WorldWideScience

Sample records for negotiating clinical knowledge

  1. Negotiation skills for clinical research professionals

    Directory of Open Access Journals (Sweden)

    Sanjay Hake

    2011-01-01

    Full Text Available Negotiation as a skill is a key requirement for each and every job profile where dealing with multiple parties is involved. The important focus while negotiating should be on the interest then position. Key to every successful negotiation is advance planning, preparation, and patience as the objective is to create value and establish the terms on which parties with differing and often conflicting aims will co-operate. While preparing one should collect facts, know priorities, principles, identify common ground, decide on walk-away position, and try and identify the next best alternative. Negotiation is a set of skills that can be learned and practiced so that your ability to utilize relationship, knowledge, money, power, time, and personality to negotiate improves with each negotiation. In a successful negotiation, all parties win. Important thing to note is that not every negotiation involves money. Anytime you want something from someone else and anytime someone wants something from you, you are negotiating. Everything is negotiable and every day you negotiate with customers, suppliers, colleagues, your wife, and even your children. Negotiation is a game, and like any game it has its rules and tactics. Clinical Research professionals deal with various parties for different purposes at the same time; hence, they require excellent negotiation skills. Project Mangers and Clinical Research Associates are the two most important roles in clinical research industry who require negotiation skills as they deal with various internal and external customers and vendors.

  2. Negotiation skills for clinical research professionals

    Science.gov (United States)

    Hake, Sanjay; Shah, Tapankumar

    2011-01-01

    Negotiation as a skill is a key requirement for each and every job profile where dealing with multiple parties is involved. The important focus while negotiating should be on the interest then position. Key to every successful negotiation is advance planning, preparation, and patience as the objective is to create value and establish the terms on which parties with differing and often conflicting aims will co-operate. While preparing one should collect facts, know priorities, principles, identify common ground, decide on walk-away position, and try and identify the next best alternative. Negotiation is a set of skills that can be learned and practiced so that your ability to utilize relationship, knowledge, money, power, time, and personality to negotiate improves with each negotiation. In a successful negotiation, all parties win. Important thing to note is that not every negotiation involves money. Anytime you want something from someone else and anytime someone wants something from you, you are negotiating. Everything is negotiable and every day you negotiate with customers, suppliers, colleagues, your wife, and even your children. Negotiation is a game, and like any game it has its rules and tactics. Clinical Research professionals deal with various parties for different purposes at the same time; hence, they require excellent negotiation skills. Project Mangers and Clinical Research Associates are the two most important roles in clinical research industry who require negotiation skills as they deal with various internal and external customers and vendors. PMID:21897886

  3. Negotiating clinical knowledge:a field study of psychiatric nurses' everyday communication

    DEFF Research Database (Denmark)

    Buus, Niels

    2008-01-01

    Nursing practices at psychiatric hospitals have changed significantly over the last decades. In this paper, everyday nursing practices were interpreted in light of these institutional changes. The objective was to examine how mental health nurses' production of clinical knowledge was influenced b...... knowledge influenced processes of clinical decision-making among the nurses as the game added to a distorted widening of a 'fictional distance' between patients and the representations produced by the nurses.......Nursing practices at psychiatric hospitals have changed significantly over the last decades. In this paper, everyday nursing practices were interpreted in light of these institutional changes. The objective was to examine how mental health nurses' production of clinical knowledge was influenced...... by the particular social relations on hospital wards. Empirical data stemming from an extended fieldwork at two Danish psychiatric hospital wards were interpreted using interactionistic theory and the metaphor: 'the game of clinical knowledge'. The results indicated that the nurses' production of clinical knowledge...

  4. Virtual reality negotiation training increases negotiation knowledge and skill

    NARCIS (Netherlands)

    Broekens, J.; Harbers, M.; Brinkman W.; Jonker, C.; Bosch, K. van den; Meyer, J.J.C.

    2012-01-01

    In this paper we experimentally investigate learning effects of a rigourously set up virtual reality (VR) negotiation training. We discuss the design of the system in detail. Further, we present results of an experiment (between subject; three experimental conditions: control, training once,

  5. Research and International Trade Policy Negotiations: Knowledge ...

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

    2009-10-07

    Oct 7, 2009 ... ... pillar of Latin America's development strategy into the 21st century. ... and policy advisors involved in trade negotiations and the formulation of trade policy. ... Expanding women's financial inclusion: A win-win for women and ...

  6. Negotiating contingent knowledges in a time of epistemic doubt

    DEFF Research Database (Denmark)

    Phillips, Louise Jane

    How can/should we produce and communicate social scientific knowledge with authority under conditions of epistemic doubt? If all knowledge is contingent and if truth is a discursive effect rather than the final claim about reality - as post-foundationalism suggests - how can we formulate...... and provide support for contingent knowledge-claims? And how can the communication of social scientificknowlege be theorised and practised as the negotiation between social scientific knowledge and other forms of contingent knowledge rather than the one-way transmission of universal, value-free truth......-claims? In the paper, I outline an approach to addressing the final question. The approach is based on a combination of approaches to the production of knowledge developed in post-foundationalist sociology and philosophy of science, approaches to the communication of knowlege developed within communication studies...

  7. Negotiating knowledges and expertise in refugee resettlement organizations

    Directory of Open Access Journals (Sweden)

    Sarah Steimel

    2016-12-01

    Full Text Available Interviews with both refugees and organizational staff in two nonprofit refugee resettlement organizations in the United States reveal the ways in which knowledge(s and expertise are crafted, threatened, and understood in refugee organizations. Refugee-participants described the need for knowledgeable communication, barriers to the communication of knowledge, and processes of negotiating whose expertise is involved. Organizational staff participants described the duty of communicating expert knowledge, the limits of knowledge as expertise, and alternative communications of expertise. These tensions surrounding “knowing” in refugee resettlement organizations highlights the need for a more complex theoretical understanding of the processes of knowing present in refugee resettlement. These tensions also suggest areas in which refugee resettlement agencies and other nonprofit staff can make on-the-ground changes to better facilitate refugee resettlement processes.

  8. Communicating specialized knowledge - negotiating knowledge communication between writer and editor

    DEFF Research Database (Denmark)

    Petersen, Margrethe

    In communicating research findings, authors of academic journal articles face the challenge of overcoming the barriers posed by the knowledge asymmetries between (a) authors and journal readership and (b) authors and editors. Considering the general taxonomy of the submission procedure and the ke...... role of academic journal editors, the issue of whether, regardless of the quality of the submissions received, editors are sometimes insurmountable barriers to knowledge communication should be debated....

  9. Negotiating Knowledges Abroad: Non-Western Students and the Global Mobility of Knowledge

    Science.gov (United States)

    van Oorschot, Irene

    2014-01-01

    Taking the Institute for Housing Studies in Rotterdam as a case study, this paper aims to theorise the ways non-Western, international students construct and negotiate knowledges in Western institutions of higher education. It describes the types of knowledges these students identify as characteristic of their learning abroad, distinguishing…

  10. Negotiating over bundles and prices using aggregate knowledge

    NARCIS (Netherlands)

    Somefun, D.J.A.; Klos, T.B.; Poutré, la J.A.; Bauknecht, K.; Bichler, M.; Pröll, B.

    2004-01-01

    Combining two or more items and selling them as one good, a practice called bundling, can be a very effective strategy for reducing the costs of producing, marketing, and selling goods. In this paper, we consider a form of multi-issue negotiation where a shop negotiates both the contents and the

  11. WTO — The knowledge deficit in trade negotiations | CRDI - Centre ...

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

    The ferocity of negotiations in the World Trade Organization (WTO) was on display again at the Fifth WTO Ministerial Conference, held in Cancún, Mexico from September 10 to 14. The intensity of the negotiations reflects more than a clash of opinions about free trade. It gives expression to a deep and dangerous power ...

  12. Too much coffee... - Negotiation of Knowledge Forms in Participatory Research Settings

    DEFF Research Database (Denmark)

    Olesen, Birgitte Ravn; Nordentoft, Helle Merete

    Based on a Bakhtinian approach negotiations of knowledge in a workshop with health professionals at two psychiatric wards were analyzed. Our analysis reveals that there is a mismatch between the dialogical context we as participatory-oriented researchers want to invoke and the monological context...

  13. Negotiation of Meaning and Co-Construction of Knowledge: An Experimental Analysis of Asynchronous Online Instruction

    Science.gov (United States)

    Hull, Darrell M.; Saxon, Terrill F.

    2009-01-01

    Variations in group co-construction of knowledge and the extent to which participants engaged in negotiating meaning were directly related to instruction. The authors examined social interaction resulting from controlled variation in instruction using a counter-balanced design in two professional development courses for teachers. Both courses were…

  14. The role of collaborative ontology development in the knowledge negotiation process

    Science.gov (United States)

    Rivera, Norma

    Interdisciplinary research (IDR) collaboration can be defined as the process of integrating experts' knowledge, perspectives, and resources to advance scientific discovery. The flourishing of more complex research problems, together with the growth of scientific and technical knowledge has resulted in the need for researchers from diverse fields to provide different expertise and points of view to tackle these problems. These collaborations, however, introduce a new set of "culture" barriers as participating experts are trained to communicate in discipline-specific languages, theories, and research practices. We propose that building a common knowledge base for research using ontology development techniques can provide a starting point for interdisciplinary knowledge exchange, negotiation, and integration. The goal of this work is to extend ontology development techniques to support the knowledge negotiation process in IDR groups. Towards this goal, this work presents a methodology that extends previous work in collaborative ontology development and integrates learning strategies and tools to enhance interdisciplinary research practices. We evaluate the effectiveness of applying such methodology in three different scenarios that cover educational and research settings. The results of this evaluation confirm that integrating learning strategies can, in fact, be advantageous to overall collaborative practices in IDR groups.

  15. Negotiating the dynamics of uncomfortable knowledge: The case of dual use and synthetic biology

    Science.gov (United States)

    Marris, Claire; Jefferson, Catherine; Lentzos, Filippa

    2014-01-01

    Institutions need to ignore some knowledge in order to function. This is “uncomfortable knowledge” because it undermines the ability of those institutions to pursue their goals (Rayner, 2012). We identify three bodies of knowledge that are relevant to understandings of the dual use threat posed by synthetic biology but are excluded from related policy discussions. We demonstrate how these “unknown knowns” constitute uncomfortable knowledge because they disrupt the simplified worldview that underpins contemporary discourse on the potential misuse of synthetic biology by malign actors. We describe how these inconvenient truths have been systematically ignored and argue that this is because they are perceived as a threat by organisations involved in the promotion of synthetic biology as well as by those involved in managing biosecurity risks. This has led to a situation where concerns about the biosecurity threat posed by synthetic biology are not only exaggerated, but are, more importantly, misplaced. This, in turn, means that related policies are misdirected and unlikely to have much impact. We focus on the dynamics of discussions about synthetic biology and dual use to demonstrate how the same “knowns” that are denied or dismissed as “unknown knowns” in certain circumstances are sometimes mobilised as “known knowns” by the same category of actors in a different context, when this serves to sustain the goals of the individuals and institutions involved. Based on our own experience, we argue that negotiating the dynamics of uncomfortable knowledge is a difficult, but necessary, component of meaningful transdisciplinary collaborations. PMID:25484910

  16. Concordance: Design Ideal for Facilitating Situated Negotiations in Out-of-clinic Healthcare

    DEFF Research Database (Denmark)

    Bagalkot, Naveen L.; Gronvall, Erik; Sokoler, Tomas

    2014-01-01

    Healthcare HCI research has explored various designs that encourage people to follow prescribed treatments, mostly adopting compliance and adherence as design ideals. However, within the medical sciences the notion of concordance also exists. Concordance promotes negotiation between the patient...... and healthcare professional for forging a therapeutic alliance. However, the HCI community has still not adopted concordance as a design ideal. This paper revisits four old design-cases to explore the role of concordance in out-of-clinic healthcare. We argue that concordance, as a design ideal, can guide new...... designs that promote a more active patient-role both at the clinic and beyond....

