused on health promotion concepts. We identified four themes about health promotion practices of family health nurses in Brazil: a) training of nurses for health promotion practice was weak; b) nurses formed health promotion groups around diseases and life stages; c) nurses formed groups to meet community needs; and d) nurses used health promotion techniques in group work. These family health nurses were somewhat aware of the importance of health promotion, and how to assist the population against various ailments using some health promotion strategies. The main weaknesses were the lack of understanding about health promotion concepts, and the difficulty of understanding the relevance of its practice, probably attributable to limitations in training. We conclude that primary care groups in Brazil's unified health system could do better in applying health promotion concepts in their practice.

Integrating a pharmacist into the general practice environment: opinions of pharmacist’s, general practitioner’s, health care consumer’s, and practice manager’s

Directory of Open Access Journals (Sweden)

Freeman Christopher

2012-08-01

Full Text Available Abstract Background Pharmacists are viewed as highly trained yet underutilised and there is growing support to extend the role of the pharmacist within the primary health care sector. The integration of a pharmacist into a general practice medical centre is not a new concept however is a novel approach in Australia and evidence supporting this role is currently limited. This study aimed to describe the opinions of local stakeholders in South-East Queensland on the integration of a pharmacist into the Australian general practice environment. Methods A sample of general practitioners, health care consumers, pharmacists and practice managers in South-East Queensland were invited to participate in focus groups or semi-structured interviews. Seeding questions common to all sessions were used to facilitate discussion. Sessions were audio recorded and transcribed verbatim. Leximancer software was used to qualitatively analyse responses. Results A total of 58 participants took part in five focus groups and eighteen semi-structured interviews. Concepts relating to six themes based on the seeding questions were identified. These included positively viewed roles such as medication reviews and prescribing, negatively viewed roles such as dispensing and diagnosing, barriers to pharmacist integration such as medical culture and remuneration, facilitators to pharmacist integration such as remuneration and training, benefits of integration such as access to the patient’s medical file, and potential funding models. Conclusions These findings and future research may aid the development of a new model of integrated primary health care services involving pharmacist practitioners.

Integrating Simulation Scenarios and Clinical Practices Guided by Concepts of Translational Medicine

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Yang, Jing; Huang, Si-min; Li, Ze-jian; Feng, Lie; Lu, Chun-ting

2018-01-01

Purpose: To develop a novel method for closely and effectively integrating simulation scenarios and clinical practices to improve clinical skills training in the concepts of translational medicine. Methods: Forty-two and 38 third-year medical students in the classes of 2010 and 2009 at Jinan University were selected as an observation group and a…

Development and Integration of Professional Core Values Among Practicing Clinicians.

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McGinnis, Patricia Quinn; Guenther, Lee Ann; Wainwright, Susan F

2016-09-01

The physical therapy profession has adopted professional core values, which define expected values for its members, and developed a self-assessment tool with sample behaviors for each of the 7 core values. However, evidence related to the integration of these core values into practice is limited. The aims of this study were: (1) to gain insight into physical therapists' development of professional core values and (2) to gain insight into participants' integration of professional core values into clinical practice. A qualitative design permitted in-depth exploration of the development and integration of the American Physical Therapy Association's professional core values into physical therapist practice. Twenty practicing physical therapists were purposefully selected to explore the role of varied professional, postprofessional, and continuing education experiences related to exposure to professional values. The Core Values Self-Assessment and résumé sort served as prompts for reflection via semistructured interviews. Three themes were identified: (1) personal values were the foundation for developing professional values, which were further shaped by academic and clinical experiences, (2) core values were integrated into practice independent of practice setting and varied career paths, and (3) participants described the following professional core values as well integrated into their practice: integrity, compassion/caring, and accountability. Social responsibility was an area consistently identified as not being integrated into their practice. The Core Values Self-Assessment tool is a consensus-based document developed through a Delphi process. Future studies to establish reliability and construct validity of the tool may be warranted. Gaining an in-depth understanding of how practicing clinicians incorporate professional core values into clinical practice may shed light on the relationship between core values mastery and its impact on patient care. Findings may

Emergence of Integrated Urology-Radiation Oncology Practices in the State of Texas

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Jhaveri, Pavan M.; Sun Zhuyi; Ballas, Leslie; Followill, David S.; Hoffman, Karen E.; Jiang Jing; Smith, Benjamin D.

2012-01-01

Purpose: Integrated urology-radiation oncology (RO) practices have been advocated as a means to improve community-based prostate cancer care by joining urologic and radiation care in a single-practice environment. However, little is known regarding the scope and actual physical integration of such practices. We sought to characterize the emergence of such practices in Texas, their extent of physical integration, and their potential effect on patient travel times for radiation therapy. Methods and Materials: A telephone survey identified integrated urology-RO practices, defined as practices owned by urologists that offer RO services. Geographic information software was used to determine the proximity of integrated urology-RO clinic sites with respect to the state's population. We calculated patient travel time and distance from each integrated urology-RO clinic offering urologic services to the RO treatment facility owned by the integrated practice and to the nearest nonintegrated (independent) RO facility. We compared these times and distances using the Wilcoxon-Mann-Whitney test. Results: Of 229 urology practices identified, 12 (5%) offered integrated RO services, and 182 (28%) of 640 Texas urologists worked in such practices. Approximately 53% of the state population resides within 10 miles of an integrated urology-RO clinic site. Patients with a diagnosis of prostate cancer at an integrated urology-RO clinic site travel a mean of 19.7 miles (26.1 min) from the clinic to reach the RO facility owned by the integrated urology-RO practice vs 5.9 miles (9.2 min) to reach the nearest nonintegrated RO facility (P<.001). Conclusions: Integrated urology-RO practices are common in Texas and are generally clustered in urban areas. In most integrated practices, the urology clinics and the integrated RO facilities are not at the same location, and driving times and distances from the clinic to the integrated RO facility exceed those from the clinic to the nearest

Marketing the academic medical center group practice.

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Eudes, J A; Divis, K L

1992-01-01

From a marketing perspective, there are many differences between private and academic medical center (AMC) group practices. Given the growing competition between the two, write John Eudes and Kathy Divis, it is important for the AMC group practice to understand and use these differences to develop a competitive market advantage.

Structuring group medical practices: tax planning aspects.

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Gassman, A S; Conetta, T F

1992-01-01

This article is the first in a series addressing the structuring of group medical practice entities, shareholder relationships, and general representation factors. In this article, a general background in federal tax planning is provided, including strategies for minimization of income tax payment and the potential problems that may be encountered when a group practice is not carefully structured.

Jodï horticultural belief, knowledge and practice: incipient or integral cultivation?

Directory of Open Access Journals (Sweden)

Stanford Zent

Full Text Available This paper describes the Jodï horticultural system, including belief, knowledge and practice aspects. The horticultural practices of the Jodï were previously characterized as 'incipient cultivation' but such practices were poorly described and documented. The antiquity of cultivation among this group is suggested by the prominence and significance of horticultural products and techniques in myth and ritual. Our field observations uncovered a fairly sophisticated system of plant management in swiddens, house gardens, trail gardens and natural forest gaps. An inventory of 67 cultivated plant species was documented, of which 36 are utilized for food, 20 for magical or medicinal purposes, and 11 for technology. The Jodï prolong the productive phase of their gardens for five years or more through successive planting-harvesting-replanting operations. Jodï swiddens display an elaborate polycultivated appearance and they possess at least five principal crops: plantain/banana, maize, yams, sweet potato, and sweet manioc. Another distinctive feature is the extensive use of natural gaps in the forest canopy as cultivation zones. The results of this study suggest that while Jodï horticultural practice is well integrated with a nomadic, foraging-dependent lifestyle, nevertheless this system does not deserve to be labeled as 'incipient' and instead is more integral than was recognized previously.

Drivers Advancing Oral Health in a Large Group Dental Practice Organization.

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Simmons, Kristen; Gibson, Stephanie; White, Joel M

2016-06-01

Three change drivers are being implemented to high standards of patient centric and evidence-based oral health care within the context of a large multispecialty dental group practice organization based on the commitment of the dental hygienist chief operating officer and her team. A recent environmental scan elucidated 6 change drivers that can impact the provision of oral health care. Practitioners who can embrace and maximize aspects of these change drivers will move dentistry forward and create future opportunities. This article explains how 3 of these change drivers are being applied in a privately held, accountable risk-bearing entity that provides individualized treatment programs for more than 417,000 members. To facilitate integration of the conceptual changes related to the drivers, a multi-institutional, multidisciplinary, highly functioning collaborative work group was formed. The document Dental Hygiene at a Crossroads for Change(1) inspired the first author, a dental hygienist in a unique position as chief operating officer of a large group practice, to pursue evidence-based organizational change and to impact the quality of patient care. This was accomplished by implementing technological advances including dental diagnosis terminology in the electronic health record, clinical decision support, standardized treatment guidelines, quality metrics, and patient engagement to improve oral health outcomes at the patient and population levels. The systems and processes used to implement 3 change drivers into a large multi-practice dental setting is presented to inform and inspire others to implement change drivers with the potential for advancing oral health. Technology implementing best practices and improving patient engagement are excellent drivers to advance oral health and are an effective use of oral health care dollars. Improved oral health can be leveraged through technological advances to improve clinical practice. Copyright © 2016 Elsevier Inc

From parallel practice to integrative health care: a conceptual framework

Directory of Open Access Journals (Sweden)

O'Hara Dennis

2004-07-01

Full Text Available Abstract Background "Integrative health care" has become a common term to describe teams of health care providers working together to provide patient care. However this term has not been well-defined and likely means many different things to different people. The purpose of this paper is to develop a conceptual framework for describing, comparing and evaluating different forms of team-oriented health care practices that have evolved in Western health care systems. Discussion Seven different models of team-oriented health care practice are illustrated in this paper: parallel, consultative, collaborative, coordinated, multidisciplinary, interdisciplinary and integrative. Each of these models occupies a position along the proposed continuum from the non-integrative to fully integrative approach they take to patient care. The framework is developed around four key components of integrative health care practice: philosophy/values; structure, process and outcomes. Summary This framework can be used by patients and health care practitioners to determine what styles of practice meet their needs and by policy makers, healthcare managers and researchers to document the evolution of team practices over time. This framework may also facilitate exploration of the relationship between different practice models and health outcomes.

Integrated reporting with CSR practices

DEFF Research Database (Denmark)

Lueg, Klarissa; Lueg, Rainer; Andersen, Karina

2016-01-01

: We find that the family-owned EGE follows a strategy of “enlightened shareholder value”, in which CSR is an essential value driver. This strategy fostered IR with guidelines and standards for CSR. The CSR practices appeared to be helpful for integrating measureable plans to the strategy...

Renewable Electricity Grid Integration Roadmap for Mexico. Supplement to the IEA Expert Group Report on Recommended Practices for Wind Integration Studies

Energy Technology Data Exchange (ETDEWEB)

Parsons, Brian [Evergreen Renewable Consulting, Evergreen, CO (United States); Cochran, Jaquelin [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Watson, Andrea [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Katz, Jessica [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Bracho, Ricardo [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

2015-08-19

As a recognized leader in efforts to mitigate global climate change, the Government of Mexico (GOM) works proactively to reduce emissions, demonstrating strong political will and capacity to comprehensively address climate change. Since 2010, the U.S. government (USG) has supported these efforts by partnering with Mexico under the Enhancing Capacity for Low Emission Development Strategies (EC-LEDS) program. Through the program, the USG has partnered with Mexico’s Ministry of Energy (SENER), as well as other government agencies, to support GOM in reaching its clean energy and climate change goals. Specifically, the EC-LEDS program is supporting GOM’s clean energy goal of generating 35% of its electricity from renewable energy (RE) by 2024. EC-LEDS, through the U.S. Agency for International Development (USAID) and the U.S Department of Energy’s (DOE’s) National Renewable Energy Laboratory (NREL), has been collaborating with SENER and GOM interagency working group—the Consejo Consultivo para las Energías Renovables (Consultative Council on Renewable Energy)—to create a grid integration roadmap for variable RE. 1 A key objective in creating a grid integration roadmap is assessing likely impacts of wind and solar energy on the power system and modifying planning and operations accordingly. This paper applies best practices in conducting a grid integration study to the Mexican context.

Reflective practice in ESL teacher development groups from practices to principles

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Farrell, T

2013-01-01

Reflective Practise in ESL Teacher Development Groups  discusses the concept of reflective practice in ESL teachers using data from a 3-year collaborative partnership in which three ESL teachers in Canada explored their professional development through reflective practice.

Developing an Integrative Play Therapy Group Model for Middle School Male Students to Address Bullying Behaviors

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Jordan, Jakarla

2016-01-01

This research examines the systematic process of developing an integrative play therapy group model for middle school male students, ages 11-15 who participate in bullying behaviors. Play therapy approaches and evidence-based practices are documented as effective measures for addressing bullying behaviors with children and adolescents. This group…

Clinical Nurse Leader Integration Into Practice: Developing Theory To Guide Best Practice.

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Bender, Miriam

2016-01-01

Numerous policy bodies have identified the clinical nurse leader (CNL) as an innovative new role for meeting higher health care quality standards. Although there is growing evidence of improved care environment and patient safety and quality outcomes after redesigning care delivery microsystems to integrate CNL practice, significant variation in CNL implementation has been noted across reports, making it difficult to causally link CNL practice to reported outcomes. This variability reflects the overall absence in the literature of a well-defined CNL theoretical framework to help guide standardized application in practice. To address this knowledge gap, an interpretive synthesis with a grounded theory analysis of CNL narratives was conducted to develop a theoretical model for CNL practice. The model clarifies CNL practice domains and proposes mechanisms by which CNL-integrated care delivery microsystems improve health care quality. The model highlights the need for a systematic approach to CNL implementation including a well-thought out strategy for care delivery redesign; a consistent, competency-based CNL workflow; and sustained macro-to-micro system leadership support. CNL practice can be considered an effective approach to organizing nursing care that maximizes the scope of nursing to influence the ways care is delivered by all professions within a clinical microsystem. Copyright © 2016 Elsevier Inc. All rights reserved.

Due diligence during the integration of physician groups.

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Ealey, Tom

2011-12-01

While contemplating physician group integration, providers should perform due diligence and ask questions in several key areas to ensure successful integrations: Financial--Is the group producing the revenue expected, and is the revenue cycle managed effectively? Statistical--What are the numbers of encounters, procedures, surgeries, and ancillaries? Compliance--Has the group developed and operated a sound compliance program, and has compliance been a priority? Succession--How many physicians are within three to five years of retirement?

Promoting a Strategic Approach to Clinical Nurse Leader Practice Integration.

Science.gov (United States)

Williams, Marjory; Avolio, Alice E; Ott, Karen M; Miltner, Rebecca S

2016-01-01

The Office of Nursing Services of the Department of Veterans Affairs (VA) piloted implementation of the clinical nurse leader (CNL) into the care delivery model and established a strategic goal in 2011 to implement the CNL role across the VA health care system. The VA Office of Nursing Services CNL Implementation and Evaluation (CNL I&E) Service was created as one mechanism to facilitate that goal in response to a need identified by facility nurse executives for consultative support for CNL practice integration. This article discusses strategies employed by the CNL I&E consultative team to help facility-level nursing leadership integrate CNLs into practice. Measures of success include steady growth in CNL practice capacity as well as positive feedback from nurse executives about the value of consultative engagement. Future steps to better integrate CNL practice into the VA include consolidation of lessons learned, collaboration to strengthen the evidence base for CNL practice, and further exploration of the transformational potential of CNL practice across the care continuum.

Jodï horticultural belief, knowledge and practice: incipient or integral cultivation?

Directory of Open Access Journals (Sweden)

Stanford Zent

2012-08-01

Full Text Available This paper describes the Jodï horticultural system, including belief, knowledge and practice aspects. The horticulturalpractices of the Jodï were previously characterized as ‘incipient cultivation’ but such practices were poorly described anddocumented. The antiquity of cultivation among this group is suggested by the prominence and significance of horticulturalproducts and techniques in myth and ritual. Our field observations uncovered a fairly sophisticated system of plantmanagement in swiddens, house gardens, trail gardens and natural forest gaps. An inventory of 67 cultivated plant specieswas documented, of which 36 are utilized for food, 20 for magical or medicinal purposes, and 11 for technology. The Jodïprolong the productive phase of their gardens for five years or more through successive planting-harvesting-replantingoperations. Jodï swiddens display an elaborate polycultivated appearance and they possess at least five principal crops:plantain/banana, maize, yams, sweet potato, and sweet manioc. Another distinctive feature is the extensive use of naturalgaps in the forest canopy as cultivation zones. The results of this study suggest that while Jodï horticultural practice iswell integrated with a nomadic, foraging-dependent lifestyle, nevertheless this system does not deserve to be labeled as‘incipient’ and instead is more integral than was recognized previously.

Integrating Technology into Teacher Preparation and Practice: A Two-way Mentoring Model

Directory of Open Access Journals (Sweden)

Jim Kerr

2004-07-01

Full Text Available This article reports on a pilot case study exploring the opportunity for authentic professional development in the use of technology. Self-selected pre-service and in- service teachers were paired so as to reinforce and enhance, firstly, their computer skill development and, secondly, their ability to integrate these same skills into classroom teaching practices. It was proposed that both groups of participants would derive benefit from these pairings. Results overwhelming support this and suggest (a a model for better preparing teacher candidates to be able to integrate computer skills into classroom programming and (b a new, perhaps more efficient, method of professional development for busy, dedicated classroom teachers.

The integration of information and communication technology into community pharmacists practice in Barcelona.

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Lupiáñez-Villanueva, Francisco; Hardey, Michael; Lluch, Maria

2014-03-01

The study aims to identify community pharmacists' (CPs) utilization of information and communication technology (ICT); to develop and characterize a typology of CPs' utilization of ICT and to identify factors that can enhance or inhibit the use of these technologies. An online survey of the 7649 members of the Pharmacist Association of Barcelona who had a registered email account in 2006 was carried out. Factor analysis, cluster analysis and binomial logit modelling were undertaken. Multivariate analysis of the CPs' responses to the survey (648) revealed two profiles of adoption of ICT. The first profile (40.75%) represents those CPs who place high emphasis on ICT within their practice. This group is therefore referred to as 'integrated CPs'. The second profile (59.25%) represents those CPs who make less use of ICT and so are consequently labelled 'non-integrated CPs'. Statistical modelling was used to identify variables that were important in predisposing CPs to integrate ICT with their work. From the analysis it is evident that responses to questions relating to 'recommend patients going on line for health information'; 'patients discuss or share their Internet health information findings'; 'emphasis on the Internet for communication and dissemination' and 'Pharmacists Professional Association information' play a positive and significant role in the probability of being an 'integrated CP'. The integration of ICT within CPs' practices cannot be adequately understood and appreciated without examining how CPs are making use of ICT within their own practice, their organizational context and the nature of the pharmacists-client relationship.

Structuring group medical practices: shareholder and partnership agreements.

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Gassman, A S

1992-01-01

This article is the second in a series addressing the structuring of group medical entities, shareholder relationships, and general representation factors. In this article, a number of the legal and business considerations for entering into shareholder and partnership agreements are discussed, and various types of practice structures and recommended group practice agreement provisions are described.

Using Action Research Projects to Examine Teacher Technology Integration Practices

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Dawson, Kara

2012-01-01

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

How do Small Groups Promote Behaviour Change? An Integrative Conceptual Review of Explanatory Mechanisms.

Science.gov (United States)

Borek, Aleksandra J; Abraham, Charles

2018-03-01

Small groups are used to promote health, well-being, and personal change by altering members' perceptions, beliefs, expectations, and behaviour patterns. An extensive cross-disciplinary literature has articulated and tested theories explaining how such groups develop, function, and facilitate change. Yet these theoretical understandings are rarely applied in the development, description, and evaluation of health-promotion, group-based, behaviour-change interventions. Medline database, library catalogues, search engines, specific journals and reference lists were searched for relevant texts. Texts were reviewed for explanatory concepts or theories describing change processes in groups, which were integrated into the developing conceptual structure. This was designed to be a parsimonious conceptual framework that could be applied to design and delivery. Five categories of interacting processes and concepts were identified and defined: (1) group development processes, (2) dynamic group processes, (3) social change processes, (4) personal change processes, and (5) group design and operating parameters. Each of these categories encompasses a variety of theorised mechanisms explaining individual change in small groups. The final conceptual model, together with the design issues and practical recommendations derived from it, provides a practical basis for linking research and theory explaining group functioning to optimal design of group-based, behaviour-change interventions. © 2018 The Authors. Applied Psychology: Health and Well-Being published by John Wiley & Sons Ltd on behalf of International Association of Applied Psychology.

BOOK REVIEW - Adrian Liviu Ivan, Teorii și practice ale integrării europene [Theories and Practices of European Integration

Directory of Open Access Journals (Sweden)

Adrian Daniel STAN

2016-06-01

Full Text Available Teorii și practice ale integrării europene [Theories and Practices of European Integration] is a genuine contribution to understanding how the European Union’s particular character has been adjusted in more than half of century of institutional growth and development. Professor Ivan`s key argument for this book is that the European Union has been shaped as a functional project taking into consideration the diverse heritage and traditions of its Member States. The opening chapter of this book focuses on the particularities of international relations discipline after the Second World War in order to introduce the theme of European Integration Process. This chapter must be analysed in a series of contributions dedicated to the European Integration process and to the theories that made this integration possible because professor Ivan has previously published books such as: Statele Unite ale Europei [The United States of Europe], Sub zodia Statelor Unite ale Europei [Under the Sign of the United States of Europe], in which he debates the origins of the European construction and brings forward arguments to support the importance of each theoretical and functional pillar of this “Common European Project”.

Physician practice management companies: implications for hospital-based integrated delivery systems.

Science.gov (United States)

Burns, L R; Robinson, J C

1997-01-01

Physician practice management companies (PPMCs) are one of the most visible entrants into the industry of managing physician practices, and anywhere from 100-150 are already in operation. Although PPMCs and hospital-based integrated delivery systems (IDSs) differ from each other in many ways, they share a number of common features, including the pursuit of capitation contracts from payors. As a result, PPMCs pose a growing, direct threat to hospital systems in competing for managed care contracts that cover physician service. PPMCs also provide an alternative to hospital-based IDSs at the local market level for physician group consolidation. This article looks at the structure, operation, and strategy of PPMCs and examines what implications their growth will have for hospital-based IDSs.

Achieving Integration in Mixed Methods Designs—Principles and Practices

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Fetters, Michael D; Curry, Leslie A; Creswell, John W

2013-01-01

Mixed methods research offers powerful tools for investigating complex processes and systems in health and health care. This article describes integration principles and practices at three levels in mixed methods research and provides illustrative examples. Integration at the study design level occurs through three basic mixed method designs—exploratory sequential, explanatory sequential, and convergent—and through four advanced frameworks—multistage, intervention, case study, and participatory. Integration at the methods level occurs through four approaches. In connecting, one database links to the other through sampling. With building, one database informs the data collection approach of the other. When merging, the two databases are brought together for analysis. With embedding, data collection and analysis link at multiple points. Integration at the interpretation and reporting level occurs through narrative, data transformation, and joint display. The fit of integration describes the extent the qualitative and quantitative findings cohere. Understanding these principles and practices of integration can help health services researchers leverage the strengths of mixed methods. PMID:24279835

Sparse Group Penalized Integrative Analysis of Multiple Cancer Prognosis Datasets

Science.gov (United States)

Liu, Jin; Huang, Jian; Xie, Yang; Ma, Shuangge

2014-01-01

SUMMARY In cancer research, high-throughput profiling studies have been extensively conducted, searching for markers associated with prognosis. Because of the “large d, small n” characteristic, results generated from the analysis of a single dataset can be unsatisfactory. Recent studies have shown that integrative analysis, which simultaneously analyzes multiple datasets, can be more effective than single-dataset analysis and classic meta-analysis. In most of existing integrative analysis, the homogeneity model has been assumed, which postulates that different datasets share the same set of markers. Several approaches have been designed to reinforce this assumption. In practice, different datasets may differ in terms of patient selection criteria, profiling techniques, and many other aspects. Such differences may make the homogeneity model too restricted. In this study, we assume the heterogeneity model, under which different datasets are allowed to have different sets of markers. With multiple cancer prognosis datasets, we adopt the AFT (accelerated failure time) model to describe survival. This model may have the lowest computational cost among popular semiparametric survival models. For marker selection, we adopt a sparse group MCP (minimax concave penalty) approach. This approach has an intuitive formulation and can be computed using an effective group coordinate descent algorithm. Simulation study shows that it outperforms the existing approaches under both the homogeneity and heterogeneity models. Data analysis further demonstrates the merit of heterogeneity model and proposed approach. PMID:23938111

Physician organization-practice team integration for the advancement of patient-centered care.

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Wise, Christopher G; Alexander, Jeffrey A; Green, Lee A; Cohen, Genna R

2012-01-01

The patient-centered medical home is being promoted as a cornerstone for transforming primary care. Physician organizations (POs) are playing a more prominent role by facilitating practices' transformation to the patient-centered medical home. Using a framework of organizational integration, we investigated the changing relationship between POs and practices through qualitative interviews. Through increased integration, POs can support both the big picture and day-to-day activities of practice transformation. Most PO-practice unit connections we identified reflected new areas of engagement-competencies that POs were not developing in the past-that are proving integral to the broad-scale practice change of patient-centered medical home implementation.

Models for integrating medical acupuncture into practice: an exploratory qualitative study of physicians' experiences.

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Crumley, Ellen T

2016-08-01

Internationally, physicians are integrating medical acupuncture into their practice. Although there are some informative surveys and reviews, there are few international, exploratory studies detailing how physicians have accommodated medical acupuncture (eg, by modifying schedules, space and processes). To examine how physicians integrate medical acupuncture into their practice. Semi-structured interviews and participant observations of physicians practising medical acupuncture were conducted using convenience and snowball sampling. Data were analysed in NVivo and themes were developed. Despite variation, three principal models were developed to summarise the different ways that physicians integrated medical acupuncture into their practice, using the core concept of 'helping'. Quotes were used to illustrate each model and its corresponding themes. There were 25 participants from 11 countries: 21 agreed to be interviewed and four engaged in participant observations. Seventy-two per cent were general practitioners. The three models were: (1) appointments (44%); (2) clinics (44%); and (3) full-time practice (24%). Some physicians held both appointments and regular clinics (models 1 and 2). Most full-time physicians initially tried appointments and/or clinics. Some physicians charged to offset administration costs or compensate for their time. Despite variation within each category, the three models encapsulated how physicians described their integration of medical acupuncture. Physicians varied in how often they administered medical acupuncture and the amount of time they spent with patients. Although 24% of physicians surveyed administered medical acupuncture full-time, most practised it part-time. Each individual physician incorporated medical acupuncture in the way that worked best for their practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Practice of the integrated endocrine system course

Institute of Scientific and Technical Information of China (English)

Wen-han MEI; Rong CAI

2015-01-01

The integrated curriculum is an important direction of the medical medical education reform under new situation and challenges of medical development.Shanghai Jiao Tong University School of Medicine has implemented the integrated curriculum reform in recent years.The endocrine system course is one of important intergrated courses and integrates relevant contents of multiple disciplines of basic medicine,diagnostics and medical imaging.Various teaching methods are adopted,such as classroom lecture,discussion,problembased learning,experimental lesson and clinical clerkship,etc.The teaching practice is carried on in several aspects:course arrangement,teaching methods,course website construction,teaching team construction and so on.

Factores, grupos de riesgo y atención integral a la conducta violenta Factors, risk groups and integral care to violent behavior

Directory of Open Access Journals (Sweden)

Anais Marta Valladares González

2010-09-01

Full Text Available La violencia es la acción ejercida por una o varias personas, en la que se somete de manera intencional al maltrato, presión, sufrimiento, manipulación u otra acción que atente contra la integridad física, psicológica y moral de cualquier persona o grupo de personas. Los factores de riesgo de la conducta violenta se pueden agrupar en macrosociales, microsociales e individuales. El enfoque integral de intervención hacia la conducta violenta, debe tener en cuenta, no solo los componentes biológicos, psicológicos y sociales, sino también las peculiaridades sociales, grupales e individuales de su determinación.Violence is the action exerted by one or a certain number of persons practicing in an intentional way the ill-treatment, the pressure, suffering, manipulation or another action attempting on physical, psychological or moral integrity of any person of group of persons. The risk factors of violent behavior may be grouped into macrosocial, microsocial and individual. The integral approach of the intervention to violent behavior must to be into account not only the biological, psychological and social components but also the social, group and individual particular features of its determination.

Achieving integration in mixed methods designs-principles and practices.

Science.gov (United States)

Fetters, Michael D; Curry, Leslie A; Creswell, John W

2013-12-01

Mixed methods research offers powerful tools for investigating complex processes and systems in health and health care. This article describes integration principles and practices at three levels in mixed methods research and provides illustrative examples. Integration at the study design level occurs through three basic mixed method designs-exploratory sequential, explanatory sequential, and convergent-and through four advanced frameworks-multistage, intervention, case study, and participatory. Integration at the methods level occurs through four approaches. In connecting, one database links to the other through sampling. With building, one database informs the data collection approach of the other. When merging, the two databases are brought together for analysis. With embedding, data collection and analysis link at multiple points. Integration at the interpretation and reporting level occurs through narrative, data transformation, and joint display. The fit of integration describes the extent the qualitative and quantitative findings cohere. Understanding these principles and practices of integration can help health services researchers leverage the strengths of mixed methods. © Health Research and Educational Trust.

Towards vertical integration in general practice education: literature review and discussion paper.

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O'Regan, A; Culhane, A; Dunne, C; Griffin, M; Meagher, D; McGrath, D; O'Dwyer, P; Cullen, W

2013-09-01

Medical education policy in Ireland has enabled an increase in undergraduate and postgraduate education activity in general practice. Internationally, 'vertical integration in general practice education' is suggested as a key strategy to support the implementation of this policy development. To review the emerging literature on vertical integration in GP education, specifically to define the concept of 'vertical integration' with regard to education in general practice and to describe its benefits and challenges. We searched 'Pubmed', 'Academic Search Complete', 'Google', and 'MEDLINE' databases using multiple terms related to 'vertical integration' and 'general practice education' for relevant articles published since 2001. Discussion papers, reports, policy documents and position statements were identified from reference lists and retrieved through internet searches. The key components of 'vertical integration' in GP education include continuous educational pathway, all stages in GP education, supporting the continuing educational/professional development needs of learners at each stage and effective curriculum planning and delivery. Many benefits (for GPs, learners and the community) and many challenges (for GPs/practices, learners and GPs in training) have been described. Characteristics of successful implementation include role sharing and collaborative organisational structures. Recent developments in medical education in Ireland, such as the increase in medical school clinical placements in general practice and postgraduate GP training and the introduction of new competence assurance requirements offer an important opportunity to further inform how vertical integration can support increased educational activity in general practice. Describing this model, recognising its benefits and challenges and supporting its implementation in practice are priorities for medical education in Ireland.

Case study on Integral Life Practice intervention for physical ...

African Journals Online (AJOL)

Findings indicated significant improvements in physical exercise, psychophysiological coherence, general health, psychological well-being, mental skills, mindfulness, mood, resilience, sense of coherence and spirituality. Findings endorse Integral Life Practice theoretical principles and practical guidelines for implementing ...

Distinguishing integrative from eclectic practice in cognitive behavioral therapies.

Science.gov (United States)

Petrik, Alexandra M; Kazantzis, Nikolaos; Hofmann, Stefan G

2013-09-01

In psychotherapy research, practice, and training, there remains marked controversy about the merits of theoretical purism (i.e., model specific), versus integration, as well as how such principles may be represented in practice. Adding to the confusion is that many attributes of the therapeutic relationship, processes in therapy, and techniques have been popularized in the context of one or two theoretical approaches, but are incorporated into the practice of many approaches. This article demonstrates the various ways in which three core interventions (i.e., activity scheduling, self-monitoring, and identification, evaluation, and modification of thoughts) can be applied within the context of different cognitive and behavioral therapeutic models. It also demonstrates the role of in-session therapist language in describing the theoretical basis and processes underpinning therapeutic interventions. Case examples are presented to illustrate therapy provided by two hypothetical clinicians, Therapist A and Therapist B. Whether or not a practitioner elects to practice integrative psychotherapy, we advocate for consistency in the theoretical approach through the course of a service for a particular patient. Implications are outlined and discussed within the context of the current state of cognitive and behaviorally focused psychotherapies and integrative psychotherapy. 2013 APA, all rights reserved

Integrable lattice models and quantum groups

International Nuclear Information System (INIS)

Saleur, H.; Zuber, J.B.

1990-01-01

These lectures aim at introducing some basic algebraic concepts on lattice integrable models, in particular quantum groups, and to discuss some connections with knot theory and conformal field theories. The list of contents is: Vertex models and Yang-Baxter equation; Quantum sl(2) algebra and the Yang-Baxter equation; U q sl(2) as a symmetry of statistical mechanical models; Face models; Face models attached to graphs; Yang-Baxter equation, braid group and link polynomials

Theory Loves Practice: A Teacher Researcher Group

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Hochtritt, Lisa; Thulson, Anne; Delaney, Rachael; Dornbush, Talya; Shay, Sarah

2014-01-01

Once a month, art educators from the Denver metro area have been gathering together in the spirit of inquiry to explore issues of the perceived theory and daily practice divide. The Theory Loves Practice (TLP) group was started in 2010 by Professors Rachael Delaney and Anne Thulson from Metropolitan State University of Denver (MSU) and now has 40…

Neural network integration during the perception of in-group and out-group members.

Science.gov (United States)

Greven, Inez M; Ramsey, Richard

2017-11-01

Group biases guide social interactions by promoting in-group favouritism, but the neural mechanisms underpinning group biases remain unclear. While neuroscience research has shown that distributed brain circuits are associated with seeing in-group and out-group members as "us" and "them", it is less clear how these networks exchange signals. This fMRI study uses functional connectivity analyses to investigate the contribution of functional integration to group bias modulation of person perception. Participants were assigned to an arbitrary group and during scanning they observed bodies of in-group or out-group members that cued the recall of positive or negative social knowledge. The results showed that functional coupling between perceptual and cognitive neural networks is tuned to particular combinations of group membership and social knowledge valence. Specifically, coupling between body perception and theory-of-mind networks is biased towards seeing a person that had previously been paired with information consistent with group bias (positive for in-group and negative for out-group). This demonstrates how brain regions associated with visual analysis of others and belief reasoning exchange and integrate signals when evaluating in-group and out-group members. The results update models of person perception by showing how and when interplay occurs between perceptual and extended systems when developing a representation of another person. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

EFFECTS OF SHORT TERM PRACTICE OF BHASTRIKA PRANAYAMA ON METABOLIC FITNESS (METF AND BONE INTEGRITY (BI

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Singh Bal Baljinder

2015-07-01

Full Text Available Purpose: The present study was conducted with the objective to determine the short term practice of bhastrika pranayama on Metabolic Fitness and Bone Integrity. Material: 30 university level females between the age group of 21-26 years were selected. The subjects were randomly matched and assigned into two groups: Group-A: Experimental (n 1=15; Group-B: Control (n 2=15. The subjects from Group-A: Experimental were provided to a 4-weeks bhastrika pranayama. Statistical Analysis: Student t test for paired samples was utilized to compare the means of the pre-test and the post-test. Results & Conclusions: Based on the analysis of the results obtained, we conclude that the significant differences were found in Metabolic Fitness (i.e., Maximal Oxygen Consumption (V O2max and blood pressure of University Level Girls. Insignificant between-group differences were noted in Blood Lipid, Blood Sugar and Bone Integrity of University Level Girls.

Oswer integrated health and safety standard operating practices. Directive

International Nuclear Information System (INIS)

1993-02-01

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

Integrative Mental Health (IMH): paradigm, research, and clinical practice.

Science.gov (United States)

Lake, James; Helgason, Chanel; Sarris, Jerome

2012-01-01

This paper provides an overview of the rapidly evolving paradigm of "Integrative Mental Health (IMH)." The paradigm of contemporary biomedical psychiatry and its contrast to non-allopathic systems of medicine is initially reviewed, followed by an exploration of the emerging paradigm of IMH, which aims to reconcile the bio-psycho-socio-spiritual model with evidence-based methods from traditional healing practices. IMH is rapidly transforming conventional understandings of mental illness and has significant positive implications for the day-to-day practice of mental health care. IMH incorporates mainstream interventions such as pharmacologic treatments, psychotherapy, and psychosocial interventions, as well as alternative therapies such as acupuncture, herbal and nutritional medicine, dietary modification, meditation, etc. Two recent international conferences in Europe and the United States show that interest in integrative mental health care is growing rapidly. In response, the International Network of Integrative Mental Health (INIMH: www.INIMH.org) was established in 2010 with the objective of creating an international network of clinicians, researchers, and public health advocates to advance a global agenda for research, education, and clinical practice of evidence-based integrative mental health care. The paper concludes with a discussion of emerging opportunities for research in IMH, and an exploration of potential clinical applications of integrative mental health care. Copyright © 2012 Elsevier Inc. All rights reserved.

Integrating new practices: a qualitative study of how hospital innovations become routine.

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Brewster, Amanda L; Curry, Leslie A; Cherlin, Emily J; Talbert-Slagle, Kristina; Horwitz, Leora I; Bradley, Elizabeth H

2015-12-05

Hospital quality improvement efforts absorb substantial time and resources, but many innovations fail to integrate into organizational routines, undermining the potential to sustain the new practices. Despite a well-developed literature on the initial implementation of new practices, we have limited knowledge about the mechanisms by which integration occurs. We conducted a qualitative study using a purposive sample of hospitals that participated in the State Action on Avoidable Rehospitalizations (STAAR) initiative, a collaborative to reduce hospital readmissions that encouraged members to adopt new practices. We selected hospitals where risk-standardized readmission rates (RSRR) had improved (n = 7) or deteriorated (n = 3) over the course of the first 2 years of the STAAR initiative (2010-2011 to 2011-2012) and interviewed a range of staff at each site (90 total). We recruited hospitals until reaching theoretical saturation. The constant comparative method was used to conduct coding and identification of key themes. When innovations were successfully integrated, participants consistently reported that a small number of key staff held the innovation in place for as long as a year while more permanent integrating mechanisms began to work. Depending on characteristics of the innovation, one of three categories of integrating mechanisms eventually took over the role of holding new practices in place. Innovations that proved intrinsically rewarding to the staff, by making their jobs easier or more gratifying, became integrated through shifts in attitudes and norms over time. Innovations for which the staff did not perceive benefits to themselves were integrated through revised performance standards if the innovation involved complex tasks and through automation if the innovation involved simple tasks. Hospitals have an opportunity to promote the integration of new practices by planning for the extended effort required to hold a new practice in place while

The integration of lean, green and best practice business principles

OpenAIRE

Annelize Wiese; Rose Luke; Gert J. Heyns; Noleen M. Pisa

2015-01-01

Background: Whilst there are separate streams of established research on lean, green and best practice initiatives, the intersection of these three strategic principles has not been addressed extensively in the past. Objectives: In this study a framework to integrate lean, green and best practice principles into an integrated business model was developed as a strategy for businesses to develop sustainable competitive advantages. Method: A descriptive case study was conducted on Toyota...

The integration of lean, green and best practice business principles

Directory of Open Access Journals (Sweden)

Annelize Wiese

2015-10-01

Full Text Available Background: Whilst there are separate streams of established research on lean, green and best practice initiatives, the intersection of these three strategic principles has not been addressed extensively in the past. Objectives: In this study a framework to integrate lean, green and best practice principles into an integrated business model was developed as a strategy for businesses to develop sustainable competitive advantages. Method: A descriptive case study was conducted on Toyota South Africa Motors (TSAM to understand whether a clear link between the company’s environmental approach, lean principles and established best practice culture could be determined. In addition, the case study tested the view that the implementation of these three principles concurrently resulted in improved business results. Results: The main findings of the study revealed that TSAM’s commitment to lean, green and best practice business principles contributed and was directly linked to its business success in terms of sales and market position. Conclusion: It is recommended that businesses implement an integrated lean, green and best practice business model as a strategy to reduce costs and sustainably enhance profitably and competitiveness.

A practical criterion of irreducibility of multi-loop Feynman integrals

International Nuclear Information System (INIS)

Baikov, P.A.

2006-01-01

A practical criterion for the irreducibility (with respect to integration by part identities) of a particular Feynman integral to a given set of integrals is presented. The irreducibility is shown to be related to the existence of stable (with zero gradient) points of a specially constructed polynomial

Aspects regarding the adoption and development of integrated reporting practices

Directory of Open Access Journals (Sweden)

Lapteș Ramona

2018-01-01

Full Text Available The current economic context brings about new challenges and responsibilities that companies have to face in the communication area based on the principle of sustainable development. This refers to both- protecting the interests of all economic agents involved and minimizing the aggression on natural resources. Hence, entities’ communication process was reconsidered in the form of integrated reporting. This relatively new type of reporting is continuously under evelopment at an international level and it was better understood in practice through the Integrated Reporting Pilot Programme . This paper aims to present the integrated reporting practices of Danone, one of the members of the Pilot Programme through a case study approach. Notwithstanding the experience it should have in the integrated reporting area, o ur findings show that Danone issued a document entitled “Integrated report” only in 2016. Until this year, the firm cho se to publish two reports related to economic and social issues and sustainability, rather combined than integrated.

Best Practices: Power Quality and Integrated Testing at JSC

Science.gov (United States)

Davis, Lydia

2018-01-01

This presentation discusses Best Practices for Power Quality and Integrated Testing at JSC in regards to electrical systems. These high-level charts include mostly generic information; however, a specific issue is discussed involving flight hardware that could have been discovered prior to flight with an integrated test.

Evidence-based music therapy practice: an integral understanding.

Science.gov (United States)

Abrams, Brian

2010-01-01

The American Music Therapy Association has recently put into action a plan called its Research Strategic Priority, with one of its central purposes to advance the music therapy field through research promoting Evidence-Based Practice of music therapy. The extant literature on music therapy practice, theory, and research conveys a range of very different perspectives on what may count as the "evidence" upon which practice is based. There is therefore a need to conceptualize evidence-based music therapy practice in a multifaceted, yet coherent and balanced way. The purpose of this paper is to illustrate a framework based upon four distinct epistemological perspectives on evidence-based music therapy practice that together represent an integral understanding.

Psychotherapy, psychopathology, research and practice: pathways of connections and integration.

Science.gov (United States)

Castonguay, Louis G

2011-03-01

This paper describes three pathways of connections between different communities of knowledge seekers: integration of psychotherapeutic approaches, integration of psychotherapy and psychopathology, and integration of science and practice. Some of the issues discussed involve the delineation and investigation of common factors (e.g., principles of change), improvement of major forms of psychotherapy, clinical implications of psychopathology research, as well as current and future directions related to practice-research networks. The aim of this paper is to suggest that building bridges across theoretical orientations, scientific fields, professional experiences, and epistemological views may be a fruitful strategy to improve our understanding and the impact of psychotherapy.

Collaborative Teaching and Learning through Multi-Institutional Integrated Group Projects

Science.gov (United States)

Long, Suzanna K.; Carlo, Héctor J.

2013-01-01

This teaching brief describes an innovative multi-institutional initiative through which integrated student groups from different courses collaborate on a common course project. In this integrated group project, students are asked to design a decentralized manufacturing organization for a company that will manufacture industrial Proton-Exchange…

Implementation of integrated care for diabetes mellitus type 2 by two Dutch care groups: a case study.