  17. Tacit knowledge in dental clinical teaching.

    Science.gov (United States)

    Fugill, M

    2012-02-01

    The term 'tacit' is used to describe knowledge that is not necessarily understood in words. We frequently make use of such knowledge without conscious awareness that we are doing so. This article explores two different conceptions of tacit knowledge and considers their implications for the clinical teaching of dentistry. It recognises the communication barrier that clinical dependence on tacit knowledge creates between teacher and student. It identifies the ability to surface tacit clinical knowledge for the student as one of the most significant skills of the clinical teacher. Finally, the article examines the potential for conflict between the evidence-based practice paradigm, with its dependence on codified, explicit knowledge and the notion of clinical practice, which is at least partly experiential and tacit. © 2011 John Wiley & Sons A/S.

  18. Assessment of hospital pharmacists' clinical knowledge and ...

    African Journals Online (AJOL)

    reproduction in any medium, provided the original work is properly credited. ... drug use, which improves the quality of life. ... balance of clinical knowledge, practical skills, ... Ethical approval ... plans, clinical decision making, and finding the.

  19. Negotiating multisectoral evidence: a qualitative study of knowledge exchange at the intersection of transport and public health

    Directory of Open Access Journals (Sweden)

    Cornelia Guell

    2017-01-01

    Full Text Available Abstract Background For the prevention and control of chronic diseases, two strategies are frequently highlighted: that public health should be evidence based, and that it should develop a multisectoral approach. At the end of a natural experimental study of the health impacts of new transport infrastructure, we took the opportunity of a knowledge exchange forum to explore how stakeholders assessed, negotiated and intended to apply multisectoral evidence in policy and practice at the intersection of transport and health. We aimed to better understand the challenges they faced in knowledge exchange, as well as their everyday experiences with working in multisectoral remits. Methods In 2015, we conducted participant observation during an interactive event with 41 stakeholders from national and local government, the third sector and academia in Cambridge, UK. Formal and informal interactions between stakeholders were recorded in observational field notes. We also conducted 18 semistructured interviews reflecting on the event and on knowledge exchange in general. Results We found that stakeholders negotiated a variety of challenges. First, stakeholders had to negotiate relatively new formal and informal multisectoral remits; and how to reconcile the differing expectations of transport specialists, who tended to emphasise the importance of precedence in guiding action, and health specialists’ concern for the rigour and synthesis of research evidence. Second, research in this field involved complex study designs, and often produced evidence with uncertain transferability to other settings. Third, health outcomes of transport schemes had political traction and were used strategically but not easily translated into cost-benefit ratios. Finally, knowledge exchange meant multiple directions of influence. Stakeholders were concerned that researchers did not always have skills to translate their findings into understandable evidence, and some stakeholders

  20. BUSINESS NEGOTIATION IN MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Svetlana Trajković

    2014-10-01

    Full Text Available Every day we are faced with some form of negotiation. Negotiation is a means of communication between two or more persons with the aim of achieving an adequate agreement that will be acceptable to both sides. Successful business negotiation in management is used in organizations of all types and sizes, at all organizational levels and in all sectors of business throughout the world. Management shall in all circumstances to plan, organize, lead and control in different ways according to their managerial position as well as the knowledge, abilities and skills that they possessed. Negotiation is an important part of communication which results should contribute to increasing the efficiency of business organizations. Any experienced negotiator in negotiation process has consciously and deliberately, and has a strategy of negotiation. The strategy represents a proactive approach to the negotiations, and the approach aims to influence the course of negotiations.

  1. Negotiating Service Learning through Community Engagement: Adaptive Leadership, Knowledge, Dialogue and Power

    Science.gov (United States)

    Preece, Julia

    2016-01-01

    This article builds on two recent publications (Preece 2013; 2013a) concerning the application of asset-based community development and adaptive leadership theories when negotiating university service learning placements with community organisations in one South African province. The first publication introduced the concept of 'adaptive…

  2. Trust and memory: organizational strategies, institutional conditions and trust negotiations in specialty clinics for Alzheimer's disease.

    Science.gov (United States)

    Beard, Renée L

    2008-03-01

    Clinicians aim to establish trust during medical encounters because, without it, health consumers may not seek medical care, consider their diagnoses legitimate, or adhere to treatment regimens. This paper examines the identification and treatment of memory loss within two specialty clinics to understand how cultural dynamics, such as organizational ethos and work practices, influence the social fabric of cognitive evaluations. Ethnographic data suggest important historical and cultural differences in the approaches to Alzheimer's disease (AD). Organizational routines, however, support a common goal, that of moving individuals from "potential patients" to patients, and ultimately research subjects, through establishing trust. Although the processes through which trust is potentially achieved, or the social conditions of trust, were similar at the sites, the object of trust was different. Whereas one clinic encouraged trust in collective medical expertise, the other focused on trust in specific clinicians. These conditions affect the clinical consequences of trust, particularly how and when the diagnosis is delivered, use of the AD label and other terminology, and the level of standardization. The individual consequences include perceptions of patients and depictions of the prognosis. Whether cognitive impairment is viewed as a scientific puzzle to be solved or is seen as a chronic illness significantly shapes the organizational processes of clinical evaluation. Alzheimer's disease, as a cultural object, is a particularly salient exemplar of the clinical negotiation of ambiguous diagnostic categorizations and the unpredictable patient in daily biomedical practice.

  3. Maximizing scientific knowledge from randomized clinical trials

    DEFF Research Database (Denmark)

    Gustafsson, Finn; Atar, Dan; Pitt, Bertram

    2010-01-01

    Trialists have an ethical and financial responsibility to plan and conduct clinical trials in a manner that will maximize the scientific knowledge gained from the trial. However, the amount of scientific information generated by randomized clinical trials in cardiovascular medicine is highly vari...

  4. Assessment of hospital pharmacists' clinical knowledge and ...

    African Journals Online (AJOL)

    Purpose: To evaluate hospital pharmacists' clinical knowledge and practical skill levels for pharmaceutical care. Methods: A quasi-experimental prospective longitudinal study design was used to evaluate the level of clinical skills with problem-based learning (PBL) sessions. Pharmacists' in three different government ...

  5. How writing records reduces clinical knowledge

    DEFF Research Database (Denmark)

    Buus, Niels

    2009-01-01

    drew on data from an extended fieldwork on two Danish "special observation" wards. The results indicated that the nurses' recording produced "stereotyping" representations of the patients and reduced the nurses' clinical knowledge but that this particular way of recording made good sense in relation......Through the practices of recording, psychiatric nurses produce clinical knowledge about the patients in their care. The objective of this study was to examine the conventionalized practices of recording among psychiatric nurses and the typical linguistic organization of their records. The study...

  6. The Political Battlefield: Negotiating Space to Protect Indigenous and Traditional Knowledge under Capitalism

    Science.gov (United States)

    Busingye, Janice; Keim, Wiebke

    2009-01-01

    Knowledge has increasingly become an essential resource in the global economy, hence the capitalist tendency to regard it as a form of capital and as a motor for innovation and profit. Like any other capitalist commodity, conflicts over the ownership and use of various types of knowledge have arisen, thereby calling for legal protection.…

  7. The Relationship between Immediate Relevant Basic Science Knowledge and Clinical Knowledge: Physiology Knowledge and Transthoracic Echocardiography Image Interpretation

    Science.gov (United States)

    Nielsen, Dorte Guldbrand; Gotzsche, Ole; Sonne, Ole; Eika, Berit

    2012-01-01

    Two major views on the relationship between basic science knowledge and clinical knowledge stand out; the Two-world view seeing basic science and clinical science as two separate knowledge bases and the encapsulated knowledge view stating that basic science knowledge plays an overt role being encapsulated in the clinical knowledge. However, resent…

  8. Negotiation Games

    OpenAIRE

    Philipp Hoffmann

    2015-01-01

    Negotiations, a model of concurrency with multi party negotiation as primitive, have been recently introduced by J. Desel and J. Esparza. We initiate the study of games for this model. We study coalition problems: can a given coalition of agents force that a negotiation terminates (resp. block the negotiation so that it goes on forever)?; can the coalition force a given outcome of the negotiation? We show that for arbitrary negotiations the problems are EXPTIME-complete. Then we show that for...

  9. Online negotiations of infertility: Knowledge production in (in)fertility blogs

    DEFF Research Database (Denmark)

    Harrison, K.

    2014-01-01

    to conceive, arguing that blogging helps women to renegotiate their experiences of femininity when motherhood is denied or difficult. To do this, I focus on blogs as a space for knowledge production, creating a new paradigm for fertility information which challenges both the doctor/patient power dynamic......Although now used for a wide range of functions such as education, marketing and political commentary, blogs were originally a space for narrating personal life stories and have much in common with autobiography and diary genres. This article examines (in)fertility blogs written by women trying...... and traditional discourses concerning fertility. I show how bloggers use their blogs to 'make sense' of their (in)fertility experiences by looking at the distinctive content, style and format of their blogs. Finally, the knowledge produced in the blogs is problematized by 'situating' them within a broader...

  10. 'Facts about Ourselves': Negotiating sexual knowledge in early twentieth-century South Africa

    Directory of Open Access Journals (Sweden)

    S.E. Duff

    Full Text Available The focus of this article is on the introduction of sex education to middle-class white children in South Africa during the 1920s and 1930s. It argues that 'Facts about Ourselves for Growing Girls and Boys', a pamphlet put out by the Johannesburg Public Health Department in 1934, opens a window onto the ways in which sexual knowledge was mobilised to teach white, middle-class children correct forms of heterosexuality, as well as to assert and patrol boundaries between these children and African adults, particularly men. Until relatively recently, the field of the history of sexuality has been dominated by efforts to retrieve the histories of marginalised groups. This risks implying that heterosexuality is not historically contingent - that it is fixed, unchanging, and not inflected by race, class and gender. An analysis of 'Facts about Ourselves' and the mobilisation of sexual knowledge becomes, then, a means of tracing the history of the construction of 'normal' sexuality and so historicising heterosexuality.

  11. Excellence in clinical teaching: knowledge transformation and development required.

    Science.gov (United States)

    Irby, David M

    2014-08-01

    Clinical teachers in medicine face the daunting task of mastering the many domains of knowledge needed for practice and teaching. The breadth and complexity of this knowledge continue to increase, as does the difficulty of transforming the knowledge into concepts that are understandable to learners. Properly targeted faculty development has the potential to expedite the knowledge transformation process for clinical teachers. Based on my own research in clinical teaching and faculty development, as well as the work of others, I describe the unique forms of clinical teacher knowledge, the transformation of that knowledge for teaching purposes and implications for faculty development. The following forms of knowledge for clinical teaching in medicine need to be mastered and transformed: (i) knowledge of medicine and patients; (ii) knowledge of context; (iii) knowledge of pedagogy and learners, and (iv) knowledge integrated into teaching scripts. This knowledge is employed and conveyed through the parallel processes of clinical reasoning and clinical instructional reasoning. Faculty development can facilitate this knowledge transformation process by: (i) examining, deconstructing and practising new teaching scripts; (ii) focusing on foundational concepts; (iii) demonstrating knowledge-in-use, and (iv) creating a supportive organisational climate for clinical teaching. To become an excellent clinical teacher in medicine requires the transformation of multiple forms of knowledge for teaching purposes. These domains of knowledge allow clinical teachers to provide tailored instruction to learners at varying levels in the context of fast-paced and demanding clinical practice. Faculty development can facilitate this knowledge transformation process. © 2014 John Wiley & Sons Ltd.

  12. Negotiation Games

    Directory of Open Access Journals (Sweden)

    Philipp Hoffmann

    2015-09-01

    Full Text Available Negotiations, a model of concurrency with multi party negotiation as primitive, have been recently introduced by J. Desel and J. Esparza. We initiate the study of games for this model. We study coalition problems: can a given coalition of agents force that a negotiation terminates (resp. block the negotiation so that it goes on forever?; can the coalition force a given outcome of the negotiation? We show that for arbitrary negotiations the problems are EXPTIME-complete. Then we show that for sound and deterministic or even weakly deterministic negotiations the problems can be solved in PTIME. Notice that the input of the problems is a negotiation, which can be exponentially more compact than its state space.

  13. Collective Construction of Knowledge in Clinical Biochemistry

    Directory of Open Access Journals (Sweden)

    S.B. Barreto

    2010-05-01

    Full Text Available The collective construction of knowledge occurs by the convergence of ideas and semantic. This paper was made for a graduation discipline, in 2009-2, with 240students who were separated into 4 groups: morning period (M1,M2 and night period (N1,N2. This study aims the collective construction of a abstract-manual of clinical biochemistry tests, due the difficulty in comprehension of certain concepts by the students; it intends to help them in the process of knowledge acquirement. The constructivist approach was adopted and the matters of the discipline were available in a “Student Group e-mail account”, a functional communication tool. The instructions were reachable on the web. M1,M2 and N1 made one part of the study at the first period. N2 did not conclude the study at the same time period of the other groups; therefore they received a new responsibility: they were supposed to conclude and correct the manual and its application which included 90 different kinds of labor exams. A textbook has been defined containing illustrative pictures of blood collection and biosecurity. Three banners were exposed inside the hall of the institution. Collective work is important for the effective arrangement in health area. In the process of teaching/learning, the teacher must proceed on practices and methodologies aiming the development of the student competences and skills which represent its professional identity.

  14. Security negotiation

    OpenAIRE

    Mitrović, Miroslav M.; Ivaniš, Željko

    2013-01-01

    Contemporary security challenges, risks and threats represent a resultant of the achieved level of interaction between various entities within the paradigm of global security relations. Asymmetry and nonlinearity are main features of contemporary challenges in the field of global security. Negotiation in the area of security, namely the security negotiation, thus goes beyond just the domain of negotiation in conflicts and takes into consideration particularly asymmetric forms of possible sour...

  15. Negotiating Aid

    DEFF Research Database (Denmark)

    Whitfield, Lindsay; Fraser, Alastair

    2011-01-01

    This article presents a new analytical approach to the study of aid negotiations. Building on existing approaches but trying to overcome their limitations, it argues that factors outside of individual negotiations (or the `game' in game-theoretic approaches) significantly affect the preferences...

  16. Theory as metaphor: clinical knowledge and its communication.

    Science.gov (United States)

    Colman, Warren

    2009-04-01

    This paper investigates the relationship between clinical knowledge and psychological theory and considers the implications for clinical writing. I argue that clinical knowledge is a way of understanding rather than a body of facts and compare clinical material to 'texts' that generate multiple and indeterminate meanings. Analytic theories, which represent the crystallization of ways of understanding clinical phenomena, have an inherently metaphorical 'as if' quality since they are derived from and adapted to the clinical process of making meaning by representing psychic states in symbolic form. Thus good clinical writing demonstrates an integration of theory and clinical material into a unified network of symbolic meanings. Redfearn's paper, 'The captive, the treasure, the hero and the "anal" stage of development' (1979), is discussed as an exemplar of such integration. It is suggested that clinical knowledge is equivalent to the skill of making effective interpretations.

  17. Meeting competition through negotiated pricing

    International Nuclear Information System (INIS)

    Keith, D.M.; Raper, J.W.

    1990-01-01

    A fundamental premise of negotiated pricing as a demand-side management (DSM) tool is that price determines cost. As the ultimate objective of energy efficiency is to increase electromotive work while conserving resources, negotiated prices can have a significant impact as a DSM tool to force costs down. Three examples are offered of the effect of negotiated pricing as a DSM tool. The examples are a small hydroelectric company and an electric utility authority owned, a utility-to-customer example of negotiated pricing with the Public Service Company of Oklahoma's (PSO) system, and a large paper mill on PSO's system. Some of the major problems associated with negotiated pricing, outside of the human effort of finding and training knowledgeable and skilled negotiators, are: obtaining enough information about the customer or potential customer to be able to determine that in negotiating prices the utility is not giving away more benefits than the utility will gain; developing a pricing plan that fits both the customer's and utility's existing and potential future mode of operation; assuring that other customers who cannot negotiate on their own behalf are not adversely affected by utility revenue shortfalls; making such negotiated prices available to all similarly situated customers, so as not to inadvertently create unfair competitive advantages among them; and defining the shared benefits before and after the fact as a result of having negotiated prices in the first place

  18. Maximizing scientific knowledge from randomized clinical trials

    DEFF Research Database (Denmark)

    Gustafsson, Finn; Atar, Dan; Pitt, Bertram

    2010-01-01

    , in particular with respect to collaboration with the trial sponsor and to analytic pitfalls. The advantages of creating screening databases in conjunction with a given clinical trial are described; and finally, the potential for posttrial database studies to become a platform for training young scientists...

  19. Email Negotiation

    OpenAIRE

    Bülow, Anne Marie

    2010-01-01

    This paper investigates a set of email negotiations in order to explain a high number of deadlocks. The paper argues that one reason is the combination of cognitive effort characteristic of the e-mail genre, and the argumentative pattern found when two parties simultaneously try to persuade the other of the justice of their cause. For a negotiation involving the wording of a contract, the evidence suggests that, while there is a distinct advantage in the features of reviewability and revis...

  20. Knowledge and skills of cancer clinical trials nurses in Australia.

    Science.gov (United States)

    Scott, Kathleen; White, Kate; Johnson, Catherine; Roydhouse, Jessica K

    2012-05-01

      This paper is a report of the development and testing of a questionnaire measuring knowledge and skills of cancer clinical trials nurse in Australia.   The role of cancer clinical trials nurse, widely acknowledged as an integral member of the clinical research team, has evolved in recent years. Elements of the clinical trials nurse role in cancer have previously been described. To evaluate specific cancer clinical trials nurse educational and training needs, the development of a valid and reliable tool is required.   In 2009, a study was conducted in three stages. Stage I: questionnaire development and pilot testing; stage II: focus group; stage III: national survey. Internal consistency reliability testing and multi-trait analysis of item convergent/divergent validity were employed. Regression analysis was used to identify predictors of clinical trials nurse knowledge and skills.   The national survey was a 48-item questionnaire, measuring six clinical trial knowledge and seven skills sub-scales. Of 61 respondents, 90% were women, with mean age 43 years, 19 years as a Registered Nurse and 5 years as a cancer clinical trials nurse. Self-reported knowledge and skills were satisfactory to good. Internal consistency reliability was high (Cronbach's alpha: knowledge = 0·98; skills = 0·90). Criteria for item convergent/divergent validity were met. Number of years as cancer clinical trials nurse was positively related to self-reported knowledge and skills.   Preliminary data suggest that the national survey is reliable and valid. Data have contributed to better understanding the knowledge and skills of cancer clinical trials nurse in Australia and development of a postgraduate course in clinical trials. © 2011 Blackwell Publishing Ltd.

  1. Medical teachers conceptualize a distinctive form of clinical knowledge.

    Science.gov (United States)

    Barrett, J; Yates, L; McColl, G

    2015-05-01

    For over four decades, there have been efforts to specify the types of knowledge that medical students need, how that knowledge is acquired and how its constituent parts are related. It is one of the areas of continuing concern underlying medical education reform. Despite their importance to medical students' learning and development, the perspectives of medical teachers in hospitals are not always considered in such discourse. This study sought to generate an understanding of these teachers' values, perspectives and approaches by listening to them and seeing them in their everyday teaching work, finding and understanding the meanings they bring to the work of medical teaching in hospitals. In interviews, all of the teachers talked more about the optimal forms of knowledge that are important for students than they talked about the form of the teaching itself. Many revealed to students what knowledge they do and do not value. They had a particular way of thinking about clinical knowledge as existing in the people and the places in which the teaching and the clinical practice happen, and represented this as 'real' knowledge. By implication, there is other knowledge in medical education or in students' heads that is not real and needs to be transformed. Their values, practices and passions add texture and vitality to existing ways of thinking about the characteristics of clinical knowledge, how it is depicted in the discourse and the curriculum and how it is more dynamically related to other knowledge than is suggested in traditional conceptualizations of knowledge relationships.

  2. The cognitive organization of music knowledge: a clinical analysis.

    Science.gov (United States)

    Omar, Rohani; Hailstone, Julia C; Warren, Jane E; Crutch, Sebastian J; Warren, Jason D

    2010-04-01

    Despite much recent interest in the clinical neuroscience of music processing, the cognitive organization of music as a domain of non-verbal knowledge has been little studied. Here we addressed this issue systematically in two expert musicians with clinical diagnoses of semantic dementia and Alzheimer's disease, in comparison with a control group of healthy expert musicians. In a series of neuropsychological experiments, we investigated associative knowledge of musical compositions (musical objects), musical emotions, musical instruments (musical sources) and music notation (musical symbols). These aspects of music knowledge were assessed in relation to musical perceptual abilities and extra-musical neuropsychological functions. The patient with semantic dementia showed relatively preserved recognition of musical compositions and musical symbols despite severely impaired recognition of musical emotions and musical instruments from sound. In contrast, the patient with Alzheimer's disease showed impaired recognition of compositions, with somewhat better recognition of composer and musical era, and impaired comprehension of musical symbols, but normal recognition of musical emotions and musical instruments from sound. The findings suggest that music knowledge is fractionated, and superordinate musical knowledge is relatively more robust than knowledge of particular music. We propose that music constitutes a distinct domain of non-verbal knowledge but shares certain cognitive organizational features with other brain knowledge systems. Within the domain of music knowledge, dissociable cognitive mechanisms process knowledge derived from physical sources and the knowledge of abstract musical entities.

  3. knowledge and adherence to clinical practice guidelines amongst ...

    African Journals Online (AJOL)

    ABEOLUGBENGAS

    Objective: The therapeutic management of patients with Low Back Pain (LBP) has long been characterized ... Keywords: Low back pain, Clinical practice Guidelines, Knowledge, Adherence ..... discourage the use of modalities such as TENS,.

  4. Negotiating reform at an arm's length from the state: Disease Management Programmes and the introduction of clinical standards in Germany.

    Science.gov (United States)

    Burau, Viola

    2009-07-01

    Studies of German health policy often highlight institutional constraints to reform. However, based on a case study of the introduction of clinical standards as part of the Disease Management Programmes for chronic illnesses, this article suggests that negotiating reform at an arm's length from the state can also lead to governance change, although the strengthening of hierarchy is not as prominent as that in some of the countries studied in this special issue. As such, the case of Germany offers interesting insights into the politics of governance change that occur in the shadow, but largely without the direct involvement of the state, which is typical of a corporatist health-care state. In this respect, the analysis identifies three leverages for change. First, the change in medical governance explicitly builds on earlier reforms and gives the reform alliance a competitive edge. Second, the organisations of the joint self-administration, as a more or less open ally of the state, play an influential role throughout the reform process. Importantly and third, this is complemented by the state steering at a distance.

  5. Defining, navigating, and negotiating success: the experiences of mid-career Robert Wood Johnson Clinical Scholar women.