Science.gov (United States)

Busetto, Loraine; Luijkx, Katrien; Huizing, Anna; Vrijhoef, Bert

2015-08-21

Even though previous research has demonstrated improved outcomes of integrated care initiatives, it is not clear why and when integrated care works. This study aims to contribute to filling this knowledge gap by examining the implementation of integrated care for type 2 diabetes by two Dutch care groups. An embedded single case study was conducted including 26 interviews with management staff, care purchasers and health professionals. The Context + Mechanism = Outcome Model was used to study the relationship between context factors, mechanisms and outcomes. Dutch integrated care involves care groups, bundled payments, patient involvement, health professional cooperation and task substitution, evidence-based care protocols and a shared clinical information system. Community involvement is not (yet) part of Dutch integrated care. Barriers to the implementation of integrated care included insufficient integration between the patient databases, decreased earnings for some health professionals, patients' insufficient medical and policy-making expertise, resistance by general practitioner assistants due to perceived competition, too much care provided by practice nurses instead of general practitioners and the funding system incentivising the provision of care exactly as described in the care protocols. Facilitators included performance monitoring via the care chain information system, increased earnings for some health professionals, increased focus on self-management, innovators in primary and secondary care, diabetes nurses acting as integrators and financial incentives for guideline adherence. Economic and political context and health IT-related barriers were discussed as the most problematic areas of integrated care implementation. The implementation of integrated care led to improved communication and cooperation but also to insufficient and unnecessary care provision and deteriorated preconditions for person-centred care. Dutch integrated diabetes care is still a

A Triangular Approach to Integrate Research, Education and Practice in Higher Engineering Education

Science.gov (United States)

Heikkinen, Eetu-Pekka; Jaako, Juha; Hiltunen, Jukka

2017-01-01

Separate approaches in engineering education, research and practice are not very useful when preparing students for working life; instead, integration of education, research and industrial practices is needed. A triangular approach (TA) as a method to accomplish this integration and as a method to provide students with integrated expertise is…

Fostering development of nursing practices to support integrated care when implementing integrated care pathways: what levers to use?

Science.gov (United States)

Longpré, Caroline; Dubois, Carl-Ardy

2017-11-29

Care integration has been the focus of recent health system reforms. Given their functions at all levels of the care continuum, nurses have a substantial and primordial role to play in such integration processes. The aim of this study was to identify levers and strategies that organizations can use to support the development of a nursing practice aligned with the requirements of care integration in a health and social services centre (HSSC) in Quebec. The research design was a cross-sectional descriptive qualitative study based on a single case study with nested levels of analysis. The case was a public, multi-disciplinary HSSC in a semi-urban region of Quebec. Semi-structured interviews with 37 persons (nurses, professionals, managers, administrators) allowed for data saturation and ensured theoretical representation by covering four care pathways constituting different care integration contexts. Analysis involved four steps: preparing a predetermined list of codes based on the reference framework developed by Minkman (2011); coding transcript content; developing general and summary matrices to group observations for each care pathway; and creating a general model showing the overall results for the four pathways. The organization's capacity for response with regard to developing an integrated system of services resulted in two types of complementary interventions. The first involved investing in key resources and renewing organizational structures; the second involved deploying a series of organizational and clinical-administrative processes. In resource terms, integration efforts resulted in setting up new strategic services, re-arranging physical infrastructures, and deploying new technological resources. Organizational and clinical-administrative processes to promote integration involved renewing governance, improving the flow of care pathways, fostering continuous quality improvement, developing new roles, promoting clinician collaboration, and strengthening

Teaching Civic Journalism: Integrating Theory and Practice.

Science.gov (United States)

McDevitt, Michael

2000-01-01

Describes a journalism course that used an integrative approach to teaching about the principles, practice, and effects of civic journalism, combining theory, news writing, and evaluation. Describes the class project on the controversial issue of panhandling. Discusses goals of civic journalism and of the project, journalistic methods used,…

The feminist/emotionally focused therapy practice model: an integrated approach for couple therapy.

Science.gov (United States)

Vatcher, C A; Bogo, M

2001-01-01

Emotionally focused therapy (EFT) is a well-developed, empirically tested practice model for couple therapy that integrates systems, experiential, and attachment theories. Feminist family therapy theory has provided a critique of biased assumptions about gender at play in traditional family therapy practice and the historical absence of discussions of power in family therapy theory. This article presents an integrated feminist/EFT practice model for use in couple therapy, using a case from practice to illustrate key concepts. Broadly, the integrated model addresses gender roles and individual emotional experience using a systemic framework for understanding couple interaction. The model provides practitioners with a sophisticated, comprehensive, and relevant practice approach for working with the issues and challenges emerging for contemporary heterosexual couples.

Integration of Learning and Practice for Job Sharing Partnerships

Science.gov (United States)

Dixon-Krausse, Pamela Marie

2007-01-01

This paper explores the forces that support the proliferation of the flexible work arrangement called job sharing. Moreover, the paper will illuminate the need for integrating learning and practice as a way to develop and support job sharing partners, or "Partners in Practice" (PiPs). The author puts forth a model derived from learning in…

Integrating pharmacogenomics into pharmacy practice via medication therapy management.

Science.gov (United States)

Reiss, Susan M

2011-01-01

To explore the application and integration of pharmacogenomics in pharmacy clinical practice via medication therapy management (MTM) to improve patient care. Department of Health & Human Services (HHS) Personalized Health Care Initiative, Food and Drug Administration (FDA) pharmacogenomics activity, and findings from the Utilizing E-Prescribing Technologies to Integrate Pharmacogenomics into Prescribing and Dispensing Practices Stakeholder Workshop, convened by the American Pharmacists Association (APhA) on March 5, 2009. Participants at the Stakeholder Workshop included diverse representatives from pharmacy, medicine, pathology, health information technology (HIT), standards, science, academia, government, and others with a key interest in the clinical application of pharmacogenomics. In 2006, HHS initiated the Personalized Health Care Initiative with the goal of building the foundation for the delivery of gene-based care, which may prove to be more effective for large patient subpopulations. In the years since the initiative was launched, drug manufacturers and FDA have begun to incorporate pharmacogenomic data and applications of this information into the drug development, labeling, and approval processes. New applications and processes for using this emerging pharmacogenomics data are needed to effectively integrate this information into clinical practice. Building from the findings of a stakeholder workshop convened by APhA and the advancement of the pharmacist's collaborative role in patient care through MTM, emerging roles for pharmacists using pharmacogenomic information to improve patient care are taking hold. Realizing the potential role of the pharmacist in pharmacogenomics through MTM will require connectivity of pharmacists into the electronic health record infrastructure to permit the exchange of pertinent health information among all members of a patient's health care team. Addressing current barriers, concerns, and system limitations and developing

Current nuclear industry practices with regard to the integration of surveillances

International Nuclear Information System (INIS)

Stewart, M.; Smith, C.

1992-04-01

Commercial nuclear industry practices regarding the integration of technical specification (TS) surveillance and maintenance activities are identified in this report. A questionnaire was developed and used to obtain current industry practices from NRC Regional personnel and INEL engineers with utility experience. Some of these practices indicate that the scheduling of TS surveillance and maintenance items could be more effectively coordinated. Also, must utilities do not formally consider risk implications when they are scheduling maintenance. Methodologies and approaches for proposing and evaluating changes to improve the integration of TS surveillance and maintenance activities have been identified for planned future work

An introduction to Lie group integrators – basics, new developments and applications

International Nuclear Information System (INIS)

Celledoni, Elena; Marthinsen, Håkon; Owren, Brynjulf

2014-01-01

We give a short and elementary introduction to Lie group methods. A selection of applications of Lie group integrators are discussed. Finally, a family of symplectic integrators on cotangent bundles of Lie groups is presented and the notion of discrete gradient methods is generalised to Lie groups

Integrable systems twistors, loop groups, and Riemann surfaces

CERN Document Server

Hitchin, NJ; Ward, RS

2013-01-01

This textbook is designed to give graduate students an understanding of integrable systems via the study of Riemann surfaces, loop groups, and twistors. The book has its origins in a series of lecture courses given by the authors, all of whom are internationally known mathematicians and renowned expositors. It is written in an accessible and informal style, and fills a gap in the existing literature. The introduction by Nigel Hitchin addresses the meaning of integrability: how do werecognize an integrable system? His own contribution then develops connections with algebraic geometry, and inclu

Consolidation of medical groups into physician practice management organizations.

Science.gov (United States)

Robinson, J C

1998-01-14

Medical groups are growing and merging to improve efficiency and bargaining leverage in the competitive managed care environment. An increasing number are affiliating with physician practice management (PPM) firms that offer capital financing, expertise in utilization management, and global capitation contracts with health insurance entities. These physician organizations provide an alternative to affiliation with a hospital system and to individual physician contracting with health plans. To describe the growth, structure, and strategy of PPM organizations that coordinate medical groups in multiple markets and contract with health maintenance organizations (HMOs). Case studies, including interviews with administrative and clinical leaders, review of company documents, and analysis of documents from investment bankers, the Securities and Exchange Commission, and industry observers. Medical groups and independent practice associations (IPAs) in California and New Jersey affiliated with MedPartners, FPA Medical Management, and UniMed. Growth in number of primary care and specialty care physicians employed by and contracting with affiliated medical groups; growth in patient enrollment from commercial, Medicare, and Medicaid HMOs; growth in capitation and noncapitation revenues; structure and governance of affiliated management service organizations and professional corporations; and contracting strategies with HMOs. Between 1994 and 1996, medical groups and IPAs affiliated with 3 PPMs grew from 3787 to 25763 physicians; 65% of employed physicians provide primary care, while the majority of contracting physicians provide specialty care. Patient enrollment in HMOs grew from 285503 to 3028881. Annual capitation revenues grew from $190 million to $2.1 billion. Medical groups affiliated with PPMs are capitated for most professional, hospital, and ancillary clinical services and are increasingly delegated responsibility by HMOs for utilization management and quality

Basurto-IGPP. A manual-directed approach of integrative group psychotherapy in psychosis.

Science.gov (United States)

Ruiz-Parra, Eduardo; González-Torres, M A; Eguiluz, I; de la Sierra, E; Trojaola, B; Catalán, A

2010-01-01

A manual on Integrative Group Psychotherapy for outpatients with schizophrenia and other psychoses (Basurto-PGIP) is presented. The model takes into account group specific therapeutic factors. It integrates influences from other integrative psychotherapeutic models, interpersonal group therapy, group analysis and recent developments in cognitive behavioural therapy for psychotic symptoms. The manual is structured in levels of different complexity that can be applied in a progressive manner. The intervention tries to adapt to patients features, therapists ability and training, and centres resources. It can be applied in two possible settings: a short term closed group and a long term open group. Advantages and disadvantages of the model are described.

Violence prevention in special education schools - an integrated practice?

Science.gov (United States)

Pihl, Patricia; Grytnes, Regine; Andersen, Lars Peter S

2018-06-01

Research has shown that employees in special education settings are at high risk for work-related threats and violence. Previous research has not yet been able to identify the essential components of training programs that offer protection from work-related threats and violence. Therefore, the aim of this study was to explore how employees in special education schools deal with prevention of work-related threats and violence. Group interviews were conducted with 14 employees working at 5 special education schools. Results show that employees use a wide range of prevention strategies drawing on specific violence prevention techniques as well as professional pedagogical approaches. We propose that the prevention of threats and violence in special education schools can be understood as an integrated pedagogical practice operating on three interrelated levels. Copyright © 2018 Elsevier Ltd. All rights reserved.

Changes in grouping practices over primary and secondary school

OpenAIRE

Baines, Ed; Blatchford, Peter; Kutnick, P.

2003-01-01

The research detailed in this paper provides a systematic description and analysis of grouping practices in primary and secondary schools in England. Practices are compared to main findings in developmental and educational literature with regard to effective contexts for learning and recent ideas about pedagogy. The research is based on an analysis of 4924 groupings from 672 Reception, Year 2 and Year 5 classes in 331 primary schools and 248 Year 7 and Year 10 classes in 47 secondary schools....

INTEGRATED WATERSHED MANAGEMENT: PRINCIPLES AND PRACTICE. Book Review

Science.gov (United States)

Through a wide range of information and topics, Integrated Watershed Management Principles and Practice shows how involved the watershed management planning process can be. The book is informative, and the author obviously has researched the subject thoroughly. The book's case...

Integrating Gender and Group Differences into Bridging Strategy

Science.gov (United States)

Yilmaz, Serkan; Eryilmaz, Ali

2010-01-01

The main goal of this study was to integrate gender and group effect into bridging strategy in order to assess the effect of bridging analogy-based instruction on sophomore students' misconceptions in Newton's Third Law. Specifically, the authors developed and benefited from anchoring analogy diagnostic test to merge the effect of group and gender…

Science Integrating Learning Objectives: A Cooperative Learning Group Process

Science.gov (United States)

Spindler, Matt

2015-01-01

The integration of agricultural and science curricular content that capitalizes on natural and inherent connections represents a challenge for secondary agricultural educators. The purpose of this case study was to create information about the employment of Cooperative Learning Groups (CLG) to enhance the science integrating learning objectives…

Connecting Practice and Research: Integrated Reading and Writing Instruction Assessment

Science.gov (United States)

Caverly, David C.; Taylor, Judi Salsburg; Dimino, Renee K.; Lampi, Jodi P.

2016-01-01

The first "Connecting Practice and Research" column (Lampi, Dimino, & Salsburg Taylor, 2015), introduced a Research-to-Practice partnership (Coburn & Penuel, 2016) between two faculty from a community college and a university professor who were aiming to develop effective integrated reading and writing (IRW) instruction through a…

Integrating Art into Science Education: A Survey of Science Teachers' Practices

Science.gov (United States)

Turkka, Jaakko; Haatainen, Outi; Aksela, Maija

2017-01-01

Numerous case studies suggest that integrating art and science education could engage students with creative projects and encourage students to express science in multitude of ways. However, little is known about art integration practices in everyday science teaching. With a qualitative e-survey, this study explores the art integration of science…

The ab-initio density matrix renormalization group in practice

Energy Technology Data Exchange (ETDEWEB)

Olivares-Amaya, Roberto; Hu, Weifeng; Sharma, Sandeep; Yang, Jun; Chan, Garnet Kin-Lic [Department of Chemistry, Princeton University, Princeton, New Jersey 08544 (United States); Nakatani, Naoki [Department of Chemistry, Princeton University, Princeton, New Jersey 08544 (United States); Catalysis Research Center, Hokkaido University, Kita 21 Nishi 10, Sapporo, Hokkaido 001-0021 (Japan)

2015-01-21

The ab-initio density matrix renormalization group (DMRG) is a tool that can be applied to a wide variety of interesting problems in quantum chemistry. Here, we examine the density matrix renormalization group from the vantage point of the quantum chemistry user. What kinds of problems is the DMRG well-suited to? What are the largest systems that can be treated at practical cost? What sort of accuracies can be obtained, and how do we reason about the computational difficulty in different molecules? By examining a diverse benchmark set of molecules: π-electron systems, benchmark main-group and transition metal dimers, and the Mn-oxo-salen and Fe-porphine organometallic compounds, we provide some answers to these questions, and show how the density matrix renormalization group is used in practice.

The ab-initio density matrix renormalization group in practice.

Science.gov (United States)

Olivares-Amaya, Roberto; Hu, Weifeng; Nakatani, Naoki; Sharma, Sandeep; Yang, Jun; Chan, Garnet Kin-Lic

2015-01-21

The ab-initio density matrix renormalization group (DMRG) is a tool that can be applied to a wide variety of interesting problems in quantum chemistry. Here, we examine the density matrix renormalization group from the vantage point of the quantum chemistry user. What kinds of problems is the DMRG well-suited to? What are the largest systems that can be treated at practical cost? What sort of accuracies can be obtained, and how do we reason about the computational difficulty in different molecules? By examining a diverse benchmark set of molecules: π-electron systems, benchmark main-group and transition metal dimers, and the Mn-oxo-salen and Fe-porphine organometallic compounds, we provide some answers to these questions, and show how the density matrix renormalization group is used in practice.

Achieving Integration in Mixed Methods Designs—Principles and Practices

OpenAIRE

Fetters, Michael D; Curry, Leslie A; Creswell, John W

2013-01-01

Mixed methods research offers powerful tools for investigating complex processes and systems in health and health care. This article describes integration principles and practices at three levels in mixed methods research and provides illustrative examples. Integration at the study design level occurs through three basic mixed method designs—exploratory sequential, explanatory sequential, and convergent—and through four advanced frameworks—multistage, intervention, case study, and participato...

Mathematical Practices and Arts Integration in an Activity-Based Projective Geometry Course

Science.gov (United States)

Ernest, Jessica Brooke

It is a general assumption that the mathematical activity of students in school should, at least to some degree, parallel the practices of professional mathematicians (Brown, Collins, Duguid, 1989; Moschkovich, 2013). This assumption is reflected in the Common Core State Standards (CCSSI, 2010) and National Council of Teachers of Mathematics (NCTM, 2000) standards documents. However, the practices included in these standards documents, while developed to reflect the practices of professional mathematicians, may be idealized versions of what mathematicians actually do (Moschkovich, 2013). This might lead us to question then: "What is it that mathematicians do, and what practices are not being represented in the standards documents?" In general, the creative work of mathematicians is absent from the standards and, in turn, from school mathematics curricula, much to the dismay of some mathematicians and researchers (Lockhart, 2009; Rogers, 1999). As a result, creativity is not typically being fostered in mathematics students. As a response to this lack of focus on fostering creativity (in each of the science, technology, engineering, and mathematics disciplines--the STEM disciplines), a movement to integrate the arts emerged. This movement, called the STEAM movement--introducing the letter A into the acronym STEM to signify incorporating the arts--has been gaining momentum, yet limited research has been carried out on the efficacy of integrating the arts into mathematics courses. My experiences as the co-instructor for an activity-based course focused on projective geometry led me to consider the course as a setting for investigating both mathematical practices and arts integration. In this work, I explored the mathematical practices in which students engaged while working to develop an understanding of projective geometry through group activities. Furthermore, I explored the way in which students' learning experiences were enriched through artistic engagement in the

Practical education in family planning: integrative review

Directory of Open Access Journals (Sweden)

Creusa Ferreira da Silva

2017-07-01

Full Text Available Objectives: To identify educational practices in family planning, facilitating factors, difficulties and resulting impacts. Method: This is an integrative literature review, using the three descriptors: "family planning", "health education" and "contraception"; In the databases of the Scientific Electronic Library Online (SciELO, Latin American and Caribbean Literature in Health Sciences (LILACS and Nursing Database (BDENF, were searched in January and February 2016. Results: Regarding the accomplishment of educational practices, most of the studies pointed out its accomplishment. The difficulties and facilitators aspects were related to the management of the health service, professional competence and users. Guarantee of family rights and autonomy were the impacts pointed out. Conclusion: The study showed that educational practices in family planning are tools to be encouraged as a guarantee and respect for sexual and reproductive rights. Descriptors: family planning; education in health; contraception.

"Keeping on track"-Hospital nurses' struggles with maintaining workflow while seeking to integrate evidence-based practice into their daily work: A grounded theory study.

Science.gov (United States)

Renolen, Åste; Høye, Sevald; Hjälmhult, Esther; Danbolt, Lars Johan; Kirkevold, Marit

2018-01-01

Evidence-based practice is considered a foundation for the provision of quality care and one way to integrate scientific knowledge into clinical problem-solving. Despite the extensive amount of research that has been conducted to evaluate evidence-based practice implementation and research utilization, these practices have not been sufficiently incorporated into nursing practice. Thus, additional research regarding the challenges clinical nurses face when integrating evidence-based practice into their daily work and the manner in which these challenges are approached is needed. The aim of this study was to generate a theory about the general patterns of behaviour that are discovered when clinical nurses attempt to integrate evidence-based practice into their daily work. We used Glaser's classical grounded theory methodology to generate a substantive theory. The study was conducted in two different medical wards in a large Norwegian hospital. In one ward, nurses and nursing assistants were developing and implementing new evidence-based procedures, and in the other ward, evidence-based huddle boards for risk assessment were being implemented. A total of 54 registered nurses and 9 assistant nurses were observed during their patient care and daily activities. Of these individuals, thirteen registered nurses and five assistant nurses participated in focus groups. These participants were selected through theoretical sampling. Data were collected during 90h of observation and 4 focus groups conducted from 2014 to 2015. Each focus group session included four to five participants and lasted between 55 and 65min. Data collection and analysis were performed concurrently, and the data were analysed using the constant comparative method. "Keeping on track" emerged as an explanatory theory for the processes through which the nurses handled their main concern: the risk of losing the workflow. The following three strategies were used by nurses when attempting to integrate evidence

CSR Reporting Practices in Visegrad Group Countries and the Quality of Disclosure

Directory of Open Access Journals (Sweden)

Patrycja Hąbek

2017-12-01

Full Text Available Companies around the world more often issue publicly available reports to disclose how responsibly they conduct their business. The practices of corporate social responsibility (CSR reporting are more popular in western part of Europe then in Central and Eastern European (CEE countries and empirical studies related to these practices in the region are sporadic and fragmented. The Visegrad Group countries have undergone tremendous changes in political, environmental and social area during the last twenty years. The CSR concept in these countries is relatively new but is rapidly spreading, in particular as part of their integration with the European Union, as well as under the influence of transnational corporations (TNCs and foreign investors. Therefore, acquisition of knowledge, which presents the functioning of CSR reporting practices in the region seems to be of interest to both the scientific community and enterprises themselves. An important part of the analysis conducted in the study was the assessment of quality of CSR reports issued in this region. The quality indicator of the studied reports was based on seventeen criteria related to relevance and credibility of disclosed information. The findings indicate that CSR reporting practices are not widespread among V4 countries and suggest some area of improvements. Furthermore, the achieved results confirm the existence of a relationship between two factors (external verification of a report and usage of the GRI guidelines when developing a report and the level of quality of the CSR report.

Striving for Scientific Integrity and Ethical Practices in Higher Education

Science.gov (United States)

Geissman, J. W.

2017-12-01

The need for the highest levels of scientific integrity and ethical principles in higher education, globally, is obvious. This is the setting where faculty scientists practice and future scientists, as entering science majors, those who change course and switch to science, and graduate students, are nurtured and mentored. Institutions of higher education across the globe are devoting increasing attention to scientific integrity and ethical practices, often as mandated by specific (funding) agencies, and this certainly is a step in the right direction. One approach has involved graduate students, particularly PhD students, in formal classes/seminars on the subjects. Another, more institution-specific, is to require freshman science majors to take one or more classes designed to assist students, in many ways, to succeed in whatever science path they choose. For the past five years I have "taught" such a class, which I like to refer to as "Science is the Rest of Your Life 101". My section is very heavy on scientific integrity and ethical practices; most students have never been exposed to nor have considered such subjects. Their interest level is exceedingly keen. So, steps are being taken, but rectifying existing concerns will take time. Here are some (potential/real) problems. One facing all of higher education is the ever decreasing number, certainly in the United States, of tenured/tenure track faculty in all disciplines together with the generational "gap" or "double gap" (some colleagues of mine are in their 80s) between those who never for all intents and purposes received any "formal" exposure to scientific integrity and ethical practices issues and those fresh in the academy for which these subjects are recently and better engrained. At most institutions, those faculty never involved in such formal training because of, well, their age, are required to pass some form of on-line "certification" class in research ethics among other subjects on an annual or bi

Barriers and facilitators to integration of physician associates into the general practice workforce: a grounded theory approach.

Science.gov (United States)

Jackson, Ben; Marshall, Michelle; Schofield, Susie

2017-11-01

Physician associates (PAs) are described as one solution to workforce capacity in primary care in the UK. Despite new investment in the role, how effective this will be in addressing unmet primary care needs is unclear. To investigate the barriers and facilitators to the integration of PAs into the general practice workforce. A modified grounded theory study in a region unfamiliar with the PA role. No a priori themes were assumed. Themes generated from stakeholder interviews informed a literature review and theoretical framework, and were then tested in focus groups with GPs, advanced nurse practitioners (ANPs), and patients. Recorded data were transcribed verbatim, and organised using NVivo version 10.2.2, with iterative analysis of emergent themes. A reflexive diary and independent verification of coding and analysis were included. There were 51 participants (30 GPs, 11 ANPs, and 10 patients) in eight focus groups. GPs, ANPs, and patients recognised that support for general practice was needed to improve access. GPs expressed concerns regarding PAs around managing medical complexity and supervision burden, non-prescriber status, and medicolegal implications in routine practice. Patients were less concerned about specific competencies as long as there was effective supervision, and were accepting of a PA role. ANPs highlighted their own negative experiences entering advanced clinical practice, and the need for support to counteract stereotypical and prejudicial attitudes CONCLUSION: This study highlights the complex factors that may impede the introduction of PAs into UK primary care. A conceptual model is proposed to help regulators and educationalists support this integration, which has relevance to other proposed new roles in primary care. © British Journal of General Practice 2017.

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.

Factors Influencing Electronic Clinical Information Exchange in Small Medical Group Practices

Science.gov (United States)

Kralewski, John E.; Zink, Therese; Boyle, Raymond

2012-01-01

Purpose: The purpose of this study was to identify the organizational factors that influence electronic health information exchange (HIE) by medical group practices in rural areas. Methods: A purposive sample of 8 small medical group practices in 3 experimental HIE regions were interviewed to determine the extent of clinical information exchange…

Vertical integration of teaching in Australian general practice--a survey of regional training providers.

Science.gov (United States)

Stocks, Nigel P; Frank, Oliver; Linn, Andrew M; Anderson, Katrina; Meertens, Sarah

2011-06-06

To examine vertical integration of teaching and clinical training in general practice and describe practical examples being undertaken by Australian general practice regional training providers (RTPs). A qualitative study of all RTPs in Australia, mid 2010. All 17 RTPs in Australia responded. Eleven had developed some vertical integration initiatives. Several encouraged registrars to teach junior doctors and medical students, others encouraged general practitioner supervisors to run multilevel educational sessions, a few coordinated placements, linkages and support across their region. Three RTPs provided case studies of vertical integration. Many RTPs in Australia use vertical integration of teaching in their training programs. RTPs with close associations with universities and rural clinical schools seem to be leading these initiatives.

Practical Integration-Free Episomal Methods for Generating Human Induced Pluripotent Stem Cells.

Science.gov (United States)

Kime, Cody; Rand, Tim A; Ivey, Kathryn N; Srivastava, Deepak; Yamanaka, Shinya; Tomoda, Kiichiro

2015-10-06

The advent of induced pluripotent stem (iPS) cell technology has revolutionized biomedicine and basic research by yielding cells with embryonic stem (ES) cell-like properties. The use of iPS-derived cells for cell-based therapies and modeling of human disease holds great potential. While the initial description of iPS cells involved overexpression of four transcription factors via viral vectors that integrated within genomic DNA, advances in recent years by our group and others have led to safer and higher quality iPS cells with greater efficiency. Here, we describe commonly practiced methods for non-integrating induced pluripotent stem cell generation using nucleofection of episomal reprogramming plasmids. These methods are adapted from recent studies that demonstrate increased hiPS cell reprogramming efficacy with the application of three powerful episomal hiPS cell reprogramming factor vectors and the inclusion of an accessory vector expressing EBNA1. Copyright © 2015 John Wiley & Sons, Inc.

Integrating mental health and social development in theory and practice.

Science.gov (United States)

Plagerson, Sophie

2015-03-01

In many low and middle income countries, attention to mental illness remains compartmentalized and consigned as a matter for specialist policy. Despite great advances in global mental health, mental health policy and practice dovetail only to a limited degree with social development efforts. They often lag behind broader approaches to health and development. This gap ignores the small but growing evidence that social development unavoidably impacts the mental health of those affected, and that this influence can be both positive and negative. This article examines the theoretical and practical challenges that need to be overcome for a more effective integration of social development and mental health policy. From a theoretical perspective, this article demonstrates compatibility between social development and mental health paradigms. In particular, the capability approach is shown to provide a strong framework for integrating mental health and development. Yet, capability-oriented critiques on 'happiness' have recently been applied to mental health with potentially detrimental outcomes. With regard to policy and practice, horizontal and vertical integration strategies are suggested. Horizontal strategies require stronger devolution of mental health care to the primary care level, more unified messages regarding mental health care provision and the gradual expansion of mental health packages of care. Vertical integration refers to the alignment of mental health with related policy domains (particularly the social, economic and political domains). Evidence from mental health research reinforces aspects of social development theory in a way that can have tangible implications on practice. First, it encourages a focus on avoiding exclusion of those affected by or at risk of mental illness. Secondly, it underscores the importance of the process of implementation as an integral component of successful policies. Finally, by retaining a focus on the individual, it seeks to

[Family groups in nursing graduation teaching practice].

Science.gov (United States)

de Assis, Aisllan Diego; da Silva, Priscila Patrícia; Claudino, Talita Xavier; de Oliveira, Alice Guimarães Bottaro

2010-09-01

The centers of psychosocial care (CAPS, acronym in Portuguese) are strategic devices for mental health care currently available in Brazil. Nurses are professionals required to compose the minimum staff of this device, which values the group activities involving users. This study presents a report of the experience of nursing undergraduates from Universidade Federal do Mato Grosso (UFMT) on their conducting waiting-room group sessions with relatives of users of a CAPS from Cuiabá, Mato Grosso state. This experience is justified by the fact that nursing students have few opportunities to develop group approach abilities during their graduation course, which focuses mainly on clinical individual care. The aim of the experience was to provide theoretical-practical learning of all the work stages of group work: recognizing the need and possibility of conducting the activity, planning, coordination and group evaluation. The results confirm the need and possibility of performing group experiences in mental health care and in nursing education.

Multi-objective group scheduling optimization integrated with preventive maintenance

Science.gov (United States)

Liao, Wenzhu; Zhang, Xiufang; Jiang, Min

2017-11-01

This article proposes a single-machine-based integration model to meet the requirements of production scheduling and preventive maintenance in group production. To describe the production for identical/similar and different jobs, this integrated model considers the learning and forgetting effects. Based on machine degradation, the deterioration effect is also considered. Moreover, perfect maintenance and minimal repair are adopted in this integrated model. The multi-objective of minimizing total completion time and maintenance cost is taken to meet the dual requirements of delivery date and cost. Finally, a genetic algorithm is developed to solve this optimization model, and the computation results demonstrate that this integrated model is effective and reliable.

Exploring Parental and Staff Perceptions of the Family-Integrated Care Model: A Qualitative Focus Group Study.

Science.gov (United States)

Broom, Margaret; Parsons, Georgia; Carlisle, Hazel; Kecskes, Zsuzsoka; Thibeau, Shelley

2017-12-01

Family-integrated care (FICare) is an innovative model of care developed at Mount Sinai Hospital, Canada, to better integrate parents into the team caring for their infant in the neonatal intensive care unit (NICU). The effects of FICare on neonatal outcomes and parental anxiety were assessed in an international multicenter randomized trial. As an Australian regional level 3 NICU that was randomized to the intervention group, we aimed to explore parent and staff perceptions of the FICare program in our dual occupancy NICU. This qualitative study took place in a level 3 NICU with 5 parent participants and 8 staff participants, using a post implementation review design. Parents and staff perceptions of FICare were explored through focus group methodology. Thematic content analysis was done on focus group transcripts. Parents and staff perceived the FICare program to have had a positive impact on parental confidence and role attainment and thought that FICare improved parent-to-parent and parent-to-staff communication. Staff reported that nurses working with families in the program performed less hands-on care and spent more time educating and supporting parents. FICare may change current NICU practice through integrating and accepting parents as active members of the infant's care team. In addition, nurse's roles may transition from bedside carer to care coordinator, educating and supporting parents during their journey through the NICU. Further research is needed to assess the long-term impact of FICare on neonates, parents, and staff.

A pilot study of the experience of participating in a Therapeutic Touch practice group.

Science.gov (United States)

Moore, Theresa; Ting, Brigid; Rossiter-Thornton, Maria

2008-09-01

This pilot study explored the experience of participating in a Therapeutic Touch practice group. A qualitative descriptive-exploratory method was used, involving 12 members of practice groups in Ontario and British Columbia, Canada. Analysis of the data using an extraction-synthesis process yielded four themes: (a) learning with others through sharing and hands-on experience is valued; (b) connecting with a network of supportive relationships that sustain self and Therapeutic Touch practice; (c) comfort-discomfort arising with self, others, or ideas; and (d) meaningful changes emerge while experiencing group energy and Therapeutic Touch. The findings expand current knowledge about the positive aspects of participating in practice groups and provide a beginning understanding of member discomfort, which had not been previously reported. This knowledge will be useful to Therapeutic Touch organizations, practice group leaders, and group members. It will also guide health care agencies and practitioners of other healing modalities who may be considering establishing practice groups.

Dynamics on the group manifolds and path integral

International Nuclear Information System (INIS)

Marinov, M.S.; Terentyev, M.V.

1979-01-01

Classical and quantum dynamics onn the compact simple Lie group and on the sphere of arbitrary dimensionality are considered. The accuracy of the semiclassical approximation for Green functions is discussed. Various path integral representations of the Green functions are presented. The special features of these representations due to the compactness and curvature are analysed. Basic results of the theory of Lie algebras and Lie groups used in the main text are presented

Building Integrated Design Practice under the Concept of Sustainable Development

Science.gov (United States)

Liu, Xuexin

2018-03-01

With the continuous development of social economy, people are more demanding for architecture. Some advanced design concepts are gradually applied to the design of buildings. Under the concept of sustainable development, building integration design has also been widely used to promote the rapid development of architectural design. Integrated design concepts and sustainable development concepts play an important role to meet people’s requirements. This article will explore the concept of sustainable development under the concept of integrated architectural design and practice analysis, propose appropriate measures.

On integral representation of the Clebsh-Gordan coefficients of SU(3) group

International Nuclear Information System (INIS)

Mal'tsev, V.M.

1985-01-01

The projection of arbitrary quark-gluon state on a singlet representation of SU(3) group is considered. It is given by an integral on the group. In this case the square of a Clebsch-Gordan coefficient is evaluated as the eight-fold integral over corresponding Eulerian angles

Integrating advanced practice providers into medical critical care teams.

Science.gov (United States)

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

2013-03-01

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

Systems thinking and incivility in nursing practice: An integrative review.

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Phillips, Janet M; Stalter, Ann M; Winegardner, Sherri; Wiggs, Carol; Jauch, Amy

2018-01-23

There is a critical need for nurses and interprofessional healthcare providers to implement systems thinking (ST) across international borders, addressing incivility and its perilous effects on patient quality and safety. An estimated one million patients die in hospitals worldwide due to avoidable patient-related errors. Establishing safe and civil workplaces using ST is paramount to promoting clear, level-headed thinking from which patient-centered nursing actions can impact health systems. The purpose of the paper is to answer the research question, What ST evidence fosters the effect of workplace civility in practice settings? Whittemore and Knafl's integrative review method guided this study. The quality of articles was determined using Chu et al.'s Mixed Methods Assessment Tool. Thirty-eight studies were reviewed. Themes emerged describing antecedents and consequences of incivility as embedded within complex systems, suggesting improvements for civility and systems/ST in nursing practice. This integrative review provides information about worldwide incivility in nursing practice from a systems perspective. Several models are offered as a means of promoting civility in nursing practice to improve patient quality and safety. Further study is needed regarding incivility and resultant effects on patient quality and safety. © 2018 Wiley Periodicals, Inc.

From Metacognition to Practice Cognition: The DNP e-Portfolio to Promote Integrated Learning.

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Anderson, Kelley M; DesLauriers, Patricia; Horvath, Catherine H; Slota, Margaret; Farley, Jean Nelson

2017-08-01

Educating Doctor of Nursing Practice (DNP) students for an increasingly complex health care environment requires novel applications of learning concepts and technology. A deliberate and thoughtful process is required to integrate concepts of the DNP program into practice paradigm changes to subsequently improve students' abilities to innovate solutions to complex practice problems. The authors constructed or participated in electronic portfolio development inspired by theories of metacognition and integrated learning. The objective was to develop DNP student's reflection, integration of concepts, and technological capabilities to foster the deliberative competencies related to the DNP Essentials and the foundations of the DNP program. The pedagogical process demonstrates how e-portfolios adapted into the doctoral-level curriculum for DNP students can address the Essentials and foster the development of metacognitive capabilities, which translates into practice changes. The authors suggest that this pedagogical approach has the potential to optimize reflective and deliberative competencies among DNP students. [J Nurs Educ. 2017;56(8):497-500.]. Copyright 2017, SLACK Incorporated.

MODUS OF SOCIAL INTEGRITY: PRACTICE OF CONSTRUCTING PRODUCTIVE CO-BEING

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I. I. Brodetskaya

2016-12-01

Full Text Available Purpose. Analysis is focused on the study of theoretical and methodological preconditions of social integrity phenomenon research. Trends in the conceptual base of modern social theory are focused on the research of social phenomenon, the study of the conditions and mechanisms for the development of sociality. This suggests the need to find new interpretive schemes. The methodology of political philosophy in the analysis of sociality was limited. This theory has brought the phenomenon of co-existence to the aspect of political discourse. In this regard, the reference to the existence of human co-beingness, mechanisms and modus of its formation is a necessary methodological step. It allows you to draw a parallel between the phenomenon of social integrity and totality. Existential installation integrity, unity of individual and social order is invested in the social context as a human desire to know the surrounding reality. Cognition is installation on the penetration deep into the object, understanding its nature. Cognition opens up the prospect of being a harmonious personality. Existential knowledge focuses on the identity of the co-existence and serves only the prospect of overcoming the limitations of the totality. The potential of this phenomenon allows penetration of rigid rational scheme of classical political methodology, introducing the community as a spiritual practice, the experience of communitas. Thus, as the research methodology used social integrity existential approach, which actualizes the potential of the spiritual foundations of co-existence. This methodological step allows disclosing sociality at a deep level of analysis as a spiritual practice to others, modus being-cognition of the human reality. Originality of this work is to extend the of heuristic possibilities of social theory in the analysis of the social problems aspect with the purpose construction of integrated research methodology problems. Conclusions. Thus, the

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

DEFF Research Database (Denmark)

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

2012-01-01

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

The Teacher Technology Integration Experience: Practice and Reflection in the Classroom

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Ruggiero, Dana; Mong, Christopher J.

2015-01-01

Previous studies indicated that the technology integration practices of teachers in the classroom often did not match their teaching styles. Researchers concluded that this was due, at least partially, to external barriers that prevented teachers from using technology in ways that matched their practiced teaching style. Many of these barriers,…

Practical steps toward integrating economic, social and institutional elements in fisheries policy and management

DEFF Research Database (Denmark)

Stephenson, Robert L.; Benson, Ashleen J.; Brooks, Kate

2017-01-01

of explicit social, economic and institutional objectives; a general lack of process (frameworks, governance) for routine integration of all four pillars of sustainability; and a bias towards biological considerations. Practical integration requires a ‘systems’ approach with explicit consideration...... of strategic and operational aspects of management; multidisciplinary or transdisciplinary evaluations; practical objectives for the four pillars of sustainability; appropriate participation; and a governance system that is able to integrate these diverse considerations in management. We challenge all involved...... governance....

Social Group Dynamics and Patterns of Latin American Integration Processes

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Sébastien Dubé

2017-04-01

Full Text Available This article proposes to incorporate social psychology elements with mainstream political science and international relations theories to help understand the contradictions related to the integration processes in Latin America. Through a theoretical analysis, it contributes to the challenge proposed by Dabène (2009 to explain the “resilience” of the Latin American regional integration process in spite of its “instability and crises.” Our main proposition calls for considering Latin America as a community and its regional organizations as “social groups.” In conclusion, three phenomena from the field of social psychology and particularly social group dynamics shed light on these contradictory patterns: the value of the group and the emotional bond, groupthink, and cognitive dissonance.

An integral equation arising in two group neutron transport theory

International Nuclear Information System (INIS)

Cassell, J S; Williams, M M R

2003-01-01

An integral equation describing the fuel distribution necessary to maintain a flat flux in a nuclear reactor in two group transport theory is reduced to the solution of a singular integral equation. The formalism developed enables the physical aspects of the problem to be better understood and its relationship with the corresponding diffusion theory model is highlighted. The integral equation is solved by reducing it to a non-singular Fredholm equation which is then evaluated numerically

The Integration of New Media in Schools: Comparing Policy with Practice

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Ismail, Nurzali

2015-01-01

Beyond policy, this paper investigates the actual practice related to the integration of new media in schools. Despite continuous government effort to integrate new media in schools, the use of digital technologies for teaching and learning in the classroom remains limited. This study suggests that, apart from the issue related to the state of…

Job sharing as an employment alternative in group medical practice.

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Vanek, E P; Vanek, J A

2001-01-01

Although physicians discuss quality-of-life and employment issues with their patients, they often fail to consider flexible scheduling and reduced employment options to lessen their own job stress. We examined one of these options by surveying two community-based, private practice groups with a combined 13-year experience with job sharing. We found that a majority of respondents rated job sharing as successful, and most wanted it to continue. Job sharers derived considerable personal benefit from the arrangement and had significantly more positive attitudes toward work than full-time physicians. Job sharing appeared to have little impact on practice parameters. Dependability, flexibility and willingness to cooperate were the most important attributes in choosing a job-sharing partner. Job sharing is an employment alternative worth exploring to retain physicians in medical group practice.

Mink's adaptation to group housing in practice

DEFF Research Database (Denmark)

Hansen, Steffen W; Møller, Steen Henrik

2012-01-01

In this project, we test the hypothesis whether mink populations with a higher social tolerance have been developed in practice and thus are better adapted to housing in stacked cages. The hypothesis has been tested by comparing the level of bite damages and bit marks in mink kept in pairs...... and in mink kept in social groups. In total, the project included 1,191 brown mink housed on four farms in up to five different types of social groups. The result showed that mink in groups had significantly more bite marks than mink kept in pairs, and that mink with bite wounds had significantly more bite...... marks than mink that did not haev bite wounds. Thus, based upon bite mark results, we cannot confirm the hypothesis that mink populations adapted to group housing have been developed. The number of mink that had died or had been removede during the test period, or that had bite wounds at the time...

Multiloop integral system test (MIST): Final report, Inter-group comparisons

Energy Technology Data Exchange (ETDEWEB)

Gloudemans, J.R.

1989-07-01

The multiloop integral system test (MIST) was part of a multiphase program started in 1983 to address small-break loss-of-coolant accidents (SBLOCAs) specific to Babcock and Wilcox-designed plants. MIST was sponsored by the US Nuclear Regulatory Commission, the Babcock and Wilcox Owners Group, the Electric Power Research Institute, and Babcock and Wilcox. The unique features of the Babcock and Wilcox design, specifically the hot leg U-bends and steam generators, prevented the use of existing integral system data or existing integral system facilities to address the thermal-hydraulic SBLOCA questions. MIST and two other supporting facilities were specifically designed and constructed for this program, and an existing facility -- the once-through integral system (OTIS) -- was also used. Data from MIST and the other facilities will be used to benchmark the adequacy of system codes, such as RELAP5 and TRAC, for predicting abnormal plant transients. The individual tests are described in detail in Volumes 2 through 8 and Volume 11, and are summarized in Volume 1. Inter-group comparisons are addressed in this document, Volume 9. These comparisons are grouped as follows: mapping versus SBLOCA transients, SBLOCA, pump effects, and the effects of noncondensible gases. Appendix A provides an index and description of the microfiched plots for each test, which are enclosed with the corresponding Volumes 2 through 8. 147 figs., 5 tabs.

Management and presentation of grouped procedures: has the IHE integration profile cracked the toughest radiology workflow nut?

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Parisot, Charles R.; Channin, David S.; Avrin, David E.; Lindop, Christopher

2001-08-01

In a simple, typical radiology workflow process, an order generates a single procedure, which in turn generates a single data set, from which, one radiology report is generated. There are, however, occasions when a single order consists of more than one procedure each with a separate report, yet the procedures are accomplished by one physical acquisition of data. The prototypical example of this is the request for computed tomographic evaluation of the chest, abdomen and pelvis. The study is accomplished, with modern day scanners, by a single helical acquisition, yet there are typically three codable and billable procedures involved, and these may be reported independently either for administrative or academic reasons. This grouping of procedures remained up to now a challenge to automate across integrated modalities, PACS and RIS. This paper discusses a number of other practical cases where this situation occurs and reviews the capabilities of the Presentation of Grouped Procedures IHE Integration Profile in solving this problem. The DICOM services used are evaluated as well as the strengths and weaknesses of this IHE Integration Profile. The implementation experience gained on both a CT and an MR for the IHE Demonstration at RSNA 2000 and HIMSS 2001 is also reviewed. In conclusion, the resulting clinical and operational benefits are discussed.