    Science.gov (United States)

    Kalet, Adina L; Fletcher, Kathlyn E; Ferdman, Dina J; Bickell, Nina A

    2006-09-01

    We studied female graduates of the Robert Wood Johnson Clinical Scholars Program (CSP, Class of 1984 to 1989) to explore and describe the complexity of creating balance in the life of mid-career academic woman physicians. We conducted and qualitatively analyzed (kappa 0.35 to 1.0 for theme identification among rater pairs) data from a semi-structured survey of 21 women and obtained their curricula vitae to quantify publications and grant support, measures of academic productivity. Sixteen of 21 (76%) women completed the survey. Mean age was 48 (range: 45 to 56). Three were full professors, 10 were associate professors, and 3 had left academic medicine. Eleven women had had children (mean 2.4; range: 1 to 3) and 3 worked part-time. From these data, the conceptual model expands on 3 key themes: (1) defining, navigating, and negotiating success, (2) making life work, and (3) making work work. The women who described themselves as satisfied with their careers (10/16) had clarity of values and goals and a sense of control over their time. Those less satisfied with their careers (6/16) emphasized the personal and professional costs of the struggle to balance their lives and described explicit institutional barriers to fulfillment of their potential. For this group of fellowship-prepared academic women physicians satisfaction is achieving professional and personal balance.

  6. Transforming RN education: clinical learning and clinical knowledge development.

    Science.gov (United States)

    Benner, P

    1993-04-01

    Transforming RN education has the potential for transforming clinical teaching and learning for all students. The returning RN student offers possibilities for clinical learning that the generic student does not have, but this should not cause us to limit the returning RN student to the generic level. Where possible innovative programs should be developed to move the RN student from baccalaureate level to the Master's level. As educators, we should take the opportunity to increase the numbers of nurses who are educationally prepared to move into advanced levels of practice. The returning RN student offers a rich human resource for the profession, and a rich resource for improving our clinical teaching as well as our practice.

  7. Negotiating Lean

    DEFF Research Database (Denmark)

    Rahbek Pedersen, Esben; Muniche, Mahad

    2011-01-01

    Purpose – The purpose of this paper is to analyse how negotiations between the constituencies affect the processes and outcomes of lean projects in Danish public sector organisations. Design/methodology/approach – The paper is based on a qualitative analysis of interviews with managers...... projects in the Danish public sector. It cannot be concluded that the findings can be generalised to reflect all types of lean projects across organisational and geographical settings. Originality/value – The paper adds value to the relatively scarce literature on lean management in the public sector...... and employees who have participated in lean projects in the Danish public sector. Negotiated order theory serves as the overarching theoretical framework for the analysis. Findings – The paper concludes that the processes and outcomes of lean depend not only on the technology itself, but also the negotiation...

  8. Knowledge and Attitude of clinical level dental students concerning ...

    African Journals Online (AJOL)

    Objective: To determine the knowledge and attitude of clinical level dental students concerning Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS). Methods: Two hundred and fifteen clinical level dental students from three Nigerian universities were requested to complete a self- ...

  9. Computer knowledge amongst clinical year medical students in a ...

    African Journals Online (AJOL)

    Objective: To study the computer knowledge and desires of clinical year medical students at one of the oldest and largest medical schools in Nigeria. Design: A survey using validated structured questionnaires. Setting: Medical school of Ahmadu Bello University, Zaria, Nigeria. Subjects: Two hundred and thirty seven clinical ...

  10. A Framework for a Clinical Reasoning Knowledge Warehouse

    DEFF Research Database (Denmark)

    Vilstrup Pedersen, Klaus; Boye, Niels

    2004-01-01

    is stored and made accessible when relevant to the reasoning context and the specific patient case. Furthermore, the information structure supports the creation of new generalized knowledge using data mining tools. The patient case is divided into an observation level and an opinion level. At the opinion......, Knowledge Management Systems and Business Intelligence to make context based, patient case specific analysis and knowledge management. The knowledge base integrates three sources of information that supports clinical reasoning: general information, guidelines and health records. New generalized knowledge...... level, reasoning participants can express their argument based opinions about a patient case, thereby enhancing the knowledge about the state of and plans for the patient. An opinion language that supports expressing a possible imprecise/uncertain opinion based on imprecise...

  11. Extreme negotiations.

    Science.gov (United States)

    Weiss, Jeff; Donigian, Aram; Hughes, Jonathan

    2010-11-01

    CEOs and other senior executives must make countless complex, high-stakes deals across functional areas and divisions, with alliance partners and critical suppliers, and with customers and regulators. The pressure of such negotiations may make them feel a lot like U.S. military officers in an Afghan village, fending off enemy fire while trying to win trust and get intelligence from the local populace. Both civilian and military leaders face what the authors call "dangerous negotiations," in which the traps are many and good advice is scarce. Although the sources of danger are quite different for executives and officers, they resort to the same kinds of behaviors. Both feel pressure to make quick progress, project strength and control (particularly when they have neither), rely on force rather than collaboration, trade resources for cooperation rather than build trust, and make unwanted compromises to minimize potential damage. The authors outline five core strategies that "in extremis" military negotiators use to resolve conflicts and influence others: maintaining a big-picture perspective; uncovering hidden agendas to improve collaboration; using facts and fairness to get buy-in; building trust; and focusing on process as well as outcomes. These strategies provide an effective framework that business executives can use to prepare for a negotiation and guide their moves at the bargaining table.

  12. Negotiating action

    Science.gov (United States)

    2017-12-01

    After years of working towards a climate accord, the Paris Agreement of 2015 marked the shift from negotiating to reach consensus on climate action to implementation of such action. The challenge now is to ensure transparency in the processes and identify the details of what is required.

  13. Negotiating choices

    Indian Academy of Sciences (India)

    Lawrence

    As a child in an academic family, I always had a lot of books around and read ... Overall, though, when I look back, I can see that the dominant influence in shaping my .... many others working in India, I have often felt that one's pub- lished work tends to ... The complexities of negotiating gender and professional roles tend to ...

  14. Email Negotiation

    DEFF Research Database (Denmark)

    Bülow, Anne Marie

    the other of the justice of their cause. For a negotiation involving the wording of a contract, the evidence suggests that, while there is a distinct advantage in the features of reviewability and revisablity, the email format allows selective attention to the other party’s arguments, which can be shown...

  15. Negotiations 1978.

    Science.gov (United States)

    Taylor, Bruce; And Others

    Reflecting the management advocacy position taken by school boards in collective bargaining procedures, this report analyzes New Jersey school labor negotiations laws and practices as of 1978. Terms and issues of special interest are defined and explained. Topics include contract language, good faith bargaining, past practice, negotiations…

  16. Cognitive development, clinical knowledge, and clinical experience related to diagnostic ability.

    Science.gov (United States)

    Aquilino, M L

    1997-01-01

    To examine the relationship among cognitive development, clinical knowledge, and clinical experience in nursing students. A survey of junior and senior baccalaureate nursing students from three Midwestern colleges (N = 55). Students' diagnostic ability increased as they gained clinical experience and clinical knowledge. However, students failed to identify many nursing diagnoses and demonstrated only moderate levels of cognitive development. Nurse educators and nursing students need to change their approaches to teaching and learning to enhance students' diagnostic ability and cognitive development.

  17. Evolution in Clinical Knowledge Management Strategy at Intermountain Healthcare

    Science.gov (United States)

    Hulse, Nathan C.; Galland, Joel; Borsato, Emerson P.

    2012-01-01

    In this manuscript, we present an overview of the clinical knowledge management strategy at Intermountain Healthcare in support of our electronic medical record systems. Intermountain first initiated efforts in developing a centralized enterprise knowledge repository in 2001. Applications developed, areas of emphasis served, and key areas of focus are presented. We also detail historical and current areas of emphasis, in response to business needs. PMID:23304309

  18. [Knowledge management system for laboratory work and clinical decision support].

    Science.gov (United States)

    Inada, Masanori; Sato, Mayumi; Yoneyama, Akiko

    2011-05-01

    This paper discusses a knowledge management system for clinical laboratories. In the clinical laboratory of Toranomon Hospital, we receive about 20 questions relevant to laboratory tests per day from medical doctors or co-medical staff. These questions mostly involve the essence to appropriately accomplish laboratory tests. We have to answer them carefully and suitably because an incorrect answer may cause a medical accident. Up to now, no method has been in place to achieve a rapid response and standardized answers. For this reason, the laboratory staff have responded to various questions based on their individual knowledge. We began to develop a knowledge management system to promote the knowledge of staff working for the laboratory. This system is a type of knowledge base for assisting the work, such as inquiry management, laboratory consultation, process management, and clinical support. It consists of several functions: guiding laboratory test information, managing inquiries from medical staff, reporting results of patient consultation, distributing laboratory staffs notes, and recording guidelines for laboratory medicine. The laboratory test information guide has 2,000 records of medical test information registered in the database with flexible retrieval. The inquiry management tool provides a methos to record all questions, answer easily, and retrieve cases. It helps staff to respond appropriately in a short period of time. The consulting report system treats patients' claims regarding medical tests. The laboratory staffs notes enter a file management system so they can be accessed to aid in clinical support. Knowledge sharing using this function can achieve the transition from individual to organizational learning. Storing guidelines for laboratory medicine will support EBM. Finally, it is expected that this system will support intellectual activity concerning laboratory work and contribute to the practice of knowledge management for clinical work support.

  19. "It´s incredible how much I´ve had to fight." Negotiating medical uncertainty in clinical encounters.

    Science.gov (United States)

    Lian, Olaug S; Robson, Catherine

    2017-01-01

    Clinical encounters related to medically unexplained physical symptoms (MUPS) are associated with high levels of conflict between patients and doctors. Collaborative difficulties are fused by the medical uncertainty that dominates these consultations. The main aim of this study is to explore the interactional dynamics of clinical encounters riddled by medical uncertainty, as experienced by people living with long-term medically unexplained fatigue in Norway. A qualitative thematic analysis of written texts from 256 study participants. We found that patients experience being met with disbelief, inappropriate psychological explanations, marginalisation of experiences, disrespectful treatment, lack of physical examination and damaging health advice. The main source of their discontent is not the lack of biomedical knowledge, but doctors who fail to communicate acknowledgement of patients' experiences, knowledge and autonomy. War metaphors are emblematic of how participants describe their medical encounters. The overarching storyline depicts experiences of being caught in a power struggle with doctors and health systems, fused by a lack of common conceptual ground. When physical symptoms cannot be detected, explained and managed by biomedical knowledge and technology, good doctor-patient partnerships are crucial. Without clearly acknowledging patients' perspectives and capabilities in clinical practice, such partnerships cannot be achieved.

  20. Does Negotiation Training Improve Negotiators' Performance?

    Science.gov (United States)

    ElShenawy, Eman

    2010-01-01

    Purpose: This paper's objective is to test the main effect of negotiation training-level on acquiring negotiation skills. Training level refers to the time a trainee spends in a negotiation training course receiving the standard style and methods of training. Negotiation skills are manifested through trainees' performance after receiving training.…

  1. Negotiation time

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-12-01

    Markets in the Pacific have been relatively stable throughout 1999 compared to its Atlantic counterparts. As a result, the outcome of annual negotiations between Australian suppliers and Japanese steel mills (JSM) and utilities will not be so easy to predict this year. The article discusses factors that will affect the prices of coking coal and thermal coal. The outlook for thermal coal prices in the Pacific market looks much more promising than for coking coal. 2 photos.

  2. Coalitional negotiation

    OpenAIRE

    Mauleon, Ana; Vannetelbosch, Vincent

    1999-01-01

    We develop a two-stage negotiation model to study the impact of costly inspections on both the coalition formation outcome and the per-member payoffs. In the first stage, the players are forming coalitions and inside each coalition formed the members share the coalition benefits. We adopt the largest consistent set (LCS) to predict which coalition structures are possibly stable. We also introduce a refinement,the largest cautious consistent set (LCCS). In the second stage, the inspection game...

  3. Clinical knowledge management: an overview of current understanding.

    Science.gov (United States)

    Bali, Rajeev K; Dwivedi, Ashish

    2005-01-01

    This chapter outlines contributions to a workshop for ICMCC 2005. We details some of the central issues surrounding the incorporation of the Knowledge Management (KM) paradigm for the healthcare and clinical sectors. The complex nature of KM is discussed, together with some essential theories and some contemporary applications of the tools and techniques are presented.

  4. Sexual Health Attitudes, Knowledge, and Clinical Behaviors: Implications for Counseling

    Science.gov (United States)

    Russell, Elizabeth B.

    2012-01-01

    This article explores the impact of practitioners' attitudes and knowledge of sexual health on clinical behaviors. Sexual health topics are often areas of concern for clients of any age in counseling. Thus, counselors must be trained and equipped to address sexual health across the life span. This study explored whether child and adolescent…

  5. Evaluating Clinical Knowledge across Years of Medical Training.

    Science.gov (United States)

    And Others; Mazzuca, Steven A

    1981-01-01

    The evolution of clinical knowledge about the management of a common chronic disease was determined by applying analysis of variance and multiple discriminant analysis to responses on two patient management problems by groups of junior medical students and internal medicine residents. The applying analysis of variance and multiple discriminant…

  6. Clinical Decision Support Knowledge Management: Strategies for Success.

    Science.gov (United States)

    Khalifa, Mohamed; Alswailem, Osama

    2015-01-01

    Clinical Decision Support Systems have been shown to increase quality of care, patient safety, improve adherence to guidelines for prevention and treatment, and avoid medication errors. Such systems depend mainly on two types of content; the clinical information related to patients and the medical knowledge related to the specialty that informs the system rules and alerts. At King Faisal Specialist Hospital and Research Center, Saudi Arabia, the Health Information Technology Affairs worked on identifying best strategies and recommendations for successful CDSS knowledge management. A review of literature was conducted to identify main areas of challenges and factors of success. A qualitative survey was used over six months' duration to collect opinions, experiences and suggestions from both IT and healthcare professionals. Recommendations were categorized into ten main topics that should be addressed during the development and implementation of CDSS knowledge management tools in the hospital.

  7. Clinical teachers' tacit knowledge of basic pedagogic principles.

    Science.gov (United States)

    McLeod, P J; Meagher, T; Steinert, Y; Schuwirth, L; McLeod, A H

    2004-02-01

    Academic faculty members in medical schools rarely receive formal instruction in basic pedagogic principles; nevertheless many develop into competent teachers. Perhaps they acquire tacit knowledge of these principles with teaching experience. This study was designed to assess clinical teachers' tacit knowledge of basic pedagogic principles and concepts. The authors developed a multiple-choice question (MCQ) exam based on 20 pedagogic principles judged by a panel of education experts to be important for clinical teaching. Three groups of clinician-educators sat the test: (1) clinicians with advanced education training and experience; (2) internal medicine specialists; (3) surgical specialists. All four groups of clinicians-educators passed the test, indicating that they possess a reasonable tacit knowledge of basic pedagogic principles. Those with advanced education training performed much better than members of the other two groups while specialists and residents working in teaching hospitals outperformed specialists from non-teaching hospitals. It is possible that converting this tacit knowledge to explicit knowledge may improve individual teaching effectiveness.

  8. Methods to Succeed in Effective Knowledge Translation in Clinical Practice.

    Science.gov (United States)

    Kitson, Alison L; Harvey, Gillian

    2016-05-01

    To explore the evidence around facilitation as an intervention for the successful implementation of new knowledge into clinical practice. The revised version of the Promoting Action on Research Implementation in Health Services (PARIHS) framework, called the integrated or i-PARIHS framework, is used as the explanatory framework. This framework posits that evidence is a multidimensional construct embedded within innovation and operationalized by clinicians (individuals and within teams), working across multiple layers of context. Facilitation is the active ingredient that promotes successful implementation. An emerging body of evidence supports facilitation as a mechanism to getting new knowledge into clinical practice. Facilitation roles are divided into beginner, experienced, and expert facilitators. Facilitators can be internal or external to the organization they work in, and their skills and attributes complement other knowledge translation (KT) roles. Complex KT projects require facilitators who are experienced in implementation methods. Facilitation is positioned as the active ingredient to effectively introduce new knowledge into a clinical setting. Levels of facilitation experience are assessed in relation to the complexity of the KT task. Three core facilitation roles are identified, and structured interventions are established taking into account the nature and novelty of the evidence, the receptiveness of the clinicians, and the context or setting where the new evidence is to be introduced. Roles such as novice, experienced, and expert facilitators have important and complementary parts to play in enabling the successful translation of evidence into everyday practice in order to provide effective care for patients. © 2016 Sigma Theta Tau International.

  9. Turning negotiation into a corporate capability.

    Science.gov (United States)

    Ertel, D

    1999-01-01

    Every company today exists in a complex web of relationships formed, one at a time, through negotiation. Purchasing and outsourcing contracts are negotiated with vendors. Marketing arrangements are negotiated with distributors. Product development agreements are negotiated with joint-venture partners. Taken together, the thousands of negotiations a typical company engages in have an enormous effect on both its strategy and its bottom line. But few companies think systematically about their negotiating activities as a whole. Instead they take a situational view, perceiving each negotiation to be a separate event with its own goals, tactics, and measures of success. Coordinating them all seems an overwhelming and impracticable job. In reality, the author argues, it is neither. A number of companies are successfully building coordinated negotiation capabilities by applying four broad changes in practice and perspective. First, they've established a company-wide negotiation infrastructure to apply the knowledge gained from forging past agreements to improve future ones. Second, they've broadened the measures they use to evaluate negotiators' performance beyond matters of cost and price. Third, they draw a clear distinction between the elements of an individual deal and the nature of the ongoing relationship between the parties. Fourth, they make their negotiators feel comfortable walking away from a deal when it's not in the company's best interests. These changes aren't radical steps. But taken together, they will let companies establish closer, more creative relationships with suppliers, customers, and other partners.

  10. A Framework for a Clinical Reasoning Knowledge Warehouse

    DEFF Research Database (Denmark)

    Vilstrup Pedersen, Klaus; Boye, Niels

    2004-01-01

    In many areas of the medical domain, the decision process i.e. reasoning, involving health care professionals is distributed, cooperative and complex. This paper presents a framework for a Clinical Reasoning Knowledge Warehouse that combines theories and models from Artificial Intelligence...... is stored and made accessible when relevant to the reasoning context and the specific patient case. Furthermore, the information structure supports the creation of new generalized knowledge using data mining tools. The patient case is divided into an observation level and an opinion level. At the opinion...

  11. Sibling negotiation

    OpenAIRE

    Rufus A. Johnstone; Alexandre Roulin

    2003-01-01

    Current discussions of offspring begging typically assume either that it is a signal directed at parents or that it represents a form of scramble competition to gain access to them. However, offspring might also display to inform nest mates that they will contest the next food item to be delivered; in other words, begging (possibly in the absence of parents) might serve purely as a form of negotiation among siblings. Here, we develop a game-theoretical model of this possibility. We assume tha...

  12. Acquiring, encoding, and re-using clinical knowledge in PRODIGY

    Directory of Open Access Journals (Sweden)

    Richard Hall

    2002-11-01

    Full Text Available The development, implementation and maintenance of computer-executable clinical guidelines encompass a series of complex processes. As they are often performed by more than one organisation, this introduces further complexity. Within the PRODIGY project we attempt to control as many aspects of the process as possible, in order to increase the likelihood of achieving success. To illustrate the complexity of the process and many of the inherent problems and solutions, this paper describes the evolution of the PRODIGY knowledge base, describing the steps from acquiring knowledge, through encoding, to the execution of guidelines, and 'closing the loop' by discussing an approach to knowledge re-use. We will also consider some of the wider implications of our work and propose directions for future research and development activities.

  13. Negotiating Marriage

    Directory of Open Access Journals (Sweden)

    Tamara Sniezek

    2013-08-01

    Full Text Available Based on data from qualitative interviews with 40 engaged heterosexual couples, this paper examines how couples transform their relationship from “serious” to being “engaged to be married.” Social Scientists have developed relationship models designed to explain the transformation, but these models fail to adequately capture how couples transform their relationship and the context in which this behavior occurs. Using a constructionist framework, an alternative process model is offered. The five-process model captures the ongoing and fluid work couples perform to negotiate a redefinition of the relationship. Couples reflexively use a host of complex symbolic interaction including talk, rituals, relationships with others, testing, and use of time to construct their relationship in a new way. By examining the underlying reality construction process, rather than merely looking at the outcome, the social processes and human actions that shape relationships are revealed.

  14. Clinical nutrition knowledge of gastroenterology fellows: is there anything omitted?

    Science.gov (United States)

    Eslamian, Ghazaleh; Jacobson, Kevan; Hekmatdoost, Azita

    2013-01-01

    Despite the increased emphasis on chronic non-communicable diseases, there are notable deficits about nutrition education in many medicine training programs particularly gastroenterology fellowship programs. In the present cross-sectional study, we examined the nutritional knowledge related to clinical nutrition among Iranian gastroenterology fellows. Thirty-six gastroenterology fellows currently enrolled in a gastroenterology fellowship program completed a questionnaire, including two sections. The first of which assessed the gastroenterology fellows experience about nutrition training, nutrition management of patients with gastrointestinal (GI) disorders and evaluating perceived nutrition education needs. The second section consisted of multiple choice questions that assessed nutritional knowledge. A total of 32 gastroenterology fellows completed the first section. The majority of gastroenterology fellows failed to partake in any nutrition education during their fellowship training particularly for inpatients despite the availability to participate in the nutrition training especially for the purpose of nutrition support. Mean correct response rates for the second section was 38%. The highest mean score was seen in nutrition assessment (48.1%), followed by scores of 40.5% in nutrition support, 37.0% nutrition in GI disease, and 25.0% in micro and macronutrients. Iranian gastroenterology fellows have serious deficits in their nutrition knowledge. This study paves the way for the development of an education program to improve nutritional knowledge of gastroenterology fellows.

  15. [Clinical practice guidelines and knowledge management in healthcare].

    Science.gov (United States)

    Ollenschläger, Günter

    2013-10-01

    Clinical practice guidelines are key tools for the translation of scientific evidence into everyday patient care. Therefore guidelines can act as cornerstones of evidence based knowledge management in healthcare, if they are trustworthy, and its recommendations are not biased by authors' conflict of interests. Good medical guidelines should be disseminated by means of virtual (digital/electronic) health libraries - together with implementation tools in context, such as guideline based algorithms, check lists, patient information, a.s.f. The article presents evidence based medical knowledge management using the German experiences as an example. It discusses future steps establishing evidence based health care by means of combining patient data, evidence from medical science and patient care routine, together with feedback systems for healthcare providers.