IGSC - Integration Group for the Safety Case

International Nuclear Information System (INIS)

2015-01-01

Countries that rely on nuclear energy and materials have an ethical obligation to manage radioactive waste in a safe and environmentally responsible manner. For society to support the sustainable solutions envisaged, disposal concepts must be technologically sound and the safety of these concepts must be convincingly demonstrated. The Nuclear Energy Agency's Integration Group for the Safety Case (IGSC) establishes and documents the technical and scientific basis for developing and reviewing safety cases as a platform for dialogue among technical experts and as a tool for decision making. The IGSC addresses various strategic and policy aspects of radioactive waste management as the technical advisory body to the NEA Radioactive Waste Management Committee (RWMC) for all issues related to repository development. For more than two decades, the IGSC and its predecessor technical groups have promoted the exchange of national experience in evaluating and implementing geological repositories. IGSC activities foster consensus on best practices and encourage the development of innovative, advanced approaches covering the technical aspects at all stages of repository implementation, including: - strategies to characterise and evaluate potential disposal sites; - methods to design and test engineered barrier systems; - priorities for research and development programmes to improve the understanding of important processes and interactions; - tools for safety assessments; - techniques for the effective presentation and communication of the results of safety cases and other factors that provide the basis for increased confidence in the safety of geological disposal facilities. The IGSC has been instrumental in further developing the 'modern safety case', a concept that originally emerged from NEA work in the 1990's. Cooperation with the International Atomic Energy Agency (IAEA) and the European Commission (EC) has led to the worldwide adoption of this safety

Self-transcendence: Lonergan's key to integration of nursing theory, research, and practice.

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Perry, Donna J

2004-04-01

This paper proposes that the philosophy of Bernard Lonergan can provide insight into the challenge of integrating nursing theory, research and practice. The author discusses Lonergan's work in regard to reflective understanding, authenticity and the human person as a subject of consciously developing unity. This is followed by a discussion of two key elements in Lonergan's work that relate to nursing: the subject-object challenge of nursing inquiry and common sense vs. scientific knowledge. The author suggests that integration of nursing theory, science and practice may be achieved through self-transcendence.

Diversified integration of practical teaching resources in ideological and political course in colleges and universities

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Xu, Jin; Chu, Biao

2018-03-01

To promote diversified integration and integrated use of practical teaching resources in ideological and political education in colleges and universities is helpful to extend the ideological and political teaching activities in colleges and universities, to update and supplement ideological and political knowledge, to build a harmonious learning environment for students and to comprehensively improve their ideological and political accomplishments. This article will analyze of ideological and political practical teaching resources diversified integration and the integration of programs by examples, and put forward personal opinions.

Development and application of knowledge-based subject group integration platforms:A case study of Shanghai Institute of Ceramics,CAS

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Yu; LIU; Jian; FU; Huijun; ZHENG; Hao; CHEN; Zhiping; YANG

2014-01-01

Purpose:According to the different requirements of research group users,we established the knowledge-based subject group integration platforms of Shanghai Institute of Ceramics,the Chinese Academy of Sciences(abbreviated as SIC CAS hereinafter),which were designed and constructed to better meet the needs of CAS research groups for their development,collaboration and communication.Design/methodology/approach:We first identified the requirements of users via preliminary investigation,and then chose CASI1 P,iLibrary and XKE technology,respectively as the building tools compatible with the major demands of users.These steps helped us complete the layout design of SIC CAS integration platforms,as well as its knowledge organization and integration.Findings:According to the need of users,we applied three types of platform construction technologies to five SIC integration platforms,and formulated standard norms for the further construction process,which could provide useful reference for a sustainable development for the extensive construction in CAS institutes.Research limitations:In order to make the SIC integration platforms more intelligent and have more functions,we need to enlarge the scale of the Platforms and upgrade the building tools for the platform construction.Practical implications:The nature of SIC sub-project integration platforms is to construct a content-sensitive environment which can embed knowledge services and knowledge applications seamlessly into scientific activities,so the Platform is expected to be a useful tool to help researchers better understand the recent development of the research field and form collaborations with their peers.Originality/value:SIC integration platforms are the only pilot construction that used 3different platform technologies in the first batch of knowledge-based subject group integration platforms of the Chinese Academy of Sciences.The construction is user-centered throughout the whole process,namely,from the technology

Multidisciplinary group performance – measuring integration intensity in the context of the North West London Integrated Care Pilot

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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.

Cultivating Perspectival Acuity: The Value and Cost of Integrating Theory, Craft, Research, and Practice

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Joe Manganelli

2016-10-01

Full Text Available This paper presents reflections on integrating theory, craft, research, and practice to improve the accuracy and resiliency of each. The reflections build toward a set of statements about the value and the cost of integrating theory, craft, research, and practice. Specifically, the authors offer the Privileged Work / Non-Privileged Work Framework and concept of cultivating Perspectival Acuity.

How an Integrative STEM Curriculum Can Benefit Students in Engineering Design Practices

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Fan, Szu-Chun; Yu, Kuang-Chao

2017-01-01

STEM-oriented engineering design practice has become recognized increasingly by technology education professionals in Taiwan. This study sought to examine the effectiveness of the application of an integrative STEM approach within engineering design practices in high school technology education in Taiwan. A quasi-experimental study was conducted…

From theory to practice: integrating instructional technology into veterinary medical education.

Science.gov (United States)

Wang, Hong; Rush, Bonnie R; Wilkerson, Melinda; Herman, Cheryl; Miesner, Matt; Renter, David; Gehring, Ronette

2013-01-01

Technology has changed the landscape of teaching and learning. The integration of instructional technology into teaching for meaningful learning is an issue for all educators to consider. In this article, we introduce educational theories including constructivism, information-processing theory, and dual-coding theory, along with the seven principles of good practice in undergraduate education. We also discuss five practical instructional strategies and the relationship of these strategies to the educational theories. From theory to practice, the purpose of the article is to share our application of educational theory and practice to work toward more innovative teaching in veterinary medical education.

Gynecologic oncologists' attitudes and practices relating to integrative medicine: results of a nationwide AGO survey.

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Klein, Evelyn; Beckmann, Matthias W; Bader, Werner; Brucker, Cosima; Dobos, Gustav; Fischer, Dorothea; Hanf, Volker; Hasenburg, Annette; Jud, Sebastian M; Kalder, Matthias; Kiechle, Marion; Kümmel, Sherko; Müller, Andreas; Müller, Myrjam-Alice T; Paepke, Daniela; Rotmann, Andre-Robert; Schütz, Florian; Scharl, Anton; Voiss, Petra; Wallwiener, Markus; Witt, Claudia; Hack, Carolin C

2017-08-01

The growing popularity and acceptance of integrative medicine is evident both among patients and among the oncologists treating them. As little data are available regarding health-care professionals' knowledge, attitudes, and practices relating to the topic, a nationwide online survey was designed. Over a period of 11 weeks (from July 15 to September 30, 2014) a self-administered, 17-item online survey was sent to all 676 members of the Research Group on Gynecological Oncology (Arbeitsgemeinschaft Gynäkologische Onkologie) in the German Cancer Society. The questionnaire items addressed the use of integrative therapy methods, fields of indications for them, advice services provided, level of specific qualifications, and other topics. Of the 104 respondents (15.4%) using integrative medicine, 93% reported that integrative therapy was offered to breast cancer patients. The second most frequent type of tumor in connection with which integrative therapy methods were recommended was ovarian cancer, at 80% of the participants using integrative medicine. Exercise, nutritional therapy, dietary supplements, herbal medicines, and acupuncture were the methods the patients were most commonly advised to use. There is considerable interest in integrative medicine among gynecological oncologists, but integrative therapy approaches are at present poorly implemented in routine clinical work. Furthermore there is a lack of specific training. Whether future efforts should focus on extending counseling services on integrative medicine approaches in gynecologic oncology or not, have to be discussed. Evidence-based training on integrative medicine should be implemented in order to safely guide patients in their wish to do something by themselves.

Practice and progress in integrated assessments of climate change

International Nuclear Information System (INIS)

Toth, F.L.

1995-01-01

This paper is intended to provide an overview of the state of the art integrated socioeconomic-biophysical assessments of climate change as presented at the IIASA workshop in October 1993. The paper seeks to tally the major improvements facilitated by integrated assessments in understanding the global warming problem and the crucial unresolved problems they currently face. The basic conclusion is that, as a result of a healthy diversity in practice, integrated assessments show significant progress in structuring the economic issues of climate change and providing the first broad insights into policy options. But, as some of the simple and traditional cases seem to be solved, more complex and difficult contingencies come to the fore. This suggests a long way to go to develop skills that will be required to address the numerous open issues. (author)

Preparing residents for family practice: role of an integrated “Triple C” curriculum

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Joseph Lee

2013-03-01

Full Text Available Background: There is limited understanding of the impact of Triple C competency-based curriculums on the preparation of residents for family practice. This paper describes a competency-based curriculum within an integrated longitudinal block design and presents preliminary evaluation data on the impact of this curriculum on preparedness for family practice. Methods: First and second year family medicine residents were surveyed as a component of a year-end program evaluation to assess the extent to which the residency program is preparing them to engage in a variety of practice domains, the likelihood that they would engage in these domains, and the extent to which this residency program is comprehensive, relevant to their development as a family physician, and promotes interprofessional practice. Results: Residents perceived themselves as prepared to engage in most practice areas and their intentions to engage in various practice domains were positively correlated to their ratings of preparedness. Ratings reflected that residents perceived this program as comprehensive and relevant to their development as a family physician and they perceived a high degree of encouragement for interprofessional practice. Conclusions: This study provides some preliminary evidence that an integrated competency-based curriculum, with an emphasis on interprofessional practice has the potential to effectively prepare residents for practice in family medicine.

Usefulness of Cochrane Skin Group reviews for clinical practice.

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Davila-Seijo, P; Batalla, A; Garcia-Doval, I

2013-10-01

Systematic reviews are one of the most important sources of information for evidence-based medicine. However, there is a general impression that these reviews rarely report results that provide sufficient evidence to change clinical practice. The aim of this study was to determine the percentage of Cochrane Skin Group reviews reporting results with the potential to guide clinical decision-making. We performed a bibliometric analysis of all the systematic reviews published by the Cochrane Skin Group up to 16 August, 2012. We retrieved 55 reviews, which were analyzed and graded independently by 2 investigators into 3 categories: 0 (insufficient evidence to support or reject the use of an intervention), 1 (insufficient evidence to support or reject the use of an intervention but sufficient evidence to support recommendations or suggestions), and 2 (sufficient evidence to support or reject the use of an intervention). Our analysis showed that 25.5% (14/55) of the studies did not provide sufficient evidence to support or reject the use of the interventions studied, 45.5% (25/25) provided sufficient but not strong evidence to support recommendations or suggestions, and 29.1% (16/55) provided strong evidence to support or reject the use of 1 or more of the interventions studied. Most of the systematic reviews published by the Cochrane Skin Group provide useful information to improve clinical practice. Clinicians should read these reviews and reconsider their current practice. Copyright © 2012 Elsevier España, S.L. and AEDV. All rights reserved.

Collision group and renormalization of the Boltzmann collision integral

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Saveliev, V. L.; Nanbu, K.

2002-05-01

On the basis of a recently discovered collision group [V. L. Saveliev, in Rarefied Gas Dynamics: 22nd International Symposium, edited by T. J. Bartel and M. Gallis, AIP Conf. Proc. No. 585 (AIP, Melville, NY, 2001), p. 101], the Boltzmann collision integral is exactly rewritten in two parts. The first part describes the scattering of particles with small angles. In this part the infinity due to the infinite cross sections is extracted from the Boltzmann collision integral. Moreover, the Boltzmann collision integral is represented as a divergence of the flow in velocity space. Owing to this, the role of collisions in the kinetic equation can be interpreted in terms of the nonlocal friction force that depends on the distribution function.

The Teacher Technology Integration Experience: Practice and Reflection in the Classroom

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Dana Ruggiero

2015-05-01

Full Text Available Previous studies indicated that the technology integration practices of teachers in the classroom often did not match their teaching styles. Researchers concluded that this was due, at least partially, to external barriers that prevented teachers from using technology in ways that matched their practiced teaching style. Many of these barriers, such as professional support and access to hardware and software, have been largely diminished over the last twenty years due to an influx of money and strategies for enhancing technology in primary and secondary schools in the United States. This mixed-methods research study was designed to examine the question, “What technology do teachers use and how do they use that technology to facilitate student learning?” K-12 classroom teachers were purposefully selected based on their full-time employment in a public, private, or religious school in a Midwestern state in the United States, supported by the endorsement of a school official. There were 1048 teachers from over 100 school corporations who completed an online survey consisting of six questions about classroom technology tools and professional development involving technology. Survey results suggest that technology integration is pervasive in the classroom with the most often used technology tool identified as PowerPoint. Moreover, teachers identified that training about technology is most effective when it is contextually based in their own classroom. Follow-up interviews were conducted with ten percent (n=111 of the teachers in order to examine the relationship between teachers’ daily classroom use of technology and their pedagogical practices. Results suggest a close relationship; for example, teachers with student-centric technology activities were supported by student-centric pedagogical practices in other areas. Moreover, teachers with strongly student-centered practices tended to exhibit a more pronounced need to create learning

Integrating Occupational Therapy Specific Assessments in Practice: Exploring Practitioner Experiences

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Eric Asaba

2017-01-01

Full Text Available Background. Occupational therapists sometimes find it challenging to integrate client-centered and occupational therapy specific assessments in practice. The aim of this study was to explore the use of occupational therapy specific assessments such as the Assessment of Motor and Process Skills (AMPS among occupational therapists in Sweden and Japan. Methods. Interviews and qualitative thematic analyses were utilized. Findings. Four themes are reported: (1 use it or lose it, (2 simply no space until after hours, (3 biggest barriers can be colleagues, and (4 being more specific: communication. Conclusion. In keeping with previous studies, occupational therapists often find it challenging to implement client-centered and occupation-based assessment tools into practice. However, more work is needed to understand how best practices can be incorporated into a changing occupational therapy daily practice.

Towards Integrated Team Practice: A Case of Malaysian Industrialised Building System (IBS Construction Projects

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Mohd Nawi Mohd Nasrun

2014-01-01

Full Text Available Problems associated with fragmentation in the traditional construction process, such as isolation of professionals, lack of co-ordination between design and construction, and the sequential manner of its processes, has impacted on construction performance leading to a lack of integration, wastage, low productivity and efficiency. Integrated team practice is perceived as paramount. Unfortunately, there has a limitation of study focus on the dimension of fully integrated team especially for Malaysian Industrialised Building System (IBS projects. Accordingly, this research paper explores and identifies the dimension of fully integrated team from the traditional approach and conduct a validation process for implementing it in Malaysian IBS projects. The research presented uses interviews case study to obtain qualitative data. It was found that the dimension of fully integrated team from the traditional construction process could apply to the Malaysian IBS projects. Suggestions on how an integrated team practice in IBS design and construction process in order to minimise the fragmentation gaps will be concluded.

A social epistemology of research groups collaboration in scientific practice

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Wagenknecht, Susann

2016-01-01

This book investigates how collaborative scientific practice yields scientific knowledge. At a time when most of today’s scientific knowledge is created in research groups, the author reconsiders the social character of science to address the question of whether collaboratively created knowledge should be considered as collective achievement, and if so, in which sense. Combining philosophical analysis with qualitative empirical inquiry, this book provides a comparative case study of mono- and interdisciplinary research groups, offering insight into the day-to-day practice of scientists. The book includes field observations and interviews with scientists to present an empirically-grounded perspective on much-debated questions concerning research groups’ division of labor, relations of epistemic dependence and trust.

Making mathematics and science integration happen: key aspects of practice

Science.gov (United States)

Ríordáin, Máire Ní; Johnston, Jennifer; Walshe, Gráinne

2016-02-01

The integration of mathematics and science teaching and learning facilitates student learning, engagement, motivation, problem-solving, criticality and real-life application. However, the actual implementation of an integrative approach to the teaching and learning of both subjects at classroom level, with in-service teachers working collaboratively, at second-level education, is under-researched due to the complexities of school-based research. This study reports on a year-long case study on the implementation of an integrated unit of learning on distance, speed and time, within three second-level schools in Ireland. This study employed a qualitative approach and examined the key aspects of practice that impact on the integration of mathematics and science teaching and learning. We argue that teacher perspective, teacher knowledge of the 'other subject' and of technological pedagogical content knowledge (TPACK), and teacher collaboration and support all impact on the implementation of an integrative approach to mathematics and science education.

A Cooperative Learning Group Procedure for Improving CTE and Science Integration

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Spindler, Matt

2016-01-01

The purpose of this case study was to create information about the employment of Cooperative Learning Groups (CLG) to enhance the science integrating learning objectives utilized in secondary CTE courses. The objectives of the study were to determine if CLGs were an effective means for increasing the number of: a) science integrating learning…

Evaluation and recommendations for work group integration within the Materials and Processes Lab

Science.gov (United States)

Farrington, Phillip A.

1992-01-01

The goal of this study was to evaluate and make recommendations for improving the level of integration of several work groups within the Materials and Processes Lab at the Marshall Space Flight Center. This evaluation has uncovered a variety of projects that could improve the efficiency and operation of the work groups as well as the overall integration of the system. In addition, this study provides the foundation for specification of a computer integrated manufacturing test bed environment in the Materials and Processes Lab.

Group Work with Adolescents: Principles and Practice. Second Edition. Social Work Practice with Children and Families

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Malekoff, Andrew

2006-01-01

This popular text provides essential knowledge and skills for conducting creative, strengths-based group work with adolescents. A rich introduction to the field, enlivened by numerous illustrations from actual sessions, the book provides principles and guidelines for practice in a wide range of settings. The book covers all phases of group work,…

New entity for conducting group practice offers new potential.

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Rich, H I

1994-01-01

A new form of entity, the limited liability company (LLC), may be used by physicians to conduct group practices with the tax advantages of a partnership and insulation from liability for copractitioner's acts. The author reviews the New Jersey Limited Liability Company Act.

The implementation evaluation of primary care groups of practice: a focus on organizational identity

Directory of Open Access Journals (Sweden)

Pozzebon Marlei

2010-02-01

Full Text Available Abstract Background Since 2002 the Health Ministry of Québec (Canada has been implementing a primary care organizational innovation called 'family medicine groups'. This is occurring in a political context in which the reorganization of primary care is considered necessary to improve health care system performance. More specifically, the purpose of this reform has been to overcome systemic deficiencies in terms of accessibility and continuity of care. This paper examines the first years of implementation of the family medicine group program, with a focus on the emergence of the organizational identity of one of the pilot groups located in the urban area of Montreal. Methods An in-depth longitudinal case study was conducted over two and a half years. Face to face individual interviews with key informants from the family medicine group under study were conducted over the research period considered. Data was gathered throuhg observations and documentary analysis. The data was analyzed using temporal bracketing and Fairclough's three-dimensional critical discourse analytical techniques. Results Three different phases were identified over the period under study. During the first phase, which corresponded to the official start-up of the family medicine group program, new resources and staff were only available at the end of the period, and no changes occurred in medical practices. Power struggles between physicians and nurses characterized the second phase, resulting in a very difficult integration of advanced nurse practitioners into the group. Indeed, the last phase was portrayed by initial collaborative practices associated with a sensegiving process prompted by a new family medicine group director. Conclusions The creation of a primary care team is a very challenging process that goes beyond the normative policy definitions of who is on the team or what the team has to do. To fulfil expectations of quality improvement through team-based care

European radiographers' challenges from mammography education and clinical practice - an integrative review.

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Metsälä, Eija; Richli Meystre, Nicole; Pires Jorge, José; Henner, Anja; Kukkes, Tiina; Sá Dos Reis, Cláudia

2017-06-01

This study aims to identify European radiographers' challenges in clinical performance in mammography and the main areas of mammography that require more and better training. An extensive search was performed to identify relevant studies focused on clinical practice, education and training in mammography published between January 2010 and December 2015 in the English language. The data were analysed by using deductive thematic analysis. A total of 27 full text articles were read, evaluating their quality. Sixteen articles out of 27 were finally selected for this integrative review. The main challenges of radiographers' mammography education/training can be divided into three groups: training needs, challenges related to radiographers, and challenges related to the organization of education. The most common challenges of clinical performance in mammography among European radiographers involved technical performance, the quality of practices, and patient-centeredness. The introduction of harmonized mammography guidelines across Europe may serve as an evidence-based tool to be implemented in practice and education. However, the variability in human and material resources as well as the different cultural contexts should be considered during this process. • Radiographers' awareness of their professional identity and enhancing multiprofessional cooperation in mammography. • Radiographers' responsibilities regarding image quality (IQ) and optimal breast imaging performance. • Patient-centred mammography services focusing on the psychosocial needs of the patient. • Challenges: positioning, QC-testing, IQ-assessment, optimization of breast compression, communication, teamwork, and patient-centred care. • Introduction of evidence-based guidelines in Europe to harmonize mammography practice and education.

Investigating Practices in Teacher Education That Promote and Inhibit Technology Integration Transfer in Early Career Teachers

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Brenner, Aimee M.; Brill, Jennifer M.

2016-01-01

The purpose of this study was to identify instructional technology integration strategies and practices in preservice teacher education that contribute to the transfer of technology integration knowledge and skills to the instructional practices of early career teachers. This study used a two-phase, sequential explanatory strategy. Data were…

Americans with Disabilities Act: physician-shareholder practice groups and ADA compliance.

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Odem, Nathan; Blanck, Peter

2003-02-01

This article examines the application of Americans with Disabilities Act requirements to professional associations like physician practice groups. In general, employers with 15 or more full-time employees must comply with the Act. However, the definition of an employee is sometimes unclear, especially as applied to business entities commonly used by physician practice groups. A recent case decided by the United States Court of Appeals for the Ninth Circuit held that physician-shareholders of a professional corporation are employees for Americans with Disabilities Act coverage purposes. Analogous cases in other federal circuits have held differently, likening the "owners" of professional corporations to partners in a partnership, who are not considered employees. Similar questions arise for popular business entities, such as Limited Liability Companies and Limited Liability Partnerships. This article discusses the nature of the business forms commonly used by physician practice groups and how their characteristics impact employee status for Americans with Disabilities Act coverage. It then suggests that examination is useful beyond business formation characteristics to the purpose of the Americans with Disabilities Act and other employment antidiscrimination statutes.

Integrating art into science education: a survey of science teachers' practices

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Turkka, Jaakko; Haatainen, Outi; Aksela, Maija

2017-07-01

Numerous case studies suggest that integrating art and science education could engage students with creative projects and encourage students to express science in multitude of ways. However, little is known about art integration practices in everyday science teaching. With a qualitative e-survey, this study explores the art integration of science teachers (n = 66). A pedagogical model for science teachers' art integration emerged from a qualitative content analysis conducted on examples of art integration. In the model, art integration is characterised as integration through content and activities. Whilst the links in the content were facilitated either directly between concepts and ideas or indirectly through themes or artefacts, the integration through activity often connected an activity in one domain and a concept, idea or artefact in the other domain with the exception of some activities that could belong to both domains. Moreover, the examples of art integration in everyday classroom did not include expression of emotions often associated with art. In addition, quantitative part of the survey confirmed that integration is infrequent in all mapped areas. The findings of this study have implications for science teacher education that should offer opportunities for more consistent art integration.

Promoting better integration of health information systems: best practices and challenges

NARCIS (Netherlands)

Michelsen, K.; Brand, H.; Achterberg, P.; Wilkinson, J.

2015-01-01

Health Evidence Network Synthesis Report [Promoting better integration of health information systems: best practices and challenges K Michelsen, H Brand, P Achterberg, J Wilkinson - 2015 ... Authors Kai Michelsen Department of International Health, Maastricht University Maastricht,

Integrating CERN e-groups into TWiki access control.

CERN Document Server

Jones, PL; Hoymr, N; CERN. Geneva. IT Department

2010-01-01

Wikis allow for easy collaborative editing of documents on the web for users located in different buildings, cities or even countries. TWiki culture lends to open free form editing and most pages are world readable and editable by CERN authenticated users, however access control is possible and is used to protect sensitive documents. This note discusses the integration of E-groups for authorisation purposes at CERN.

An integrated course in pain management and palliative care bridging the basic sciences and pharmacy practice.

Science.gov (United States)

Kullgren, Justin; Radhakrishnan, Rajan; Unni, Elizabeth; Hanson, Eric

2013-08-12

To describe the development of an integrated pain and palliative care course and to investigate the long-term effectiveness of the course during doctor of pharmacy (PharmD) students' advanced pharmacy practice experiences (APPEs) and in their practice after graduation. Roseman University College of Pharmacy faculty developed a 3-week elective course in pain and palliative care by integrating relevant clinical and pharmaceutical sciences. Instructional strategies included lectures, team and individual activities, case studies, and student presentations. Students who participated in the course in 2010 and 2011 were surveyed anonymously to gain their perception about the class as well as the utility of the course during their APPEs and in their everyday practice. Traditional and nontraditional assessment of students confirmed that the learning outcomes objectives were achieved. Students taking the integrated course on pain management and palliative care achieved mastery of the learning outcome objectives. Surveys of students and practicing pharmacists who completed the course showed that the learning experience as well as retention was improved with the integrated mode of teaching. Integrating basic and clinical sciences in therapeutic courses is an effective learning strategy.

Dissecting stimulus-response binding effects: Grouping by color separately impacts integration and retrieval processes.

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Laub, Ruth; Frings, Christian; Moeller, Birte

2018-04-23

In selection tasks, target and distractor features can be encoded together with the response into the same short-lived memory trace, or event file (see Hommel, 2004), leading to bindings between stimulus and response features. The repetition of a stored target or distractor feature can lead to the retrieval of the entire episode, including the response-so-called "binding effects." Binding effects due to distractor repetition are stronger for grouped than for nongrouped target and distractor stimulus configurations. Modulation of either of two mechanisms that lead to the observed binding effects might be responsible here: Grouping may influence either stimulus-response integration or stimulus-response retrieval. In the present study we investigated the influences of grouping on both mechanisms independently. In two experiments, target and distractor letters were grouped (or nongrouped) via color (dis)similarity separately during integration and retrieval. Grouping by color similarity affected integration and retrieval mechanisms independently and in different ways. Color dissimilarity enhanced distractor-based retrieval, whereas color similarity enhanced distractor integration. We concluded that stimulus grouping is relevant for binding effects, but that the mechanisms that contribute to binding effects should be carefully separated.

Leveling the Playing Field: Teacher Perception of Integrated STEM, Engineering, and Engineering Practices

Science.gov (United States)

Fincher, Bridgette Ann

The purpose of this study was to describe the perceptions and approaches of 14 third-through-fifth grade Arkansan elementary teachers towards integrative engineering and engineering practices during 80 hours of integrated STEM professional development training in the summer and fall of 2014. This training was known as Project Flight. The purpose of the professional development was to learn integrated STEM content related to aviation and to write grade level curriculum units using Wiggins and McTighe's Understanding by Design curriculum framework. The current study builds upon on the original research. Using a mixed method exploratory, embedded QUAL[quan] case study design and a non-experimental convenience sample derived from original 20 participants of Project Flight, this research sought to answer the following question: Does professional development influence elementary teachers' perceptions of the curriculum and instruction of integrated STEM engineering and engineering practices in a 3-to-5 grade level setting? A series of six qualitative and one quantitative sub-questions informed the research of the mixed method question. Hermeneutic content analysis was applied to archival and current qualitative data sets while descriptive statistics, independent t-tests, and repeated measures ANOVA tests were performed on the quantitative data. Broad themes in the teachers' perceptions and understanding of the nature of integrated engineering and engineering practices emerged through triangulation. After the professional development and the teaching of the integrated STEM units, all 14 teachers sustained higher perceptions of personal self-efficacy in their understanding of Next Generation Science Standards (NGSS). The teachers gained understanding of engineering and engineering practices, excluding engineering habits of mind, throughout the professional development training and unit teaching. The research resulted in four major findings specific to elementary engineering

Evaluation of an Ongoing Diabetes Group Medical Visit in a Family Medicine Practice.

Science.gov (United States)

Cunningham, Amy T; Delgado, David J; Jackson, Joseph D; Crawford, Albert G; Jabbour, Serge; Lieberthal, Robert D; Diaz, Victor; LaNoue, Marianna

2018-01-01

Group medical visits (GMVs), which combine 1-on-1 clinical consultations and group self-management education, have emerged as a promising vehicle for supporting type 2 diabetes management in primary care. However, few evaluations exist of ongoing diabetes GMVs embedded in medical practices. This study used a quasi-experimental design to evaluate diabetes GMV at a large family medicine practice. We examined program attendance and attrition, used propensity score matching to create a matched comparison group, and compared participants and the matched group on clinical, process of care, and utilization outcomes. GMV participants (n = 230) attended an average of 1 session. Participants did not differ significantly from the matched comparison group (n = 230) on clinical, process of care or utilization outcomes. The diabetes GMV was not associated with improvements in outcomes. Further studies should examine diabetes GMV implementation challenges to enhance their effectiveness in everyday practice. © Copyright 2018 by the American Board of Family Medicine.

Integrating Social Class into Vocational Psychology: Theory and Practice Implications

Science.gov (United States)

Diemer, Matthew A.; Ali, Saba Rasheed

2009-01-01

Although social class plays a salient and significant role in career development and occupational attainment, social class is underrepresented in vocational psychology theory, scholarship, and practice. Vocational psychologists are in a unique position to meet the career development needs of persons from all social classes by integrating a fuller…

Integrative practices in hospitals and their impact on patient flow

NARCIS (Netherlands)

Drupsteen, J.; van der Vaart, T.; van Donk, D.P.

2013-01-01

Purpose - The aim of this paper is to investigate which integrative planning and control practices are used in hospitals and what their effects are on patient flow. Design/methodology/approach - The study is based on a three-hospital multi-case study carried out in The Netherlands. The main findings

XBoard: A Framework for Integrating and Enhancing Collaborative Work Practices

Science.gov (United States)

Shab, Ted

2006-01-01

Teams typically collaborate in different modes including face-to-face meetings, meetings that are synchronous (i. e. require parties to participate at the same time) but distributed geographically, and meetings involving asynchronously working on common tasks at different times. The XBoard platform was designed to create an integrated environment for creating applications that enhance collaborative work practices. Specifically, it takes large, touch-screen enabled displays as the starting point for enhancing face-to-face meetings by providing common facilities such as whiteboarding/electronic flipcharts, laptop projection, web access, screen capture and content distribution. These capabilities are built upon by making these functions inherently distributed by allowing these sessions to be easily connected between two or more systems at different locations. Finally, an information repository is integrated into the functionality to provide facilities for work practices that involve work being done at different times, such as reports that span different shifts. The Board is designed to be extendible allowing customization of both the general functionality and by adding new functionality to the core facilities by means of a plugin architecture. This, in essence, makes it a collaborative framework for extending or integrating work practices for different mission scenarios. XBoard relies heavily on standards such as Web Services and SVG, and is built using predominately Java and well-known open-source products such as Apache and Postgres. Increasingly, organizations are geographically dispersed, and rely on "virtual teams" that are assembled from a pool of various partner organizations. These organizations often have different infrastructures of applications and workflows. The XBoard has been designed to be a good partner in these situations, providing the flexibility to integrate with typical legacy applications while providing a standards-based infrastructure that is

Practical approach for the study of metabolic regulation

Directory of Open Access Journals (Sweden)

D.V. Macedo

2004-05-01

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

From Knowledge Theory to Management Practice: Towards an Integrated Approach.

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Shin, Minsoo; Holden, Tony; Schmidt, Ruth A.

2001-01-01

Critically contrasts the three main schools of thought on knowledge and assesses the resulting implications for knowledge management. Presents a conceptual model to integrate theoretical and practical themes to serve as a framework for developing a future research agenda for the development of knowledge management business tools and applications.…

Towards integration of health economics into medical education and clinical practice in Saudi Arabia.

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Da'ar, Omar B; Al Shehri, Ali M

2015-04-01

In an era of expanding health sectors and rising costs, doctors are expected to have a working knowledge of health economics to better use resources and improve outcomes and quality of health care. This article recognizes the dearth of knowledge and application of economic analyses in medical education and clinical practice in Saudi Arabia. In particular, it highlights the desirability of knowledge of health economics in ensuring certain competencies in medical education and the rationale for inviting doctors to apply knowledge of economics in Saudi Arabia. In addition, the article discusses challenges that hinder integrating health economics into clinical practice. Furthermore, the article typifies some of the important economic phenomena that physicians need to discern. Besides, the article provides implications for incorporating economic analysis into medical education and clinical practice in Saudi Arabia. Finally, the article concludes by demonstrating how health economics can enhance doctors' knowledge and recommends the country to move towards integrating health economics into medical education and clinical practice for best practice.

Do clinical practice education groups result in sustained change in GP prescribing?

Science.gov (United States)

Richards, Dee; Toop, Les; Graham, Patrick

2003-04-01

Concern has been expressed at the poor uptake of evidence into clinical practice. This is despite the fact that continuing education is an embedded feature of quality assurance in general practice. There are a variety of clinical practice education methods available for dissemination of new evidence. Recent systematic reviews indicate that the effectiveness of these different strategies is extremely variable. Our aim was to determine whether a peer-led small group education pilot programme used to promote rational GP prescribing is an effective tool in changing practice when added to prescribing audit and feedback, academic detailing and educational bulletins, and to determine whether any effect seen decays over time. A retrospective analysis of a controlled trial of a small group education strategy with 24 month follow-up was carried out. The setting was an independent GPs association (IPA) of 230 GPs in the Christchurch New Zealand urban area. All intervention and control group GPs were already receiving prescribing audit and feedback, academic detailing and educational bulletins. The intervention group were the first 52 GPs to respond to an invitation to pilot the project. Two control groups were used, one group who joined the pilot later and a second group which included all other GPs in the IPA. The main outcome measures were targeted prescribing data for 12 months before and 24 months after each of four education sessions. An effect in the expected direction was seen in six of the eight key messages studied. This effect was statistically significant for five of the eight messages studied. The effect size varied between 7 and 40%. Where a positive effect was seen, the effect decayed with time but persisted to a significant level for 6-24 months of observation. The results support a positive effect of the education strategy on prescribing behaviour in the intervention group for most outcomes measured. The effect seen is statistically significant, sustained and

A quantum group structure in integrable conformal field theories

International Nuclear Information System (INIS)

Smit, D.J.

1990-01-01

We discuss a quantization prescription of the conformal algebras of a class of d=2 conformal field theories which are integrable. We first give a geometrical construction of certain extensions of the classical Virasoro algebra, known as classical W algebras, in which these algebras arise as the Lie algebra of the second Hamiltonian structure of a generalized Korteweg-de Vries hierarchy. This fact implies that the W algebras, obtained as a reduction with respect to the nilpotent subalgebras of the Kac-Moody algebra, describe the intergrability of a Toda field theory. Subsequently we determine the coadjoint operators of the W algebras, and relate these to classical Yang-Baxter matrices. The quantization of these algebras can be carried out using the concept of a so-called quantum group. We derive the condition under which the representations of these quantum groups admit a Hilbert space completion by exploring the relation with the braid group. Then we consider a modification of the Miura transformation which we use to define a quantum W algebra. This leads to an alternative interpretation of the coset construction for Kac-Moody algebras in terms of nonlinear integrable hierarchies. Subsequently we use the connection between the induced braid group representations and the representations of the mapping class group of Riemann surfaces to identify an action of the W algebras on the moduli space of stable curves, and we give the invariants of this action. This provides a generalization of the situation for the Virasoro algebra, where such an invariant is given by the so-called Mumford form which describes the partition function of the bosonic string. (orig.)

Theory and (In) Practice: The Problem of Integration in Art and Design Education

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Rintoul, Jenny Ruth

2014-01-01

This paper examines the relationship between art "theory" and art "practice" in British art education at post-compulsory level, with a focus on the ways in which theory is framed and delivered and what this means for its integration. Drawing upon constructions of knowledge and approaches to integration as a technique and…

Issues and Impediments Faced by Canadian Teachers While Integrating ICT in Pedagogical Practice

Science.gov (United States)

Saxena, Anoop

2017-01-01

Teachers in many schools struggle to integrate Information and Communications Technology (ICT) as part of their teaching practice. Among the issues faced by teachers when attempting to integrate ICT into their classrooms are gaps in ICT knowledge and skills, lack of training and inadequate support and scaffolding. Other issues include inability to…

Does integrating research into the prosthetics and orthotics undergraduate curriculum enhance students' clinical practice? An interview study on students' perception.

Science.gov (United States)

Al Qaroot, Bashar S; Sobuh, Mohammad

2016-06-01

Problem-based learning (where rather than feeding students the knowledge, they look for it themselves) has long been thought of as an ideal approach in teaching because it would encourage students to acquire knowledge from an undetermined medium of wrong and right answers. However, the effect of such approach in the learning experience of prosthetics and orthotics students has never been investigated. This study explores the implications of integrating problem-based learning into teaching on the students' learning experience via implementing a research-informed clinical practice module into the curriculum of last year prosthetics and orthotics undergraduate students at the University of Jordan (Amman, Jordan). Qualitative research pilot study. Grounded theory approach was used based on the data collected from interviewing a focus group of four students. Students have identified a number of arguments from their experience in the research-informed clinical practice where, generally speaking, students described research-informed clinical practice as a very good method of education. Integrating problem-based learning into teaching has many positive implications. In particular, students pointed out that their learning experience and clinical practice have much improved after the research-informed clinical practice. Findings from this investigation demonstrate that embedding problem-based learning into prosthetics and orthotics students' curriculum has the potential to enhance students' learning experience, particularly students' evidence-based practice. This may lead to graduates who are more knowledgeable and thus who can offer the optimal patient care (i.e. clinical practice). © The International Society for Prosthetics and Orthotics 2014.

The existential dimension in general practice

DEFF Research Database (Denmark)

Assing Hvidt, Elisabeth; Søndergaard, Jens; Ammentorp, Jette

2016-01-01

Objective: The objective of this study is to identify points of agreement and disagreements among general practitioners (GPs) in Denmark concerning how the existential dimension is understood, and when and how it is integrated in the GP–patient encounter. Design: A qualitative methodology with semi......-structured focus group interviews was employed. Setting: General practice setting in Denmark. Subjects: Thirty-one GPs from two Danish regions between 38 and 68 years of age participated in seven focus group interviews. Results: Although understood to involve broad life conditions such as present and future being...... points Although integration of the existential dimension is recommended for patient care in general practice, little is known about GPs’ understanding and integration of this dimension in the GP–patient encounter. The existential dimension is understood to involve broad and universal life conditions...

The existential dimension in general practice

DEFF Research Database (Denmark)

Assing Hvidt, Elisabeth; Søndergård, Jens; Ammentorp, Jette

2016-01-01

OBJECTIVE: The objective of this study is to identify points of agreement and disagreements among general practitioners (GPs) in Denmark concerning how the existential dimension is understood, and when and how it is integrated in the GP-patient encounter. DESIGN: A qualitative methodology with semi......-structured focus group interviews was employed. SETTING: General practice setting in Denmark. SUBJECTS: Thirty-one GPs from two Danish regions between 38 and 68 years of age participated in seven focus group interviews. RESULTS: Although understood to involve broad life conditions such as present and future being...... POINTS: Although integration of the existential dimension is recommended for patient care in general practice, little is known about GPs’ understanding and integration of this dimension in the GP-patient encounter. The existential dimension is understood to involve broad and universal life conditions...

Groups as a part of integrated treatment plans : Inpatient psychotherapy for outpatients?

NARCIS (Netherlands)

Staats, H

2005-01-01

Group psychotherapy in Germany is well established as part of an integrative treatment plan in inpatient treatment. Outpatient group psychotherapy, however, is conceptualized as a separate treatment option in competition with individual therapy. German guidelines for outpatient psychotherapy exclude

Review of The Behavioral Health Specialist in Primary Care: Skills for Integrated Practice.

Science.gov (United States)

Harsh, Jennifer

2016-03-01

Reviews the book, The Behavioral Health Specialist in Primary Care: Skills for Integrated Practice edited by Mary Ann Burg and Oliver Oyama (see record 2015-46891-000). The editors and the chapter authors of this useful book provide insight into the skills and knowledge needed to do integrated behavioral health in primary care. The most beneficial part of the book is the layout of the chapters, and the authors do a great job of articulating the clinical components of care. Behavioral health and medical providers in practice or in training could greatly benefit from reading this book. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Practical steps toward integrating economic, social and institutional elements in fisheries policy and management

DEFF Research Database (Denmark)

Stephenson, Robert L.; Benson, Ashleen J.; Brooks, Kate

2017-01-01

While international agreements and legislation call for incorporation of four pillars of sustainability, the social (including cultural), economic and institutional aspects (the ‘human dimension’) have been relatively neglected to date. Three key impediments have been identified: a relative lack...... of explicit social, economic and institutional objectives; a general lack of process (frameworks, governance) for routine integration of all four pillars of sustainability; and a bias towards biological considerations. Practical integration requires a ‘systems’ approach with explicit consideration...... in fisheries to immediately take five practical steps toward integrating ecological, economic, social and institutional aspects: (1) Adopt the perspective of the fishery as a ‘system’ with interacting natural, human and management elements; (2) Be aware of both strategic and operational aspects of fisheries...

Group Organization and Communities of Practice in Translational Research

Directory of Open Access Journals (Sweden)

Victor J. Krawczyk

2014-12-01

Full Text Available The collective lived experience of translational research teams requires further appreciation, particularly at the stages of group formation. To achieve this, we conducted a case study of a translational research team (n = 16. Through the case description and then discussing case-based themes with community of practice theory, themes such as “Being Open” and “Working as a Group” found that this team’s mutual respect, cooperation, and their sharing of knowledge uncovered an alternative way that professionals organize themselves for translational research projects. In conjunction to this finding, our analysis showed that the team has qualities of a community of practice.

Integrating Practice Guidelines into Professional Training: Implications for Diversity Competence

Science.gov (United States)

Miville, Marie L.; Duan, Changming; Nutt, Roberta L.; Waehler, Charles A.; Suzuki, Lisa; Pistole, M. Carole; Arredondo, Patricia; Duffy, Michael; Mejia, Brenda X.; Corpus, Melissa

2009-01-01

The authors present the findings of a special task group (STG) organized to explore effective training strategies for the practice guidelines focused on diverse populations. They provide a brief literature review and summarize survey data from academic training directors regarding current use of practice guidelines. The authors then describe the…

A practical description and student perspective of the integration of radiology into lower limb musculoskeletal anatomy.

Science.gov (United States)

Davy, S; O'Keeffe, G W; Mahony, N; Phelan, N; Barry, D S

2017-05-01

Anatomy educators are increasing their utilisation of radiology in anatomy education in line with growing requirements for undergraduate radiology competency and clinical need. We aimed to evaluate student perceptions of radiology and to outline the technical and academic considerations underlying the integration of radiology into musculoskeletal practical anatomy sessions. The formal integration of radiology into anatomy practical sessions took place over a 5-week period during the lower limb musculoskeletal component of the anatomy course taught to first-year medical students. During practical sessions, students were required to rotate between aligned audio-visual radiology presentations, osteology/anatomical models, and prosection/dissection learning stations. After completing the course, students were invited to complete a survey to establish their opinions on radiology as a mode of learning and their satisfaction with radiological integration in anatomical practical sessions. Most students were not familiar with radiology prior to attending our university. All our students agreed or strongly agreed that learning to read radiographs in anatomy is important and most agreed that radiology is a valid assessment tool. Sixty percent stated that radiology facilitated their understanding of anatomy. The majority believed that radiology was best suited to clinically relevant anatomy and X-rays were their preferred learning tool. The practical approach to integrating radiology into undergraduate musculoskeletal anatomy described here did not place strain on existing academic resources. Most students agreed that radiology should be increased in anatomy education and that learning to understand radiographs in anatomy was important for clinical practice.

Investment practices in Australian coal: the practice and profit of quasi-integration in the Australia-Japan coal trade

International Nuclear Information System (INIS)

Colley, Peter

1997-01-01

The Australian coal industry has frequently been described as a perpetual case of 'profitless prosperity'. Industry literature on the subject usually sources this problem to government charges on the industry and to labour costs. However, these alleged problems do not appear to have diminished the enthusiasm for new investment in the industry. This study argues that a more complete explanation must look at who is investing in the Australian coal industry, what the rationale for those investments is, how they are financed and what their specific profitability is. The particular examination made here is of the quasi-integration investment practices of Japanese trading, steel and power companies -easily the largest group of buyers in the international coal trade. The close co-operation between Japanese government and business in this strategic raw materials industry is documented, as are the methods of subsidised investment. An examination of the financial performance of these companies' Australian coal investments shows that the profitability of their investments is significantly below that of most other investors in Australian mining over a recent 5-year period. Taken together, there is significant support for the conclusion that a process of co-ordinated quasi-integration has taken place and that the principal aim of such investments has not been to make profits from coal-mining. (author)

Vertical integration: hospital ownership of physician practices is associated with higher prices and spending.

Science.gov (United States)

Baker, Laurence C; Bundorf, M Kate; Kessler, Daniel P

2014-05-01

We examined the consequences of contractual or ownership relationships between hospitals and physician practices, often described as vertical integration. Such integration can reduce health spending and increase the quality of care by improving communication across care settings, but it can also increase providers' market power and facilitate the payment of what are effectively kickbacks for inappropriate referrals. We investigated the impact of vertical integration on hospital prices, volumes (admissions), and spending for privately insured patients. Using hospital claims from Truven Analytics MarketScan for the nonelderly privately insured in the period 2001-07, we constructed county-level indices of prices, volumes, and spending and adjusted them for enrollees' age and sex. We measured hospital-physician integration using information from the American Hospital Association on the types of relationships hospitals have with physicians. We found that an increase in the market share of hospitals with the tightest vertically integrated relationship with physicians--ownership of physician practices--was associated with higher hospital prices and spending. We found that an increase in contractual integration reduced the frequency of hospital admissions, but this effect was relatively small. Taken together, our results provide a mixed, although somewhat negative, picture of vertical integration from the perspective of the privately insured.

Frequency of satisfaction and dissatisfaction with practice among rural-based, group-employed physicians and non-physician practitioners.

Science.gov (United States)

Waddimba, Anthony C; Scribani, Melissa; Krupa, Nicole; May, John J; Jenkins, Paul

2016-10-22

Widespread dissatisfaction among United States (U.S.) clinicians could endanger ongoing reforms. Practitioners in rural/underserved areas withstand stressors that are unique to or accentuated in those settings. Medical professionals employed by integrating delivery systems are often distressed by the cacophony of organizational change(s) that such consolidation portends. We investigated the factors associated with dis/satisfaction with rural practice among doctors/non-physician practitioners employed by an integrated healthcare delivery network serving 9 counties of upstate New York, during a time of organizational transition. We linked administrative data about practice units with cross-sectional data from a self-administered multi-dimensional questionnaire that contained practitioner demographics plus valid scales assessing autonomy/relatedness needs, risk aversion, tolerance for uncertainty/ambiguity, meaningfulness of patient care, and workload. We targeted medical professionals on the institutional payroll for inclusion. We excluded those who retired, resigned or were fired during the study launch, plus members of the advisory board and research team. Fixed-effects beta regressions were performed to test univariate associations between each factor and the percent of time a provider was dis/satisfied. Factors that manifested significant fixed effects were entered into multivariate, inflated beta regression models of the proportion of time that practitioners were dis/satisfied, incorporating clustering by practice unit as a random effect. Of the 473 eligible participants. 308 (65.1 %) completed the questionnaire. 59.1 % of respondents were doctoral-level; 40.9 % mid-level practitioners. Practitioners with heavier workloads and/or greater uncertainty intolerance were less likely to enjoy top-quintile satisfaction; those deriving greater meaning from practice were more likely. Higher meaningfulness and gratified relational needs increased one's likelihood of

A New Era of Science Education: Science Teachers' Perceptions and Classroom Practices of Science, Technology, Engineering, and Mathematics (STEM) Integration

Science.gov (United States)

Wang, Hui-Hui

Quality STEM education is the key in helping the United States maintain its lead in global competitiveness and in preparing for new economic and security challenges in the future. Policymakers and professional societies emphasize STEM education by legislating the addition of engineering standards to the existing science standards. On the other hand, the nature of the work of most STEM professionals requires people to actively apply STEM knowledge to make critical decisions. Therefore, using an integrated approach to teaching STEM in K-12 is expected. However, science teachers encounter numerous difficulties in adapting the new STEM integration reforms into their classrooms because of a lack of knowledge and experience. Therefore, high quality STEM integration professional development programs are an urgent necessity. In order to provide these high quality programs, it is important to understand teachers' perceptions and classroom practices regarding STEM integration. A multiple-case study was conducted with five secondary school science teachers in order to gain a better understanding of teachers' perceptions and classroom practices in using STEM integration. This study addresses the following research questions: 1) What are secondary school science teachers' practices of STEM integration? 2) What are secondary science teachers' overall perceptions of STEM integration? and 3) What is the connection between secondary science teachers' perceptions and understanding of STEM integration with their classroom practices? This research aims to explore teachers' perceptions and classroom practices in order to set up the baseline for STEM integration and also to determine STEM integration professional development best practices in science education. Findings from the study provide critical data for making informed decision about the direction for STEM integration in science education in K-12.

Integrative analysis of multiple diverse omics datasets by sparse group multitask regression

Directory of Open Access Journals (Sweden)

Dongdong eLin

2014-10-01

Full Text Available A variety of high throughput genome-wide assays enable the exploration of genetic risk factors underlying complex traits. Although these studies have remarkable impact on identifying susceptible biomarkers, they suffer from issues such as limited sample size and low reproducibility. Combining individual studies of different genetic levels/platforms has the promise to improve the power and consistency of biomarker identification. In this paper, we propose a novel integrative method, namely sparse group multitask regression, for integrating diverse omics datasets, platforms and populations to identify risk genes/factors of complex diseases. This method combines multitask learning with sparse group regularization, which will: 1 treat the biomarker identification in each single study as a task and then combine them by multitask learning; 2 group variables from all studies for identifying significant genes; 3 enforce sparse constraint on groups of variables to overcome the ‘small sample, but large variables’ problem. We introduce two sparse group penalties: sparse group lasso and sparse group ridge in our multitask model, and provide an effective algorithm for each model. In addition, we propose a significance test for the identification of potential risk genes. Two simulation studies are performed to evaluate the performance of our integrative method by comparing it with conventional meta-analysis method. The results show that our sparse group multitask method outperforms meta-analysis method significantly. In an application to our osteoporosis studies, 7 genes are identified as significant genes by our method and are found to have significant effects in other three independent studies for validation. The most significant gene SOD2 has been identified in our previous osteoporosis study involving the same expression dataset. Several other genes such as TREML2, HTR1E and GLO1 are shown to be novel susceptible genes for osteoporosis, as confirmed

Professional training in physiotherapy: barriers to the diversification of practical learning scenarios and for teaching-service integration

Directory of Open Access Journals (Sweden)

Ana Paula Maihack Gauer

2018-06-01

Full Text Available Abstract Introduction: Professional training in health, at present, aims to develop competencies and skills for a performance according the principles of the Unified Health System (SUS, in Portuguese. In this sense, the Ministries of Health and Education have set up devices for training reorientation that prioritize teaching-service integration and diversification of learning scenarios. Objective: To describe barriers to the diversification of practical learning scenarios and for teaching-service integration in a physiotherapy course from the perspective of teachers and students. Methods: This is a qualitative research developed according to the case study method, with the participation of 16 students and 11 teachers-physiotherapists. During the data collection three focus groups were established, two with students and one with professors, besides individual interviews with both the course coordinator and the pedagogical articulator of the National Program for the Reorientation of Professional Health Training of the assessed course. Data were analyzed through thematic content analysis. Results: Among the identified barriers there are students’ low participation in public health services; saturation of public health services for students to carry out practical activities; low number of physiotherapists in Primary Care; indirect relationship of Clinical School with SUS. Conclusion: In order to improve the teaching-service interaction and to diversify the learning scenarios it is necessary to prioritize an integrated planning of actions to overcome identified barriers, including the participation of both the university managers and health services.

Introduction to quantum groups

CERN Document Server

Chaichian, Masud

1996-01-01

In the past decade there has been an extemely rapid growth in the interest and development of quantum group theory.This book provides students and researchers with a practical introduction to the principal ideas of quantum groups theory and its applications to quantum mechanical and modern field theory problems. It begins with a review of, and introduction to, the mathematical aspects of quantum deformation of classical groups, Lie algebras and related objects (algebras of functions on spaces, differential and integral calculi). In the subsequent chapters the richness of mathematical structure

Integrating Motivational Interviewing and Brief Behavioral Activation Therapy: Theoretical and Practical Considerations

OpenAIRE

Balán, Iván C.; Lejuez, C. W.; Hoffer, Marcela; Blanco, Carlos

2016-01-01

Behavioral Activation and specifically the Brief Behavioral Activation Therapy for Depression (BATD) has a strong record of empirical support but its focus on practical out of session activation-based assignments can lead to poor levels of adherence if efforts to enhance motivation are not prioritized. Towards this end, this manuscript describes the assimilative integration of Motivational Interviewing (MI) and BATD to improve clinical outcomes by integrating MI's focus on building and mainta...

An integrative review of facilitators and barriers influencing collaboration and teamwork between general practitioners and nurses working in general practice.

Science.gov (United States)

McInnes, Susan; Peters, Kath; Bonney, Andrew; Halcomb, Elizabeth

2015-09-01

To identify facilitators and barriers influencing collaboration and teamwork between general practitioners and nurses working in general (family) practice. Internationally, a shortage of doctors entering and remaining in general practice and an increasing burden of chronic disease has diversified the nurse's role in this setting. Despite a well-established general practice nursing workforce, little attention has been paid to the ways doctors and nurses collaborate in this setting. Integrative literature review. CINAHL, Scopus, Web of Life, Cochrane Library, Joanna Briggs Institute Library of Systematic Reviews and Trove (dissertation and theses) were searched for papers published between 2000 and May 2014. This review was informed by the approach of Whittemore and Knafl (2005). All included papers were assessed for methodological quality. Findings were extracted, critically examined and grouped into themes. Eleven papers met the inclusion criteria. Thematic analysis revealed three themes common to the facilitators of and barriers to collaboration and teamwork between GPs in general practice: (1) roles and responsibilities; (2) respect, trust and communication; and (3) hierarchy, education and liability. This integrative review has provided insight into issues around role definition, communication and organizational constraints which influence the way nurses and general practitioners collaborate in a team environment. Future research should investigate in more detail the ways doctors and nurses work together in general practice and the impact of collaboration on nursing leadership and staff retention. © 2015 John Wiley & Sons Ltd.

Guiding students towards sensemaking: teacher questions focused on integrating scientific practices with science content

Science.gov (United States)

Benedict-Chambers, Amanda; Kademian, Sylvie M.; Davis, Elizabeth A.; Palincsar, Annemarie Sullivan

2017-10-01

Science education reforms articulate a vision of ambitious science teaching where teachers engage students in sensemaking discussions and emphasise the integration of scientific practices with science content. Learning to teach in this way is complex, and there are few examples of sensemaking discussions in schools where textbook lessons and teacher-directed discussions are the norm. The purpose of this study was to characterise the questioning practices of an experienced teacher who taught a curricular unit enhanced with educative features that emphasised students' engagement in scientific practices integrated with science content. Analyses indicated the teacher asked four types of questions: explication questions, explanation questions, science concept questions, and scientific practice questions, and she used three questioning patterns including: (1) focusing students on scientific practices, which involved a sequence of questions to turn students back to the scientific practice; (2) supporting students in naming observed phenomena, which involved a sequence of questions to help students use scientific language; and (3) guiding students in sensemaking, which involved a sequence of questions to help students learn about scientific practices, describe evidence, and develop explanations. Although many of the discussions in this study were not yet student-centred, they provide an image of a teacher asking specific questions that move students towards reform-oriented instruction. Implications for classroom practice are discussed and recommendations for future research are provided.

Employing finite-state machines in data integrity problems

Directory of Open Access Journals (Sweden)

Malikov Andrey

2016-01-01

Full Text Available This paper explores the issue of group integrity of tuple subsets regarding corporate integrity constraints in relational databases. A solution may be found by applying the finite-state machine theory to guarantee group integrity of data. We present a practical guide to coding such an automaton. After creating SQL queries to manipulate data and control its integrity for real data domains, we study the issue of query performance, determine the level of transaction isolation, and generate query plans.

Optimising, generalising and integrating educational practice using neuroscience

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Colvin, Robert

2016-07-01

Practical collaboration at the intersection of education and neuroscience research is difficult because the combined discipline encompasses both the activity of microscopic neurons and the complex social interactions of teachers and students in a classroom. Taking a pragmatic view, this paper discusses three education objectives to which neuroscience can be effectively applied: optimising, generalising and integrating instructional techniques. These objectives are characterised by: (1) being of practical importance; (2) building on existing education and cognitive research; and (3) being infeasible to address based on behavioural experiments alone. The focus of the neuroscientific aspect of collaborative research should be on the activity of the brain before, during and after learning a task, as opposed to performance of a task. The objectives are informed by literature that highlights possible pitfalls with educational neuroscience research, and are described with respect to the static and dynamic aspects of brain physiology that can be measured by current technology.

The role of ICT in nursing practice: an integrative literature review of the Swedish context.

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Fagerström, Cecilia; Tuvesson, Hanna; Axelsson, Lisa; Nilsson, Lina

2017-09-01

The Swedish healthcare system employs information and communication technologies (ICT) in nursing practice to meet quality-, security- and efficiency-related demands. Although ICT is integrated with nursing practices, nurses do not always feel that they are convenient to use it. We need to improve our knowledge of the role of ICT in healthcare environments and so we decided to complement existing experience of how ICT influences nursing practice. This study aimed to review and synthesise the available literature on the role of ICT in nursing practice in Swedish healthcare settings. To consolidate previous studies based on diverse methodologies, an integrative literature review was carried out. Three databases were used to search for literature, 20 articles met the inclusion criteria. The literature review indicates that ICT integration into nursing practice is a complex process that impacts nurses' communication and relationships in patient care, working conditions, and professional identities and development. Nurses are found to express ambiguous views on ICT as a usable service in their everyday practice since it impacts both positively and negatively. Although ICT cannot replace physical presence, it can be considered a complementary service that gives rise to improved patient care. However, nonverbal communication cues may be missed when ICT is used as mediating tool and ICT can be limiting because it is not always designed to meet nurse and patient needs. The meaning of an encounter appears to change when ICT is used in nursing practice, not only for patient relationships but also for interpersonal communication. © 2016 Nordic College of Caring Science.

Do patient and practice characteristics confound age-group differences in preferences for general practice care? A quantitative study

Science.gov (United States)

2013-01-01

Background Previous research showed inconsistent results regarding the relationship between the age of patients and preference statements regarding GP care. This study investigates whether elderly patients have different preference scores and ranking orders concerning 58 preference statements for GP care than younger patients. Moreover, this study examines whether patient characteristics and practice location may confound the relationship between age and the categorisation of a preference score as very important. Methods Data of the Consumer Quality Index GP Care were used, which were collected in 32 general practices in the Netherlands. The rank order and preference score were calculated for 58 preference statements for four age groups (0–30, 31–50, 51–74, 75 years and older). Using chi-square tests and logistic regression analyses, it was investigated whether a significant relationship between age and preference score was confounded by patient characteristics and practice location. Results Elderly patients did not have a significant different ranking order for the preference statements than the other three age groups (r = 0.0193; p = 0.41). However, in 53% of the statements significant differences were found in preference score between the four age groups. Elderly patients categorized significantly less preference statements as ‘very important’. In most cases, the significant relationships were not confounded by gender, education, perceived health, the number of GP contacts and location of the GP practice. Conclusion The preferences of elderly patients for GP care concern the same items as younger patients. However, their preferences are less strong, which cannot be ascribed to gender, education, perceived health, the number of GP contacts and practice location. PMID:23800156

A Review and Conceptual Framework for Integrating Leadership into Clinical Practice

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Kutz, Matthew R.

2012-01-01

Context: The purpose of this review is to assess leadership education and practice in athletic training. Leadership is a critical component of athletic training and health care. Leadership research in athletic training is dramatically behind other health care professions. Objective: To develop a model for integrating leadership behavior and…

Unbounded representations of symmetry groups in gauge quantum field theory. II. Integration

International Nuclear Information System (INIS)

Voelkel, A.H.

1986-01-01

Within the gauge quantum field theory of the Wightman--Garding type, the integration of representations of Lie algebras is investigated. By means of the covariance condition (substitution rules) for the basic fields, it is shown that a form skew-symmetric representation of a Lie algebra can be integrated to a form isometric and in general unbounded representation of the universal covering group of a corresponding Lie group provided the conditions (Nelson, Sternheimer, etc.), which are well known for the case of Hilbert or Banach representations, hold. If a form isometric representation leaves the subspace from which the physical Hilbert space is obtained via factorization and completion invariant, then the same is proved to be true for its differential. Conversely, a necessary and sufficient condition is derived for the transmission of the invariance of this subspace under a form skew-symmetric representation of a Lie algebra to its integral

Literacy and Technology: Integrating Technology with Small Group, Peer-led Discussions of Literature

Directory of Open Access Journals (Sweden)

Genya Coffey

2012-03-01

Full Text Available This review examines research of computer-mediated small group discussion of literature. The goal of this review is to explore several instructional formats for integrating print-based and new literacies skills. First, the theoretical foundations for the shift from teacher-led to student led discussion are outlined. Research exploring ways in which technology has been infused into several common elements of literature discussion groups are presented next. Benefits and challenges of such integration are highlighted and suggestions for future research are presented.

Integrated management system best practices in radioecological laboratories

International Nuclear Information System (INIS)

Carvalho, Claudia Aparecida Zerbinatti de

2010-01-01

The research aims to study the best practices to support a conceptual proposal for IMS - Integrated Management System (quality, environment, safety and health) applicable to Radioecology laboratories. The research design is organized into the following steps: in a first step, it was developed the bibliographic and documentary research in IMS, survey and study of standards (QMS ISO 9000 (2005), ISO 9001 (2008), ISO 9004 (2000), EMS ISO 14001 (2004) and OHSMS OHSAS 18001 (2007) and OHSAS 18002 (2008)), identification and characterization of processes in Radioecology Laboratories and study of best practices methodology and benchmarking; in the second stage of the research it was developed a case study (qualitative research, with questionnaires via e-mail and interviews, when possible), preceded by a survey and selection of international and national radioecology laboratories and then these laboratories were contacted and some of them agreed to participate in this research; in the third stage of the research it was built the framework of best practices that showed results that could support the conceptual proposal for the IMS Radioecology Laboratory; the fourth and final stage of research consisted in the construction of the proposed conceptual framework of SGI for Radioecology Laboratory, being then achieved the initial objective of the research. (author)

Surgical education and adult learning: Integrating theory into practice [version 1; referees: 3 approved

Directory of Open Access Journals (Sweden)

Prem Rashid

2017-02-01

Full Text Available Surgical education continues to evolve from the master-apprentice model. Newer methods of the process need to be used to manage the dual challenges of educating while providing safe surgical care. This requires integrating adult learning concepts into delivery of practical training and education in busy clinical environments. A narrative review aimed at outlining and integrating adult learning and surgical education theory was undertaken. Additionally, this information was used to relate the practical delivery of surgical training and education in day-to-day surgical practice. Concepts were sourced from reference material. Additional material was found using a PubMed search of the words: ‘surgical education theory’ and ‘adult learning theory medical’. This yielded 1351 abstracts, of which 43 articles with a focus on key concepts in adult education theory were used. Key papers were used to formulate structure and additional cross-referenced papers were included where appropriate. Current concepts within adult learning have a lot to offer when considering how to better deliver surgical education and training. Better integration of adult learning theory can be fruitful. Individual teaching surgical units need to rethink their paradigms and consider how each individual can contribute to the education experience. Up skilling courses for trainers can do much to improve the delivery of surgical education. Understanding adult learning concepts and integrating these into day-to-day teaching can be valuable.

Social Ecology of Asthma: Engaging Stakeholders in Integrating Health Behavior Theories and Practice-Based Evidence through Systems Mapping

Science.gov (United States)

Gillen, Emily M.; Hassmiller Lich, Kristen; Yeatts, Karin B.; Hernandez, Michelle L.; Smith, Timothy W.; Lewis, Megan A.

2014-01-01

This article describes a process for integrating health behavior and social science theories with practice-based insights using participatory systems thinking and diagramming methods largely inspired by system dynamics methods. This integration can help close the gap between research and practice in health education and health behavior by offering…

Integrating 3D Printing into an Early Childhood Teacher Preparation Course: Reflections on Practice

Science.gov (United States)

Sullivan, Pamela; McCartney, Holly

2017-01-01

This reflection on practice describes a case study integrating 3D printing into a creativity course for preservice teachers. The theoretical rationale is discussed, and the steps for integration are outlined. Student responses and reflections on the experience provide the basis for our analysis. Examples and resources are provided, as well as a…

Osteoporosis: knowledge and practices among females of reproductive age group

International Nuclear Information System (INIS)

Idrees, Z.; Zakir, U.; Khushdil, A.; Shehzadi, H.

2017-01-01

To assess the knowledge of osteoporosis and evaluation of the practice of osteoporosis preventive measures, among females of reproductive age group. Methodology: A cross-sectional questionnaire based study was undertaken from September 2015 to February 2016 on 174 females (age range 15-49 years) from Military Hospital and Combined Military Hospital, Rawalpindi, Pakistan through non- probability convenient sampling. Females with any metabolic, muscular or diagnosed bone disease were excluded from the study. The self -administered questionnaire consisted of questions regarding basic demographics, knowledge and practice of preventive factors related to osteoporosis. Result: Majority (86.8%) females knew about osteoporosis. 80% considered major risk factor to be low calcium intake. Regarding practices, 44.3% of women practiced daily intake of milk in their diet, 69.5 % females practiced physical activity like walking on daily basis and 65.5% have direct exposure of sunlight but only 12.1% of women used calcium supplements. Conclusion: The study revealed that majority of the women knew about osteoporosis and its risk factors but many of them were not practicing appropriate lifestyle and dietary habits to decrease their risk of osteoporosis. Thus, there is a need of standardized approach to promote healthy behaviors to decrease the risk of osteoporosis before menopause. (author)

Service-learning in nursing: Integrating student learning and ...

African Journals Online (AJOL)

Service-learning in nursing: Integrating student learning and community-based service experience through reflective practice. ... the students' reflective journals, group project reports and a focus-group discussion as the primary data sources.

Integration of a hand-reared chimpanzee (Pan troglodytes) infant into a social group of conspecifics.

Science.gov (United States)

Thunström, Maria; Persson, Tomas; Björklund, Mats

2013-01-01

Rejections of infants among non-human primates occasionally occur in the wild as well as in captive settings. Controlled adoptions of orphans and introductions of individuals into new groups are therefore sometimes necessary in captivity. Consequently, behavioral research on integration procedures and on the acceptance of infants by adoptive mothers is much needed. In this study, the introduction and subsequent adoption were examined in an 18-month-old hand-reared chimpanzee (Pan troglodytes). The infant was introduced into an age/sex-diversified social group of conspecifics at Furuvik Zoo, Gävle, Sweden, and continuous focal data was collected during the final stage of integration, including infant care exhibited by the group members and the infant's secure base behavior. The infant was successfully integrated into the group and engaged in positive social interactions with all group members. An adult primiparous female chimpanzee formed a bond resembling a mother-infant relationship with the infant, which continues to be maintained at publication. However, the female initially showed very limited interest in the infant. It was, in fact, two other younger female group members that exhibited most infant care. The infant's secure base behavior patterns indicate that she adapted well to the new circumstances in the chimpanzee group as the integration progressed. This provides evidence that a final adopter does not necessarily initially show maternal interest and that there can be flexibility in maternal behavior in adult chimpanzee females. Moreover, the methods applied employing gradual familiarization with all the group members and the use of an integration enclosure, may have contributed to a successful result. These findings extend our knowledge of introduction procedures in captivity as well as provide information on foster mother-infant attachment in chimpanzees.

Group theoretical symmetries and generalized Bäcklund transformations for integrable systems

Science.gov (United States)

Haak, Guido

1994-05-01

A notion of symmetry for 1+1-dimensional integrable systems is presented which is consistent with their group theoretic description. It is shown how a group symmetry may be used together with a dynamical reduction to produce new generalizations of the Bäcklund transformation for the Korteweg-de Vries equation to its SL(n,C) generalization. An additional application to the relativistic invariance of the Leznov-Saveliev systems is given.

IT-supported integrated care pathways for diabetes: A compilation and review of good practices.

Science.gov (United States)

Vrijhoef, Hubertus Jm; de Belvis, Antonio Giulio; de la Calle, Matias; de Sabata, Maria Stella; Hauck, Bastian; Montante, Sabrina; Moritz, Annette; Pelizzola, Dario; Saraheimo, Markku; Guldemond, Nick A

2017-06-01

Integrated Care Pathways (ICPs) are a method for the mutual decision-making and organization of care for a well-defined group of patients during a well-defined period. The aim of a care pathway is to enhance the quality of care by improving patient outcomes, promoting patient safety, increasing patient satisfaction, and optimizing the use of resources. To describe this concept, different names are used, e.g. care pathways and integrated care pathways. Modern information technologies (IT) can support ICPs by enabling patient empowerment, better management, and the monitoring of care provided by multidisciplinary teams. This study analyses ICPs across Europe, identifying commonalities and success factors to establish good practices for IT-supported ICPs in diabetes care. A mixed-method approach was applied, combining desk research on 24 projects from the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) with follow-up interviews of project participants, and a non-systematic literature review. We applied a Delphi technique to select process and outcome indicators, derived from different literature sources which were compiled and applied for the identification of successful good practices. Desk research identified sixteen projects featuring IT-supported ICPs, mostly derived from the EIP on AHA, as good practices based on our criteria. Follow-up interviews were then conducted with representatives from 9 of the 16 projects to gather information not publicly available and understand how these projects were meeting the identified criteria. In parallel, the non-systematic literature review of 434 PubMed search results revealed a total of eight relevant projects. On the basis of the selected EIP on AHA project data and non-systematic literature review, no commonalities with regard to defined process or outcome indicators could be identified through our approach. Conversely, the research produced a heterogeneous picture in all aspects of the projects

Integrating mobile technology with routine dietetic practice: the case of myPace for weight management.

Science.gov (United States)

Harricharan, Michelle; Gemen, Raymond; Celemín, Laura Fernández; Fletcher, David; de Looy, Anne E; Wills, Josephine; Barnett, Julie

2015-05-01

The field of Mobile health (mHealth), which includes mobile phone applications (apps), is growing rapidly and has the potential to transform healthcare by increasing its quality and efficiency. The present paper focuses particularly on mobile technology for body weight management, including mobile phone apps for weight loss and the available evidence on their effectiveness. Translation of behaviour change theory into weight management strategies, including integration in mobile technology is also discussed. Moreover, the paper presents and discusses the myPace platform as a case in point. There is little clinical evidence on the effectiveness of currently available mobile phone apps in enabling behaviour change and improving health-related outcomes, including sustained body weight loss. Moreover, it is unclear to what extent these apps have been developed in collaboration with health professionals, such as dietitians, and the extent to which apps draw on and operationalise behaviour change techniques has not been explored. Furthermore, presently weight management apps are not built for use as part of dietetic practice, or indeed healthcare more widely, where face-to-face engagement is fundamental for instituting the building blocks for sustained lifestyle change. myPace is an innovative mobile technology for weight management meant to be embedded into and to enhance dietetic practice. Developed out of systematic, iterative stages of engagement with dietitians and consumers, it is uniquely designed to complement and support the trusted health practitioner-patient relationship. Future mHealth technology would benefit if engagement with health professionals and/or targeted patient groups, and behaviour change theory stood as the basis for technology development. Particularly, integrating technology into routine health care practice, rather than replacing one with the other, could be the way forward.

78 FR 10618 - Re-Establishment of the Advisory Group on Prevention, Health Promotion, and Integrative and...

Science.gov (United States)

2013-02-14

..., Health Promotion, and Integrative and Public Health AGENCY: Office of the Assistant Secretary for Health..., Health Promotion, and Integrative and Public Health (hereafter referred to as ``the Advisory Group... Advisory Group provides recommendations and advice to the National Prevention, Health Promotion, and Public...

The Weight Management Dietetics Practice Group collecting outcomes mentoring program

Science.gov (United States)

The is a newsletter article for the Academy of Nutrition and Dietetics (AND), Weight Management Dietetics Practice Group (WM DPG). The article presents the ‘Collecting Outcomes Mentoring Program’ for 2017 that is managed by the Research Section of the WM DPG. Dietitians in the WM DGP are provided wi...

Developing Integrated Rural Tourism: Actor Practices in the English/Welsh Border

Science.gov (United States)

Saxena, Gunjan; Ilbery, Brian

2010-01-01

This paper examines community attitudes and distinctive practices that shape local responses to integrated rural tourism (IRT) development in the lagging rural region of the English/Welsh border area. The focus is on how actors acquire attributes as a result of their relations with others and how these assumed identities are performed in, by and…

Parenting Practices and Children's Physical Activity: An Integrative Review

Science.gov (United States)

Hutchens, Amy; Lee, Rebecca E.

2018-01-01

The purpose of this integrative review was to analyze the state of science concerning the influence of parenting practices on children's physical activity (PA) levels. A total of 38 studies met the inclusion criteria after full-text review. The body of research is limited in experimental designs with only three studies measuring the influence of…

Path integral for coherent states of the dynamical U2 group and U2/1 supergroup

International Nuclear Information System (INIS)

Kochetov, E.A.

1992-01-01

A part-integral formulation in the representation of coherent states for the unitary U 2 group and U 2/1 supergroup is introduced. U 2 and U 2/1 path integrals are shown to be defined on the coset spaces U 2 /U 1 xU 1 and U 2/1 /U 1/1 xU 1 , respectively. These coset appears as curved classical phase spaces. Partition functions are expressed as path integrals over these spaces. In the case when U 2 and U 2/1 are the dynamical groups, the corresponding path integrals are evaluated with the help of linear fractional transformations that appear as the group (supergroup) action in the coset space (superspace). Possible applications for quantum models are discussed. 9 refs

ATLAS Detector Interface Group

CERN Multimedia

Mapelli, L

Originally organised as a sub-system in the DAQ/EF-1 Prototype Project, the Detector Interface Group (DIG) was an information exchange channel between the Detector systems and the Data Acquisition to provide critical detector information for prototype design and detector integration. After the reorganisation of the Trigger/DAQ Project and of Technical Coordination, the necessity to provide an adequate context for integration of detectors with the Trigger and DAQ lead to organisation of the DIG as one of the activities of Technical Coordination. Such an organisation emphasises the ATLAS wide coordination of the Trigger and DAQ exploitation aspects, which go beyond the domain of the Trigger/DAQ project itself. As part of Technical Coordination, the DIG provides the natural environment for the common work of Trigger/DAQ and detector experts. A DIG forum for a wide discussion of all the detector and Trigger/DAQ integration issues. A more restricted DIG group for the practical organisation and implementation o...

International piping integrity research group (IPIRG) program final report

International Nuclear Information System (INIS)

Schmidt, R.; Wilkowski, G.; Scott, P.; Olsen, R.; Marschall, C.; Vieth, P.; Paul, D.

1992-04-01

This is the final report of the International Piping Integrity Research Group (IPIRG) Programme. The IPIRG Programme was an international group programme managed by the U.S. Nuclear Regulatory Commission and funded by a consortium of organizations from nine nations: Canada, France, Italy, Japan, Sweden, Switzerland, Taiwan, the United Kingdom, and the United states. The objective of the programme was to develop data needed to verify engineering methods for assessing the integrity of nuclear power plant piping that contains circumferential defects. The primary focus was an experimental task that investigated the behaviour of circumferentially flawed piping and piping systems to high-rate loading typical of seismic events. To accomplish these objectives a unique pipe loop test facility was designed and constructed. The pipe system was an expansion loop with over 30 m of 406-mm diameter pipe and five long radius elbows. Five experiments on flawed piping were conducted to failure in this facility with dynamic excitation. The report: provides background information on leak-before-break and flaw evaluation procedures in piping; summarizes the technical results of the programme; gives a relatively detailed assessment of the results from the various pipe fracture experiments and complementary analyses; and, summarizes the advances in the state-of-the-art of pipe fracture technology resulting from the IPIRG Program

International Piping Integrity Research Group (IPIRG) Program. Final report

International Nuclear Information System (INIS)

Wilkowski, G.; Schmidt, R.; Scott, P.

1997-06-01

This is the final report of the International Piping Integrity Research Group (IPIRG) Program. The IPIRG Program was an international group program managed by the U.S. Nuclear Regulatory Commission and funded by a consortium of organizations from nine nations: Canada, France, Italy, Japan, Sweden, Switzerland, Taiwan, the United Kingdom, and the United States. The program objective was to develop data needed to verify engineering methods for assessing the integrity of circumferentially-cracked nuclear power plant piping. The primary focus was an experimental task that investigated the behavior of circumferentially flawed piping systems subjected to high-rate loadings typical of seismic events. To accomplish these objectives a pipe system fabricated as an expansion loop with over 30 meters of 16-inch diameter pipe and five long radius elbows was constructed. Five dynamic, cyclic, flawed piping experiments were conducted using this facility. This report: (1) provides background information on leak-before-break and flaw evaluation procedures for piping, (2) summarizes technical results of the program, (3) gives a relatively detailed assessment of the results from the pipe fracture experiments and complementary analyses, and (4) summarizes advances in the state-of-the-art of pipe fracture technology resulting from the IPIRG program

International Piping Integrity Research Group (IPIRG) Program. Final report

Energy Technology Data Exchange (ETDEWEB)

Wilkowski, G.; Schmidt, R.; Scott, P. [and others

1997-06-01

This is the final report of the International Piping Integrity Research Group (IPIRG) Program. The IPIRG Program was an international group program managed by the U.S. Nuclear Regulatory Commission and funded by a consortium of organizations from nine nations: Canada, France, Italy, Japan, Sweden, Switzerland, Taiwan, the United Kingdom, and the United States. The program objective was to develop data needed to verify engineering methods for assessing the integrity of circumferentially-cracked nuclear power plant piping. The primary focus was an experimental task that investigated the behavior of circumferentially flawed piping systems subjected to high-rate loadings typical of seismic events. To accomplish these objectives a pipe system fabricated as an expansion loop with over 30 meters of 16-inch diameter pipe and five long radius elbows was constructed. Five dynamic, cyclic, flawed piping experiments were conducted using this facility. This report: (1) provides background information on leak-before-break and flaw evaluation procedures for piping, (2) summarizes technical results of the program, (3) gives a relatively detailed assessment of the results from the pipe fracture experiments and complementary analyses, and (4) summarizes advances in the state-of-the-art of pipe fracture technology resulting from the IPIRG program.

Practical considerations for integrating switch mode audio amplifiers and loudspeakers for a higher power efficiency

DEFF Research Database (Denmark)

Poulsen, Søren; Andersen, Michael Andreas E.

2004-01-01

An integration of electrodynamic loudspeakers and switch mode amplifiers has earlier been proposed in [1]. The work presented in this paper is related to the practical aspects of integration of switch mode audio amplifiers and electro dynamic loudspeakers, using the speaker’s voice coil as output...

Tech-Savvy Science Education? Understanding Teacher Pedagogical Practices for Integrating Technology in K-12 Classrooms

Science.gov (United States)

Hechter, Richard; Vermette, Laurie Anne

2014-01-01

This paper examines the technology integration practices of Manitoban K-12 inservice science educators based on the Technological, Pedagogical, and Content knowledge (TPACK) framework. Science teachers (n = 433) completed a 10-item online survey regarding pedagogical beliefs about technology integration, types of technology used, and how often…

EDUCATION AS THE PRACTICE OF FREEDOM AND THE PROSPECT OF INTEGRAL EDUCATION IN HIGHER EDUCATION

Directory of Open Access Journals (Sweden)

João Ricardo Silva

2018-03-01

Full Text Available In this article we discuss the idea of Education as a Freedom Practice, taking into account an emancipatory perspective of Integral Education for Higher Education. Thus, we reflect on an integral education in opposition to the hegemonic and simplistic version of an education for the market and even in opposition to that which means absorption of superior objective knowledge. The methodology used was the bibliographical research, where we sought a dynamic synthesis between Marxist authors and the colonial / postcolonial discussion. The theoretical horizon was a dialectical historical materialism, but without neglecting that knowledge is beyond the Western gaze and that science is not the only logic of valid knowledge. Given that knowledge is not only a reflection of reality, but the interpretation of this, the search for an integral education is also the search for inter-knowledge. This leads us to deacralize the university and to transform it into a place of building democratic relations. Keywords: Integral Education. Practices of freedom. Higher Education.

The degree of integration of non-dispensing pharmacists in primary care practice and the impact on health outcomes: A systematic review.

Science.gov (United States)

Hazen, Ankie C M; de Bont, Antoinette A; Boelman, Lia; Zwart, Dorien L M; de Gier, Johan J; de Wit, Niek J; Bouvy, Marcel L

2018-03-01

A non-dispensing pharmacist conducts clinical pharmacy services aimed at optimizing patients individual pharmacotherapy. Embedding a non-dispensing pharmacist in primary care practice enables collaboration, probably enhancing patient care. The degree of integration of non-dispensing pharmacists into multidisciplinary health care teams varies strongly between settings. The degree of integration may be a determinant for its success. This study investigates how the degree of integration of a non-dispensing pharmacist impacts medication related health outcomes in primary care. In this literature review we searched two electronic databases and the reference list of published literature reviews for studies about clinical pharmacy services performed by non-dispensing pharmacists physically co-located in primary care practice. We assessed the degree of integration via key dimensions of integration based on the conceptual framework of Walshe and Smith. We included English language studies of any design that had a control group or baseline comparison published from 1966 to June 2016. Descriptive statistics were used to correlate the degree of integration to health outcomes. The analysis was stratified for disease-specific and patient-centered clinical pharmacy services. Eighty-nine health outcomes in 60 comparative studies contributed to the analysis. The accumulated evidence from these studies shows no impact of the degree of integration of non-dispensing pharmacists on health outcomes. For disease specific clinical pharmacy services the percentage of improved health outcomes for none, partial and fully integrated NDPs is respectively 75%, 63% and 59%. For patient-centered clinical pharmacy services the percentage of improved health outcomes for none, partial and fully integrated NDPs is respectively 55%, 57% and 70%. Full integration adds value to patient-centered clinical pharmacy services, but not to disease-specific clinical pharmacy services. To obtain maximum benefits

Drama and Role Playing in Teaching Practice: The Role of Group Works

Science.gov (United States)

Çerkez, Yagmur; Altinay, Zehra; Altinay, Fahriye; Bashirova, Elnara

2012-01-01

The research study aims to explore the essence of group work in drama and role playing for teaching practice inline with the nature of collaborative learning process. This research study has qualitative nature by capturing experiences of volunteer ninety pre-service teachers about group works, gained skills from drama and role playing in their…

Modern tendencies in psychotherapy: The specialisation of practice and knowledge integration

Directory of Open Access Journals (Sweden)

Gavrilov-Jerković Vesna

2003-01-01

Full Text Available The paper considers chronological and theoretical development of psychotherapy with the aim of formulating psychotherapeutic paradigm as an expression of scientific improvement in this field, as well as methodological and empirical assumption of integrative models in the psychotherapy. Special attention is paid to the phenomena that have characterised the field of psychotherapy in recent time, such as, on one hand, the emphasis on the increased need for the empirical evaluation of practice and accompanied trend regarding specialisation, and, on the other hand, the strengthening of the trend towards defining and researching general change mechanisms from wider, more integrative and transtheoretical perspective.

Friends forever? The Role of the Visegrad Group and European Integration

Directory of Open Access Journals (Sweden)

Schmidt Andrea

2016-12-01

Full Text Available The Visegrad Group celebrated its 25th anniversary in February 2016. Established as an initiative of three statesmen from the Central and Eastern European (CEE region, this cooperation has experienced booms and crises. The aim of this paper is to analyse the function of this regional integration in the years following the end of bipolar system as Visegrad Group members headed down the road to Euro-Atlantic integration. To this end, I apply different theoretical approaches and attempt to explain the influence of key former politicians as well as new scenarios for the Visegrad Group’s position in the European Union. This analysis also covers the latest foreign policy changes and challenges facing CEE due to the involvement of a wider region that creates a counter-balance to the core EU. Statistical data and official documents from the Visegrad Group’s website strengthen these findings.

Integration of Formal Job Hazard Analysis and ALARA Work Practice

International Nuclear Information System (INIS)

NELSEN, D.P.

2002-01-01

ALARA work practices have traditionally centered on reducing radiological exposure and controlling contamination. As such, ALARA policies and procedures are not well suited to a wide range of chemical and human health issues. Assessing relative risk, identifying appropriate engineering/administrative controls and selecting proper Personal Protective Equipment (PPE) for non nuclear work activities extends beyond the limitations of traditional ALARA programs. Forging a comprehensive safety management program in today's (2002) work environment requires a disciplined dialog between health and safety professionals (e.g. safety, engineering, environmental, quality assurance, industrial hygiene, ALARA, etc.) and personnel working in the field. Integrating organizational priorities, maintaining effective pre-planning of work and supporting a team-based approach to safety management represents today's hallmark of safety excellence. Relying on the mandates of any single safety program does not provide industrial hygiene with the tools necessary to implement an integrated safety program. The establishment of tools and processes capable of sustaining a comprehensive safety program represents a key responsibility of industrial hygiene. Fluor Hanford has built integrated safety management around three programmatic attributes: (1) Integration of radiological, chemical and ergonomic issues under a single program. (2) Continuous improvement in routine communications among work planning/scheduling, job execution and management. (3) Rapid response to changing work conditions, formalized work planning and integrated worker involvement

Teen Perceptions of the Promotion of Safer Sexual Practices: A Focus Group Study

Science.gov (United States)

Herrman, Judith W.; Kelley, Andrea; Haigh, Katherine M.

2017-01-01

Teens' own thoughts on fostering safe sexual practice are important perspectives in promoting adolescent sexual health yet are relatively absent in the literature. This focus group study explored teens' perceptions about the supports and challenges that exist as teens strive to engage in healthy sexual practices. Seventy-five teens participated in…

Capturing the Integration of Practice-Based Learning with Beliefs, Values, and Attitudes using Modified Concept Mapping.

Science.gov (United States)

Mcnaughton, Susan; Barrow, Mark; Bagg, Warwick; Frielick, Stanley

2016-01-01

Practice-based learning integrates the cognitive, psychomotor, and affective domains and is influenced by students' beliefs, values, and attitudes. Concept mapping has been shown to effectively demonstrate students' changing concepts and knowledge structures. This article discusses how concept mapping was modified to capture students' perceptions of the connections between the domains of thinking and knowing, emotions, behavior, attitudes, values, and beliefs and the specific experiences related to these, over a period of eight months of practice-based clinical learning. The findings demonstrate that while some limitations exist, modified concept mapping is a manageable way to gather rich data about students' perceptions of their clinical practice experiences. These findings also highlight the strong integrating influence of beliefs and values on other areas of practice, suggesting that these need to be attended to as part of a student's educational program.

Integrating research into clinical internship training bridging the science/practice gap in pediatric psychology.