  16. Guideline Formalization and Knowledge Representation for Clinical Decision Support

    Directory of Open Access Journals (Sweden)

    Tiago OLIVEIRA

    2012-09-01

    Full Text Available Normal 0 21 false false false EN-US JA X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabla normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:Cambria; mso-ascii-font-family:Cambria; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Cambria; mso-hansi-theme-font:minor-latin; mso-ansi-language:EN-US;} The prevalence of situations of medical error and defensive medicine in healthcare institutions is a great concern of the medical community. Clinical Practice Guidelines are regarded by most researchers as a way to mitigate theseoccurrences; however, there is a need to make them interactive, easier to update and to deploy. This paper provides a model for Computer-Interpretable Guidelines based on the generic tasks of the clinical process, devised to be included in the framework of a Clinical Decision Support System. Aiming to represent medical recommendations in a simple and intuitive way. Hence, this work proposes a knowledge representation formalism that uses an Extension to Logic Programming to handle incomplete information. This model is used to represent different cases of missing, conflicting and inexact information with the aid of a method to quantify its quality. The integration of the guideline model with the knowledge representation formalism yields a clinical decision model that relies on the development of multiple information scenarios and the exploration of different clinical hypotheses.

  17. Guideline Formalization and Knowledge Representation for Clinical Decision Support

    Directory of Open Access Journals (Sweden)

    Paulo NOVAIS

    2013-07-01

    Full Text Available Normal 0 21 false false false EN-US JA X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabla normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:Cambria; mso-ascii-font-family:Cambria; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Cambria; mso-hansi-theme-font:minor-latin; mso-ansi-language:EN-US;} The prevalence of situations of medical error and defensive medicine in healthcare institutions is a great concern of the medical community. Clinical Practice Guidelines are regarded by most researchers as a way to mitigate these occurrences; however, there is a need to make them interactive, easier to update and to deploy. This paper provides a model for Computer-Interpretable Guidelines based on the generic tasks of the clinical process, devised to be included in the framework of a Clinical Decision Support System. Aiming to represent medical recommendations in a simple and intuitive way. Hence, this work proposes a knowledge representation formalism that uses an Extension to Logic Programming to handle incomplete information. This model is used to represent different cases of missing, conflicting and inexact information with the aid of a method to quantify its quality. The integration of the guideline model with the knowledge representation formalism yields a clinical decision model that relies on the development of multiple information scenarios and the exploration of different clinical hypotheses.

  18. Community occupational therapists' clinical reasoning: identifying tacit knowledge.

    Science.gov (United States)

    Carrier, Annie; Levasseur, Mélanie; Bédard, Denis; Desrosiers, Johanne

    2010-12-01

      Occupational therapy interventions in the community, a fast expanding practice setting, are central to an important social priority, the ability to live at home. These interventions generally involve only a small number of home visits, which aim at maximising the safety and autonomy of community-dwelling clients. Knowing how community occupational therapists determine their interventions, i.e. their clinical reasoning, can improve intervention efficacy. However, occupational therapists are often uninformed about and neglect the importance of clinical reasoning, which could underoptimise their interventions.   To synthesise current knowledge about community occupational therapists' clinical reasoning.   A scoping study of the literature on community occupational therapists' clinical reasoning was undertaken.   Fifteen textbooks and 25 articles, including six focussing on community occupational therapists' clinical reasoning, were reviewed. Community occupational therapists' clinical reasoning is influenced by internal and external factors. Internal factors include past experiences, expertise and perceived complexity of a problem. One of the external factors, practice context (e.g. organisational or cultural imperatives, physical location of intervention), particularly shapes community occupational therapists' clinical reasoning, which is interactive, complex and multidimensional. However, the exact influence of many factors (personal context, organisational and legal aspects of health care, lack of resources and increased number of referrals) remains unclear.   Further studies are needed to understand better the influence of internal and external factors. The extent to which these factors mould the way community occupational therapists think and act could have a direct influence on the services they provide to their clients. © 2010 The Authors. Australian Occupational Therapy Journal © 2010 Australian Association of Occupational Therapists.

  19. Clinical Knowledge Governance Framework for Nationwide Data Infrastructure Projects.

    Science.gov (United States)

    Wulff, Antje; Haarbrandt, Birger; Marschollek, Michael

    2018-01-01

    The availability of semantically-enriched and interoperable clinical information models is crucial for reusing once collected data across institutions like aspired in the German HiGHmed project. Funded by the Federal Ministry of Education and Research, this nationwide data infrastructure project adopts the openEHR approach for semantic modelling. Here, strong governance is required to define high-quality and reusable models. Design of a clinical knowledge governance framework for openEHR modelling in cross-institutional settings like HiGHmed. Analysis of successful practices from international projects, published ideas on archetype governance and own modelling experiences as well as modelling of BPMN processes. We designed a framework by presenting archetype variations, roles and responsibilities, IT support and modelling workflows. Our framework has great potential to make the openEHR modelling efforts manageable. Because practical experiences are rare, prospectively our work will be predestinated to evaluate the benefits of such structured governance approaches.

  20. A brief simulation intervention increasing basic science and clinical knowledge

    Directory of Open Access Journals (Sweden)

    Maria L. Sheakley

    2016-04-01

    Full Text Available Background: The United States Medical Licensing Examination (USMLE is increasing clinical content on the Step 1 exam; thus, inclusion of clinical applications within the basic science curriculum is crucial. Including simulation activities during basic science years bridges the knowledge gap between basic science content and clinical application. Purpose: To evaluate the effects of a one-off, 1-hour cardiovascular simulation intervention on a summative assessment after adjusting for relevant demographic and academic predictors. Methods: This study was a non-randomized study using historical controls to evaluate curricular change. The control group received lecture (n l=515 and the intervention group received lecture plus a simulation exercise (nl+s=1,066. Assessment included summative exam questions (n=4 that were scored as pass/fail (≥75%. USMLE-style assessment questions were identical for both cohorts. Descriptive statistics for variables are presented and odds of passage calculated using logistic regression. Results: Undergraduate grade point ratio, MCAT-BS, MCAT-PS, age, attendance at an academic review program, and gender were significant predictors of summative exam passage. Students receiving the intervention were significantly more likely to pass the summative exam than students receiving lecture only (P=0.0003. Discussion: Simulation plus lecture increases short-term understanding as tested by a written exam. A longitudinal study is needed to assess the effect of a brief simulation intervention on long-term retention of clinical concepts in a basic science curriculum.

  1. Knowledge is not enough to solve the problems – The role of diagnostic knowledge in clinical reasoning activities

    Directory of Open Access Journals (Sweden)

    Jan Kiesewetter

    2016-11-01

    Full Text Available Abstract Background Clinical reasoning is a key competence in medicine. There is a lack of knowledge, how non-experts like medical students solve clinical problems. It is known that they have difficulties applying conceptual knowledge to clinical cases, that they lack metacognitive awareness and that higher level cognitive actions correlate with diagnostic accuracy. However, the role of conceptual, strategic, conditional, and metacognitive knowledge for clinical reasoning is unknown. Methods Medical students (n = 21 were exposed to three different clinical cases and instructed to use the think-aloud method. The recorded sessions were transcribed and coded with regards to the four different categories of diagnostic knowledge (see above. The transcripts were coded using the frequencies and time-coding of the categories of knowledge. The relationship between the coded data and accuracy of diagnosis was investigated with inferential statistical methods. Results The use of metacognitive knowledge is correlated with application of conceptual, but not with conditional and strategic knowledge. Furthermore, conceptual and strategic knowledge application is associated with longer time on task. However, in contrast to cognitive action levels the use of different categories of diagnostic knowledge was not associated with better diagnostic accuracy. Conclusions The longer case work and the more intense application of conceptual knowledge in individuals with high metacognitive activity may hint towards reduced premature closure as one of the major cognitive causes of errors in medicine. Additionally, for correct case solution the cognitive actions seem to be more important than the diagnostic knowledge categories.

  2. Impact of Residency Training Redesign on Residents' Clinical Knowledge.

    Science.gov (United States)

    Waller, Elaine; Eiff, M Patrice; Dexter, Eve; Rinaldo, Jason C B; Marino, Miguel; Garvin, Roger; Douglass, Alan B; Phillips, Robert; Green, Larry A; Carney, Patricia A

    2017-10-01

    The In-training Examination (ITE) is a frequently used method to evaluate family medicine residents' clinical knowledge. We compared family medicine ITE scores among residents who trained in the 14 programs that participated in the Preparing the Personal Physician for Practice (P4) Project to national averages over time, and according to educational innovations. The ITE scores of 802 consenting P4 residents who trained in 2007 through 2011 were obtained from the American Board of Family Medicine. The primary analysis involved comparing scores within each academic year (2007 through 2011), according to program year (PGY) for P4 residents to all residents nationally. A secondary analysis compared ITE scores among residents in programs that experimented with length of training and compared scores among residents in programs that offered individualized education options with those that did not. Release of ITE scores was consented to by 95.5% of residents for this study. Scores of P4 residents were higher compared to national scores in each year. For example, in 2011, the mean P4 score for PGY1 was 401.2, compared to the national average of 386. For PGY2, the mean P4 score was 443.1, compared to the national average of 427, and for PGY3, the mean P4 score was 477.0, compared to the national PGY3 score of 456. Scores of residents in programs that experimented with length of training were similar to those in programs that did not. Scores were also similar between residents in programs with and without individualized education options. Family medicine residency programs undergoing substantial educational changes, including experiments in length of training and individualized education, did not appear to experience a negative effect on resident's clinical knowledge, as measured by ITE scores. Further research is needed to study the effect of a wide range of residency training innovations on ITE scores over time.

  3. Handbook of group decision and negotiation

    CERN Document Server

    Eden, Colin

    2010-01-01

    The growing field of Group Decision and Negotiation is best described as the empirical, formal, computational, and strategic analysis of group decision-making and negotiation, especially from the viewpoints of Management Science and Operations Research. The topic crosses many traditional disciplinary boundaries. It has connections to business administration and business strategy, management science, systems engineering, computer science, mathematics, and law, as well as economics, psychology, and other social sciences. This defining handbook provides an up-to-date reference on new approaches to the principles and practice of negotiation, group decision-making, and collaboration, including the origins, development, and prospects of electronic negotiation, as well as the associated development of on-line or computer-based arbitration systems. It also provides a current and comprehensive reference on how traditional issues in negotiation, such as knowledge, language, strategy, fairness and justice, have been tra...

  4. Strategies and tactics of the negotiation for powerplant siting, model analysis of negotiation with the local fishermen's union, 2

    International Nuclear Information System (INIS)

    Wakatani, Yoshifumi; Yamanaka, Yoshiro

    1983-01-01

    Recently, the negotiation with local inhabitants in powerplant siting area is apt to drag on and is becoming more intricate. The purpose of this study is to present strategies and tactics for stepping up the negotiation more smoothly, taking the case of the negotiation with a fishermen's union. In this report, we obtained knowledge about the negotiation regarding compensation by the process as follows. (1) A gaming simulation model of the negotiation was built from the case study. This model reenacted the negotiation by having role-players represent the role of a power industry and fishermen's union. (2) Applying this model, 16 cases of simulated negotiations were carried out. As a result, similarities to actual negotiations were observed in the development of the negotiations and in the behavior of the interested party. We confirmed the model's ability to reproduce the negotiations. (3) Knowledge and information was also obtained by this simulation, concerning the developmental pattern of the negotiations, the effectiveness of measures for the promotion of fishery, the role of mediation, the utilization of preliminary negotiation, and so on. (author)

  5. Intercultural Negotiation: The “Nomadic” Approach

    Directory of Open Access Journals (Sweden)

    Sandra E. WALKER

    2012-01-01

    Full Text Available Globalization has a strong impact on international negotiation. Negotiators must manage situationswhere they may have to deal with several people coming from many different cultures. It is thusnecessary to manage diversity during the negotiation processes and interactions to achieve asufficiently high level of performance to be competitive in world markets.Researchers have tended to focus on the importance of cultural knowledge to internationalnegotiators. Many articles describe different styles of negotiations according to countries, regionsor even cultural groupings, such as for Anglo-Saxon or Arab negotiating partners.However, researchers have given less attention to the notion of intercultural competence and howcompanies could develop the ability to adapt to any culture, even if a negotiator has little priorinformation concerning their partners. This skill is universal across all cultures and could be addedto the profile of a successful negotiator. It is an attitude based on openness towards people comingfrom a different culture. This paper describes negotiators who adopt this attitude: the way of a‘nomad’.