Science.gov (United States)

McQuaid, Elizabeth L; Spirito, Anthony

2012-03-01

Existing literature highlights a critical gap between science and practice in clinical psychology. The internship year is a "capstone experience"; training in methods of scientific evaluation should be integrated with the development of advanced clinical competencies. We provide a rationale for continued exposure to research during the clinical internship year, including, (a) critical examination and integration of the literature regarding evidence-based treatment and assessment, (b) participation in faculty-based and independent research, and (c) orientation to the science and strategy of grantsmanship. Participation in research provides exposure to new empirical models and can foster the development of applied research questions. Orientation to grantsmanship can yield an initial sense of the "business of science." Internship provides an important opportunity to examine the challenges to integrating the clinical evidence base into professional practice; for that reason, providing research exposure on internship is an important strategy in training the next generation of pediatric psychologists.

Integrating Research Into Clinical Internship Training Bridging the Science/Practice Gap in Pediatric Psychology

Science.gov (United States)

Spirito, Anthony

2012-01-01

Existing literature highlights a critical gap between science and practice in clinical psychology. The internship year is a “capstone experience”; training in methods of scientific evaluation should be integrated with the development of advanced clinical competencies. We provide a rationale for continued exposure to research during the clinical internship year, including, (a) critical examination and integration of the literature regarding evidence-based treatment and assessment, (b) participation in faculty-based and independent research, and (c) orientation to the science and strategy of grantsmanship. Participation in research provides exposure to new empirical models and can foster the development of applied research questions. Orientation to grantsmanship can yield an initial sense of the “business of science.” Internship provides an important opportunity to examine the challenges to integrating the clinical evidence base into professional practice; for that reason, providing research exposure on internship is an important strategy in training the next generation of pediatric psychologists. PMID:22286345

TEACHER TRAINING IN COMMUNITIES OF PRACTICE: THE CASE OF A GROUP OF PRE-SERVICE CHEMISTRY TEACHERS

OpenAIRE

Santos, Valéria C.; Arroio, Agnaldo

2015-01-01

This work deals with communities of practice and their contribution to pre-service teacher training. A group of eight pre-service chemistry teachers was accompanied during their participation in the PIBID program. Based on their interaction in planning teaching activities, the group was characterized as a community of practice. For this characterization the three dimensions of communities of practice were observed: mutual engagement, joint enterprise and shared repertoire. The results showed ...

Care Model Design for E-Health: Integration of Point-of-Care Testing at Dutch General Practices

Directory of Open Access Journals (Sweden)

Bart Verhees

2017-12-01

Full Text Available Point-of-care testing (POCT—laboratory tests performed with new mobile devices and online technologies outside of the central laboratory—is rapidly outpacing the traditional laboratory test market, growing at a rate of 12 to 15% each year. POCT impacts the diagnostic process of care providers by yielding high efficiency benefits in terms of turnaround time and related quality improvements in the reduction of errors. However, the implementation of this disruptive eHealth technology requires the integration and transformation of diagnostic services across the boundaries of healthcare organizations. Research has revealed both advantages and barriers of POCT implementations, yet to date, there is no business model for the integration of POCT within general practice. The aim of this article is to contribute with a design for a care model that enables the integration of POCT in primary healthcare. In this research, we used a design modelling toolkit for data collection at five general practices. Through an iterative design process, we modelled the actors and value transactions, and designed an optimized care model for the dynamic integration of POCTs into the GP’s network of care delivery. The care model design will have a direct bearing on improving the integration of POCT through the connectivity and norm guidelines between the general practice, the POC technology, and the diagnostic centre.

Care Model Design for E-Health: Integration of Point-of-Care Testing at Dutch General Practices.

Science.gov (United States)

Verhees, Bart; van Kuijk, Kees; Simonse, Lianne

2017-12-21

Point-of-care testing (POCT)-laboratory tests performed with new mobile devices and online technologies outside of the central laboratory-is rapidly outpacing the traditional laboratory test market, growing at a rate of 12 to 15% each year. POCT impacts the diagnostic process of care providers by yielding high efficiency benefits in terms of turnaround time and related quality improvements in the reduction of errors. However, the implementation of this disruptive eHealth technology requires the integration and transformation of diagnostic services across the boundaries of healthcare organizations. Research has revealed both advantages and barriers of POCT implementations, yet to date, there is no business model for the integration of POCT within general practice. The aim of this article is to contribute with a design for a care model that enables the integration of POCT in primary healthcare. In this research, we used a design modelling toolkit for data collection at five general practices. Through an iterative design process, we modelled the actors and value transactions, and designed an optimized care model for the dynamic integration of POCTs into the GP's network of care delivery. The care model design will have a direct bearing on improving the integration of POCT through the connectivity and norm guidelines between the general practice, the POC technology, and the diagnostic centre.

Integrating CHWs as part of the team leading diabetes group visits: A randomized controlled feasibility study

Science.gov (United States)

The purpose of the study was to evaluate the feasibility of integrating Community Health Workers (CHWs) as part of the team leading diabetes group visits. This was a randomized controlled study that integrated CHWs as part of the team leading diabetes group visits for low-income Hispanic adults (n=5...

Will Large DSO-Managed Group Practices Be the Predominant Setting for Oral Health Care by 2025? Two Viewpoints: Viewpoint 1: Large DSO-Managed Group Practices Will Be the Setting in Which the Majority of Oral Health Care Is Delivered by 2025 and Viewpoint 2: Increases in DSO-Managed Group Practices Will Be Offset by Models Allowing Dentists to Retain the Independence and Freedom of a Traditional Practice.

Science.gov (United States)

Cole, James R; Dodge, William W; Findley, John S; Young, Stephen K; Horn, Bruce D; Kalkwarf, Kenneth L; Martin, Max M; Winder, Ronald L

2015-05-01

This Point/Counterpoint article discusses the transformation of dental practice from the traditional solo/small-group (partnership) model of the 1900s to large Dental Support Organizations (DSO) that support affiliated dental practices by providing nonclinical functions such as, but not limited to, accounting, human resources, marketing, and legal and practice management. Many feel that DSO-managed group practices (DMGPs) with employed providers will become the setting in which the majority of oral health care will be delivered in the future. Viewpoint 1 asserts that the traditional dental practice patterns of the past are shifting as many younger dentists gravitate toward employed positions in large group practices or the public sector. Although educational debt is relevant in predicting graduates' practice choices, other variables such as gender, race, and work-life balance play critical roles as well. Societal characteristics demonstrated by aging Gen Xers and those in the Millennial generation blend seamlessly with the opportunities DMGPs offer their employees. Viewpoint 2 contends the traditional model of dental care delivery-allowing entrepreneurial practitioners to make decisions in an autonomous setting-is changing but not to the degree nor as rapidly as Viewpoint 1 professes. Millennials entering the dental profession, with characteristics universally attributed to their generation, see value in the independence and flexibility that a traditional practice allows. Although DMGPs provide dentists one option for practice, several alternative delivery models offer current dentists and future dental school graduates many of the advantages of DMGPs while allowing them to maintain the independence and freedom a traditional practice provides.

Some Practical Issues in the Design and Implementation of Group Communication Services

National Research Council Canada - National Science Library

Mishra, Shivakant

2000-01-01

The main objective of the proposed research was to investigate four important practical issues in the understanding, design, and implementation of group communication services. These issues were (1) Performance...

Learner Behaviour in a MOOC Practice-Oriented Course: In Empirical Study Integrating TAM and TPB

Science.gov (United States)

Yang, Hsi-Hsun; Su, Chung-Ho

2017-01-01

Few practice-oriented courses are currently integrated into online learning platforms, such as OpenCourseWare, Khan Academy, and Massive Open Online Courses (MOOCs). It is worthwhile to explore how learners respond to information technology and new teaching methods when practice-oriented course are placed online. Therefore, this study probes…

Leadership emergence over time in short-lived groups: Integrating expectations states theory with temporal person-perception and self-serving bias.

Science.gov (United States)

Kalish, Yuval; Luria, Gil

2016-10-01

Research into leadership emergence typically focuses on the attributes of the emergent leader. By considering also the attributes of perceivers and the passage of time, we develop a more complete theory of leadership emergence in short-lived groups. Using expectation states theory as an overarching theoretical framework, and integrating it with the surface- and deep-level diversity literature and with theories of self-serving biases, we examine the predictors of leadership emergence in short timeframes. We conduct a field study in a military assessment boot camp (a pilot study, n = 60; and a main study, n = 89). We use cross-sectional and longitudinal exponential random graph models to analyze data on participants' abilities and on their perceptions of who, in their respective groups, were "leaders." We find that the criteria by which people perceive leadership in others change over time, from easily noticeable attributes to covert leadership-relevant attributes, and that people also rely on leadership-relevant attributes that they possess at high levels to inform their perceptions of leadership in others. The integration of expectation states theory, attribute salience over time and theories of self-serving bias is needed for a full understanding of leadership emergence in groups, because perceivers' own abilities are instrumental in shaping their perceptions of emergent leadership over time. Theoretical and practical implications are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Exploring the perceived usefulness of practical food groups in day treatment for individuals with eating disorders.

Science.gov (United States)

Biddiscombe, Rachel J; Scanlan, Justin Newton; Ross, Jessica; Horsfield, Sarah; Aradas, Jessica; Hart, Susan

2018-04-01

Recovery from eating disorders is a challenging process. Emerging literature suggests that occupational therapists may provide a useful contribution in delivering purposeful eating-related interventions as a potential treatment to support sustained cognitive and behavioural changes for individuals with eating disorders. This study aimed to evaluate participants' perceptions of the contribution of occupational therapy practical food groups (food based outings and cooking groups) in supporting their functional recovery. Individuals attended practical food groups as part of standard treatment at an outpatient eating disorders day program. Ninety-nine participants completed questionnaires at discharge and up to three follow-up points (6, 12 and 24 months). Questions related to practical food groups were analysed, exploring participants' experiences and perceived usefulness of groups using rating-scale and open-ended questions. Open-ended responses were analysed using thematic analysis. Descriptive statistics were calculated for responses to rating-scale questions. At discharge, participants rated the importance and usefulness of practical food groups as high (4.73 and 4.43 on 5-point scales, respectively), but tended to rate their enjoyment of the groups lower (3.50 on a 5-point scale). Some skill transfer was typically reported by participants at discharge (3.92 on a 5-point scale). One core theme, 'success through participation', emerged from qualitative comments. Six subthemes were also identified: helpful components of practical food groups; perceived benefit of exposure; impact of applying cognitive and behavioural skills; challenges affecting participation; facilitating adaptation; and influence of eating disorders on challenging feared foods. This study highlights that participation in practical food groups was perceived as useful in assisting individuals to improve eating behaviours and, in some circumstances, transfer these skills into their lives outside of

Consumer-sponsored prepaid group practice: restructuring the health care system.

Science.gov (United States)

Warden, G L

1984-01-01

The traditional separation of health care delivery and financing systems is breaking down as various new types of health care facilities are established and as payment continues to be a major concern. Group Health Cooperative of Puget Sound (GHC) was organized as a prepaid group practice system responsive to consumers. Costs, methods of payment and delivery of care are interrelated and are all influenced by consumer ownership. GHC has been refining its benefit programs since 1945. Strategies for controlling use and costs focus on improved provider management and on flexibility. This article explains how the structure of GHC benefits the consumer.

Patient safety and infection control: bases for curricular integration.

Science.gov (United States)

Silva, Andréa Mara Bernardes da; Bim, Lucas Lazarini; Bim, Felipe Lazarini; Sousa, Alvaro Francisco Lopes; Domingues, Pedro Castania Amadio; Nicolussi, Adriana Cristina; Andrade, Denise de

2018-05-01

To analyze curricular integration between teaching of patient safety and good infection prevention and control practices. Integrative review, designed to answer the question: "How does curricular integration of content about 'patient safety teaching' and content about 'infection prevention and control practices' occur in undergraduate courses in the health field?". The following databases were searched for primary studies: CINAHL, LILACS, ScienceDirect, Web of Science, Scopus, Europe PMC and MEDLINE. The final sample consisted of 13 studies. After content analysis, primary studies were grouped into two subject categories: "Innovative teaching practices" and "Curricular evaluation. Patient safety related to infection prevention and control practices is present in the curriculum of health undergraduate courses, but is not coordinated with other themes, is taught sporadically, and focuses mainly on hand hygiene.

The Mastery Matrix for Integration Praxis: The development of a rubric for integration practice in addressing weight-related public health problems.

Science.gov (United States)

Berge, Jerica M; Adamek, Margaret; Caspi, Caitlin; Grannon, Katherine Y; Loth, Katie A; Trofholz, Amanda; Nanney, Marilyn S

2018-06-01

In response to the limitations of siloed weight-related intervention approaches, scholars have called for greater integration that is intentional, strategic, and thoughtful between researchers, health care clinicians, community members, and policy makers as a way to more effectively address weight and weight-related (e.g., obesity, diabetes, cardiovascular disease, cancer) public health problems. The Mastery Matrix for Integration Praxis was developed by the Healthy Eating and Activity across the Lifespan (HEAL) team in 2017 to advance the science and praxis of integration across the domains of research, clinical practice, community, and policy to address weight-related public health problems. Integrator functions were identified and developmental stages were created to generate a rubric for measuring mastery of integration. Creating a means to systematically define and evaluate integration praxis and expertise will allow for more individuals and teams to master integration in order to work towards promoting a culture of health. Copyright © 2018 Elsevier Inc. All rights reserved.

New approach to the adjustment of group cross sections fitting integral measurements - 2

International Nuclear Information System (INIS)

Chao, Y.A.

1980-01-01

The method developed in the first paper concerning group cross sections fitting integral measurements is generalized to cover the case when the source of the extracted negligence discrepancy cannot be identified and the theoretical relation between the integral and differential measurements is also subject to uncertainty. The question of how to divide in such a case the negligence discrepancy between the integral and differential data is resolved. Application to a specific problem with real experimental data is shown as a demonstration of the method. 4 refs

SPIRIT: Systematic Planning of Intelligent Reuse of Integrated Clinical Routine Data. A Conceptual Best-practice Framework and Procedure Model.

Science.gov (United States)

Hackl, W O; Ammenwerth, E

2016-01-01

Secondary use of clinical routine data is receiving an increasing amount of attention in biomedicine and healthcare. However, building and analysing integrated clinical routine data repositories are nontrivial, challenging tasks. As in most evolving fields, recognized standards, well-proven methodological frameworks, or accurately described best-practice approaches for the systematic planning of solutions for secondary use of routine medical record data are missing. We propose a conceptual best-practice framework and procedure model for the systematic planning of intelligent reuse of integrated clinical routine data (SPIRIT). SPIRIT was developed based on a broad literature overview and further refined in two case studies with different kinds of clinical routine data, including process-oriented nursing data from a large hospital group and high-volume multimodal clinical data from a neurologic intensive care unit. SPIRIT aims at tailoring secondary use solutions to specific needs of single departments without losing sight of the institution as a whole. It provides a general conceptual best-practice framework consisting of three parts: First, a secondary use strategy for the whole organization is determined. Second, comprehensive analyses are conducted from two different viewpoints to define the requirements regarding a clinical routine data reuse solution at the system level from the data perspective (BOTTOM UP) and at the strategic level from the future users perspective (TOP DOWN). An obligatory clinical context analysis (IN BETWEEN) facilitates refinement, combination, and integration of the different requirements. The third part of SPIRIT is dedicated to implementation, which comprises design and realization of clinical data integration and management as well as data analysis solutions. The SPIRIT framework is intended to be used to systematically plan the intelligent reuse of clinical routine data for multiple purposes, which often was not intended when the

Practices in NASA's EOSDIS to Promote Open Data and Research Integrity

Science.gov (United States)

Behnke, J.; Ramapriyan, H.

2017-12-01

The purpose of this paper is to highlight the key practices adopted by NASA in its Earth Observing System Data and Information System (EOSDIS) to promote and facilitate open data and research integrity. EOSDIS is the system that manages most of NASA's Earth science data from various sources - satellites, aircraft, field campaigns and some research projects. Since its inception in 1990 as a part of the Earth Observing System (EOS) Program, EOSDIS has been following NASA's free and open data and information policy, whereby data are shared with all users on a non-discriminatory basis and are provided at no cost. To ensure that the data are discoverable and accessible to the user community, NASA follows an evolutionary development approach, whereby the latest technologies that can be practically adopted are infused into EOSDIS. This results in continuous improvements in system capabilities such that technologies that users are accustomed to in other environments are brought to bear in their access to NASA's Earth observation data. Mechanisms have existed for ensuring that the data products offered by EOSDIS are vetted by the community before they are released. Information about data products such as Algorithm Theoretical Basis Documents and quality assessments are openly available with the products. The EOSDIS Distributed Active Archive Centers (DAACs) work with the science teams responsible for product generation to assist with proper use of metadata. The DAACs have knowledgeable staff to answer users' questions and have access to scientific experts as needed. Citation of data products in scientific papers are facilitated by assignment of Digital Object Identifiers (DOIs) - at present, over 50% of data products in EOSDIS have been assigned DOIs. NASA gathers and publishes citation metrics for the datasets offered by the DAACs. Through its Software and Services Citations Working Group, NASA is currently investigating broadening DOI assignments to promote greater

Towards the integration of mental practice in rehabilitation programs. A critical review

Directory of Open Access Journals (Sweden)

Francine eMalouin

2013-09-01

Full Text Available Many clinical studies have investigated the use of mental practice (MP through motor imagery (MI to enhance functional recovery of patients with diverse physical disabilities. Although beneficial effects have been generally reported for training motor functions in persons with chronic stroke (e.g. reaching, writing, walking, attempts to integrate MP within rehabilitation programs have been met with mitigated results. These findings have stirred further questioning about the value of MP in neurological rehabilitation. In fact, despite abundant systematic reviews, which customarily focused on the methodological merits of selected studies, several questions about factors underlying observed effects remain to be addressed. This review discusses these issues in an attempt to identify factors likely to hamper the integration of MP within rehabilitation programs. First, the rationale underlying the use of MP for training motor function is briefly reviewed. Second, three modes of MI delivery are proposed based on the analysis of the research protocols from 27 studies in persons with stroke and Parkinson’s disease. Third, for each mode of MI delivery, a general description of MI training is provided. Fourth, the review discusses factors influencing MI training outcomes such as: the adherence to MI training, the amount of training and the interaction between physical and mental rehearsal; the use of relaxation, the selection of reliable, valid and sensitive outcome measures, the heterogeneity of the patient groups, the selection of patients and the mental rehearsal procedures. To conclude, the review proposes a framework for integrating MP in rehabilitation programs and suggests research targets for steering the implementation of MP in the early stages of the rehabilitation process. The challenge has now shifted towards the demonstration that MI training can enhance the effects of regular therapy in persons with subacute stroke during the period of

Integrating CHWs as Part of the Team Leading Diabetes Group Visits: A Randomized Controlled Feasibility Study.

Science.gov (United States)

Vaughan, Elizabeth M; Johnston, Craig A; Cardenas, Victor J; Moreno, Jennette P; Foreyt, John P

2017-12-01

Purpose The purpose of the study was to evaluate the feasibility of integrating Community Health Workers (CHWs) as part of the team leading diabetes group visits. Methods This was a randomized controlled study that integrated CHWs as part of the team leading diabetes group visits for low-income Hispanic adults (n = 50). Group visits met for 3 hours each month for a 6-month duration. Main measures included baseline and 6-month clinical outcomes (ie, A1C, lipids), concordance with 8 standard of care guidelines (ie, screens for cervical, breast, and colon cancer) from the US Preventive Task Force and American Diabetes Association, and participant acceptability. Results Compared to control participants, the intervention group resulted in significantly better clinical outcomes or guideline concordance for the following areas: target A1C levels, retinal eye exams, diabetes foot exams, mammograms, and urine microalbumin. Significantly more individuals in the control group gained weight, whereas a greater number of participants in the intervention group lost weight. Intervention participants found the group visits highly acceptable. Conclusions Integrating CHWs as part a comprehensive diabetes group visit program is a feasible and effective system-level intervention to improve glycemic control and achieve guideline concordance.

A knowledge transfer scheme to bridge the gap between science and practice: an integration of existing research frameworks into a tool for practice.

Science.gov (United States)

Verhagen, Evert; Voogt, Nelly; Bruinsma, Anja; Finch, Caroline F

2014-04-01

Evidence of effectiveness does not equal successful implementation. To progress the field, practical tools are needed to bridge the gap between research and practice and to truly unite effectiveness and implementation evidence. This paper describes the Knowledge Transfer Scheme integrating existing implementation research frameworks into a tool which has been developed specifically to bridge the gap between knowledge derived from research on the one side and evidence-based usable information and tools for practice on the other.

The perceived impact of the group practice model on enhancing interpersonal skills of predoctoral dental students.

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Errante, Margaret R; Gill, Gurjinder S; Rodriguez, Tobias E

2018-01-01

The purpose of this study was to assess if a clinical group practice model has an impact on enhancing the interpersonal skills of predoctoral dental students, what factors may influence the development of these skills, and what, if any, are innovative and technological solutions that can potentially influence interpersonal skills in predoctoral dental students. This study surveyed the faculty responsible for teaching the dental students in a recently developed group practice model. Out of 18 eligible group practice leaders at one US dental school, 17 respondents (94.4%) completed the survey. In addition, this study asked the faculty to provide qualitative response and recommendations to improve interpersonal skills. Based on the feedback, a focus group was conducted to explore opportunities to further enhance the skills. The results of the study suggest that the group practice model has a positive and distinct impact on the development of overall interpersonal skills for students. Further research suggests that the greatest impacted areas of personal development are critical thinking skills and teamwork. However, as a way to make the model more effectual, most faculty suggested the need for additional time, for both students and faculty. To some extent, using technology and innovative teaching pedagogies could potentially address the challenge of limited time. Based on the results of the survey, one may conclude that with adequate design and conditions, the group practice model can have a positive effect on the interpersonal skills of its students.

The perceived impact of the group practice model on enhancing interpersonal skills of predoctoral dental students

Science.gov (United States)

Errante, Margaret R; Gill, Gurjinder S; Rodriguez, Tobias E

2018-01-01

Purpose The purpose of this study was to assess if a clinical group practice model has an impact on enhancing the interpersonal skills of predoctoral dental students, what factors may influence the development of these skills, and what, if any, are innovative and technological solutions that can potentially influence interpersonal skills in predoctoral dental students. Methods This study surveyed the faculty responsible for teaching the dental students in a recently developed group practice model. Out of 18 eligible group practice leaders at one US dental school, 17 respondents (94.4%) completed the survey. In addition, this study asked the faculty to provide qualitative response and recommendations to improve interpersonal skills. Based on the feedback, a focus group was conducted to explore opportunities to further enhance the skills. Results The results of the study suggest that the group practice model has a positive and distinct impact on the development of overall interpersonal skills for students. Further research suggests that the greatest impacted areas of personal development are critical thinking skills and teamwork. However, as a way to make the model more effectual, most faculty suggested the need for additional time, for both students and faculty. To some extent, using technology and innovative teaching pedagogies could potentially address the challenge of limited time. Conclusion Based on the results of the survey, one may conclude that with adequate design and conditions, the group practice model can have a positive effect on the interpersonal skills of its students. PMID:29720884

AN INTEGRATIVE GROUP PSYCHOTHERAPY PROGRAM FOR CHILDREN. THE WIZARDING SCHOOL

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Oana Maria Popescu

2012-02-01

Full Text Available One of the most important tendencies in child psychotherapy is the integration of various psychotherapeutic approaches and technical interventions belonging to different orientations. Based on the Harry Potter stories, the „Wizarding School” structured group therapy program is a 12-step integratively oriented program applicable in personal development, individual and group therapy for children aged 6 to 13 (at present being adapted for adult psychotherapy. The program takes place within a fairy tale, being therefore a type of informal hypnotic trance. The interventions are drawn from the lessons described in Harry Potter’s story at Hogwarts, based on the fundamental principles of child psychotherapy and including elements of play therapy, art therapy, hypnotherapy, cognitive- behavioural therapy, transactional analysis, supportive therapy, family therapy and person centred therapy. From a theoretical point of view the program is based on elements from a number of psychotherapeutic approaches, the main concept being that we need to create a therapeutic myth that is acceptable to a child. The program is not suitable for children with structural deficits, who have difficulties in making the difference between fantasy and reality.

The context of oncology nursing practice: an integrative review.

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Bakker, Debra; Strickland, Judith; Macdonald, Catherine; Butler, Lorna; Fitch, Margaret; Olson, Karin; Cummings, Greta

2013-01-01

In oncology, where the number of patients is increasing, there is a need to sustain a quality oncology nursing workforce. Knowledge of the context of oncology nursing can provide information about how to create practice environments that will attract and retain specialized oncology nurses. The aims of this review were to determine the extent and quality of the literature about the context of oncology nursing, explicate how "context" has been described as the environment where oncology nursing takes place, and delineate forces that shape the oncology practice environment. The integrative review involved identifying the problem, conducting a structured literature search, appraising the quality of data, extracting and analyzing data, and synthesizing and presenting the findings. Themes identified from 29 articles reflected the surroundings or background (structural environment, world of cancer care), and the conditions and circumstances (organizational climate, nature of oncology nurses' work, and interactions and relationships) of oncology nursing practice settings. The context of oncology nursing was similar yet different from other nursing contexts. The uniqueness was attributed to the dynamic and complex world of cancer control and the personal growth that is gained from the intense therapeutic relationships established with cancer patients and their families. The context of healthcare practice has been linked with patient, professional, or system outcomes. To achieve quality cancer care, decision makers need to understand the contextual features and forces that can be modified to improve the oncology work environment for nurses, other providers, and patients.

Owning Up to Negative Ingroup Traits: How Personal Autonomy Promotes the Integration of Group Identity.

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Legault, Lisa; Weinstein, Netta; Mitchell, Jahlil; Inzlicht, Michael; Pyke, Kristen; Upal, Afzal

2017-10-01

Our experiences, attributes, and behaviors are diverse, inconsistent, and often negative. Consequently, our capacity to assimilate divergent experiences-particularly negative aspects-is important to the development of a unified self. Whereas this process of integration has received attention at the level of personal identity, it has not been assessed at the level of group identity. We examined the mechanisms involved in integrating positive and negative ingroup identities, as well as related outcomes. In three experiments, participants (N = 332) high and low in autonomy identified either positive or negative aspects of their ingroup and then indicated the extent to which they integrated the attribute. Those high in personal autonomy integrated both positive and negative identities, whereas those low in autonomy acknowledged only positive identities. Study 2 showed that, regardless of identity valence, those high in autonomy felt satisfied and close with their group. Conversely, those low in autonomy felt less close and more dissatisfied with their group after reflecting on negative identities. Finally, reflecting on a negative identity reduced prejudice, but only for those high in autonomy. Owning up to negative group traits is facilitated by autonomy and demonstrates benefits for ingroup and intergroup processes. © 2016 Wiley Periodicals, Inc.

Integrated management system best practices in radioecological laboratories

International Nuclear Information System (INIS)

Carvalho, Claudia Aparecida Zerbinatti de

2009-01-01

This paper presents a Master dissertation advancements with the target of studying the best practices, in order to give support to an IMS conceptual model ?Integrated Management System (quality, environment, work safety and health), applied to radioecological laboratories. The planning of the proposed research comprises the following stages: first stage - the bibliographic and documental survey in IMS; a survey and study of the applied standards (QMS NBR ISO 9000 (2005), NBR ISO 9001 (2008), NBR ISO 9004 (2000), EMS 14001(2004) and OHSMS OHSAS 18001 (2007) and OHSAS 18002 (2008)); identification and characterization in radioecological laboratories processes; a methodological study of better practices and benchmarking is carried out. In the second stage of the research, the development of a case study is forecast (qualitative research, with electronic questionnaires and personal interviews, when possible), preceded by a survey and selection of international and national radioecological laboratories to be studied and, in sequence, these laboratories should be contacted and agree to participate in the research; in a third stage, the construction of a matrix of better practices, which incur in the results able to subside an IMS conceptual model proposition for radioecological laboratories; the fourth and last stage of the research comprises the construction of a conceptual proposal of an IMS structure for radioecological laboratories. The first stage of the research results are presented concisely, as well as a preliminary selection of laboratories to be studied. (author)

Integrated management system best practices in radioecological laboratories

Energy Technology Data Exchange (ETDEWEB)

Carvalho, Claudia Aparecida Zerbinatti de [Centro Tecnologico da Marinha em Sao Paulo (CTMSP), SP (Brazil). Dept. da Qualidade], e-mail: clau.zerbina@gmail.com; Zouain, Desiree Moraes [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)], e-mail: dmzouain@ipen.br

2009-07-01

This paper presents a Master dissertation advancements with the target of studying the best practices, in order to give support to an IMS conceptual model ?Integrated Management System (quality, environment, work safety and health), applied to radioecological laboratories. The planning of the proposed research comprises the following stages: first stage - the bibliographic and documental survey in IMS; a survey and study of the applied standards (QMS NBR ISO 9000 (2005), NBR ISO 9001 (2008), NBR ISO 9004 (2000), EMS 14001(2004) and OHSMS OHSAS 18001 (2007) and OHSAS 18002 (2008)); identification and characterization in radioecological laboratories processes; a methodological study of better practices and benchmarking is carried out. In the second stage of the research, the development of a case study is forecast (qualitative research, with electronic questionnaires and personal interviews, when possible), preceded by a survey and selection of international and national radioecological laboratories to be studied and, in sequence, these laboratories should be contacted and agree to participate in the research; in a third stage, the construction of a matrix of better practices, which incur in the results able to subside an IMS conceptual model proposition for radioecological laboratories; the fourth and last stage of the research comprises the construction of a conceptual proposal of an IMS structure for radioecological laboratories. The first stage of the research results are presented concisely, as well as a preliminary selection of laboratories to be studied. (author)

Insights of private general practitioners in group practice on the introduction of National Health Insurance in South Africa

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Shabir Moosa

2016-06-01

Full Text Available Background: The South African government intends to contract with ‘accredited provider groups’ for capitated primary care under National Health Insurance (NHI. South African solo general practitioners (GPs are unhappy with group practice. There is no clarity on the views of GPs in group practice on contracting to the NHI. Objectives: To describe the demographic and practice profile of GPs in group practice in South Africa, and evaluate their views on NHI, compared to solo GPs. Methods: This was a descriptive survey. The population of 8721 private GPs in South Africa with emails available were emailed an online questionnaire. Descriptive statistical analyses and thematic content analysis were conducted. Results: In all, 819 GPs responded (568 solo GPs and 251 GPs in groups. The results are focused on group GPs. GPs in groups have a different demographic practice profile compared to solo GPs. GPs in groups expected R4.86 million ($0.41 million for a hypothetical NHI proposal of comprehensive primary healthcare (excluding medicines and investigations to a practice population of 10 000 people. GPs planned a clinical team of 8 to 12 (including nurses and 4 to 6 administrative staff. GPs in group practices saw three major risks: patient, organisational and government, with three related risk management strategies. Conclusions: GPs can competitively contract with NHI, although there are concerns. NHI contracting should not be limited to groups. All GPs embraced strong teamwork, including using nurses more effectively. This aligns well with the emergence of family medicine in Africa. Keywords: Capitation, human resource, primary health care,  family medicine, South Africa, health systems

Integrated Qs Al Mudatsir in the reality group counseling to grow the character of students academic responsibility

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Asroful Kadafi

2017-11-01

The emotional development of students in early teens showed a sensitive and recreative nature (critical, emotions are often negative and temperamental. This negative passion is evidenced by the findings in the field of Indonesian teenagers, such as Tawuran, promiscuity, students who dare to do nasty with school friends (Tirto, 2013. Many factors are the cause, one of which is still the weak character of academic responsibility that students have. This problem becomes a serious problem in the world of education Indonesia. Therefore, it is natural for educational practitioners to take solutive steps to overcome the problem. One education practitioner who has a strategic position to handle the case is Counselor. Counselors are deemed able to provide practical solutions through Reality Group Counseling services by integrating spiritual values (Islam to foster student academic responsibilities. Reality group counseling emphasizes the growth of personal responsibility. This advice is also in line with Islamic values that encourage individuals always to be responsible for every action as reflected in the QS. Al Muddassir: 38.

The Federal Trade Commission, clinical integration, and the organization of physician practice.

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Casalino, Lawrence P

2006-06-01

This article examines Federal Trade Commission (FTC) policy--in particular, the agency's controversial 1996 statements on clinical integration--toward joint negotiations for nonrisk contracts with health plans by physicians organized into independent practice associations (IPAs) and (with hospitals) into physician-hospital organizations (PHOs). The article concludes that the policy is consistent with anti-trust principles, consistent with current thinking on the use of organized processes to improve medical care quality, specific enough to provide guidance to physicians wanting to integrate clinically, and general enough to encourage ongoing innovations in physician organization. The FTC should consider stronger sanctions for IPAs and PHOs whose clinical integration is nothing more than a sham intended to provide cover for joint negotiations, should give the benefit of the doubt to organizations whose clinical integration appears to be reasonably consonant with the statements, and should clarify several ambiguities in the statements. Health plans should facilitate IPA and PHO efforts to improve care by rewarding quality and efficiency and by providing clinically integrated organizations with claims information on individual patients. Though creating clinically integrated organizations is difficult and expensive, physicians should recognize that clinical integration can help them both to gain some negotiating leverage with health plans and to improve the quality of care for their patients.

Examining Current Beliefs, Practices and Barriers about Technology Integration: A Case Study

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Hsu, Pi-Sui

2016-01-01

The purpose of this mixed-methods study was to examine the current beliefs, practices and barriers concerning technology integration of Kindergarten through Grade Six teachers in the midwestern United States. The three data collection methods were online surveys with 152 teachers as well as interviews and observations with 8 teachers. The findings…

Perceptions of Geography Teachers to Integrating Technology to Teaching and Their Practices

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Sanli, Cennet; Sezer, Adem; Pinar, Adnan

2016-01-01

In present study the objective has been to manifest perceptions and practices of geography teachers towards integrating technology to teaching geography. In 5 different types of schools within Nevsehir (Turkey) city center, a total of 22 geography teachers volunteering to participate in the research were included in this study in which data were…

Practical integrated design of a condenser-objective lens for transmission electron microscope

International Nuclear Information System (INIS)

Li Wenping; Wu Jian; Zhou Zhen; Gui Lijiang; Han Li

2009-01-01

A condenser-objective lens is designed through combination of separating and integrating to consider the effect of the front condenser field on its objective performance. A practical lens model including magnetic pole piece, magnetic circuit and coil windings is built to optimize its rear field. The front field can be integrated into the rear one by simply adjusting the position of the specimen and the excitation on the condenser-objective lens. Optical performance of the integrated lens is researched as both a condenser lens and an imaging one. The total aberrations at the specimen plane are 0.01nm under STEM operation mode and its spherical aberration coefficient is 1.5mm when being an imaging objective lens, which can meet for high resolution microanalysis and TEM imaging.

Needs assessment for business strategies of anesthesiology groups' practices.

Science.gov (United States)

Scurlock, Corey; Dexter, Franklin; Reich, David L; Galati, Maria

2011-07-01

Progress has been made in understanding strategic decision making influencing anesthesia groups' operating room business practices. However, there has been little analysis of the remaining gaps in our knowledge. We performed a needs assessment to identify unsolved problems in anesthesia business strategy based on Porter's Five Forces Analysis. The methodology was a narrative literature review. We found little previous investigation for 2 of the 5 forces (threat of new entrants and bargaining power of suppliers), modest understanding for 1 force (threat of substitute products or services), and substantial understanding for 2 forces (bargaining power of customers and jockeying for position among current competitors). Additional research in strategic decisions influencing anesthesia groups should focus on the threat of new entrants, bargaining power of suppliers, and the threat of substitute products or services.

Group Development and Integration in a Cross-Disciplinary and Intercultural Research Team

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Kirk-Lawlor, Naomi; Allred, Shorna

2017-04-01

Cross-disciplinary research is necessary to solve many complex problems that affect society today, including problems involving linked social and environmental systems. Examples include natural resource management or scarcity problems, problematic effects of climate change, and environmental pollution issues. Intercultural research teams are needed to address many complex environmental matters as they often cross geographic and political boundaries, and involve people of different countries and cultures. It follows that disciplinarily and culturally diverse research teams have been organized to investigate and address environmental issues. This case study investigates a team composed of both monolingual and bilingual Chilean and US university researchers who are geoscientists, engineers and economists. The objective of this research team was to study both the natural and human parts of a hydrologic system in a hyper-arid region in northern Chile. Interviews ( n = 8) addressed research questions focusing on the interaction of cross-disciplinary diversity and cultural diversity during group integration and development within the team. The case study revealed that the group struggled more with cross-disciplinary challenges than with intercultural ones. Particularly challenging ones were instances the of disciplinary crosstalk, or hidden misunderstandings, where team members thought they understood their cross-disciplinary colleagues, when in reality they did not. Results showed that translation served as a facilitator to cross-disciplinary integration of the research team. The use of translation in group meetings as a strategy for effective cross-disciplinary integration can be extended to monolingual cross-disciplinary teams as well.

Group Development and Integration in a Cross-Disciplinary and Intercultural Research Team.

Science.gov (United States)

Kirk-Lawlor, Naomi; Allred, Shorna

2017-04-01

Cross-disciplinary research is necessary to solve many complex problems that affect society today, including problems involving linked social and environmental systems. Examples include natural resource management or scarcity problems, problematic effects of climate change, and environmental pollution issues. Intercultural research teams are needed to address many complex environmental matters as they often cross geographic and political boundaries, and involve people of different countries and cultures. It follows that disciplinarily and culturally diverse research teams have been organized to investigate and address environmental issues. This case study investigates a team composed of both monolingual and bilingual Chilean and US university researchers who are geoscientists, engineers and economists. The objective of this research team was to study both the natural and human parts of a hydrologic system in a hyper-arid region in northern Chile. Interviews (n = 8) addressed research questions focusing on the interaction of cross-disciplinary diversity and cultural diversity during group integration and development within the team. The case study revealed that the group struggled more with cross-disciplinary challenges than with intercultural ones. Particularly challenging ones were instances the of disciplinary crosstalk, or hidden misunderstandings, where team members thought they understood their cross-disciplinary colleagues, when in reality they did not. Results showed that translation served as a facilitator to cross-disciplinary integration of the research team. The use of translation in group meetings as a strategy for effective cross-disciplinary integration can be extended to monolingual cross-disciplinary teams as well.

The role of medical group practice administrators in the adoption and implementation of Medicare's physician quality reporting system.

Science.gov (United States)

Coulam, Robert; Kralewski, John; Dowd, Bryan; Gans, David

2016-01-01

Although there are numerous studies of the factors influencing the adoption of quality assurance (QA) programs by medical group practices, few have focused on the role of group practice administrators. To gain insights into the role these administrators play in QA programs, we analyzed how medical practices adopted and implemented the Medicare Physician Quality Reporting System (PQRS), the largest physician quality reporting system in the United States. We conducted focus group interviews in 2011 with a national convenience sample of 76 medical group practice administrators. Responses were organized and analyzed using the innovation decision framework of Van de Ven and colleagues. Administrators conducted due diligence on PQRS, influenced how the issue was presented to physicians for adoption, and managed implementation thereafter. Administrators' recommendations were heavily influenced by practice characteristics, financial incentives, and practice commitments to early adoption of quality improvement innovations. Virtually, all who attempted it agreed that PQRS was straightforward to implement. However, the complexities of Medicare's PQRS reports impeded use of the data by administrators to support quality management. Group practice administrators are playing a prominent role in activities related to the quality of patient care--they are not limited to the business side of the practice. Especially, as PQRS becomes more nearly universal after 2014, Medicare should take account of the role that administrators play, by more actively engaging administrators in shaping these programs and making it easier for administrators to use the results. More research is needed on the rapidly evolving role of nonphysician administration in medical group practices. Practice administrators have a larger role than commonly understood in how quality reporting initiatives are adopted and used and are in an exceptional position to influence the more appropriate use of these resources if

Using structural equation modelling to integrate human resources with internal practices for lean manufacturing implementation

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Protik Basu

2018-01-01

Full Text Available The purpose of this paper is to explore and integrate the role of human resources with the internal practices of the Indian manufacturing industries towards successful implementation of lean manu-facturing (LM. An extensive literature survey is carried out. An attempt is made to build an ex-haustive list of all the input manifests related to human resources and internal practices necessary for LM implementation, coupled with a similar exhaustive list of the benefits accrued from its suc-cessful implementation. A structural model is thus conceptualized, which is empirically validated based on the data from the Indian manufacturing sector. Hardly any survey based empirical study in India has been found to integrate human resources with the internal processes towards success-ful LM implementation. This empirical research is thus carried out in the Indian manufacturing in-dustries. The analysis reveals six key input constructs and three output constructs, indicating that these constructs should act in unison to maximize the benefits of implementing lean. The structural model presented in this paper may be treated as a guide to integrate human resources with internal practices to successfully implement lean, leading to an optimum utilization of resources. This work is one of the very first researches to have a survey-based empirical analysis of the role of human resources and internal practices of the Indian manufacturing sector towards an effective lean im-plementation.

[Establishment and testing practice of an integrative medical pathway for clinical management of acute myocardial infarction].

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Wang, Lei; Zhang, Min-zhou; Zhang, Jun

2011-01-01

To establish an integrative medical approach (IMA) for clinical management of acute myocardial infarction (AMI), and to test its efficacy. IMA was preliminarily established according to the guidelines and based on the Chinese medical therapy of benefiting vital qi and promoting blood circulation. And adopting non-synchronous queue design, AMI patients were assigned to the IMA group (71 cases) and the non-IMA group (70 cases), they were managed following or didn't follow the established IMA respectively. The total hospitalization time (THT), the ICU indwelling time (ICUD) and the total medical expenditure (TME) of patients were compared between groups. Moreover, for patients received primary PCI, the time for door-to-balloon (DTB) was compared in addition. Comparisons between groups showed that THT in the IMA group was shorter than that in the non-IMA group (9.80 +/- 5.62 days vs. 12.01 +/- 7. 35 days , P < 0.05); but the difference of TME between groups was insignificant. For those received PCT, the DTB in the IMA group was shorter than that in the non-IMA group in terms of DTB time (82.56 +/- 17.36 min vs. 119.19 +/- 30.88 min, P < 0.01), THT (9.69 +/- 5.59 vs. 13.34 +/- 7.49 days, P < 0.01) and TME. Practicing IMA for AMI, which was established based on Chinese medical therapy of benefiting vital qi and promoting blood circulation, could shorten the hospitalization time of patients, reduce the DTB time and TME in patients receiving primary PCI; fully displays its significance in hospital administration and quality control on AMI.

Formation of a Community of Practice in the Watershed Scale, with Integrated Local Environmental Knowledge

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Kenji Kitamura

2018-02-01

Full Text Available Rural communities around the world face formidable problems such as resource depletion, environmental degradation and economic decline. While the term ‘community’ is often used without clear definition or context, it can be viewed as a group of people emerging through social interaction. Through a series of collaborative action toward a shared goal, a community of practice can be formed. This paper proposes a hypothetical framework of integrated local environmental knowledge (ILEK, and applies it to analyze the processes of collaborative actions in the case of the Nishibetsu Watershed in Hokkaido, Japan. The case study identified several phases of actions, all initiated by a group of local residents on a grassroots and voluntary basis. These local resident-initiated collaborative actions had a particular confluence of elements to facilitate gradual strengthening of formal and informal institutions in the watershed scale beyond jurisdictional boundaries, making this a worthy case to study. The local residents used diverse types of knowledge, including livelihood-based technologies and skills of working as a group and with local governments, for establishing and strengthening various institutions for collaborative actions, with such knowledge being used in the manner of tools in a box of bricolage for community formation.

The Effect of WhatsApp Messenger As Mobile Learning Integrated with Group Investigation Method of Learning Achievement

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Hendrik Pratama

2017-12-01

Full Text Available The purpose of this research was determined the effect of application WhatsApp Messenger in the Group Investigation (GI method on learning achievement. The methods used experimental research with control group pretest-postest design. The sampling procedure used the purposive sampling technique that consists of 17 students as a control group and 17 students as an experimental group. The sample in this research is students in Electrical Engineering Education Study Program. The experimental group used the GI method that integrated with WhatsApp Messenger. The control group used lecture method without social media integration. The collecting data used observation, documentation, interview, questionnaire, and test. The researcher used a t-test for compared the control group and the experimental group’s learning outcomes at an alpha level of 0,05. The results showed differences between the experiment group and the control group. The study result of the experimental higher than the control groups. This learning was designed with start, grouping, planning, presenting, organizing, investigating, evaluating, ending’s stage. Integration of WhatsApp with group investigation method could cause the positive communication between student and lecturer. Discussion in this learning was well done, the student’s knowledge could appear in a group and the information could spread evenly and quickly.

Integration of children school age with ADHD in to a peer group

OpenAIRE

Zemanová, Hana

2012-01-01

This work is focussed on the integration of the children with ADHD into the peer group. Its target is to find out, if the integration proceeds and if it satisfies the children, the parents and the teachers. There's the issue of the ADHD, history of this term, the manifestations, the etiology, and the diagnostics by MKN-10 and DSM-IV and terminology explained. The applied part was realized through the use of the questionaries fullfiled bz the children with ADHD, their parents and the teachers ...

Path integral quantization of the Symplectic Leaves of the SU(2)*Poisson-Lie Group

International Nuclear Information System (INIS)

Morariu, B.

1997-01-01

The Feynman path integral is used to quantize the symplectic leaves of the Poisson-Lie group SU(2)*. In this way we obtain the unitary representations of Uq(su(2)). This is achieved by finding explicit Darboux coordinates and then using a phase space path integral. I discuss the *-structure of SU(2)* and give a detailed description of its leaves using various parameterizations and also compare the results with the path integral quantization of spin

A Practice-Based Approach to Student Reflection in the Workplace during a Work-Integrated Learning Placement

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Sykes, Christopher; Dean, Bonnie Amelia

2013-01-01

In the Work-Integrated Learning (WIL) curriculum, reflection on workplace activities is widely used to support student learning. Recent critiques have demonstrated the limitations of current approaches to support students' reflective learning of workplace practices. By employing a practice-based approach, we seek to refocus WIL reflection on…

Value of wireless personal digital assistants for practice: perceptions of advanced practice nurses.

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Garrett, Bernard; Klein, Gerri

2008-08-01

The aims were to explore advanced practice nurses' perceptions on wireless Personal Digital Assistant technologies, to establish the type and range of tools that would be useful to support their practice and to identify any requirements and limitations that may impact the implementation of wireless Personal Digital Assistants in practice. The wireless Personal Digital Assistant is becoming established as a hand-held computing tool for healthcare professionals. The reflections of advanced practice nurses' about the value of wireless Personal Digital Assistants and its potential to contribute to improved patient care has not been investigated. A qualitative interpretivist design was used to explore advanced practice nurses' perceptions on the value of wireless Personal Digital Assistant technologies to support their practice. The data were collected using survey questionnaires and individual and focus group interviews with nurse practitioners, clinical nurse specialists and information technology managers based in British Columbia, Canada. An open-coding content analysis was performed using qualitative data analysis software. Wireless Personal Digital Assistant's use supports the principles of pervasivity and is a technology rapidly being adopted by advanced practice nurses. Some nurses indicated a reluctance to integrate wireless Personal Digital Assistant technologies into their practices because of the cost and the short technological life cycle of these devices. Many of the barriers which precluded the use of wireless networks within facilities are being removed. Nurses demonstrated a complex understanding of wireless Personal Digital Assistant technologies and gave good rationales for its integration in their practice. Nurses identified improved client care as the major benefit of this technology in practice and the type and range of tools they identified included clinical reference tools such as drug and diagnostic/laboratory reference applications and wireless

Personal value preferences, group identifications, and cultural practices of Palestinian Israelis working in close contact with Jewish Israelis.

Science.gov (United States)

Tartakovsky, Eugene; Abu Kheit, Ayat

2017-01-01

The present study investigates the connection between personal value preferences, group identifications, and cultural practices among Palestinian Israelis working in close contact with the Jewish population in Israel. One hundred twenty-two Palestinian Israelis participated in the study. The participants were employed in different professional positions in the Tel Aviv Metropolitan area and were recruited to the study using the snowball technique. A stronger national identification was associated with a higher preference for the security and conformity values, and a lower preference for the humility values. A stronger ethnic identification was associated with a lower preference for the security, power, and stimulation values. Group identifications mediated the connection between personal value preferences and cultural practices. A longer time working in close contact with the majority group and less frequent visits home were associated with a greater adherence to the majority group's cultural practices but not with adherence to the ethnic group's practices and not with the group identifications.

Meeting the Challenge of Preparing Social Workers for Integrated Health Practice: Evidence from Two MSW Cohorts

Science.gov (United States)

Rishel, Carrie W.; Hartnett, Helen P.

2017-01-01

Changes in health care policy have led to an expansion of integrated care models that rely on collaboration among interprofessional health teams. Recent federal funding has encouraged the development of innovative training models to prepare social workers for integrated health practice. This article presents evidence from the first two MSW cohorts…

Positive is usually good, negative is not always bad: The effects of group affect on social integration and task performance.

Science.gov (United States)

Knight, Andrew P; Eisenkraft, Noah

2015-07-01

Grounded in a social functional perspective, this article examines the conditions under which group affect influences group functioning. Using meta-analysis, the authors leverage heterogeneity across 39 independent studies of 2,799 groups to understand how contextual factors-group affect source (exogenous or endogenous to the group) and group life span (one-shot or ongoing)-moderate the influence of shared feelings on social integration and task performance. As predicted, results indicate that group positive affect has consistent positive effects on social integration and task performance regardless of contextual idiosyncrasies. The effects of group negative affect, on the other hand, are context-dependent. Shared negative feelings promote social integration and task performance when stemming from an exogenous source or experienced in a 1-shot group, but undermine social integration and task performance when stemming from an endogenous source or experienced in an ongoing group. The authors discuss implications of their findings and highlight directions for future theory and research on group affect. (c) 2015 APA, all rights reserved).

Integrative mental health care: from theory to practice, part 1.

Science.gov (United States)

Lake, James

2007-01-01

Integrative approaches will lead to more accurate and different understandings of mental illness. Beneficial responses to complementary and alternative therapies provide important clues about the phenomenal nature of the human body in space-time and disparate biological, informational, and energetic factors associated with normal and abnormal psychological functioning. The conceptual framework of contemporary Western psychiatry includes multiple theoretical viewpoints, and there is no single best explanatory model of mental illness. Future theories of mental illness causation will not depend exclusively on empirical verification of strictly biological processes but will take into account both classically described biological processes and non-classical models, including complexity theory, resulting in more complete explanations of the characteristics and causes of symptoms and mechanisms of action that result in beneficial responses to treatments. Part 1 of this article examines the limitations of the theory and contemporary clinical methods employed in Western psychiatry and discusses implications of emerging paradigms in physics and the biological sciences for the future of psychiatry. In part 2, a practical methodology for planning integrative assessment and treatment strategies in mental health care is proposed. Using this methodology the integrative management of moderate and severe psychiatric symptoms is reviewed in detail. As the conceptual framework of Western medicine evolves toward an increasingly integrative perspective, novel understandings of complex relationships between biological, informational, and energetic processes associated with normal psychological functioning and mental illness will lead to more effective integrative assessment and treatment strategies addressing the causes or meanings of symptoms at multiple hierarchic levels of body-brain-mind.

Integrative mental health care: from theory to practice, Part 2.

Science.gov (United States)

Lake, James

2008-01-01

Integrative approaches will lead to more accurate and different understandings of mental illness. Beneficial responses to complementary and alternative therapies provide important clues about the phenomenal nature of the human body in space-time and disparate biological, informational, and energetic factors associated with normal and abnormal psychological functioning. The conceptual framework of contemporary Western psychiatry includes multiple theoretical viewpoints, and there is no single best explanatory model of mental illness. Future theories of mental illness causation will not depend exclusively on empirical verification of strictly biological processes but will take into account both classically described biological processes and non-classical models, including complexity theory, resulting in more complete explanations of the characteristics and causes of symptoms and mechanisms of action that result in beneficial responses to treatments. Part 1 of this article examined the limitations of the theory and contemporary clinical methods employed in Western psychiatry and discussed implications of emerging paradigms in physics and the biological sciences for the future of psychiatry. In part 2, a practical methodology, for planning integrative assessment and treatment strategies in mental health care is proposed. Using this methodology the integrative management of moderate and severe psychiatric symptoms is reviewed in detail. As the conceptual framework of Western medicine evolves toward an increasingly integrative perspective, novel understanding of complex relationships between biological, informational, and energetic processes associated with normal psychological functioning and mental illness will lead to more effective integrative assessment and treatment strategies addressing the causes or meanings of symptoms at multiple hierarchic levels of body-brain-mind.

Leading practices in Integrated Reporting

OpenAIRE

Quattrone, Paolo; Busco, Cristiano; Frigo, Mark L; Riccaboni, Angelo

2014-01-01

Integrated Reporting (IR) is making the leap from promising concept to powerfulpractice. Released at the end of 2013 by the International IntegratedReporting Council (IIRC), a global coalition of regulators, investors, companies,standards setters, the accounting profession, and nongovernmental organizations(NGOs), the IR Framework has been robustly tested and piloted in25 countries. As we described in the article “Redefining Corporate Accountabilitythrough Integrated Reporting” (Strategic Fin...

[Clinical ethics consultation - an integrative model for practice and reflection].

Science.gov (United States)

Reiter-Theil, Stella

2008-07-01

Broad evidence exists that health care professionals are facing ethical difficulties in patient care demanding a spectrum of useful ethics support services. Clinical ethics consultation is one of these forms of ethics support being effective in the acute setting. An authentic case is presented as an illustration. We introduce an integrative model covering the activities being characteristic for ethics consultation and going beyond "school"-specific approaches. Finally, we formulate some do's and don'ts of ethics consultation that are considered to be key issues for successful practice.

Undergraduate physiotherapy students' competencies, attitudes and perceptions after integrated educational pathways in evidence-based practice: a mixed methods study.

Science.gov (United States)

Bozzolan, M; Simoni, G; Balboni, M; Fiorini, F; Bombardi, S; Bertin, N; Da Roit, M

2014-11-01

This mixed methods study aimed to explore perceptions/attitudes, to evaluate knowledge/ skills, to investigate clinical behaviours of undergraduate physiotherapy students exposed to a composite education curriculum on evidence-based practice (EBP). Students' knowledge and skills were assessed before and after integrated learning activities, using the Adapted Fresno test, whereas their behaviour in EBP was evaluated by examining their internship documentation. Students' perceptions and attitudes were explored through four focus groups. Sixty-two students agreed to participate in the study. The within group mean differences (A-Fresno test) were 34.2 (95% CI 24.4 to 43.9) in the first year and 35.1 (95% CI 23.2 to 47.1) in the second year; no statistically significant change was observed in the third year. Seventy-six percent of the second year and 88% of the third year students reached the pass score. Internship documentation gave evidence of PICOs and database searches (95-100%), critical appraisal of internal validity (25-75%) but not of external validity (5-15%). The correct application of these items ranged from 30 to 100%. Qualitative analysis of the focus groups indicated students valued EBP, but perceived many barriers, with clinicians being both an obstacle and a model. Key elements for changing students' behaviours seem to be internship environment and possibility of continuous practice and feedback.

Integrating social science knowledge into natural resource management public involvement practice

DEFF Research Database (Denmark)

Stummann, Cathy Brown

This PhD study explores the long-recognized challenge of integrating social science knowledge into NRM public involvement practice theoretically and empirically. Theoretically, the study draws on research from adult learning, continuing rofessional education and professional knowledge development...... to better understand how social science knowledge can benefit NRM public involvement practice. Empirically, the study explores the potential of NRM continuing professional education as a means for introducing social science knowledge to public NRM professionals. The study finds social science knowledge can...... be of value to NRM public involvement prospectively and retrospectively; and that continuing professional education can be an effective means to introducing social science knowledge to public NRM professionals. In the design of NRM continuing professional education focused on social science knowledge...

Interval-Valued Intuitionistic Fuzzy Multicriteria Group Decision Making Based on VIKOR and Choquet Integral

Directory of Open Access Journals (Sweden)

Chunqiao Tan

2013-01-01

Full Text Available An effective decision making approach based on VIKOR and Choquet integral is developed to solve multicriteria group decision making problem with conflicting criteria and interdependent subjective preference of decision makers in a fuzzy environment where preferences of decision makers with respect to criteria are represented by interval-valued intuitionistic fuzzy sets. First, an interval-valued intuitionistic fuzzy Choquet integral operator is given. Some of its properties are investigated in detail. The extended VIKOR decision procedure based on the proposed operator is developed for solving the multicriteria group decision making problem where the interactive criteria weight is measured by Shapley value. An illustrative example is given for demonstrating the applicability of the proposed decision procedure for solving the multi-criteria group decision making problem in interval-valued intuitionistic fuzzy environment.

Integrating a social network group with a 3D collaborative learning environment

NARCIS (Netherlands)

Pourmirza, S.; Gardner, M.; Callaghan, V; Augusto, J.C.; Zhang, T.

2014-01-01

Although extensive research has been carried out on virtual learning environments and the role of groups and communities in social networks, few studies exist which adequately cover the relationship between these two domains. In this paper, the authors demonstrate the effectiveness of integrating

Knowledge, attitudes and practices of food handlers in food safety: An integrative review.

Science.gov (United States)

Zanin, Laís Mariano; da Cunha, Diogo Thimoteo; de Rosso, Veridiana Vera; Capriles, Vanessa Dias; Stedefeldt, Elke

2017-10-01

This study presents an overview of the relationship between knowledge, attitudes and practices (KAP) of food handlers with training in food safety, in addition to proposing reflections on the training of food handlers, considering its responsibility for food safety and health of consumers. The review was based on the integrative method. The descriptors used were: (food handler), (knowledge, attitudes and practice) and (training). Six databases were searched, 253 articles were consulted and 36 original articles were included. Fifty per cent of the articles pointed that there was no proper translation of knowledge into attitudes/practices or attitudes into practices after training. Knowledge, attitudes and practices of food handlers are important for identifying how efficient training in food safety is allowing prioritize actions in planning training. The evaluation of KAP is the first step to understand the food handler's point of view. After this evaluation other diagnostic strategies become necessary to enhance this understanding. Copyright © 2017. Published by Elsevier Ltd.

What the patient wants: Addressing patients' treatment targets in an integrative group psychotherapy programme.

Science.gov (United States)

Kealy, David; Joyce, Anthony S; Weber, Rainer; Ehrenthal, Johannes C; Ogrodniczuk, John S

2018-02-13

Limited empirical attention has been devoted to individualized treatment objectives in intensive group therapy for personality dysfunction. This study investigated patients' ratings of distress associated with individual therapy goals - referred to as target object severity - in an intensive Evening Treatment Programme for patients with personality dysfunction. Change in target objective severity was examined in a sample of 81 patients who completed treatment in an intensive, integrative group therapy programme. Correlation and regression analyses were used to examine associations between change in target object severity and patients' pre-treatment diagnosis, symptom distress, and treatment outcome expectancy, and between change in target objective severity and patients' ratings of group therapy process (group climate, therapeutic alliance, group cohesion). The relationship between change in target objective severity and longer-range life satisfaction was also examined in a subsample of patients who rated life satisfaction at follow-up. While change in target objective severity was not significantly related to pre-treatment variables, significant associations were found with several aspects of group therapy process. Patients' experience of a highly engaged group climate was uniquely associated with improvement in target object severity. Such improvement was significantly related to longer-term life satisfaction after controlling for general symptom change. The working atmosphere in group therapy contributes to patients' progress regarding individual treatment targets, and such progress is an important factor in later satisfaction. Attention to individualized treatment targets deserves further clinical and research attention in the context of integrative group therapy for personality dysfunction. This study found that patients attending an integrative group treatment programme for personality dysfunction experienced significant improvement in severity of distress

Practical applications approach to design, development and implementation of an integrated management system

International Nuclear Information System (INIS)

Holdsworth, Rodger

2003-01-01

The introduction of quality, risk, safety, health and environmental management philosophies has significantly changed industry's view of company organization and controlling processes. Quality, risk, safety, health and environmental programs and systems, such as ISO 9000, ISO 14000, process safety, and risk management are impacting the way industry will meet the challenges of safety and environmental risks and the needs of the customer in the future. A wealth of knowledge has been extracted from practical application case studies, which would otherwise be unobtainable without years of experience related to management systems design, development, implementation and control. This paper discusses a practical applications approach to design, develop and implement an integrated management system encompassing quality (ISO 9000), process safety management (CFR 29 1910.119), risk management programs (CFR 40 part 68), environmental management (ISO 14000), and safety and health. This paper includes a discussion of management systems integration and an overview of management systems standards that apply to the petrochemical and chemical manufacturers industries. The paper also provides an overview on integrating management systems, including issues related to the following topics: - Establishing a management system team and objectives. - Assessing and knowing your organization. - Designing the management system to meet site objectives. - Developing system documentation. - Implementing effective management systems. - Measuring program performance. - Continuous improvement

Using pedagogical approaches to influence evidence-based practice integration - processes and recommendations: findings from a grounded theory study.

Science.gov (United States)

Malik, Gulzar; McKenna, Lisa; Griffiths, Debra

2017-04-01

The study aimed to explore the processes undertaken by nurse academics when integrating evidence-based practice (EBP) into their teaching and learning practices. This article focuses on pedagogical approaches employed by academics to influence evidence-based practice integration into undergraduate programs across Australian universities. Nursing academics are challenged to incorporate a variety of teaching and learning strategies to teach evidence-based practice and determine their effectiveness. However, literature suggests that there are limited studies available focusing on pedagogical approaches in evidence-based practice education. A constructivist grounded theory methodology, informed by Charmaz was used for this study. Data were collected during 2014 from 23 nurse academics across Australian universities through semi-structured interviews. Additionally, nine were observed during teaching of undergraduate students. Twenty subject outlines were also analysed following Charmaz's approach of data analysis. 'Influencing EBP integration' describes the pedagogical approaches employed by academics to incorporate EBP knowledge and skills into undergraduate curricula. With the use of various teaching and learning strategies, academics attempted to contextualize EBP by engaging students with activities aiming to link evidence to practice and with the EBP process. Although, some strategies appeared to be engaging, others were traditional and seemed to be disengaging for students due to the challenges experienced by participants that impeded the use of the most effective teaching methods. Study findings offer valuable insights into the teaching practices and identify some key challenges that require the adoption of appropriate strategies to ensure future nurses are well prepared in the paradigm of evidence-based practice. © 2016 John Wiley & Sons Ltd.

Practice patterns of radiotherapy in endometrial cancer among member groups of the gynecologic cancer intergroup

DEFF Research Database (Denmark)

Small, W.Jr.; Bois, A. Du; Bhatnagar, S.

2009-01-01

PURPOSE: To describe radiotherapeutic practice of the treatment of endometrial cancer in members of the Gynecologic Cancer Intergroup (GCIG). METHODS: A survey was developed and distributed to the members of the GCIG. The GCIG is a global association of cooperative groups involved in the research.......57 [10.13] Gy in a mean of 4.3 insertions), and 5 groups used low-dose-rate brachytherapy (41.45 [17.5] Gy). Nineteen of the 28 respondents measured the doses to the bladder and the rectum when performing VBT. For brachytherapy, there was no uniformity in the fraction of the vagina treated or the doses...... and schedules used. CONCLUSIONS: Radiotherapy practices among member groups of the GCIG are similar in doses and dose per fraction with external beam. There is a moderate discrepancy in the brachytherapy practice after hysterectomy. There are no serious impediments to intergroup participation in radiation...

An Integral Representation of Standard Automorphic L Functions for Unitary Groups

Directory of Open Access Journals (Sweden)

Yujun Qin

2007-01-01

Full Text Available Let F be a number field, G a quasi-split unitary group of rank n. We show that given an irreducible cuspidal automorphic representation π of G(A, its (partial L function LS(s,π,σ can be represented by a Rankin-Selberg-type integral involving cusp forms of π, Eisenstein series, and theta series.

Social research design: framework for integrating philosophical and practical elements.

Science.gov (United States)

Cunningham, Kathryn Burns

2014-09-01

To provide and elucidate a comprehensible framework for the design of social research. An abundance of information exists concerning the process of designing social research. The overall message that can be gleaned is that numerable elements - both philosophical (ontological and epistemological assumptions and theoretical perspective) and practical (issue to be addressed, purpose, aims and research questions) - are influential in the process of selecting a research methodology and methods, and that these elements and their inter-relationships must be considered and explicated to ensure a coherent research design that enables well-founded and meaningful conclusions. There is a lack of guidance concerning the integration of practical and philosophical elements, hindering their consideration and explication. The author's PhD research into loneliness and cancer. This is a methodology paper. A guiding framework that incorporates all of the philosophical and practical elements influential in social research design is presented. The chronological and informative relationships between the elements are discussed. The framework presented can be used by social researchers to consider and explicate the practical and philosophical elements influential in the selection of a methodology and methods. It is hoped that the framework presented will aid social researchers with the design and the explication of the design of their research, thereby enhancing the credibility of their projects and enabling their research to establish well-founded and meaningful conclusions.

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

Technology Integration in Elementary Classrooms: Teaching Practices of Student Teachers

Science.gov (United States)

Liu, Ping

2016-01-01

This study examines how and why student teachers integrated technology to enhance instruction in elementary classrooms. The participants were 31 student teachers who completed an assignment of eight weeks. Multiple data sets including observation notes of 347 lessons were obtained from three key groups for data triangulation. Results reveal that…

Integrate oral communication with technical writing: Towards a rationale

Science.gov (United States)

Skelton, T.

1981-01-01

Integrating oral communication and technical writing instruction, to give students the opportunity to learn and practice interpersonal skills, is proposed. By linking speech and writing the importance of small-group interaction in developing transferrable ideas is acknowledged. Three reasons for integration are examined: workday activities, application of role-taking to writing, and conflict resolution. Four advantages of integration are stated.

Report of study group 4.3 ''pipeline integrity management and safety''

Energy Technology Data Exchange (ETDEWEB)

Clavel, P.

2000-07-01

This report highlights the Pipeline integrity Management methods being implemented by gas companies. These aim at maintaining the current high safety level, prevent major hazards, ensure the integrity of the pipeline and protect people and environment in the vicinity of the pipeline in the most cost effective way. It should be noticed that Pipeline Integrity Management aspects, technical and organisational, are included in the more general framework of the Safety Management System. Currently, more and more gas companies implement such a system on the basis of standards like ISO 9000 and so on. In this way, the report shows how practices of Pipeline Integrity Management are continually developing in order to adapt to their environment, and to improve performance. Past experience and imminent developments show that Pipeline Integrity Management is a flexible and efficient approach to improve safety in the long term. Consequently, Pipeline Integrity Management Systems are, under the control of authorities, the best alternative to additional safety regulations. Within the context of deregulation of the European markets and globalization Pipeline Integrity Management appears to be a tool to promote the gas industry in the eyes of the authorities, the market regulators and the customers (industrialists,...). (author)

How does the culture of medical group practices influence the types of programs used to assure quality of care?

Science.gov (United States)

Kaissi, Amer; Kralewski, John; Curoe, Ann; Dowd, Bryan; Silversmith, Janet

2004-01-01

It is widely acknowledged that the culture of medical group practices greatly influences the quality of care, but little is known about how cultures are translated into specific types of programs focused on quality. This study explores this issue by assessing the influence of the organizational culture on these types of programs in medical group practices in the upper Midwest. Data were obtained from two surveys of medical group practices. The first survey was designed to assess the culture of the practice using a nine-dimension instrument developed previously. The second survey was designed to obtain organizational structure data including the programs identified by the literature as important to the quality of care in medical practices. Completed surveys were obtained from eighty-eight medical groups. The relationship of the group practice culture to structural programs focused on quality of care was analyzed using logistic regression equations. Several interesting patterns emerged. As expected, practices with a strong information culture favor electronic data systems and formal programs that provide comparative or evidence-based data to enhance their clinical practices. However, those with a quality-centered culture appear to prefer patient satisfaction surveys to assess the quality of their care, while practices that are more business-oriented rely on bureaucratic strategies such as benchmarking and physician profiling. Cultures that emphasize the autonomy of physician practice were negatively (but not at a statistically significant level) associated with all the programs studied. Practices with a highly collegial culture appear to rely on informal peer review mechanisms to assure quality rather than any of the structural programs included in this analysis. This study suggests that the types of quality programs that group practices develop differ according to their cultures. Consequently, it is important for practice administrators and medical directors to

Best Practice: Integrated Marketing Communications

OpenAIRE

Schultz, Don; Macdonald, Emma K.; Baines, Paul R.

2012-01-01

Integrated marketing communications can substantially improve target audience reception, message resonance, and positive behavioural response but, to reach its true potential, the process requires a strong focus on data integration/customer insight.

Integrated Knowledge Translation and Grant Development: Addressing the Research Practice Gap through Stakeholder-informed Research.

Science.gov (United States)

Henderson, Joanna; Brownlie, Elizabeth; Rosenkranz, Susan; Chaim, Gloria; Beitchman, Joseph

2013-11-01

We describe our stakeholder engagement process for grant application development that occurred as part of our integrated knowledge translation plan and make recommendations for researchers. In phase 1, a stakeholder consultation group was developed. In phase 2, surveys regarding knowledge gathering, research agenda, and research collaboration preferences were sent to 333 cross-sectoral youth-serving organizations in Ontario, including family and consumer organizations. In phase 1, 28 stakeholders from six sectors participated in the consultation group and provided input on multiple aspects of the proposal. Through this process, 19 stakeholders adopted formal roles within the project. In phase 2, 206 surveys were received (response rate = 62%). Survey responses supported the grant focus (concurrent youth mental health and substance use problems). Respondents also prioritized project goals and provided specific feedback on research and knowledge translation. Finally, although some stakeholders chose greater involvement, most survey respondents indicated a preference for a moderate level of participation in research rather than full team membership. Despite short timelines and feasibility challenges, stakeholders can be meaningfully engaged in and contribute to the grant proposal development process. Consideration is needed for the practical challenges that stakeholder organizations face in supporting and participating in research.

Social and Occupational Integration of Disadvantaged People. Leonardo da Vinci Good Practices Series.

Science.gov (United States)

Commission of the European Communities, Brussels (Belgium). Directorate-General for Education and Culture.

This document profiles nine European programs that exemplify good practice in social and occupational integration of disadvantaged people. The programs profiled are as follows: (1) Restaurant Venezia (a CD-ROM program to improve the reading and writing skills of young people in Luxembourg who have learning difficulties); (2) an integrated…

Integrating Theory, Research, and Practice in Vocational Psychology: Current Status and Future Directions

Science.gov (United States)

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

2017-01-01

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

Students integrate knowledge acquisition and practical work in the laboratory.

Science.gov (United States)

Agüera, E I; Sánchez-Hermosín, P; Díz-Pérez, J; Tovar, P; Camacho, R; Escribano, B M

2015-09-01

The aim of the present work was to transfer a wider concept of teamwork and self-learning to the laboratory, encouraging students' capabilities when seeking, acquiring, and processing knowledge. This educational innovation was carried out with a total of 38 students (fourth year of degree in Biology) in the area of physiology (Advances in Reproduction course) at University of Córdoba in Córdoba, Spain. The design of the project's application methodology consisted of establishing a way in which problems would be tackled in the practical classes. For this purpose, the different tasks were set up so that students could relate them to the concepts learned in the theory classes. On the first day of class, the project was presented to the students. Groups of two to three students worked in the laboratory and set up an outline of the protocol of the practical work that they had done. This outline was performed individually and sent to the lecturers through a learning management system (Moodle). The teachers gave feedback and assessed student submissions. Upon finishing the course, students completed a survey. The project-based learning method promotes practical self-learning on the part of students. This methodology demonstrated to us that it stimulates a critical and self-critical capacity in students, both individually and in groups, and that writing didactic practical material helped students to enhance their theory knowledge. The experiment was a success in view of the scores obtained upon finishing the subject. Copyright © 2015 The American Physiological Society.

Clinical practice guidelines on the evidence-based use of integrative therapies during and following breast cancer treatment

Science.gov (United States)

Greenlee, Heather; DuPont-Reyes, Melissa J.; Balneaves, Lynda G.; Carlson, Linda E.; Cohen, Misha R.; Deng, Gary; Johnson, Jillian A.; Mumber, Matthew; Seely, Dugald; Zick, Suzanna; Boyce, Lindsay; Tripathy, Debu

2018-01-01

Patients with breast cancer commonly use complementary and integrative therapies as supportive care during cancer treatment and to manage treatment-related side effects. However, evidence supporting the use of such therapies in the oncology setting is limited. This report provides updated clinical practice guidelines from the Society for Integrative Oncology on the use of integrative therapies for specific clinical indications during and after breast cancer treatment, including anxiety/stress, depression/mood disorders, fatigue, quality of life/physical functioning, chemotherapy-induced nausea and vomiting, lymphedema, chemotherapy-induced peripheral neuropathy, pain, and sleep disturbance. Clinical practice guidelines are based on a systematic literature review from 1990 through 2015. Music therapy, meditation, stress management, and yoga are recommended for anxiety/stress reduction. Meditation, relaxation, yoga, massage, and music therapy are recommended for depression/mood disorders. Meditation and yoga are recommended to improve quality of life. Acupressure and acupuncture are recommended for reducing chemotherapy-induced nausea and vomiting. Acetyl-L-carnitine is not recommended to prevent chemotherapy-induced peripheral neuropathy due to a possibility of harm. No strong evidence supports the use of ingested dietary supplements to manage breast cancer treatment-related side effects. In summary, there is a growing body of evidence supporting the use of integrative therapies, especially mind-body therapies, as effective supportive care strategies during breast cancer treatment. Many integrative practices, however, remain understudied, with insufficient evidence to be definitively recommended or avoided. PMID:28436999

Group integrative reminiscence therapy on self-esteem, life satisfaction and depressive symptoms in institutionalised older veterans.

Science.gov (United States)

Wu, Li-Fen

2011-08-01

The purpose of this study was to use group integrative reminiscence as a nursing intervention to evaluate the immediate effects on self-esteem, life satisfaction and depressive symptoms for a special group named 'institutionalised older veterans' after a 12-week intervention. The study group comprised institutionalised older veterans with combat experience, including being wounded in war and who were twice forced to relocate. The group participants had lower life satisfaction, and greater use for mental health services and greater non-specific health complaints were reported from this group. Reminiscence therapy has been considered an effective nursing intervention, but the effects on institutionalised older veterans have not been studied. A quasi-experimental design and purposive sampling were conducted. A total of 74 participants were studied with pre- and post-tests to measure the effect of group integrative reminiscence therapy. The activity was held once weekly for 12 weeks. The Life Satisfaction Index A, self-esteem scale and Geriatric Depression Scale Short Form were used as research tools, and the t-test, Fisher's exact test and generalised estimating equation were used for data analysis. All participants were male, with an average age of 81·34 years old, 91·9% unmarried and were in bad health. After 12 weeks of intervention, the reminiscence groups significantly improved their self-esteem and life satisfaction and decreased depressive symptoms compared with control groups. Group integrative reminiscence revealed immediate effects on improving the self-esteem and life satisfaction of institutionalised older veterans, and depressive symptoms were also decreased. Moreover, a sense of positive self-value and belonging to the institution was produced. Group integrative reminiscence is an applicable nursing intervention for vulnerable persons such as institutionalised older veterans. A structured protocol based on the characteristics of the residents and the

Combined horizontal and vertical integration of care: a goal of practice-based commissioning.

Science.gov (United States)

Thomas, Paul; Meads, Geoffrey; Moustafa, Ahmet; Nazareth, Irwin; Stange, Kurt C; Donnelly Hess, Gertrude

2008-01-01

Practice-based commissioning (PBC) in the UK is intended to improve both the vertical and horizontal integration of health care, in order to avoid escalating costs and enhance population health. Vertical integration involves patient pathways to treat named medical conditions that transcend organisational boundaries and connect community-based generalists with largely hospital-sited specialists, whereas horizontal integration involves peer-based and cross-sectoral collaboration to improve overall health. Effective mechanisms are now needed to permit ongoing dialogue between the vertical and horizontal dimensions to ensure that medical and nonmedical care are both used to their best advantage. This paper proposes three different models for combining vertical and horizontal integration - each is a hybrid of internationally recognised ideal types of primary care organisation. Leaders of PBC should consider a range of models and apply them in ways that are relevant to the local context. General practitioners, policy makers and others whose job it is to facilitate horizontal and vertical integration must learn to lead such combined approaches to integration if the UK is to avoid the mistakes of the USA in over-medicalising health issues.

Resource Information and Forecasting Group; Electricity, Resources, & Building Systems Integration (ERBSI) (Fact Sheet)

Energy Technology Data Exchange (ETDEWEB)

2009-11-01

Researchers in the Resource Information and Forecasting group at NREL provide scientific, engineering, and analytical expertise to help characterize renewable energy resources and facilitate the integration of these clean energy sources into the electricity grid.

77 FR 42313 - Recharter of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

Science.gov (United States)

2012-07-18

... Promotion, and Integrative and Public Health AGENCY: Office of the Assistant Secretary for Health, Office of... Promotion, and Integrative and Public Health. FOR FURTHER INFORMATION CONTACT: Corinne Graffunder... Integrative and Public Health (the ``Advisory Group'') within the Department of Health and Human Services. To...

Integration of health technology assessment recommendations into organizational and clinical practice: A case study in Catalonia.

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Gagnon, Marie-Pierre; Sánchez, Emília; Pons, Joan M V

2006-01-01

Evaluating the impact of recommendations based upon health technology assessment (HTA) represents a challenge for both HTA agencies and healthcare policy makers. This research sought to understand factors affecting the uptake of HTA recommendations to support decision making with respect to the introduction of three health technologies. Using a multidimensional framework, based upon a combination of theoretical models, a case study was conducted. A total of twenty-eight semistructured interviews were done with physicians from fifteen hospitals and other stakeholders in Catalonia. Interview content was analyzed iteratively and classified according to theoretical dimensions and contextual factors. At the sociopolitical level, factors related to the organization and financing of the health system were found to affect the utilization of HTA recommendations. At the healthcare organization level, existing collaborations between the hospital and the HTA agency favored the integration of recommendations into practices. Formalism in the organization also influenced the utilization of HTA recommendations. At the professional level, the high degree of autonomy of specialists, the importance of peers and collegial control, and the definition of professional roles and responsibilities influenced physicians' willingness to integrate HTA recommendations into their practice. This study offers a comprehensive framework to understand the complex dynamics that affect adoption of health technologies in organizational and professional practices. The findings suggest some avenues to promote the integration of HTA recommendations into practices and, thus, increase the utilization of scientific evidence to support decision making in health care.

Knowledge integration, teamwork and performance in health care.

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Körner, Mirjam; Lippenberger, Corinna; Becker, Sonja; Reichler, Lars; Müller, Christian; Zimmermann, Linda; Rundel, Manfred; Baumeister, Harald

2016-01-01

Knowledge integration is the process of building shared mental models. The integration of the diverse knowledge of the health professions in shared mental models is a precondition for effective teamwork and team performance. As it is known that different groups of health care professionals often tend to work in isolation, the authors compared the perceptions of knowledge integration. It can be expected that based on this isolation, knowledge integration is assessed differently. The purpose of this paper is to test these differences in the perception of knowledge integration between the professional groups and to identify to what extent knowledge integration predicts perceptions of teamwork and team performance and to determine if teamwork has a mediating effect. The study is a multi-center cross-sectional study with a descriptive-explorative design. Data were collected by means of a staff questionnaire for all health care professionals working in the rehabilitation clinics. The results showed that there are significant differences in knowledge integration within interprofessional health care teams. Furthermore, it could be shown that knowledge integration is significantly related to patient-centered teamwork as well as to team performance. Mediation analysis revealed partial mediation of the effect of knowledge integration on team performance through teamwork. PRACTICAL/IMPLICATIONS: In practice, the results of the study provide a valuable starting point for team development interventions. This is the first study that explored knowledge integration in medical rehabilitation teams and its relation to patient-centered teamwork and team performance.

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

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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.

Evaluation of Integrated Coastal Zone Management Plan Practices in the Turkish Case

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Doruk Özügül, M.; Yerliyurt, Bora; Seçilmişler, Töre

2017-10-01

In terms of both international and national contexts, mostly coastal zones are the place of complexity, vulnerability and competition, so that they have to be well-planned and managed. Diversity in users, land uses, investments, sectoral plans and policies make coastal areas highly complex and problematic zones where competition also takes place. Unless these dimensions of pressure aren’t balanced with precautionary actions, coastal zones transform into more vulnerable geographies. Within this context “Integrated Coastal Zone Management (ICZM) Plan” appears as a major tool where “integration” becomes a vital keyword for such diversifying environments. This integration challenge covers sectoral, administrative, spatial, interdisciplinary (in terms of scientific research fields) and internationality dimensions. A set of basic principles could also be obtained from the literature in order to reach a better ICZM Plan practice. These could be summarized as; “a broader perspective”, “a long-term perspective”, “adaptive management and monitoring”, “local specificities, specific solutions and flexible measures”, “carrying capacity of ecosystems”, “a participatory process”, “well coordination of policies and partners” and “coherence between sectoral policy objectives, planning and management”. A similar problematic conceptualization is also viable for Turkey, where approximately 76% of the total border length and 27 of 81 provinces are coastal. Naturally, both ICZM and coastal zone planning are within the emerging planning issues of national agenda. The purpose of this paper is to examine the Turkish practices depending on the above-mentioned principles by comparing various official ICZM plans of selected provinces. As a general conclusion it is seen that ICZM -to be an integrative and multi-dimensional tool- is contextually misunderstood. From this perspective “the determination of the plan borders”, “unsuitability of the

The Impact of Integrated Practices of Lean, Green, and Social Management Systems on Firm Sustainability Performance—Evidence from Chinese Fashion Auto-Parts Suppliers

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Lin Wu

2015-03-01

Full Text Available To better satisfy various stakeholders, firms are seeking integrated practices that can enhance their sustainability performance, also well known as the Triple Bottom Line (3BL. The fashion industry exhibits potential conflicts with the spirit of sustainability because of the waste created by high levels of demand uncertainty and the extant usage of resources in production. Literature suggests that selected stand-alone practices of lean, green, and Corporate Social Responsibility (CSR management systems have a positive impact on firm sustainability performance. However, how the combination of selected practices from these three management systems impacts the 3BL remains unclear. Based on case studies, we build an integrated sustainable practices model incorporating the most popular lean, green, and social practices and develop propositions for future tests. Our framework suggests the implementation of integrated practices would have a stronger influence on 3BL performance than individual practice implementation.

Arts Integration: What Is Really Happening in the Elementary Classroom?

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LaJevic, Lisa

2013-01-01

Researching how Arts Integration is practiced in a primary school, this article explores how elementary teachers understand, implement, and experience Arts Integration. Weaving together personal experiences, teacher interviews, focus group sessions, classroom observations, and written texts, I investigate how the arts are often devalued in Arts…

Digital communication between clinician and patient and the impact on marginalised groups: a realist review in general practice.

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Huxley, Caroline J; Atherton, Helen; Watkins, Jocelyn Anstey; Griffiths, Frances

2015-12-01

Increasingly, the NHS is embracing the use of digital communication technology for communication between clinicians and patients. Policymakers deem digital clinical communication as presenting a solution to the capacity issues currently faced by general practice. There is some concern that these technologies may exacerbate existing inequalities in accessing health care. It is not known what impact they may have on groups who are already marginalised in their ability to access general practice. To assess the potential impact of the availability of digital clinician-patient communication on marginalised groups' access to general practice in the UK. Realist review in general practice. A four-step realist review process was used: to define the scope of the review; to search for and scrutinise evidence; to extract and synthesise evidence; and to develop a narrative, including hypotheses. Digital communication has the potential to overcome the following barriers for marginalised groups: practical access issues, previous negative experiences with healthcare service/staff, and stigmatising reactions from staff and other patients. It may reduce patient-related barriers by offering anonymity and offers advantages to patients who require an interpreter. It does not impact on inability to communicate with healthcare professionals or on a lack of candidacy. It is likely to work best in the context of a pre-existing clinician-patient relationship. Digital communication technology offers increased opportunities for marginalised groups to access health care. However, it cannot remove all barriers to care for these groups. It is likely that they will remain disadvantaged relative to other population groups after their introduction. © British Journal of General Practice 2015.

'The singing hospital'--integrated group therapy in the Black mentally ill.

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Benjamin, B

1983-06-04

Integrated group therapy was originally introduced at Sterkfontein Hospital in 1957, and reintroduced 6 years ago in an effort to overcome difficulties in communication with approximately 100 Black male and female mental hospital patients. This therapy consisted mainly of song and dance activation, sociodrama, psychodrama and behavioural modification methods. These techniques are flexible, and can be carried out by proxy therapists working with doctors and psychologists.

A Survey of the Music Integration Practices of North Dakota Elementary Classroom Teachers

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O'Keefe, KariJo; Dearden, Katherine Norman; West, Robert

2016-01-01

The purpose of this study was to identify and describe the nature of North Dakota elementary classroom teachers' (NDECT) music integration in the general classroom. The majority of NDECTs integrated music with: the subjects of Language Arts (62.01%), Mathematics (55.00%), and Physical Education (50.89%); the settings of Group Work Time (64.29%),…

Integrating policy, disintegrating practice: water resources management in Botswana

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Swatuk, Larry A.; Rahm, Dianne

Botswana is generally regarded as an African ‘success story’. Nearly four decades of unabated economic growth, multi-party democracy, conservative decision-making and low-levels of corruption have made Botswana the darling of the international donor community. One consequence of rapid and sustained economic development is that water resources use and demands have risen dramatically in a primarily arid/semi-arid environment. Policy makers recognize that supply is limited and that deliberate steps must be taken to manage demand. To this end, and in line with other members of the Southern African Development Community (SADC), Botswana devised a National Water Master Plan (NWMP) and undertook a series of institutional and legal reforms throughout the 1990s so as to make water resources use more equitable, efficient and sustainable. In other words, the stated goal is to work toward Integrated Water Resources Management (IWRM) in both policy and practice. However, policy measures have had limited impact on de facto practice. This paper reflects our efforts to understand the disjuncture between policy and practice. The information presented here combines a review of primary and secondary literatures with key informant interviews. It is our view that a number of constraints-cultural, power political, managerial-combine to hinder efforts toward sustainable forms of water resources use. If IWRM is to be realized in the country, these constraints must be overcome. This, however, is no small task.

An integrated approach to the diagnosis and treatment of anxiety within the practice of cardiology.

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Janeway, David

2009-01-01

Coronary heart disease (CHD) is the leading cause of death and disability in the United States and in highly industrialized countries. Many modifiable psychosocial risk factors have been identified and can affect the course of cardiac illness. These include the negative emotional states of depression, anxiety, stress, anger/hostility, and social isolation. Anxiety has been found to increase the risk of developing CHD in healthy subjects and can lead to worsening of existing CHD. There is much overlap and confusion throughout the research literature between what authors define as anxiety, stress, Type A behavioral pattern, and anger/hostility.There is a need for better screening within the practice of cardiology for these psychosocial risk factors to ensure better integration of mental health services. Established screening tools such as the Beck Anxiety Inventory, Patient Health Questionnaire-9, Zung Self-Rating Anxiety Scale, and the Hamilton Anxiety Scale are described and compared with the newer Screening Tool for Psychologic Distress as part of the initial work-up of every cardiac patient. Recommendations are made using the author's Anxiety Treatment Algorithm regarding when to refer to a mental health professional along with how to reduce stigma and provide more integrated care. The diagnosis and treatment of anxiety disorders is reviewed, with attention to selective serotonin reuptake inhibitors, benzodiazepines, cognitive-behavioral therapy, stress reduction, and behavioral medicine group programs. These group programs are recommended because they help to overcome social isolation and counsel patients on how to adapt to a healthy lifestyle. Better clinical outcome research is needed that specifically addresses the question of whether the treatment of anxiety and anxiety disorders can affect the course of cardiac illness.