  6. Successful international negotiations

    International Nuclear Information System (INIS)

    Gerry, G.

    1997-01-01

    These remarks on successful international trade negotiations deal with the following topics: culture and differences in psychology; building friendly relationships and letting both sides appear to win; well written proposals; security of negotiating information; the complexity and length of nuclear negotiations

  7. Negotiation Skill Development Exercise

    Science.gov (United States)

    Benson, Gregory E.; Chau, Ngan N.

    2017-01-01

    Conflict occurs naturally in all marketing related activities. When such conflict is handled well through proper negotiation, it helps solve problems and build stronger, deeper relationships between the negotiating parties. Nevertheless, many students feel uneasy about negotiating, yet they know it is a crucial skill that needs to be developed.…

  8. Personality determinants of manipulative behavior in the negotiation process

    Directory of Open Access Journals (Sweden)

    Ludmila V. Matveeva

    2012-01-01

    Full Text Available Negotiations are an inalienable component of human society in the modernworld, so studying those personal characteristics of negotiators that infl uencetheir choice of negotiating strategy, tactics, and style is relevant and signifi cant.Knowledge of the patterns of a partner’s choice of one strategy of behavior or anotherinfl uences on successful negotiation process and assists in achieving goals.We did research on the connections among level of anxiety, motivation to succeedand to avoid failure, and self-esteem to the level of Machiavellianism. This articlediscusses the personal characteristics that infl uence the choice of manipulativetactics of behavior in negotiations.

  9. The Antenarrative of Negotiation

    DEFF Research Database (Denmark)

    Bülow, Anne Marie; Boje, David M.

    2015-01-01

    Within organizations, there are occasions where a contract negotiation is recognizable, e.g. a job offer. However, that situation is already embedded in other structures and negotiations. This article explores the nature of such embeddedness. We extend negotiation theory by adding an analysis...... of argumentation that underlie negotiation. We study a case of New Public Management in a university, as an organization with several layers of decision-makers and distributed responsibility for resource allocation. By examining the dynamic development of antenarrative, we contribute a theory of embeddedness...... that helps to develop strategic ‘bets on the future’ that practitioners can use as a preparation tool before negotiations....

  10. Justice and Negotiation.

    Science.gov (United States)

    Druckman, Daniel; Wagner, Lynn M

    2016-01-01

    This review article examines the literature regarding the role played by principles of justice in negotiation. Laboratory experiments and high-stakes negotiations reveal that justice is a complex concept, both in relation to attaining just outcomes and to establishing just processes. We focus on how justice preferences guide the process and outcome of negotiated exchanges. Focusing primarily on the two types of principles that have received the most attention, distributive justice (outcomes of negotiation) and procedural justice (process of negotiation), we introduce the topic by reviewing the most relevant experimental and field or archival research on the roles played by these justice principles in negotiation. A discussion of the methods used in these studies precedes a review organized in terms of a framework that highlights the concept of negotiating stages. We also develop hypotheses based on the existing literature to point the way forward for further research on this topic.

  11. Patterns of Negotiation

    Science.gov (United States)

    Sood, Suresh; Pattinson, Hugh

    Traditionally, face-to-face negotiations in the real world have not been looked at as a complex systems interaction of actors resulting in a dynamic and potentially emergent system. If indeed negotiations are an outcome of a dynamic interaction of simpler behavior just as with a complex system, we should be able to see the patterns contributing to the complexities of a negotiation under study. This paper and the supporting research sets out to show B2B (business-to-business) negotiations as complex systems of interacting actors exhibiting dynamic and emergent behavior. This paper discusses the exploratory research based on negotiation simulations in which a large number of business students participate as buyers and sellers. The student interactions are captured on video and a purpose built research method attempts to look for patterns of interactions between actors using visualization techniques traditionally reserved to observe the algorithmic complexity of complex systems. Students are videoed negotiating with partners. Each video is tagged according to a recognized classification and coding scheme for negotiations. The classification relates to the phases through which any particular negotiation might pass, such as laughter, aggression, compromise, and so forth — through some 30 possible categories. Were negotiations more or less successful if they progressed through the categories in different ways? Furthermore, does the data depict emergent pathway segments considered to be more or less successful? This focus on emergence within the data provides further strong support for face-to-face (F2F) negotiations to be construed as complex systems.

  12. STRATEGIES FOR SMALL ENTERPRISES NEGOTIATING WITH LARGE FIRMS

    Directory of Open Access Journals (Sweden)

    Stefania Anca Stan

    2013-12-01

    Full Text Available All around the world business is changing. All traditional business practices have been called into question as markets, customers competitors, problems and solutions have changed. As a result, business practices we once took for granted, like traditional negotiating approaches are falling by the wayside in favor of more collaborative, equally beneficial, win-win strategies. A new negotiation paradigm away from negotiating a deal and toward negotiating a relationship is needed for the twenty first century. Business can no longer stay on top by negotiating short term victories. The key to winning unbeatable, long term results is to negotiate solid, long term relationship. Smart business owners are trying to find ways to leverage their assets, and one important way is to negotiate for long - term relationships. Traditional knowledge and skills remain important. Yet global managers can better respond to global demands by learning continuously managing diversity, and developing a global mindset.

  13. Multi-issue Agent Negotiation Based on Fairness

    Science.gov (United States)

    Zuo, Baohe; Zheng, Sue; Wu, Hong

    Agent-based e-commerce service has become a hotspot now. How to make the agent negotiation process quickly and high-efficiently is the main research direction of this area. In the multi-issue model, MAUT(Multi-attribute Utility Theory) or its derived theory usually consider little about the fairness of both negotiators. This work presents a general model of agent negotiation which considered the satisfaction of both negotiators via autonomous learning. The model can evaluate offers from the opponent agent based on the satisfaction degree, learn online to get the opponent's knowledge from interactive instances of history and negotiation of this time, make concessions dynamically based on fair object. Through building the optimal negotiation model, the bilateral negotiation achieved a higher efficiency and fairer deal.

  14. Clinical profile, knowledge, and beliefs about diabetes among ...

    African Journals Online (AJOL)

    Conclusion: Knowing patients' beliefs and knowledge about diabetes is important to impart overall care for them. Health education about a disease should be planned to address beliefs and knowledge of patients about their medical condition to address misinformation and misconceptions about their disease conditions.

  15. The biomedical disciplines and the structure of biomedical and clinical knowledge.

    Science.gov (United States)

    Nederbragt, H

    2000-11-01

    The relation between biomedical knowledge and clinical knowledge is discussed by comparing their respective structures. The knowledge of a disease as a biological phenomenon is constructed by the interaction of facts and theories from the main biomedical disciplines: epidemiology, diagnostics, clinical trial, therapy development and pathogenesis. Although these facts and theories are based on probabilities and extrapolations, the interaction provides a reliable and coherent structure, comparable to a Kuhnian paradigma. In the structure of clinical knowledge, i.e. knowledge of the patient with the disease, not only biomedical knowledge contributes to the structure but also economic and social relations, ethics and personal experience. However, the interaction between each of the participating "knowledges" in clinical knowledge is not based on mutual dependency and accumulation of different arguments from each, as in biomedical knowledge, but on competition and partial exclusion. Therefore, the structure of biomedical knowledge is different from that of clinical knowledge. This difference is used as the basis for a discussion in which the place of technology, evidence-based medicine and the gap between scientific and clinical knowledge are evaluated.

  16. World championship in negotiation?

    DEFF Research Database (Denmark)

    Smolinski, Remigiusz; Kesting, Peter

    2013-01-01

    for negotiation pedagogy.These benefits include: the high level of student commitment generated by participation in a competition, which enhances the quality of negotiation; the opportunity that the competitions give students to experience authentic cultural diversity; and the networking opportunities......The last decade has seen the emergence of several new negotiation competitions around the world.We think the two major drivers of this development are a general trend toward the increasing internationalization of higher education and a recognition of the specific benefits of competitions...... for students and instructors that the competitions create.This article focuses on the role that negotiation competitions can play in negotiation pedagogy. We first present an overview of the currently most important international negotiation competitions.This is followed by an outline of the specific benefits...

  17. Ontolology Negotiation Between Scientific Archives

    Science.gov (United States)

    Bailin, Sidney C.; Truszkowski, Walt; Obenschain, Arthur F. (Technical Monitor)

    2001-01-01

    knowledge about imaging, climate analysis, ecology, demographics, industrial economics, and biology. The need for ontology negotiation also arises at the boundaries between scientific programs. For example, a Principal Investigator may want to use information from a previous mission to complement downloads from the instruments currently deployed.

  18. Negotiation and management

    OpenAIRE

    Ademi, Nermin

    2010-01-01

    Negotiations are a means of how to solve conflicts and differences through direct communication. It is a structured process through which parties overcome their differences and conflicts trying to reach an agreement about which solution will be acceptable to all. The basic meaning of negotiations is to obtain what you want from others. In this work the principal aspects of negotiations are being discussed, as one of the key business processes and an essential source of competitive advanta...

  19. Clinical profile, knowledge, and beliefs about diabetes among ...

    African Journals Online (AJOL)

    2015-11-19

    Nov 19, 2015 ... Conclusion: Knowing patients' beliefs and knowledge about diabetes is important to impart overall care ... 150 participants in our survey to increase the study power .... Glycemic control in patients with diabetes on anti‑diabetic.

  20. Negotiation within labor relations

    Directory of Open Access Journals (Sweden)

    Iulia BĂDOI

    2014-06-01

    Full Text Available Negotiation is the process we use in order to obtain things that we want and are controlled by others. Any desire we intend to fulfill, any need that we are obliged to meet is a potential bargaining situations. Between groups and individuals, negotiation occurs naturally, as some have one thing that the other wants and is willing to bargain to get it. More or less we are all involved in negotiations: closing a contract, buying a thing, obtaining sponsorships, collective decision making, conflict resolution, agreement on work plans. Within the field of labor relations, negotiation can occur on the occasion of closing / amending employment contracts or in order to regulate employment or work relations. Moreover, used properly, the negotiation can be an effective tool for solving labor disputes, with benefits for both involved parties. This paper aims to present negotiating principles and steps to follow in planning and preparing negotiations and the negotiating techniques that can lead to a successful negotiation based on a well-developed plan.

  1. Representing clinical communication knowledge through database management system integration.

    Science.gov (United States)

    Khairat, Saif; Craven, Catherine; Gong, Yang

    2012-01-01

    Clinical communication failures are considered the leading cause of medical errors [1]. The complexity of the clinical culture and the significant variance in training and education levels form a challenge to enhancing communication within the clinical team. In order to improve communication, a comprehensive understanding of the overall communication process in health care is required. In an attempt to further understand clinical communication, we conducted a thorough methodology literature review to identify strengths and limitations of previous approaches [2]. Our research proposes a new data collection method to study the clinical communication activities among Intensive Care Unit (ICU) clinical teams with a primary focus on the attending physician. In this paper, we present the first ICU communication instrument, and, we introduce the use of database management system to aid in discovering patterns and associations within our ICU communications data repository.