Formative Evaluation of Clinician Experience with Integrating Family History-Based Clinical Decision Support into Clinical Practice

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Megan Doerr

2014-03-01

Full Text Available Family health history is a leading predictor of disease risk. Nonetheless, it is underutilized to guide care and, therefore, is ripe for health information technology intervention. To fill the family health history practice gap, Cleveland Clinic has developed a family health history collection and clinical decision support tool, MyFamily. This report describes the impact and process of implementing MyFamily into primary care, cancer survivorship and cancer genetics clinics. Ten providers participated in semi-structured interviews that were analyzed to identify opportunities for process improvement. Participants universally noted positive effects on patient care, including increases in quality, personalization of care and patient engagement. The impact on clinical workflow varied by practice setting, with differences observed in the ease of integration and the use of specific report elements. Tension between the length of the report and desired detail was appreciated. Barriers and facilitators to the process of implementation were noted, dominated by the theme of increased integration with the electronic medical record. These results fed real-time improvement cycles to reinforce clinician use. This model will be applied in future institutional efforts to integrate clinical genomic applications into practice and may be useful for other institutions considering the implementation of tools for personalizing medical management.

Community for Data Integration 2014 annual report

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Langseth, Madison L.; Chang, Michelle Y.; Carlino, Jennifer; Birch, Daniella D.; Bradley, Joshua; Bristol, R. Sky; Conzelmann, Craig; Diehl, Robert H.; Earle, Paul S.; Ellison, Laura E.; Everette, Anthony L.; Fuller, Pamela L.; Gordon, Janice M.; Govoni, David L.; Guy, Michelle R.; Henkel, Heather S.; Hutchison, Vivian B.; Kern, Tim; Lightsom, Frances L.; Long, Joseph W.; Longhenry, Ryan; Preston, Todd M.; Smith, Stan W.; Viger, Roland J.; Wesenberg, Katherine; Wood, Eric C.

2015-10-02

The U.S. Geological Survey (USGS) researches Earth science to help address complex issues affecting society and the environment. In 2006, the USGS held the first Scientific Information Management Workshop to bring together staff from across the organization to discuss the data and information management issues affecting the integration and delivery of Earth science research and investigate the use of “communities of practice” as mechanisms to share expertise about these issues. Out of this effort emerged the Council for Data Integration, which was conceived as an official organizational function that would help guide data integration activities and formalize communities of practice into working groups; however, by 2009 it became evident that many members of the Council for Data Integration had an interest in developing data integration solutions and sharing expertise in a less formal, grassroots manner, which transformed the Council into a Community for Data Integration (CDI). As of 2014, the CDI represents a dynamic community of practice focused on advancing science data and information management and integration capabilities across the USGS and the CDI community.

A Clinical Nurse Leader (CNL) practice development model to support integration of the CNL role into microsystem care delivery.

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Kaack, Lorraine; Bender, Miriam; Finch, Michael; Borns, Linda; Grasham, Katherine; Avolio, Alice; Clausen, Shawna; Terese, Nadine A; Johnstone, Diane; Williams, Marjory

The Veterans Health Administration (VHA) Office of Nursing Services (ONS) was an early adopter of Clinical Nurse Leader (CNL) practice, generating some of the earliest pilot data of CNL practice effectiveness. In 2011 the VHA ONS CNL Implementation & Evaluation Service (CNL I&E) piloted a curriculum to facilitate CNL transition to effective practice at local VHA settings. In 2015, the CNL I&E and local VHA setting stakeholders collaborated to refine the program, based on lessons learned at the national and local level. The workgroup reviewed the literature to identify theoretical frameworks for CNL practice and practice development. The workgroup selected Benner et al.'s Novice-to-Expert model as the defining framework for CNL practice development, and Bender et al.'s CNL Practice Model as the defining framework for CNL practice integration. The selected frameworks were cross-walked against existing curriculum elements to identify and clarify additional practice development needs. The work generated key insights into: core stages of transition to effective practice; CNL progress and expectations for each stage; and organizational support structures necessary for CNL success at each stage. The refined CNL development model is a robust tool that can be applied to support consistent and effective integration of CNL practice into care delivery. Published by Elsevier Inc.

INTEGRATIVE AUGMENTATION OF STANDARDIZED MANAGEMENT SYSTEMS

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Stanislav Karapetrovic

2008-03-01

Full Text Available The development, features and integrating abilities of different international standards related to management systems are discussed. A group of such standards that augment the performance of quality management systems in organizations is specifically focused on. The concept, characteristics and an illustrative example of one augmenting standard, namely ISO 10001, are addressed. Integration of standardized augmenting systems, both by themselves and within the overall management system, is examined. It is argued that, in research and practice alike, integrative augmentation represents the future of standardized quality and other management systems.

Association of Group Prenatal Care in US Family Medicine Residencies With Maternity Care Practice: A CERA Secondary Data Analysis.

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Barr, Wendy B; Tong, Sebastian T; LeFevre, Nicholas M

2017-03-01

Group prenatal care has been shown to improve both maternal and neonatal outcomes. With increasing adaption of group prenatal care by family medicine residencies, this model may serve as a potential method to increase exposure to and interest in maternity care among trainees. This study aims to describe the penetration, regional and program variations, and potential impacts on future maternity care practice of group prenatal care in US family medicine residencies. The CAFM Educational Research Alliance (CERA) conducted a survey of all US family medicine residency program directors in 2013 containing questions about maternity care training. A secondary data analysis was completed to examine relevant data on group prenatal care in US family medicine residencies and maternity care practice patterns. 23.1% of family medicine residency programs report provision of group prenatal care. Programs with group prenatal care reported increased number of vaginal deliveries per resident. Controlling for average number of vaginal deliveries per resident, programs with group prenatal care had a 2.35 higher odds of having more than 10% of graduates practice obstetrics and a 2.93 higher odds of having at least one graduate in the past 5 years enter an obstetrics fellowship. Residency programs with group prenatal care models report more graduates entering OB fellowships and practicing maternity care. Implementing group prenatal care in residency training can be one method in a multifaceted approach to increasing maternity care practice among US family physicians.

Integration of Health Coaching Concepts and Skills into Clinical Practice Among VHA Providers: A Qualitative Study.

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Collins, David A; Thompson, Kirsten; Atwood, Katharine A; Abadi, Melissa H; Rychener, David L; Simmons, Leigh Ann

2018-01-01

Although studies of health coaching for behavior change in chronic disease prevention and management are increasing, to date no studies have reported on what concepts and skills providers integrate into their clinical practice following participation in health coaching courses. The purpose of this qualitative study was to assess Veterans Health Administration (VHA) providers' perceptions of the individual-level and system-level changes they observed after participating with colleagues in a 6-day Whole Health Coaching course held in 8 VHA medical centers nationwide. Data for this study were from the follow-up survey conducted with participants 2 to 3 months after completing the training. A total of 142 responses about individual-level changes and 99 responses about system-level changes were analyzed using content analysis. Eight primary themes emerged regarding individual changes, including increased emphasis on Veterans' values, increased use of listening and other specific health coaching skills in their clinical role, and adding health coaching to their clinical practice.Four primary themes emerged regarding system-level changes, including leadership support, increased staff awareness/support/learning and sharing, increased use of health coaching skills or tools within the facility, and organizational changes demonstrating a more engaged workforce, such as new work groups being formed or existing groups becoming more active. Findings suggest that VHA providers who participate in health coaching trainings do perceive positive changes within themselves and their organizations. Health coaching courses that emphasize patient-centered care and promote patient-provider partnerships likely have positive effects beyond the individual participants that can be used to promote desired organizational change.

Educating Social Workers for Practice in Integrated Health Care: A Model Implemented in a Graduate Social Work Program

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Mattison, Debra; Weaver, Addie; Zebrack, Brad; Fischer, Dan; Dubin, Leslie

2017-01-01

This article introduces a curricular innovation, the Integrated Health Scholars Program (IHSP), developed to prepare master's-level social work students for practice in integrated health care settings, and presents preliminary findings related to students' self-reported program competencies and perceptions. IHSP, implemented in a…

Practical integration: The art of balancing values, institutions and knowledge - lessons from the History of British Public Health and Town Planning.

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De Grandis, Giovanni

2016-04-01

The paper uses two historical examples, public health (1840-1880) and town planning (1945-1975) in Britain, to analyse the challenges faced by goal-driven research, an increasingly important trend in science policy, as exemplified by the prominence of calls for addressing Grand Challenges. Two key points are argued. (1) Given that the aim of research addressing social or global problems is to contribute to improving things, this research should include all the steps necessary to bring science and technology to fruition. This need is captured by the idea of practical integration, which brings this type of research under the umbrella of collective practical reason rather than under the aegis of science. Achieving practical integration is difficult for many reasons: the complexity of social needs, the plurality of values at stake, the limitation of our knowledge, the elusive nature of the skills needed to deal with uncertainty, incomplete information and asymmetries of power. Nevertheless, drawing from the lessons of the case studies, it is argued that (2) practical integration needs a proper balance between values, institutions and knowledge: i.e. a combination of mutual support and mutual limitation. Pursuing such a balance provides a flexible strategy for approximating practical integration. Copyright © 2015 Elsevier Ltd. All rights reserved.

Practical Steps to Integrate Family Voice in Organization, Policy, Planning, and Decision-Making for Socio-Emotional Trauma-Informed Integrated Pediatric Care.

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Dayton, Lauren; Buttress, Amelia; Agosti, Jen; Aceves, Javier; Kieschnick, Meredith; Popejoy, Agatha; Robbins, Robyn; Farinholt, Kate

2016-12-01

This article explores barriers and strategies to achieving family-driven integrated child health care. Family involvement in health system design and reform has become a guiding principle in national and local efforts to improve children's mental health services. In practice, primary care clinicians, staff, and families continue to describe common barriers to integrating family voice. Drawing from the collective knowledge of the Pediatric Integrated Care Collaborative (PICC) and the National Alliance on Mental Illness (NAMI), we present strategies to overcome these barriers to successfully recruit, sustain, and expand family influence on health systems. Family advocates and clinical leaders from two clinic sites in Albuquerque, New Mexico and Santa Rosa, California share challenges and strategies for building family involvement in system design. Copyright © 2016. Published by Elsevier Inc.

Practice patterns of radiotherapy in cervical cancer among member groups of the Gynecologic Cancer Intergroup (GCIG).

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Gaffney, David K; Du Bois, Andreas; Narayan, Kailash; Reed, Nick; Toita, Takafumi; Pignata, Sandro; Blake, Peter; Portelance, Lorraine; Sadoyze, Azmat; Pötter, Richard; Colombo, Alessandro; Randall, Marcus; Mirza, Mansoor R; Trimble, Edward L

2007-06-01

The aim of this study was to describe radiotherapeutic practice of the treatment of cervical cancer in member groups of the Gynecologic Cancer Intergroup (GCIG). A survey was developed and distributed to the members of the GCIG focusing on details of radiotherapy practice. Different scenarios were queried including advanced cervical cancer, postoperative patients, and para-aortic-positive lymph node cases. Items focused on indications for radiation therapy, radiation fields, dose, use of chemotherapy, brachytherapy and others. The cooperative groups from North America were compared with the other groups to evaluate potential differences in radiotherapy doses. A total of 39 surveys were returned from 13 different cooperative groups. For the treatment of advanced cervical cancer, external beam pelvic doses and total doses to point A were 47 + 3.5 Gy (mean + SD) and 79.1 + 7.9 Gy, respectively. Point A doses were not different between the North American cooperative groups compared with the others (p = 0.103). All groups used concomitant chemotherapy, with 30 of 36 respondents using weekly cisplatin. Of 33 respondents, 31 intervened for a low hemoglobin level. For a para-aortic field, the upper border was most commonly (15 of 24) at the T12-L1 interspace. Maintenance chemotherapy (after radiotherapy) was not performed by 68% of respondents. For vaginal brachytherapy after hysterectomy, 23 groups performed HDR brachytherapy and four groups used LDR brachytherapy. In the use of brachytherapy, there was no uniformity in dose prescription. Radiotherapy practices among member groups of the GCIG are similar in terms of both doses and use of chemotherapy.

Cognitive load in distributed and massed practice in virtual reality mastoidectomy simulation.

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Andersen, Steven Arild Wuyts; Mikkelsen, Peter Trier; Konge, Lars; Cayé-Thomasen, Per; Sørensen, Mads Sølvsten

2016-02-01

Cognitive load theory states that working memory is limited. This has implications for learning and suggests that reducing cognitive load (CL) could promote learning and skills acquisition. This study aims to explore the effect of repeated practice and simulator-integrated tutoring on CL in virtual reality (VR) mastoidectomy simulation. Prospective trial. Forty novice medical students performed 12 repeated virtual mastoidectomy procedures in the Visible Ear Simulator: 21 completed distributed practice with practice blocks spaced in time and 19 participants completed massed practice (all practices performed in 1 day). Participants were randomized for tutoring with the simulator-integrated tutor function. Cognitive load was estimated by measuring reaction time in a secondary task. Data were analyzed using linear mixed models for repeated measurements. The mean reaction time increased by 37% during the procedure compared with baseline, demonstrating that the procedure placed substantial cognitive demands. Repeated practice significantly lowered CL in the distributed practice group but not in massed practice group. In addition, CL was found to be further increased by 10.3% in the later and more complex stages of the procedure. The simulator-integrated tutor function did not have an impact on CL. Distributed practice decreased CL in repeated VR mastoidectomy training more consistently than was seen in massed practice. This suggests a possible effect of skills and memory consolidation occurring over time. To optimize technical skills learning, training should be organized as time-distributed practice rather than as a massed block of practice, which is common in skills-training courses. N/A. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Transfusion practice in Helsinki University Central Hospital: an analysis of diagnosis-related groups (DRG).

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Syrjälä, M T; Kytöniemi, I; Mikkolainen, K; Ranimo, J; Lauharanta, J

2001-12-01

Transfusion data combined with data automatically recorded in hospital databases provides an outstanding tool for blood utilization reporting. When the reporting is performed with an online analytical processing (OLAP) tool, real time reporting can be provided to blood subscribers. When this data is combined with a common patient classification system, Diagnosis-Related Groups (DRG), it is possible to produce statistical results, that are similar in different institutions and may provide a means for international transfusion bench-marking and cost comparison. We use a DRG classification to describe the transfusion practice in Helsinki University Central Hospital. The key indicators include the percentage of transfused patients, the number of transfused units and costs in different DRG groups, as well as transfusion rates per DRG weighted treatment episodes. Ninety-three per cent of all transfusions could be classified into different DRGs. The largest blood-using DRG group was acute adult leukaemia (DRG 473), which accounted for 10.4% of all transfusion costs. The 13 largest blood consuming DRGs accounted for half the total costs in 1998. Currently, there is a lack of an internationally accepted standardized way to report institutional or national transfusion practices. DRG-based transfusion reporting might serve as a means for transfusion benchmarking and thus aid studies of variations in transfusion practice.

Shared Decision-Making for Nursing Practice: An Integrative Review.

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Truglio-Londrigan, Marie; Slyer, Jason T

2018-01-01

Shared decision-making has received national and international interest by providers, educators, researchers, and policy makers. The literature on shared decision-making is extensive, dealing with the individual components of shared decision-making rather than a comprehensive process. This view of shared decision-making leaves healthcare providers to wonder how to integrate shared decision-making into practice. To understand shared decision-making as a comprehensive process from the perspective of the patient and provider in all healthcare settings. An integrative review was conducted applying a systematic approach involving a literature search, data evaluation, and data analysis. The search included articles from PubMed, CINAHL, the Cochrane Central Register of Controlled Trials, and PsycINFO from 1970 through 2016. Articles included quantitative experimental and non-experimental designs, qualitative, and theoretical articles about shared decision-making between all healthcare providers and patients in all healthcare settings. Fifty-two papers were included in this integrative review. Three categories emerged from the synthesis: (a) communication/ relationship building; (b) working towards a shared decision; and (c) action for shared decision-making. Each major theme contained sub-themes represented in the proposed visual representation for shared decision-making. A comprehensive understanding of shared decision-making between the nurse and the patient was identified. A visual representation offers a guide that depicts shared decision-making as a process taking place during a healthcare encounter with implications for the continuation of shared decisions over time offering patients an opportunity to return to the nurse for reconsiderations of past shared decisions.

Integrating group counseling, cell phone messaging, and participant-generated songs and dramas into a microcredit program increases Nigerian women's adherence to international breastfeeding recommendations.

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Flax, Valerie L; Negerie, Mekebeb; Ibrahim, Alawiyatu Usman; Leatherman, Sheila; Daza, Eric J; Bentley, Margaret E

2014-07-01

In northern Nigeria, interventions are urgently needed to narrow the large gap between international breastfeeding recommendations and actual breastfeeding practices. Studies of integrated microcredit and community health interventions documented success in modifying health behaviors but typically had uncontrolled designs. We conducted a cluster-randomized controlled trial in Bauchi State, Nigeria, with the aim of increasing early breastfeeding initiation and exclusive breastfeeding among female microcredit clients. The intervention had 3 components. Trained credit officers led monthly breastfeeding learning sessions during regularly scheduled microcredit meetings for 10 mo. Text and voice messages were sent out weekly to a cell phone provided to small groups of microcredit clients (5-7 women). The small groups prepared songs or dramas about the messages and presented them at the monthly microcredit meetings. The control arm continued with the regular microcredit program. Randomization occurred at the level of the monthly meeting groups. Pregnant clients were recruited at baseline and interviewed again when their infants were aged ≥6 mo. Logistic regression models accounting for clustering were used to estimate the odds of performing recommended behaviors. Among the clients who completed the final survey (n = 390), the odds of exclusive breastfeeding to 6 mo (OR: 2.4; 95% CI: 1.4, 4.0) and timely breastfeeding initiation (OR: 2.6; 95% CI: 1.6, 4.1) were increased in the intervention vs. control arm. Delayed introduction of water explained most of the increase in exclusive breastfeeding among clients receiving the intervention. In conclusion, a breastfeeding promotion intervention integrated into microcredit increased the likelihood that women adopted recommended breastfeeding practices. This intervention could be scaled up in Nigeria, where local organizations provide microcredit to >500,000 clients. Furthermore, the intervention could be adopted more widely

Why we do what we do: a theoretical evaluation of the integrated practice model for forensic nursing science.

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Valentine, Julie L

2014-01-01

An evaluation of the Integrated Practice Model for Forensic Nursing Science () is presented utilizing methods outlined by . A brief review of nursing theory basics and evaluation methods by Meleis is provided to enhance understanding of the ensuing theoretical evaluation and critique. The Integrated Practice Model for Forensic Nursing Science, created by forensic nursing pioneer Virginia Lynch, captures the theories, assumptions, concepts, and propositions inherent in forensic nursing practice and science. The historical background of the theory is explored as Lynch's model launched the role development of forensic nursing practice as both a nursing and forensic science specialty. It is derived from a combination of nursing, sociological, and philosophical theories to reflect the grounding of forensic nursing in the nursing, legal, psychological, and scientific communities. As Lynch's model is the first inception of forensic nursing theory, it is representative of a conceptual framework although the title implies a practice theory. The clarity and consistency displayed in the theory's structural components of assumptions, concepts, and propositions are analyzed. The model is described and evaluated. A summary of the strengths and limitations of the model is compiled followed by application to practice, education, and research with suggestions for ongoing theory development.

Integration of Multiple Data Sources for predicting the Engagement of Students in Practical Activities

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Llanos Tobarra

2014-09-01

Full Text Available This work presents the integration of an automatic assessment system for virtual/remote laboratories and the institutional Learning Management System (LMS, in order to analyze the students’ progress and their collaborative learning in virtual/remote laboratories. As a result of this integration, it is feasible to extract useful information for the characterization of the students’ learning process and detecting the students’ engagement with the practical activities of our subjects. From this integration, a dashboard has been created to graphically present to lecturers the analyzed results. Thanks to this, faculty can use the analyzed information in order to guide the learning/teaching process of each student. As an example, a subject focused on the configuration of network services has been chosen to implement our proposal.

Basis of integrated approach to sports and recreational activities of students of special medical groups

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L.V. Zaharova

2014-02-01

Full Text Available Purpose : to prove the superiority of techniques integrated approach to sports and recreational activities of students of special medical groups in the educational institution. Material / methods : the annual pedagogical experiment conducted on three groups that have been formed based on the results of preliminary studies based on diagnosis. Learning process based on the principle of improving training. Results : the advantages of an integrated approach to sports and recreational activities of students with disorders of the musculoskeletal system. Recommended approaches to increase physical and functional training. Also - the formation of a stable demand of motor activity, leading healthy lifestyles, in the acquisition of social status in the educational activity. Conclusions : the integrated approach will meet the educational needs of students to form a cultural competence of the individual in the preservation and conservation of health, ability to adapt and successfully implement their professional activities.

Learning Curves of Virtual Mastoidectomy in Distributed and Massed Practice.

Science.gov (United States)

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

2015-10-01

Repeated and deliberate practice is crucial in surgical skills training, and virtual reality (VR) simulation can provide self-directed training of basic surgical skills to meet the individual needs of the trainee. Assessment of the learning curves of surgical procedures is pivotal in understanding skills acquisition and best-practice implementation and organization of training. To explore the learning curves of VR simulation training of mastoidectomy and the effects of different practice sequences with the aim of proposing the optimal organization of training. A prospective trial with a 2 × 2 design was conducted at an academic teaching hospital. Participants included 43 novice medical students. Of these, 21 students completed time-distributed practice from October 14 to November 29, 2013, and a separate group of 19 students completed massed practice on May 16, 17, or 18, 2014. Data analysis was performed from June 6, 2014, to March 3, 2015. Participants performed 12 repeated virtual mastoidectomies using a temporal bone surgical simulator in either a distributed (practice blocks spaced in time) or massed (all practice in 1 day) training program with randomization for simulator-integrated tutoring during the first 5 sessions. Performance was assessed using a modified Welling Scale for final product analysis by 2 blinded senior otologists. Compared with the 19 students in the massed practice group, the 21 students in the distributed practice group were older (mean age, 25.1 years), more often male (15 [62%]), and had slightly higher mean gaming frequency (2.3 on a 1-5 Likert scale). Learning curves were established and distributed practice was found to be superior to massed practice, reported as mean end score (95% CI) of 15.7 (14.4-17.0) in distributed practice vs. 13.0 (11.9-14.1) with massed practice (P = .002). Simulator-integrated tutoring accelerated the initial performance, with mean score for tutored sessions of 14.6 (13.9-15.2) vs. 13.4 (12.8-14.0) for

Community for Data Integration 2013 Annual Report

Science.gov (United States)

Chang, Michelle Y.; Carlino, Jennifer; Barnes, Christopher; Blodgett, David L.; Bock, Andrew R.; Everette, Anthony L.; Fernette, Gregory L.; Flint, Lorraine E.; Gordon, Janice M.; Govoni, David L.; Hay, Lauren E.; Henkel, Heather S.; Hines, Megan K.; Holl, Sally L.; Homer, Collin G.; Hutchison, Vivian B.; Ignizio, Drew A.; Kern, Tim J.; Lightsom, Frances L.; Markstrom, Steven L.; O'Donnell, Michael S.; Schei, Jacquelyn L.; Schmid, Lorna A.; Schoephoester, Kathryn M.; Schweitzer, Peter N.; Skagen, Susan K.; Sullivan, Daniel J.; Talbert, Colin; Warren, Meredith Pavlick

2015-01-01

The U.S. Geological Survey (USGS) conducts earth science to help address complex issues affecting society and the environment. In 2006, the USGS held the first Scientific Information Management Workshop to bring together staff from across the organization to discuss the data and information management issues affecting the integration and delivery of earth science research and investigate the use of “communities of practice” as mechanisms to share expertise about these issues. Out of this effort emerged the Council for Data Integration, which was conceived as an official organizational function that would help guide data integration activities and formalize communities of practice into working groups. However by 2009, it became apparent that many members of the council had an interest in developing data integration solutions and sharing expertise in a less formal grassroots perspective, thus transforming the “Council” into a “Community” for Data Integration (CDI). Today, the CDI represents a dynamic community of practice focused on advancing science data and information management and integration capabilities across the USGS and the CDI community.

Russian practice of RPV integrity assessment under PTS conditions

International Nuclear Information System (INIS)

Piminov, V.; Dragunov, Yu.; Kostyrkin, S.; Akbachev, I.

1997-01-01

In this paper the approach used by Gidopress (main designer of Russian WWER reactors) for RPV integrity assessment is presented. Recently performed calculations for RPVs of Novoronezh NPP, units 3 and 4, are used as an example of practical application of this approach. The calculations have been performed on the base of Russian regulatory requirements, at the same time the recommendations of IAEA Guidelines for PTS assessment was also taken into account. The scope of the work includes: Analysis of real state of NPP systems and PTS selection; analysis of material behavior including results of templets investigation; thermal hydraulic calculations; structural analyses for the leading transients; development of supplementary measures to reduce the risk of RPV fracture. 5 refs, 9 figs, 1 tab

Russian practice of RPV integrity assessment under PTS conditions

Energy Technology Data Exchange (ETDEWEB)

Piminov, V; Dragunov, Yu; Kostyrkin, S; Akbachev, I

1997-09-01

In this paper the approach used by Gidopress (main designer of Russian WWER reactors) for RPV integrity assessment is presented. Recently performed calculations for RPVs of Novoronezh NPP, units 3 and 4, are used as an example of practical application of this approach. The calculations have been performed on the base of Russian regulatory requirements, at the same time the recommendations of IAEA Guidelines for PTS assessment was also taken into account. The scope of the work includes: Analysis of real state of NPP systems and PTS selection; analysis of material behavior including results of templets investigation; thermal hydraulic calculations; structural analyses for the leading transients; development of supplementary measures to reduce the risk of RPV fracture. 5 refs, 9 figs, 1 tab.

Integrating relationship- and research-based approaches in Australian health promotion practice.

Science.gov (United States)

Klinner, Christiane; Carter, Stacy M; Rychetnik, Lucie; Li, Vincy; Daley, Michelle; Zask, Avigdor; Lloyd, Beverly

2015-12-01

We examine the perspectives of health promotion practitioners on their approaches to determining health promotion practice, in particular on the role of research and relationships in this process. Using Grounded Theory methods, we analysed 58 semi-structured interviews with 54 health promotion practitioners in New South Wales, Australia. Practitioners differentiated between relationship-based and research-based approaches as two sources of knowledge to guide health promotion practice. We identify several tensions in seeking to combine these approaches in practice and describe the strategies that participants adopted to manage these tensions. The strategies included working in an evidence-informed rather than evidence-based way, creating new evidence about relationship-based processes and outcomes, adopting 'relationship-based' research and evaluation methods, making research and evaluation useful for communities, building research and evaluation skills and improving collaboration between research and evaluation and programme implementation staff. We conclude by highlighting three systemic factors which could further support the integration of research-based and relationship-based health promotion practices: (i) expanding conceptions of health promotion evidence, (ii) developing 'relationship-based' research methods that enable practitioners to measure complex social processes and outcomes and to facilitate community participation and benefit, and (iii) developing organizational capacity. © The Author (2014). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Source-Based Tasks in Writing Independent and Integrated Essays

Directory of Open Access Journals (Sweden)

Javad Gholami

2017-07-01

Full Text Available Integrated writing tasks have gained considerable attention in ESL and EFL writing assessment and are frequently needed and used in academic settings and daily life. However, they are very rarely practiced and promoted in writing classes. This paper explored the effects of source-based writing practice on EFL learners’ composing abilities and investigated the probable differences between those tasks and independent writing ones in improving Iranian EFL learners’ essay writing abilities. To this end, a quasi-experimental design was implemented to gauge EFL learners’ writing improvements using a pretest-posttest layout. Twenty female learners taking a TOEFL iBT preparation course were randomly divided into an only-writing group with just independent writing instruction and essay practice, and a hybrid-writing-approach group receiving instruction and practice on independent writing plus source-based essay writing for ten sessions. Based on the findings, the participants with hybrid writing practice outperformed their counterparts in integrated essay tests. Their superior performance was not observed in the case of traditional independent writing tasks. The present study calls for incorporating more source-based writing tasks in writing courses.

Educational technology integration and distance learning in respiratory care: practices and attitudes.

Science.gov (United States)

Hopper, Keith B; Johns, Carol L

2007-11-01

Educational technologies have had an important role in respiratory care. Distance learning via postal correspondence has been used extensively in respiratory care, and Internet-based distance learning is now used in the training of respiratory therapists (RTs), clinical continuing education, and in baccalaureate degree and higher programs for RTs and educators. To describe the current scope of respiratory care educational technology integration, including distance learning. To investigate online research potential in respiratory care. A probabilistic online survey of United States respiratory care program directors was conducted on educational technology practices and attitudes, including distance learning. A parallel exploratory study of United States respiratory care managers was conducted. One-hundred seventy-seven (53%) program directors participated. One-hundred twenty-eight respiratory care managers participated. For instructional purposes, the respiratory care programs heavily use office-productivity software, the Internet, e-mail, and commercial respiratory care content-based computer-based instruction. The programs use, or would use, online resources provided by text publishers, but there is a paucity. Many program directors reported that their faculty use personal digital assistants (PDAs), often in instructional roles. 74.6% of the programs offer no fully online courses, but 61.0% reported at least one course delivered partially online. The managers considered continuing education via online technologies appropriate, but one third reported that they have not/will not hire RTs trained via distance learning. Neither group considered fully online courses a good match for RT training, nor did they consider training via distance learning of comparable quality to on-campus programs. Both groups rated baccalaureate and higher degrees via distance learning higher if the program included face-to-face instruction. Online distance-learning participatory experience

Committee Opinion No. 661: Integrating Immunizations Into Practice.

Science.gov (United States)

2016-04-01

Immunization against vaccine-preventable diseases is an essential component of women's primary and preventive health care. Despite the importance of vaccination and clear guidance from public health agencies, rates of vaccination lag behind national goals. Obstetrician-gynecologists can play a major role in reducing morbidity and mortality from a range of vaccine-preventable diseases, including pertussis, influenza, human papillomavirus, and hepatitis. Given demonstrated vaccine efficacy and safety, and the large potential for prevention of many infectious diseases that affect adults, pregnant women, and newborns, obstetrician-gynecologists should include immunizations as an integral part of their practice. To do so, they must embrace their role as important sources of information and advice on immunization for adults, adolescents, and pregnant women, and advance their patients' well-being with continued efforts to augment immunization services in their offices. Increasing awareness combined with the many suggestions in this document will work to enhance immunization uptake.

Content and Language Integrated Learning in the Netherlands: Teachers' Self-Reported Pedagogical Practices

Science.gov (United States)

van Kampen, Evelyn; Admiraal, Wilfried; Berry, Amanda

2018-01-01

In recent years, a surging uptake of content and language integrated learning (CLIL) has permeated the European context. This article presents the outcomes of a study about the self-reported pedagogical practices of CLIL teachers in the Netherlands. To investigate these teachers' pedagogies, a questionnaire was designed, validated and,…

Practice patterns of radiotherapy in cervical cancer among member groups of the Gynecologic Cancer Intergroup (GCIG)

DEFF Research Database (Denmark)

Gaffney, David K; Du Bois, Andreas; Narayan, Kailash

2007-01-01

PURPOSE: The aim of this study was to describe radiotherapeutic practice of the treatment of cervical cancer in member groups of the Gynecologic Cancer Intergroup (GCIG). METHODS AND MATERIALS: A survey was developed and distributed to the members of the GCIG focusing on details of radiotherapy...... practice. Different scenarios were queried including advanced cervical cancer, postoperative patients, and para-aortic-positive lymph node cases. Items focused on indications for radiation therapy, radiation fields, dose, use of chemotherapy, brachytherapy and others. The cooperative groups from North...... America were compared with the other groups to evaluate potential differences in radiotherapy doses. RESULTS: A total of 39 surveys were returned from 13 different cooperative groups. For the treatment of advanced cervical cancer, external beam pelvic doses and total doses to point A were 47 + 3.5 Gy...

Intensive versus conventional blood pressure monitoring in a general practice population. The Blood Pressure Reduction in Danish General Practice trial: a randomized controlled parallel group trial

DEFF Research Database (Denmark)

Klarskov, Pia; Bang, Lia E; Schultz-Larsen, Peter

2018-01-01

To compare the effect of a conventional to an intensive blood pressure monitoring regimen on blood pressure in hypertensive patients in the general practice setting. Randomized controlled parallel group trial with 12-month follow-up. One hundred and ten general practices in all regions of Denmark....... One thousand forty-eight patients with essential hypertension. Conventional blood pressure monitoring ('usual group') continued usual ad hoc blood pressure monitoring by office blood pressure measurements, while intensive blood pressure monitoring ('intensive group') supplemented this with frequent...... a reduction of blood pressure. Clinical Trials NCT00244660....

Simple group password-based authenticated key agreements for the integrated EPR information system.

Science.gov (United States)

Lee, Tian-Fu; Chang, I-Pin; Wang, Ching-Cheng

2013-04-01

The security and privacy are important issues for electronic patient records (EPRs). The goal of EPRs is sharing the patients' medical histories such as the diagnosis records, reports and diagnosis image files among hospitals by the Internet. So the security issue for the integrated EPR information system is essential. That is, to ensure the information during transmission through by the Internet is secure and private. The group password-based authenticated key agreement (GPAKE) allows a group of users like doctors, nurses and patients to establish a common session key by using password authentication. Then the group of users can securely communicate by using this session key. Many approaches about GAPKE employ the public key infrastructure (PKI) in order to have higher security. However, it not only increases users' overheads and requires keeping an extra equipment for storing long-term secret keys, but also requires maintaining the public key system. This investigation presents a simple group password-based authenticated key agreement (SGPAKE) protocol for the integrated EPR information system. The proposed SGPAKE protocol does not require using the server or users' public keys. Each user only remembers his weak password shared with a trusted server, and then can obtain a common session key. Then all users can securely communicate by using this session key. The proposed SGPAKE protocol not only provides users with convince, but also has higher security.

Improving Group Work Practices in Teaching Life Sciences: Trialogical Learning

Science.gov (United States)

Tammeorg, Priit; Mykkänen, Anna; Rantamäki, Tomi; Lakkala, Minna; Muukkonen, Hanni

2017-08-01

Trialogical learning, a collaborative and iterative knowledge creation process using real-life artefacts or problems, familiarizes students with working life environments and aims to teach skills required in the professional world. We target one of the major limitation factors for optimal trialogical learning in university settings, inefficient group work. We propose a course design combining effective group working practices with trialogical learning principles in life sciences. We assess the usability of our design in (a) a case study on crop science education and (b) a questionnaire for university teachers in life science fields. Our approach was considered useful and supportive of the learning process by all the participants in the case study: the students, the stakeholders and the facilitator. Correspondingly, a group of university teachers expressed that the trialogical approach and the involvement of stakeholders could promote efficient learning. In our case in life sciences, we identified the key issues in facilitating effective group work to be the design of meaningful tasks and the allowance of sufficient time to take action based on formative feedback. Even though trialogical courses can be time consuming, the experience of applying knowledge in real-life cases justifies using the approach, particularly for students just about to enter their professional careers.

Patient Engagement Practices in Clinical Research among Patient Groups, Industry, and Academia in the United States: A Survey.

Directory of Open Access Journals (Sweden)

Sophia K Smith

Full Text Available Patient-centered clinical trial design and execution is becoming increasingly important. No best practice guidelines exist despite a key stakeholder declaration to create more effective engagement models. This study aims to gain a better understanding of attitudes and practices for engaging patient groups so that actionable recommendations may be developed.Individuals from industry, academic institutions, and patient groups were identified through Clinical Trials Transformation Initiative and Drug Information Association rosters and mailing lists. Objectives, practices, and perceived barriers related to engaging patient groups in the planning, conduct, and interpretation of clinical trials were reported in an online survey. Descriptive and inferential statistical analysis of survey data followed a literature review to inform survey questions.Survey respondents (n = 179 valued the importance of involving patient groups in research; however, patient group respondents valued their contributions to research protocol development, funding acquisition, and interpretation of study results more highly than those contributions were valued by industry and academic respondents (all p < .001. Patient group respondents placed higher value in open communications, clear expectations, and detailed contract execution than did non-patient group respondents (all p < .05. Industry and academic respondents more often cited internal bureaucratic processes and reluctance to share information as engagement barriers than did patient group respondents (all p < .01. Patient groups reported that a lack of transparency and understanding of the benefits of collaboration on the part of industry and academia were greater barriers than did non-patient group respondents (all p< .01.Despite reported similarities among approaches to engagement by the three stakeholder groups, key differences exist in perceived barriers and benefits to partnering with patient groups among the

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

Science.gov (United States)

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

2018-04-01

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

The Utility of Home-Practice in Mindfulness-Based Group Interventions: A Systematic Review.

Science.gov (United States)

Lloyd, Annette; White, Ross; Eames, Catrin; Crane, Rebecca

2018-01-01

A growing body of research supports the efficacy of mindfulness-based interventions (MBIs). MBIs consider home-practice as essential to increasing the therapeutic effects of the treatment. To date however, the synthesis of the research conducted on the role of home-practice in controlled MBI studies has been a neglected area. This review aimed to conduct a narrative synthesis of published controlled studies, evaluating mindfulness-based group interventions, which have specifically measured home-practice. Empirical research literature published until June 2016 was searched using five databases. The search strategy focused on mindfulness-based stress reduction (MBSR), mindfulness-based cognitive therapy (MBCT), and home-practice. Included studies met the following criteria: controlled trials, participants 18 years and above, evaluations of MBSR or MBCT, utilised standardised quantitative outcome measures and monitored home-practice using a self-reported measure. Fourteen studies met the criteria and were included in the review. Across all studies, there was heterogeneity in the guidance and resources provided to participants and the approaches used for monitoring home-practice. In addition, the guidance on the length of home-practice was variable across studies, which indicates that research studies and teachers are not adhering to the published protocols. Finally, only seven studies examined the relationship between home-practice and clinical outcomes, of which four found that home-practice predicted improvements on clinical outcome measures. Future research should adopt a standardised approach for monitoring home-practice across MBIs. Additionally, studies should assess whether the amount of home-practice recommended to participants is in line with MBSR/MBCT manualised protocols. Finally, research should utilise experimental methodologies to explicitly explore the relationship between home-practice and clinical outcomes.

Identification of climate-resilient integrated nutrient management practices for rice-rice cropping system--an empirical approach to uphold food security.

Science.gov (United States)

Subash, N; Gangwar, B; Singh, Rajbir; Sikka, A K

2015-01-01

Yield datasets of long-term experiments on integrated nutrient management in rice-rice cropping systems were used to investigate the relationship of variability in rainfall, temperature, and integrated nutrient management (INM) practices in rice-rice cropping system in three different agroecological regions of India. Twelve treatments with different combinations of inorganic (chemical fertilizer) and organic (farmyard manure, green manure, and paddy straw) were compared with farmer's conventional practice. The intraseasonal variations in rice yields are largely driven by rainfall during kharif rice and by temperature during rabi rice. Half of the standard deviation from the average monthly as well as seasonal rainfall during kharif rice and 1 °C increase or decrease from the average maximum and minimum temperature during rabi rice has been taken as the classification of yield groups. The trends in the date of effective onset of monsoon indicate a 36-day delay during the 30-year period at Rajendranagar, which is statistically significant at 95 % confidence level. The mean annual maximum temperature shows an increasing trend in all the study sites. The length of monsoon also showed a shrinking trend in the rate of 40 days during the 30-year study period at Rajendranagar representing a semiarid region. At Bhubaneshwar, the application of 50 % recommended NPK through chemical fertilizers and 50 % N through green manure resulted in an overall average higher increase of 5.1 % in system productivity under both excess and deficit rainfall years and also during the years having seasonal mean maximum temperature ≥35 °C. However, at Jorhat, the application of 50 % recommended NPK through chemical fertilizers and 50 % N through straw resulted in an overall average higher increase of 7.4 % in system productivity, while at Rajendranagar, the application of 75 % NPK through chemical fertilizers and 25 % N through green manusre resulted in an overall average higher increase of

Identification of climate-resilient integrated nutrient management practices for rice-rice cropping system—an empirical approach to uphold food security

Science.gov (United States)

Subash, N.; Gangwar, B.; Singh, Rajbir; Sikka, A. K.

2015-01-01

Yield datasets of long-term experiments on integrated nutrient management in rice-rice cropping systems were used to investigate the relationship of variability in rainfall, temperature, and integrated nutrient management (INM) practices in rice-rice cropping system in three different agroecological regions of India. Twelve treatments with different combinations of inorganic (chemical fertilizer) and organic (farmyard manure, green manure, and paddy straw) were compared with farmer's conventional practice. The intraseasonal variations in rice yields are largely driven by rainfall during kharif rice and by temperature during rabi rice. Half of the standard deviation from the average monthly as well as seasonal rainfall during kharif rice and 1 °C increase or decrease from the average maximum and minimum temperature during rabi rice has been taken as the classification of yield groups. The trends in the date of effective onset of monsoon indicate a 36-day delay during the 30-year period at Rajendranagar, which is statistically significant at 95 % confidence level. The mean annual maximum temperature shows an increasing trend in all the study sites. The length of monsoon also showed a shrinking trend in the rate of 40 days during the 30-year study period at Rajendranagar representing a semiarid region. At Bhubaneshwar, the application of 50 % recommended NPK through chemical fertilizers and 50 % N through green manure resulted in an overall average higher increase of 5.1 % in system productivity under both excess and deficit rainfall years and also during the years having seasonal mean maximum temperature ≥35 °C. However, at Jorhat, the application of 50 % recommended NPK through chemical fertilizers and 50 % N through straw resulted in an overall average higher increase of 7.4 % in system productivity, while at Rajendranagar, the application of 75 % NPK through chemical fertilizers and 25 % N through green manusre resulted in an overall average higher increase of

Practical use of the integrated reporting framework – an analysis of the content of integrated reports of selected companies

Directory of Open Access Journals (Sweden)

Monika Raulinajtys-Grzybek

2017-09-01

Full Text Available Practical use of the integrated reporting framework – an analysis of the content of integrated reports of selected companies The purpose of the article is to provide a research tool for an initial assessment of whether a company’s integrated reports meet the objectives set out in the IIRC Integrated Reporting Framework and its empirical verification. In particular, the research addresses whether the reports meet the goal of improving the quality of information available and covering all factors that influence the organization’s ability to create value. The article uses the theoretical output on the principles of preparing integrated reports and analyzes the content of selected integrated reports. Based on the source analysis, a research tool has been developed for an initial assessment of whether an integrated report fulfills its objectives. It consists of 42 questions that verify the coverage of the defined elements and the implementation of the guiding principles set by the IIRC. For empirical verification of the tool, a comparative analysis was carried out for reports prepared by selected companies operating in the utilities sector. Answering questions from the research tool allows a researcher to formulate conclusions about the implementation of the guiding principles and the completeness of the presentation of the content elements. As a result of the analysis of selected integrated reports, it was stated that various elements of the report are presented with different levels of accuracy in different reports. Reports provide the most complete information on performance and strategy. The information about business model and prospective data is in some cases presented without making a link to other parts of the report – e.g. risks and opportunities, financial data or capitals. The absence of such links limits the ability to claim that an integrated report meets its objectives, since a set of individual reports, each presenting

The impact of continuous integration on other software development practices: a large-scale empirical study

NARCIS (Netherlands)

Zhao, Y.; Serebrenik, A.; Zhou, Y.; Filkov, V.; Vasilescu, B.N.

2017-01-01

Continuous Integration (CI) has become a disruptive innovation in software development: with proper tool support and adoption, positive effects have been demonstrated for pull request throughput and scaling up of project sizes. As any other innovation, adopting CI implies adapting existing practices

Polarization and Persuasion: Integrating the Elaboration Likelihood Model with Explanations of Group Polarization.

Science.gov (United States)

Mongeau, Paul A.

Interest has recently focused on group polarization as a function of attitude processes. Several recent reviewers have challenged polarization researchers to integrate the explanations of polarization to existing theories of attitude change. This review suggests that there exists a clear similarity between the social comparison and persuasive…

Physician Acceptance of a Computerized Outpatient Medication System in a Teaching Hospital Group Practice

OpenAIRE

Blish, Christi; Proctor, Rita; Fletcher, Suzanne W.; O'Malley, Michael

1983-01-01

As part of a new automated ambulatory medical record, a computerized outpatient medication system was developed for a teaching hospital general medicine group practice. Seven months after its implementation, the system was evaluated to determine physician acceptance and approval. Practice physicians were surveyed, and 94% of the respondents approved of the system. Over 90% thought that the computerized system had improved the completeness and accuracy of medication information as well as thei...

Meditation is associated with increased brain network integration.

Science.gov (United States)

van Lutterveld, Remko; van Dellen, Edwin; Pal, Prasanta; Yang, Hua; Stam, Cornelis Jan; Brewer, Judson

2017-09-01

This study aims to identify novel quantitative EEG measures associated with mindfulness meditation. As there is some evidence that meditation is associated with higher integration of brain networks, we focused on EEG measures of network integration. Sixteen novice meditators and sixteen experienced meditators participated in the study. Novice meditators performed a basic meditation practice that supported effortless awareness, which is an important quality of experience related to mindfulness practices, while their EEG was recorded. Experienced meditators performed a self-selected meditation practice that supported effortless awareness. Network integration was analyzed with maximum betweenness centrality and leaf fraction (which both correlate positively with network integration) as well as with diameter and average eccentricity (which both correlate negatively with network integration), based on a phase-lag index (PLI) and minimum spanning tree (MST) approach. Differences between groups were assessed using repeated-measures ANOVA for the theta (4-8 Hz), alpha (8-13 Hz) and lower beta (13-20 Hz) frequency bands. Maximum betweenness centrality was significantly higher in experienced meditators than in novices (P = 0.012) in the alpha band. In the same frequency band, leaf fraction showed a trend toward being significantly higher in experienced meditators than in novices (P = 0.056), while diameter and average eccentricity were significantly lower in experienced meditators than in novices (P = 0.016 and P = 0.028 respectively). No significant differences between groups were observed for the theta and beta frequency bands. These results show that alpha band functional network topology is better integrated in experienced meditators than in novice meditators during meditation. This novel finding provides the rationale to investigate the temporal relation between measures of functional connectivity network integration and meditation quality, for example using

Physician groups' use of data from patient experience surveys.

Science.gov (United States)

Friedberg, Mark W; SteelFisher, Gillian K; Karp, Melinda; Schneider, Eric C

2011-05-01

In Massachusetts, physician groups' performance on validated surveys of patient experience has been publicly reported since 2006. Groups also receive detailed reports of their own performance, but little is known about how physician groups have responded to these reports. To examine whether and how physician groups are using patient experience data to improve patient care. During 2008, we conducted semi-structured interviews with the leaders of 72 participating physician groups (out of 117 groups receiving patient experience reports). Based on leaders' responses, we identified three levels of engagement with patient experience reporting: no efforts to improve (level 1), efforts to improve only the performance of low-scoring physicians or practice sites (level 2), and efforts to improve group-wide performance (level 3). Groups' level of engagement and specific efforts to improve patient care. Forty-four group leaders (61%) reported group-wide improvement efforts (level 3), 16 (22%) reported efforts to improve only the performance of low-scoring physicians or practice sites (level 2), and 12 (17%) reported no performance improvement efforts (level 1). Level 3 groups were more likely than others to have an integrated medical group organizational model (84% vs. 31% at level 2 and 33% at level 1; P customer service. The most commonly reported improvement initiatives were changing office workflow, providing additional training for nonclinical staff, and adopting or enhancing an electronic health record. Despite statewide public reporting, physician groups' use of patient experience data varied widely. Integrated organizational models were associated with greater engagement, and efforts to enhance clinicians' interpersonal skills were uncommon, with groups predominantly focusing on office workflow and support staff.

Integrated monitoring: Setting new standards for the next decade of clinical trial practice

Directory of Open Access Journals (Sweden)

Kamala Rai

2011-01-01

Full Text Available The new age clinical research professional is now geared toward an "integrated monitoring" approach. A number of critical activities at the site level and at the sponsor′s organization need convergence to harness rich dividends in early study start and quick close of the study. The field monitor needs full integration to ensure standard of care, train the site in protocol, select the right site, ensure regulatory support, ensure excellent project management skills, coach, support the logistics team, manage the vendor, ensure good documentation practices, develop patient recruitment and retention, lean the applicable process, as well as ensure effective site management amongst the myriad activities assigned toward developing the drug in the clinic.

Interorganisational Integration: Healthcare Professionals’ Perspectives on Barriers and Facilitators within the Danish Healthcare System

Directory of Open Access Journals (Sweden)

Anne Marie Lyngsø

2016-03-01

Full Text Available 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 as perceived by healthcare professionals caring for patients with chronic obstructive pulmonary disease within the Danish healthcare system. Methods: Seven focus groups were conducted in January through July 2014 with 21 informants from general practice, local healthcare centres and a pulmonary department 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. Especially, clinical, functional and normative integration seems fundamental to developing integrated care in practice from the perspective of healthcare professionals.

Discourse versus practice: are traditional practices and beliefs in pregnancy and childbirth included or excluded in the Ecuadorian health care system?

Science.gov (United States)

Gallegos, Carlos Andres; Waters, William F; Kuhlmann, Anne Sebert

2017-03-01

Traditional beliefs, knowledge and practices are formally integrated into the Ecuadorian health system. We sought to understand whether they are integrated in practice. Qualitative data were collected in two rural parishes in the central highlands of Ecuador through four focus group discussions (30 participants), eight key informant interviews, three participatory exercises (24 participants), structured observations of health facilities and analysis of official documents. We found different levels of integration, coexistence, tolerance, and intolerance of traditional health beliefs and practices in health facilities. One parish has undergone dramatic social and cultural transformation, and the role of traditional birth attendants is limited. In the other parish, traditional indigenous norms and values persist, and traditional birth attendants are sought during pregnancy and childbirth. The degree to which traditional birth attendants, indigenous women and their families are included or excluded from public health services depends largely on decisions taken by local health professionals. Formal policies in Ecuador stipulate that health care should be intercultural, but the role of traditional birth attendants is not necessarily incorporated in practice. The integration of culturally-informed beliefs and practices is critical for providing appropriate health services to members of vulnerable populations. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Pilot trial of a licensed practical nurse intervention for hypertension and depression.

Science.gov (United States)

Bogner, Hillary R; de Vries, Heather F; Kaye, Elise M; Morales, Knashawn H

2013-05-01

Depression is a risk factor for hypertension, and risk of depression is increased substantially in patients with hypertension. Our objective was to examine whether an intervention carried out by Licensed Practical Nurses (LPNs) integrating depression treatment into care for hypertension improved blood pressure control and depressive symptoms. In all, 60 patients ages 41 to 92 years with hypertension and depressive symptoms at a large primary care practice in Philadelphia were randomly assigned to an integrated care intervention carried out by LPNs (n=30) or usual care (n=30). Intervention and control groups did not differ statistically on baseline measures. Outcomes assessed at baseline and 12 weeks included standard laboratory procedures to measure blood pressure control and the Patient Health Questionnaire (PHQ-9) to assess depression. Patients in the integrated care intervention had lower diastolic blood pressure (intervention 74.2 mmHg versus usual care 82.0 mmHg) and fewer depressive symptoms (PHQ-9 mean scores, intervention 2.4 versus usual care 7.1) compared with patients in the usual care group at 12 weeks after adjustment for baseline values. Patients in the integrated care intervention also had lower systolic blood pressure (intervention 130.0 mmHg versus usual care 140.6 mmHg) compared with patients in the usual care group at 12 weeks although the results approached but did not reach conventional levels of statistical significance. Training existing primary care practice office staff will facilitate implementation in real world practices with limited resources and competing demands.

Pilot Trial of a Licensed Practical Nurse Intervention for Hypertension and Depression

Science.gov (United States)

Bogner, Hillary R.; de Vries, Heather F.; Kaye, Elise M.; Morales, Knashawn H.

2014-01-01

BACKGROUND AND OBJECTIVES Depression is a risk factor for hypertension, and risk of depression is increased substantially in patients with hypertension. Our objective was to examine whether an intervention carried out by Licensed Practical Nurses (LPNs) integrating depression treatment into care for hypertension improved blood pressure control and depressive symptoms. METHODS In all, 60 patients ages 41 to 92 years with hypertension and depressive symptoms at a large primary care practice in Philadelphia were randomly assigned to an integrated care intervention carried out by LPNs (n=30) or usual care (n=30). Intervention and control groups did not differ statistically on baseline measures. Outcomes assessed at baseline and 12 weeks included standard laboratory procedures to measure blood pressure control and the Patient Health Questionnaire (PHQ-9) to assess depression. RESULTS Patients in the integrated care intervention had lower diastolic blood pressure (intervention 74.2 mmHg versus usual care 82.0 mmHg) and fewer depressive symptoms (PHQ-9 mean scores, intervention 2.4 versus usual care 7.1) compared with patients in the usual care group at 12 weeks after adjustment for baseline values. Patients in the integrated care intervention also had lower systolic blood pressure (intervention 130.0 mmHg versus usual care 140.6 mmHg) compared with patients in the usual care group at 12 weeks although the results approached but did not reach conventional levels of statistical significance. CONCLUSION Training existing primary care practice office staff will facilitate implementation in real world practices with limited resources and competing demands. PMID:23681683

Evidence-based integrated environmental solutions for secondary lead smelters: Pollution prevention and waste minimization technologies and practices

Energy Technology Data Exchange (ETDEWEB)

Genaidy, A.M., E-mail: world_tek_inc@yahoo.com [University of Cincinnati, Cincinnati, Ohio (United States); Sequeira, R. [University of Cincinnati, Cincinnati, Ohio (United States); Tolaymat, T. [U.S. Environmental Protection Agency, Office of Research and Development, Cincinnati, Ohio (United States); Kohler, J. [US Environmental Protection Agency, Office of Solid Waste and Emergency Response, Washington DC (United States); Rinder, M. [WorldTek Inc, Cincinnati (United States)

2009-05-01

An evidence-based methodology was adopted in this research to establish strategies to increase lead recovery and recycling via a systematic review and critical appraisal of the published literature. In particular, the research examines pollution prevention and waste minimization practices and technologies that meet the following criteria: (a) reduce/recover/recycle the largest quantities of lead currently being disposed of as waste, (b) technically and economically viable, that is, ready to be diffused and easily transferable, and (c) strong industry interest (i.e., industry would consider implementing projects with higher payback periods). The following specific aims are designed to achieve the study objectives: Aim 1 - To describe the recycling process of recovering refined lead from scrap; Aim 2 - To document pollution prevention and waste management technologies and practices adopted by US stakeholders along the trajectory of LAB and lead product life cycle; Aim 3 - To explore improved practices and technologies which are employed by other organizations with an emphasis on the aforementioned criteria; Aim 4 - To demonstrate the economic and environmental costs and benefits of applying improved technologies and practices to existing US smelting operations; and Aim 5 - To evaluate improved environmental technologies and practices using an algorithm that integrates quantitative and qualitative criteria. The process of identifying relevant articles and reports was documented. The description of evidence was presented for current practices and technologies used by US smelters as well as improved practices and technologies. Options for integrated environmental solutions for secondary smelters were introduced and rank ordered on the basis of costs (i.e., capital investment) and benefits (i.e., production increases, energy and flux savings, and reduction of SO2 and slag). An example was provided to demonstrate the utility of the algorithm by detailing the costs and

Evidence-based integrated environmental solutions for secondary lead smelters: pollution prevention and waste minimization technologies and practices.

Science.gov (United States)

Genaidy, A M; Sequeira, R; Tolaymat, T; Kohler, J; Rinder, M

2009-05-01

An evidence-based methodology was adopted in this research to establish strategies to increase lead recovery and recycling via a systematic review and critical appraisal of the published literature. In particular, the research examines pollution prevention and waste minimization practices and technologies that meet the following criteria: (a) reduce/recover/recycle the largest quantities of lead currently being disposed of as waste, (b) technically and economically viable, that is, ready to be diffused and easily transferable, and (c) strong industry interest (i.e., industry would consider implementing projects with higher payback periods). The following specific aims are designed to achieve the study objectives: Aim 1 - To describe the recycling process of recovering refined lead from scrap; Aim 2 - To document pollution prevention and waste management technologies and practices adopted by US stakeholders along the trajectory of LAB and lead product life cycle; Aim 3 - To explore improved practices and technologies which are employed by other organizations with an emphasis on the aforementioned criteria; Aim 4 - To demonstrate the economic and environmental costs and benefits of applying improved technologies and practices to existing US smelting operations; and Aim 5 - To evaluate improved environmental technologies and practices using an algorithm that integrates quantitative and qualitative criteria. The process of identifying relevant articles and reports was documented. The description of evidence was presented for current practices and technologies used by US smelters as well as improved practices and technologies. Options for integrated environmental solutions for secondary smelters were introduced and rank ordered on the basis of costs (i.e., capital investment) and benefits (i.e., production increases, energy and flux savings, and reduction of SO(2) and slag). An example was provided to demonstrate the utility of the algorithm by detailing the costs and

Integrating Maternal and Children's Oral Health Promotion into Nursing and Midwifery Practice- A Systematic Review.

Directory of Open Access Journals (Sweden)

Reham Abou El Fadl

Full Text Available Globally, oral diseases contribute to major disease problems and oral health disparities persistently exist amongst vulnerable population groups. Two contributory factors to these challenges are the shortage of dental practitioners and the characteristic separation between the medical and dental professions. Nurses and midwives, in particular, are in a potentially excellent position to assist in basic oral health services such as dental health education and intraoral screening. We aimed to assess the effectiveness of integrating promotion of oral health of young children and their mothers into nursing and midwifery practice.Seven electronic databases including CENTRAL, EMBASE, MEDLINE, GLOBAL HEALTH, CINHAL, Scopus, and Web of Science were systematically searched whereas conference proceedings and theses were retrieved via PROQUEST. Only randomized, non-randomized trials and observational studies on preventive oral health programs delivered by nurses or midwives in healthcare settings or through home visits were included. Two investigators reviewed full-text articles independently to decide on eligibility for inclusion. Quality assessment was done using Cochrane tool for risk of bias for randomized trials and Downs and Black assessment tool for all other studies. Out of 3162 retrieved records, twenty one trials on oral health interventions incorporated into standard nursing practice were reviewed. Eighteen programs reported significant positive outcomes including reduction in caries experience, better oral hygiene and dietary habits and increased rates of dental visits amongst young children as reported by their caregivers.Incorporating oral health promotion into nursing practice is a promising initiative for reducing oral health disparities by contributing to a downward trend in caries experience and increased access to dental care especially amongst the poor disadvantaged communities.

Preservice Teachers' Attitudes and Beliefs about Democratic Classroom Practice: Influences on Intentions for Pedagogical Integration

Science.gov (United States)

Pryor, Caroline R.; Pryor, Brandt W.

2005-01-01

This study investigated preservice teachers' intentions to integrate democratic practice into their teaching and the influence of attitudes and beliefs on intentions. Participants were 76 undergraduates from 3 social studies methods classes. A theory of reasoned action (Fishbein & Ajzen, 1975) guided instrument development. Intention was…

Effect of Integrated Yoga Module on Selected Psychological Variables among Women with Anxiety Problem.

Science.gov (United States)

Parthasarathy, S; Jaiganesh, K; Duraisamy

2014-01-01

The implementation of yogic practices has proven benefits in both organic and psychological diseases. Forty-five women with anxiety selected by a random sampling method were divided into three groups. Experimental group I was subjected to asanas, relaxation and pranayama while Experimental group II was subjected to an integrated yoga module. The control group did not receive any intervention. Anxiety was measured by Taylor's Manifest Anxiety Scale before and after treatment. Frustration was measured through Reaction to Frustration Scale. All data were spread in an Excel sheet to be analysed with SPSS 16 software using analysis of covariance (ANCOVA). Selected yoga and asanas decreased anxiety and frustration scores but treatment with an integrated yoga module resulted in significant reduction of anxiety and frustration. To conclude, the practice of asanas and yoga decreased anxiety in women, and yoga as an integrated module significantly improved anxiety scores in young women with proven anxiety without any ill effects.

PRACTICING SPEECH THERAPY INTERVENTION FOR SOCIAL INTEGRATION OF CHILDREN WITH SPEECH DISORDERS

Directory of Open Access Journals (Sweden)

Martin Ofelia POPESCU

2016-11-01

Full Text Available The article presents a concise speech correction intervention program in of dyslalia in conjunction with capacity development of intra, interpersonal and social integration of children with speech disorders. The program main objectives represent: the potential increasing of individual social integration by correcting speech disorders in conjunction with intra- and interpersonal capacity, the potential growth of children and community groups for social integration by optimizing the socio-relational context of children with speech disorder. In the program were included 60 children / students with dyslalia speech disorders (monomorphic and polymorphic dyslalia, from 11 educational institutions - 6 kindergartens and 5 schools / secondary schools, joined with inter-school logopedic centre (CLI from Targu Jiu city and areas of Gorj district. The program was implemented under the assumption that therapeutic-formative intervention to correct speech disorders and facilitate the social integration will lead, in combination with correct pronunciation disorders, to social integration optimization of children with speech disorders. The results conirm the hypothesis and gives facts about the intervention program eficiency.

Integrating evidence into practice: use of McKenzie-based treatment for mechanical low back pain

Directory of Open Access Journals (Sweden)

Clarke S

2011-11-01

Full Text Available Angela Dunsford1, Saravana Kumar1,2, Sarah Clarke1 1International Centre for Allied Health Evidence, 2School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia Abstract: Low back pain (LBP is a major health issue with significant socioeconomic implications in most Western countries. Many forms of treatment have been proposed and investigated in the past, with exercise being a commonly prescribed intervention. Within allied health, in particular physiotherapy, there has been a growing movement that recognizes the role of the McKenzie method in treating LBP. Within the McKenzie framework, directional preference (DP exercises are one such intervention, with preliminary data demonstrating its effectiveness in the management of LBP. In this paper, we aim to integrate the evidence from current research, identified using a systematic review, and utilize a practical real-life case scenario to outline how evidence from the literature can be implemented in clinical practice. The findings from the systematic review indicate that DP exercises may have positive effects in the management of LBP. While the body of evidence to support this is limited (only four studies and therefore modest at best, it does provide some emerging evidence to support the use of DP exercises in clinical practice. Despite this, gaps also persist in the literature on DP exercises, and this relates to the exercise parameters and the compliance rates. Recognizing this dichotomy (modest evidence in some areas and evidence gaps in other areas, which is likely to confront health practitioners, using a practical approach with a real-life clinical scenario, we outline how the evidence from the systematic review can be implemented in clinical practice. This approach builds on the philosophy of evidence-based practice of integrating research evidence with clinical expertise and patient values. Keywords: low back pain, McKenzie method, directional

[Integrated skills laboratory concept for undergraduate training in internal medicine].

Science.gov (United States)

Nikendei, C; Schilling, T; Nawroth, P; Hensel, M; Ho, A D; Schwenger, V; Zeier, M; Herzog, W; Schellberg, D; Katus, H A; Dengler, T; Stremmel, W; Müller, M; Jünger, J

2005-05-06

An amendment to the German medical curriculum in April 2002 will place basic practical skills at the centre of medical training. We report here on the implementation and evaluation of an obligatory, tutor-guided, and integrated skills laboratory concept in the field of internal medicine. To test the effectiveness of a skills laboratory training on OSCE performance a pilot study was carried out. The experimental group, of 77 students, participated in seven sessions of communication training, skills laboratory training, and bedside teaching, each lasting one and a half hours. The control group of 66 students had as many sessions but was only offered bedside-teaching. The evaluation of acceptance of skills' training as well as the related increase in individual competence is on-going (summer term 2004: n = 176 students). The integrated skills laboratory concept was rated at 3.5 (SD = 1.2) on a 5-point scale and was acknowledged as practice-oriented (M = 4.2; SD = 1.0) and relevant for doctors' everyday lives (M = 3.6; SD = 1.1). Increased levels of competence according to individual self-evaluations proved to be highly significant (p<.001), and results of the pilot study showed that the experimental group had a significantly better OSCE performance than the control group (p<.001). This pilot study shows that curriculum changes promoting basic clinical skills are effective and lead to an improved practical education of tomorrow's physicians. The integrated skills laboratory concept is well accepted and leads to a relevant increase in competence in the practice of internal medical. The presented skills laboratory concept in internal medicine is proving to be a viable and efficient learning tool.

Developing an integrated career and competency framework for diabetes nursing.

Science.gov (United States)

Davis, Ruth; Turner, Eileen; Hicks, Deborah; Tipson, Margaret

2008-01-01

To describe the development of an integrated career and competency framework for diabetes nursing. The UK Nursing and Midwifery Council provides a definition of competence, but the terminology used in relation to the subject is often ambiguous and confusing. These concepts are explored in relation to nursing practice and the different approaches to competency framework development are described. To work alongside the Royal College of Nursing (RCN) and Skills for Health competency initiatives, a Diabetes Nursing Strategy Group representing nurses working in diabetes care was formed to oversee the development of an integrated career and competency framework for diabetes nursing. At the outset, the design was guided by the RCN Practice Development Team and employed qualitative methodology including the modified Delphi and nominal group technique. A purposive sample of nurses representing all sectors and grades of staff involved in diabetes care was invited to workshops to undertake a values clarification exercise. Content analysis was performed to identify themes. Further workshops identified areas of specialist practice and competence statements were developed and refined in a series of consultations. Competence statements for a range of diabetes-related areas were produced for nurses at the levels of unregistered practitioners, competent nurses, experience/proficient nurses, senior practitioners/expert nurses and consultant nurses. The description of the process of developing of the integrated career and competency framework should help other groups going through the same process. Relevance to clinical practice. In addition to helping groups identify a formula for the development of a competency framework, the framework itself is designed to provide a basis for educational programmes, personal career development and a tool for managers managing career progression within diabetes nursing.

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

Science.gov (United States)

Collins, Loel; Collins, Dave

2015-01-01

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

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

OpenAIRE

Amanda Nichols Hess; Katie Greer

2016-01-01

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

Interpretations of integration in early accountable care organizations.

Science.gov (United States)

Kreindler, Sara A; Larson, Bridget K; Wu, Frances M; Carluzzo, Kathleen L; Gbemudu, Josette N; Struthers, Ashley; VAN Citters, Aricca D; Shortell, Stephen M; Nelson, Eugene C; Fisher, Elliott S

2012-09-01

It is widely hoped that accountable care organizations (ACOs) will improve health care quality and reduce costs by fostering integration among diverse provider groups. But how do implementers actually envision integration, and what will integration mean in terms of managing the many social identities that ACOs bring together? Using the lens of the social identity approach, this qualitative study examined how four nascent ACOs engaged with the concept of integration. During multiday site visits, we conducted interviews (114 managers and physicians), observations, and document reviews. In no case was the ACO interpreted as a new, overarching entity uniting disparate groups; rather, each site offered a unique interpretation that flowed from its existing strategies for social-identity management: An independent practice association preserved members' cherished value of autonomy by emphasizing coordination, not "integration"; a medical group promoted integration within its employed core, but not with affiliates; a hospital, engaging community physicians who mistrusted integrated systems, reimagined integration as an equal partnership; an integrated delivery system advanced its careful journey towards intergroup consensus by presenting the ACO as a cultural, not structural, change. The ACO appears to be a model flexible enough to work in synchrony with whatever social strategies are most context appropriate, with the potential to promote alignment and functional integration without demanding common identification with a superordinate group. "Soft integration" may be a promising alternative to the vertically integrated model that, though widely assumed to be ideal, has remained unattainable for most organizations. © 2012 Milbank Memorial Fund.

Miniaturized Balanced Antenna with Integrated Balun for Practical LTE Applications

Directory of Open Access Journals (Sweden)

I. T. E. Elfergani

2017-06-01

Full Text Available A design of dual-band balanced antenna structure operating in the 700 and 2600MHz LTE bands is studied and investigated. The overall dimensions of the radiator are 50 × 18 × 7 mm^3 allowing it to be easily concealed within mobile handsets. A broad-band balun is designed and integrated with the antenna handset in order to provide the feeding network and perform the measurements of the antenna radiation performance. Prototypes of proposed antenna with and without balun are fabricated and verified. The simulated and practical results with and without the handheld effects in terms of reflection coefficient, power gain and radiation pattern, are studied and shown reasonable agreement.

Conversation as Academic Practice: Tutors' Strategies in Integrating Student Learning in a Professional Training Degree Programme

Directory of Open Access Journals (Sweden)

Matt Bowden

2013-04-01

Full Text Available Tutors are generally considered to be an additional resource in teaching and learning, as a means of augmenting that of the lecturer. This article explores tutors as academic staff with responsibilities for developing practice competencies and integrating student learning in a social care professional training degree programme. The research is small-scale, based upon data from a purposive sample of five interviews; and upon insider-participant observation notes and reflections in one single setting. The author deployed a situated ethnographic methodology alongside a frame analytic approach. The research found that in their academic practice, tutors reveal how their student contact is oriented to developing a reflective practitioner and they discuss how programme inputs impact on the student’s professional self. Simultaneously, tutors seek to create cross programme integration through finding overlaps with academic programme strands.

Effect of difference between group constants processed by codes TIMS and ETOX on integral quantities

International Nuclear Information System (INIS)

Takano, Hideki; Ishiguro, Yukio; Matsui, Yasushi.

1978-06-01

Group constants of 235 U, 238 U, 239 Pu, 240 Pu and 241 Pu have been produced with the processing code TIMS using the evaluated nuclear data of JENDL-1. The temperature and composition dependent self-shielding factors have been calculated for the two cases with and without considering mutual interference resonant nuclei. By using the group constants set produced by the TIMS code, the integral quantities, i.e. multiplication factor, Na-void reactivity effect and Doppler reactivity effect, are calculated and compared with those calculated with the use of the cross sections set produced by the ETOX code to evaluate accuracy of the approximate calculation method in ETOX. There is much difference in self-shielding factor in each energy group between the two codes. For the fast reactor assemblies under study, however, the integral quantities calculated with these two sets are in good agreement with each other, because of eventual cancelation of errors. (auth.)

Exploration of the affordances of mobile devices in integrating theory and clinical practice in an undergraduate nursing programme.

Science.gov (United States)

Willemse, Juliana J; Bozalek, Vivienne

2015-01-01

Promoting the quality and effectiveness of nursing education is an important factor, given the increased demand for nursing professionals. It is important to establish learning environments that provide personalised guidance and feedback to students about their practical skills and application of their theoretical knowledge. To explore and describe the knowledge and points of view of students and educators about introduction of new technologies into an undergraduate nursing programme. The qualitative design used Tesch's (1990) steps of descriptive data analysis to complete thematic analysis of the data collected in focus group discussions (FGDs) and individual interviews to identify themes. Themes identified from the students’ FGDs and individual interviews included: mobile devices as a communication tool; email, WhatsApp and Facebook as methods of communication; WhatsApp as a method of communication; nurses as role-models in the clinical setting; setting personal boundaries; and impact of mobile devices in clinical practice on professionalism. Themes identified from the FGD, individual interviews and a discussion session held with educators included: peer learning via mobile devices; email, WhatsApp and Facebook as methods of communication; the mobile device as a positive learning method; students need practical guidance; and ethical concerns in clinical facilities about Internet access and use of mobile devices. The research project established an understanding of the knowledge and points of view of students and educators regarding introduction of new technologies into an undergraduate nursing programme with the aim of enhancing integration of theory and clinical practice through use of mobile devices.

New approach to the adjustment of group cross sections fitting integral measurements

International Nuclear Information System (INIS)

Chao, Y.A.

1979-01-01

The adjustment of group cross sections fitting integral measurements is viewed as a process of estimating theoretical and/or experimental negligence errors to bring statistical consistency to the integral and differential data so that they can be combined to form an enlarged ensemble, based on which an improved estimation of the physical constants can be made. A three-step approach is suggested, and its formalism of general validity is developed. In step one, the data of negligence error are extracted from the given integral and differential data. The method of extraction is based on the concepts of prior probability and information entropy. It automatically leads to vanishing negligence error as the two sets of data are statistically consistent. The second step is to identify the sources of negligence error and adjust the data by an amount compensating for the extracted negligence discrepancy. In the last step, the two data sets, already adjusted to mutual consistency are combined as a single unified ensemble. Standard methods of statistics can then be applied to reestimate the physical constants. 1 figure

The process of care in integrative health care settings - a qualitative study of US practices.

Science.gov (United States)

Grant, Suzanne J; Bensoussan, Alan

2014-10-23

There is a lack of research on the organisational operations of integrative healthcare (IHC) practices. IHC is a therapeutic strategy integrating conventional and complementary medicine in a shared context to administer individualized treatment. To better understand the process of care in IHC - the way in which patients are triaged and treatment plans are constructed, interviews were conducted with integrative health care leaders and practitioners in the US. Semi-structured interviews were conducted with a pragmatic group of fourteen leaders and practitioners from nine different IHC settings. All interviews were conducted face-to-face with the exception of one phone interview. Questions focussed on understanding the "process of care" in an integrative healthcare setting. Deductive categories were formed from the aims of the study, focusing on: organisational structure, processes of care (subcategories: patient intake, treatment and charting, use of guidelines or protocols), prevalent diseases or conditions treated, and the role of research in the organisation. The similarities and differences of the ITH entities emerged from this process. On an organisational level, conventional and CM services and therapies were co-located in all nine settings. For patients, this means there is more opportunity for 'seamless care'. Shared information systems enabled easy communication using internal messaging or email systems, and shared patient intake information. But beyond this infrastructure alignment for integrative health care was less supported. There were no use of protocols or guidelines within any centre, no patient monitoring mechanism beyond that which occurred within one-on-one appointments. Joint planning for a patient treatment was typically ad hoc through informal mechanisms. Additional duties typically come at a direct financial cost to fee-for-service practitioners. In contrast, service delivery and the process of care within hospital inpatient services followed

Feminism and group psychotherapy: an ethical responsibility.

Science.gov (United States)

Lazerson, J

1992-10-01

In response to Martin Lakin's (1991) IJGP article, "Some Ethical Issues in Feminist-Oriented Therapy Groups for Women," this article examines recent developments in feminist theory and proposes that a feminist perspective is both ethical and can make significant contributions to the practice of group psychotherapy. The overview of feminist theory focuses on (1) the importance of the social context, (2) contributions and challenges to psychoanalytic and developmental theory, (3) attention to power relations, (4) the connection between the personal and political, and (5) recognition and integration of diversity and difference. Clinical examples illustrate ways in which male and female group therapists can take a feminist perspective and become "ethical advocates."

78 FR 69853 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

Science.gov (United States)

2013-11-21

... Promotion, and Integrative and Public Health AGENCY: Office of the Surgeon General of the United States Public Health Service, Office of the Assistant Secretary for Health, Office of the Secretary, Department... Integrative and Public Health (the ``Advisory Group''). The meeting will be open to the public. Information...

78 FR 48877 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

Science.gov (United States)

2013-08-12

... Promotion, and Integrative and Public Health AGENCY: Office of the Surgeon General of the United States Public Health Service, Office of the Assistant Secretary for Health, Office of the Secretary, Department... Integrative and Public Health (the ``Advisory Group''). The meeting will be open to the public. Information...

Music plus Music Integration: A Model for Music Education Policy Reform That Reflects the Evolution and Success of Arts Integration Practices in 21st Century American Public Schools

Science.gov (United States)

Scripp, Lawrence; Gilbert, Josh

2016-01-01

This article explores the special case of integrative teaching and learning in music as a model for 21st century music education policy reform based on the principles that have evolved out of arts integration research and practices over the past century and informed by the recent rising tide of evidence of music's impact on brain capacity and…

Practice Innovation for Care Integration, Opioid Management, and Quality Measurement in Family Medicine.

Science.gov (United States)

Neale, Anne Victoria; Bowman, Marjorie A; Seehusen, Dean A

Ringing in the new year 2017! This may finally be the year of real practice improvement after many false starts. Research into practice transformation has informed both local work and national policy. Human factors and payment structures are key. And payment structures depend on how quality is measured. Large gaps between practicing physician recommendations for the most important quality measures and those currently imposed externally are exposed in this issue. Also see information on in-practice social work consultations and their outcomes and recommendations from innovators in integrated care, and for chronic opioid therapy management based on visits to many family medicine offices. Visit entropy is negative for hospital readmissions. Another article reaffirms the importance of family physicians in rural obstetrics, including Cesarean deliveries. Two articles address changing Latino health care access. New Mexico's innovative health extension agent implementation now includes research in ways that benefit all. And a glass half-full: the growth in the diversity of family medicine faculty is above average, but is not occurring as quickly as in the general population. © Copyright 2017 by the American Board of Family Medicine.

Integrated crop management practices for maximizing grain yield of double-season rice crop

Science.gov (United States)

Wang, Depeng; Huang, Jianliang; Nie, Lixiao; Wang, Fei; Ling, Xiaoxia; Cui, Kehui; Li, Yong; Peng, Shaobing

2017-01-01

Information on maximum grain yield and its attributes are limited for double-season rice crop grown under the subtropical environment. This study was conducted to examine key characteristics associated with high yielding double-season rice crop through a comparison between an integrated crop management (ICM) and farmers’ practice (FP). Field experiments were conducted in the early and late seasons in the subtropical environment of Wuxue County, Hubei Province, China in 2013 and 2014. On average, grain yield in ICM was 13.5% higher than that in FP. A maximum grain yield of 9.40 and 10.53 t ha-1 was achieved under ICM in the early- and late-season rice, respectively. Yield improvement of double-season rice with ICM was achieved with the combined effects of increased plant density and optimized nutrient management. Yield gain of ICM resulted from a combination of increases in sink size due to more panicle number per unit area and biomass production, further supported by the increased leaf area index, leaf area duration, radiation use efficiency, crop growth rate, and total nitrogen uptake compared with FP. Further enhancement in the yield potential of double-season rice should focus on increasing crop growth rate and biomass production through improved and integrated crop management practices.

76 FR 67731 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

Science.gov (United States)

2011-11-02

... Promotion, and Integrative and Public Health AGENCY: Department of Health and Human Services, Office of the... Public Health Service. ACTION: Notice. SUMMARY: In accordance with Section 10(a) of the Federal Advisory... scheduled to be held for the Advisory Group on Prevention, Health Promotion, and Integrative and Public...

76 FR 26300 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

Science.gov (United States)

2011-05-06

... Promotion, and Integrative and Public Health AGENCY: Department of Health and Human Services, Office of the... Public Health Service. ACTION: Notice. SUMMARY: In accordance with Section 10(a) of the Federal Advisory... scheduled to be held for the Advisory Group on Prevention, Health Promotion, and Integrative and Public...

78 FR 38345 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

Science.gov (United States)

2013-06-26

... Promotion, and Integrative and Public Health AGENCY: Office of the Surgeon General of the United States Public Health Service, Office of the Assistant Secretary for Health, Office of the Secretary, Department... Integrative and Public Health (the ``Advisory Group''). The meeting will be open to the public. [[Page 38346...

76 FR 58007 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

Science.gov (United States)

2011-09-19

... Promotion, and Integrative and Public Health AGENCY: Department of Health and Human Services, Office of the... Public Health Service. ACTION: Notice. SUMMARY: In accordance with Section 10(a) of the Federal Advisory... scheduled to be held for the Advisory Group on Prevention, Health Promotion, and Integrative and Public...

77 FR 15372 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

Science.gov (United States)

2012-03-15

... Promotion, and Integrative and Public Health AGENCY: Department of Health and Human Services, Office of the... Public Health Service. ACTION: Notice. SUMMARY: In accordance with Section 10(a) of the Federal Advisory... scheduled to be held for the Advisory Group on Prevention, Health Promotion, and Integrative and Public...

Book Review of Relational Patterns, Therapeutic Presence: Concepts and practice of Integrative Psychotherapy by Richard G. Erskine

OpenAIRE

Marye O'Reilly-Knapp

2015-01-01

Book Review of Relational Patterns, Therapeutic Presence: Concepts and practice of Integrative Psychotherapy by Richard G. Erskine. Published by Karnac Books: London, 2015 Paperback, Pages 366, ISBN 13: 978-1-78220-190-8

Consumer preferences and values as an integral key to evidence-based practice.

Science.gov (United States)

Melnyk, Bernadette Mazurek; Fineout-Overholt, Ellen

2006-01-01

Although evidence-based practice (EBP) integrates the best evidence from well-designed studies with a clinician's expertise and patient preferences and values, most of what is emphasized in books and reports on EBP is the 5-step EBP process. However, the consideration of patient values and preferences in making clinical decisions is essential to deliver the highest quality of care. This article briefly reviews the status of EBP in the United States, described the ARCC mentorship model, and highlights how to engage consumers in the EBP process.

Integrating Science and Technology: Using Technological Pedagogical Content Knowledge as a Framework to Study the Practices of Science Teachers

Science.gov (United States)

Pringle, Rose M.; Dawson, Kara; Ritzhaupt, Albert D.

2015-01-01

In this study, we examined how teachers involved in a yearlong technology integration initiative planned to enact technological, pedagogical, and content practices in science lessons. These science teachers, engaged in an initiative to integrate educational technology in inquiry-based science lessons, provided a total of 525 lesson plans for this…

DEFORMATION PRACTICES OF SOCIAL REALITY INTEGRITY: OBJECTIFICATION OF DESIRES AS THE INHERITANCE OF CIVILIZATION PROGRESS

Directory of Open Access Journals (Sweden)

Yu. Yu. Brodetskaya

2014-12-01

Full Text Available Objective. The interest of the article focuses on the analysis of the social integrity phenomenon and its deformation practices in the modern society. The character’s sociality of the modern era indicates serious problems and contradictions that actualize the possibility of social integrity. The cultural crisis, spiritual vacuum, updated existential problems of the modern humanity forces to turn to the problem of the integrity constructing and maintaining and social reality functioning, as well as to the mechanisms and practices of its deformation. Methodology. Thus, in the analysis of the above mentioned points the problem of desires is getting more relevant, and these desires are actively being invested by the civilization progress in the human life. As simulacra of the natural mechanisms of individual activity (needs desires help to transform the personality harmonious development process (cultural consumption in a destructive civilization strategy – consumerism. Under these conditions consumption is losing its traditional meaning. From the natural processes of meeting the needs and developing the world it is transforming into a total destructive act that implements certain desires. Consumption grows borders of the traditional practice (it has not been already determined only by food, clothes, car, etc.. It is turning into an active mass orientation; practice of the materialization that is aimed to transform the surrounding world into a thing, a symbol of use. Thus, consumption transforms into a practice of total consumerism. The scientific novelty. In this context, the aim of the research is to analyze the destructive potential of consumerism, which nature is getting a real threat to the integrity of both individual world and social reality. This pattern of consumption determines the gap between a real purpose of the things and their contrived sense that gives them the desired effect (prestige, power, material wealth, etc.. In this

Meeting Curation Challenges in a Neuroimaging Group

Directory of Open Access Journals (Sweden)

Angus Whyte

2008-08-01

Full Text Available The SCARP project is a series of short studies with two aims; firstly to discover more about disciplinary approaches and attitudes to digital curation through ‘immersion’ in selected cases; secondly to apply known good practice, and where possible, identify new lessons from practice in the selected discipline areas. The study summarised here is of the Neuroimaging Group in the University of Edinburgh’s Division of Psychiatry, which plays a leading role in eScience collaborations to improve the infrastructure for neuroimaging data integration and reuse. The Group also aims to address growing data storage and curation needs, given the capabilities afforded by new infrastructure. The study briefly reviews the policy context and current challenges to data integration and sharing in the neuroimaging field. It then describes how curation and preservation risks and opportunities for change were identified throughout the curation lifecycle; and their context appreciated through field study in the research site. The results are consistent with studies of neuroimaging eInfrastructure that emphasise the role of local data sharing and reuse practices. These sustain mutual awareness of datasets and experimental protocols through sharing peer to peer, and among senior researchers and students, enabling continuity in research and flexibility in project work. This “human infrastructure” is taken into account in considering next steps for curation and preservation of the Group’s datasets and a phased approach to supporting data documentation.

Impact of a Multifaceted and Clinically Integrated Training Program in Evidence-Based Practice on Knowledge, Skills, Beliefs and Behaviour among Clinical Instructors in Physiotherapy: A Non-Randomized Controlled Study.

Science.gov (United States)

Olsen, Nina Rydland; Bradley, Peter; Espehaug, Birgitte; Nortvedt, Monica Wammen; Lygren, Hildegunn; Frisk, Bente; Bjordal, Jan Magnus

2015-01-01

Physiotherapists practicing at clinical placement sites assigned the role as clinical instructors (CIs), are responsible for supervising physiotherapy students. For CIs to role model evidence-based practice (EBP) they need EBP competence. The aim of this study was to assess the short and long term impact of a six-month multifaceted and clinically integrated training program in EBP on the knowledge, skills, beliefs and behaviour of CIs supervising physiotherapy students. We invited 37 CIs to participate in this non-randomized controlled study. Three self-administered questionnaires were used pre- and post-intervention, and at six-month follow-up: 1) The Adapted Fresno test (AFT), 2) the EBP Belief Scale and 3) the EBP Implementation Scale. The analysis approach was linear regression modeling using Generalized Estimating Equations. In total, 29 CIs agreed to participate in the study: 14 were invited to participate in the intervention group and 15 were invited to participate in the control group. One in the intervention group and five in the control group were lost to follow-up. At follow-up, the group difference was statistically significant for the AFT (mean difference = 37, 95% CI (15.9 -58.1), p students.

Authentic Science Research Opportunities: How Do Undergraduate Students Begin Integration into a Science Community of Practice?

Science.gov (United States)

Gardner, Grant E.; Forrester, Jennifer H.; Jeffrey, Penny Shumaker; Ferzli, Miriam; Shea, Damian

2015-01-01

The goal of the study described was to understand the process and degree to which an undergraduate science research program for rising college freshmen achieved its stated objectives to integrate participants into a community of practice and to develop students' research identities.

77 FR 33220 - Advisory Group on Prevention, Health Promotion, and Integrative and Public Health; Notice of Meeting

Science.gov (United States)

2012-06-05

... Integrative and Public Health; Notice of Meeting AGENCY: Office of the Surgeon General of the United States Public Health Service, Office of the Assistant Secretary for Health, Office of the Secretary, Department... Integrative and Public Health (the ``Advisory Group''). The web meeting will be open to the public. The agenda...

The effectiveness of a cardiometabolic prevention program in general practices offering integrated care programs including a patient tailored lifestyle treatment.

NARCIS (Netherlands)

Hollander, M.; Eppink, L.; Nielen, M.; Badenbroek, I.; Stol, D.; Schellevis, F.; Wit, N. de

2016-01-01

Background & Aim: Selective cardio-metabolic prevention programs (CMP) may be especially effective in well-organized practices. We studied the effect of a CMP program in the academic primary care practices of the Julius Health Centers (JHC) that offer integrated cardiovascular disease management

A Nordic survey of management practices and owners’ attitudes towards keeping horses in groups

DEFF Research Database (Denmark)

Hartmann, E.; Bøe, K.E.; Christensen, Janne Winther

2015-01-01

Keeping horses in groups is widely recommended but limited information is vailable about how this is implemented in practice. The aim of this survey was to describe how horses are kept in the Nordic countries in relation to sex, age, breed, and equestrian discipline and to assess owners’ attitudes...... widespread, such as it is the case for most farm animals, future research could focus on solving some of the reoccurring problems perceived with keeping horses in groups. The dissemination of evidence-based information on all aspects around keeping horses in groups can ultimately stimulate further positive...

Cancer screening promotion among medically underserved Asian American women: integration of research and practice.

Science.gov (United States)

Yu, Mei-yu; Seetoo, Amy D; Hong, Oi Saeng; Song, Lixin; Raizade, Rekha; Weller, Adelwisa L Agas

2002-01-01