  2. On the constraints of encapsulated knowledge : Clinical case representations by medical experts and subexperts

    NARCIS (Netherlands)

    Rikers, Remy MJP; Schmidt, Henk G; Boshuizen, Henny PA

    2002-01-01

    This article is concerned with the role of so-called encapsulated knowledge and biomedical knowledge in the process of diagnosing clinical cases within and outside the medical specialist's domain of expertise. Based on the theory of knowledge encapsulation, we predicted that subexperts (i.e.,

  3. A Profile of Clinical Nutrition Knowledge Among Physicians and Medical Students

    Science.gov (United States)

    Podell, Richard N.; And Others

    1975-01-01

    An assessment of the clinical nutritional knowledge of third- and fourth-year medical students and practicing physicians revealed that overall nutritional knowledge is modest and that knowledge is highest among topics which have received the most publicity in the popular press. Methodology and specific findings are included. (JT)

  4. From Idea to Product--Translating Knowledge between the Lab and the Clinic

    Science.gov (United States)

    Ali, Ayfer Habib

    2012-01-01

    This dissertation is composed of three essays looking at innovation at Academic Medical Centers. It tries to empirically explore the problem of translating knowledge from the laboratory bench to the clinic and from the clinic to the bench. Chapter 1, co-authored with Iain Cockburn, establishes the importance of in-house complementary knowledge in…

  5. Knowledge of genital herpes infection among antenatal clinic ...

    African Journals Online (AJOL)

    Background: Herpes simplex virus (HSV) is a major cause of genital ulcer disease worldwide and a significant factor for increased risk of acquisition and transmission of the Human Immune Deficiency Virus (HIV). The determination of the level of knowledge of genital herpes is necessary for the design and implementation of ...

  6. Clinical practitioners' knowledge of ionizing radiation doses in ...

    African Journals Online (AJOL)

    Questions on radiosensitivity of different organs, imaging modalities that use ionizing radiation and considerations for the choice of ionizing radiation (IR) based examinations were included. Participants were also asked for their preferred methods of filling any knowledge gap on IR issues. Responses were presented in ...

  7. Intelligence and negotiating

    International Nuclear Information System (INIS)

    George, D.G.

    1990-01-01

    This paper discusses the role of US intelligence during arms control negotiations between 1982 and 1987. It also covers : the orchestration of intelligence projects; an evaluation of the performance of intelligence activities; the effect intelligence work had on actual arms negotiations; and suggestions for improvements in the future

  8. Preparing for Negotiations.

    Science.gov (United States)

    Lundberg, Larry

    The school board's negotiating team is all-important in the collective bargaining process, especially in light of the unity and organization of teacher association teams. Upper echelon administrative personnel, not the board members themselves, should compose the board's negotiating team. A board inexperienced in collective bargaining can hire a…

  9. Negotiating with payers.

    Science.gov (United States)

    Kaufman, Joel M

    2010-05-01

    Negotiating with payers for better reimbursement, contract language, support for practice enhancement, or changes in policies and procedures is a critical function that may greatly enhance a practice's success over time. This article discusses keys to successful negotiating and several specific areas beyond reimbursement that deserve the reader's attention. Copyright 2010 Elsevier Inc. All rights reserved.

  10. Injection safety knowledge and practices among clinical health care ...

    African Journals Online (AJOL)

    Injection safety is therefore critical in preventing occupational exposure and infection from blood borne pathogens, hence prevention is a vital part of any ... safety among clinical healthcare workers at the Garissa Provincial General Hospital.

  11. Semantics-based plausible reasoning to extend the knowledge coverage of medical knowledge bases for improved clinical decision support.

    Science.gov (United States)

    Mohammadhassanzadeh, Hossein; Van Woensel, William; Abidi, Samina Raza; Abidi, Syed Sibte Raza

    2017-01-01

    Capturing complete medical knowledge is challenging-often due to incomplete patient Electronic Health Records (EHR), but also because of valuable, tacit medical knowledge hidden away in physicians' experiences. To extend the coverage of incomplete medical knowledge-based systems beyond their deductive closure, and thus enhance their decision-support capabilities, we argue that innovative, multi-strategy reasoning approaches should be applied. In particular, plausible reasoning mechanisms apply patterns from human thought processes, such as generalization, similarity and interpolation, based on attributional, hierarchical, and relational knowledge. Plausible reasoning mechanisms include inductive reasoning , which generalizes the commonalities among the data to induce new rules, and analogical reasoning , which is guided by data similarities to infer new facts. By further leveraging rich, biomedical Semantic Web ontologies to represent medical knowledge, both known and tentative, we increase the accuracy and expressivity of plausible reasoning, and cope with issues such as data heterogeneity, inconsistency and interoperability. In this paper, we present a Semantic Web-based, multi-strategy reasoning approach, which integrates deductive and plausible reasoning and exploits Semantic Web technology to solve complex clinical decision support queries. We evaluated our system using a real-world medical dataset of patients with hepatitis, from which we randomly removed different percentages of data (5%, 10%, 15%, and 20%) to reflect scenarios with increasing amounts of incomplete medical knowledge. To increase the reliability of the results, we generated 5 independent datasets for each percentage of missing values, which resulted in 20 experimental datasets (in addition to the original dataset). The results show that plausibly inferred knowledge extends the coverage of the knowledge base by, on average, 2%, 7%, 12%, and 16% for datasets with, respectively, 5%, 10%, 15

  12. Detailed clinical models: representing knowledge, data and semantics in healthcare information technology.

    Science.gov (United States)

    Goossen, William T F

    2014-07-01

    This paper will present an overview of the developmental effort in harmonizing clinical knowledge modeling using the Detailed Clinical Models (DCMs), and will explain how it can contribute to the preservation of Electronic Health Records (EHR) data. Clinical knowledge modeling is vital for the management and preservation of EHR and data. Such modeling provides common data elements and terminology binding with the intention of capturing and managing clinical information over time and location independent from technology. Any EHR data exchange without an agreed clinical knowledge modeling will potentially result in loss of information. Many attempts exist from the past to model clinical knowledge for the benefits of semantic interoperability using standardized data representation and common terminologies. The objective of each project is similar with respect to consistent representation of clinical data, using standardized terminologies, and an overall logical approach. However, the conceptual, logical, and the technical expressions are quite different in one clinical knowledge modeling approach versus another. There currently are synergies under the Clinical Information Modeling Initiative (CIMI) in order to create a harmonized reference model for clinical knowledge models. The goal for the CIMI is to create a reference model and formalisms based on for instance the DCM (ISO/TS 13972), among other work. A global repository of DCMs may potentially be established in the future.

  13. Knowledge Creation in Clinical Product Development Management Research

    DEFF Research Database (Denmark)

    Karlsson, Christer; Sköld, Martin

    2012-01-01

    This paper explores the clinical approach to management research and positions it in relation to other similar approaches. It achieves this by pointing out the most important historical milestones in the development of such approaches. The literature on the approach is mapped, including that on t......This paper explores the clinical approach to management research and positions it in relation to other similar approaches. It achieves this by pointing out the most important historical milestones in the development of such approaches. The literature on the approach is mapped, including...... of the approaches, the paper discusses the research issues to which clinical research is relevant and how the research framework should be designed, then practical issues relating to how to approach the study objects, the design of the research instruments, and the conducting of the field research. Finally...

  14. Culture and Negotiation

    DEFF Research Database (Denmark)

    Bülow, Anne Marie; Kumar, Rajesh

    2011-01-01

    The literature on cross-cultural negotiation has expanded considerably over the past few decades, but the findings are often ambiguous and sometimes even contradictory. This introduction highlights the critical areas where objections are commonly raised about the relevance of national culture......, the applicability of typologies that treat cultures as static, and the problem of ambiguous terminology. It may not be surprising that studies contradict each other given the ambiguity of the national cultural construct and variations in the context of the negotiating situations that are studied. The articles...... in this issue contribute to deepening our understanding about cross-cultural negotiation processes....

  15. Negotiating through conflict

    International Nuclear Information System (INIS)

    Cormick, G.W.

    1986-01-01

    There are several major causes of conflict over the nuclear waste disposal siting process but conflict should not be ended or avoided merely to have peace. A number of issues are listed that should be addressed to ensure that negotiations can be performed in a manner that will result in agreements. During the negotiation process, participants should not reveal all secrets, but must not appear to be holding things back. The agreements reached as a result of negotiations should be spelled out clearly, in writing. The agreement should tell how to implement the decision and state how all parties will be involved. The agreement should also contain provisions for continued interaction among parties

  16. Business Negotiations Idioms

    OpenAIRE

    Юрченко, С.О.

    2013-01-01

    English idioms or idiomatic expressions have always been one of the trickiest topics. This is because the real meanings of English idioms are so far off their literal meanings. To make things more complicated, idioms are used in business negotiations.

  17. Intelligence and negotiating

    International Nuclear Information System (INIS)

    Hetherington, J.A.

    1990-01-01

    This paper gives some background on how people from the INF went about their jobs during the last two years of negotiations, and also relates some of the goals the INF had in mind and some of their concerns

  18. Complex Business Negotiation

    OpenAIRE

    Lindholst, Morten

    2015-01-01

    Most scholars agree that engaging in preparation and planning is key to a negotiation’s effectiveness but research has largely focused solely on what happens at the negotiation table, rather than in preparation for it. This thesis addresses the balance by clarifying which preparation and planning activities are undertaken to conduct a complex business negotiation. It examines not only what activities are conducted, but also by whom, and when. One important question for both pra...

  19. Metformin and breast cancer: basic knowledge in clinical context.

    Science.gov (United States)

    Pizzuti, Laura; Vici, Patrizia; Di Lauro, Luigi; Sergi, Domenico; Della Giulia, Marina; Marchetti, Paolo; Maugeri-Saccà, Marcello; Giordano, Antonio; Barba, Maddalena

    2015-05-01

    Although preclinical work is vital in unraveling the molecular tenets which apply to metformin action in breast cancer, it is by nature unable to capture the host's response to metformin in terms of insulin-mediated effects and related changes in the hormonal and metabolic asset at the systemic level. The latter might sound seemingly paradoxical when considering the inveterate use of metformin in dysmetabolisms and pathologic conditions with underlying hormonal disruption. Bridging the gap between the molecular target and characteristics of breast cancer patients may help lab-based experiments and clinical work converge into one or more well characterized sub-populations instead of a sub optimally selected one. An appropriate patient selection is the main key to the most suitable outcome interpretation and amelioration, in an attempt to meet our patients needs midway between overestimation of benefits and efficacy dilution for any given intervention and/or co-intervention. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. The Importance of Medicinal Chemistry Knowledge in the Clinical Pharmacist's Education.

    Science.gov (United States)

    Fernandes, João Paulo S

    2018-03-01

    Objective. To show why medicinal chemistry must be a key component of the education of pharmacy students, as well as in the pharmacist's practice. Findings. Five case reports were selected by their clinically relevant elements of medicinal chemistry and were explained using structure-activity relationship data of the drugs involved in the case easily obtained from primary literature and in medicinal chemistry textbooks. Summary. This paper demonstrates how critical clinical decisions can be addressed using medicinal chemistry knowledge. While such knowledge may not explain all clinical decisions, medicinal chemistry concepts are essential for the education of pharmacy students to explain drug action in general and clinical decisions.

  1. Fear of knowledge: Clinical hypotheses in diagnostic and prognostic reasoning.

    Science.gov (United States)

    Chiffi, Daniele; Zanotti, Renzo

    2017-10-01

    Patients are interested in receiving accurate diagnostic and prognostic information. Models and reasoning about diagnoses have been extensively investigated from a foundational perspective; however, for all its importance, prognosis has yet to receive a comparable degree of philosophical and methodological attention, and this may be due to the difficulties inherent in accurate prognostics. In the light of these considerations, we discuss a considerable body of critical thinking on the topic of prognostication and its strict relations with diagnostic reasoning, pointing out the distinction between nosographic and pathophysiological types of diagnosis and prognosis, underlying the importance of the explication and explanation processes. We then distinguish between various forms of hypothetical reasoning applied to reach diagnostic and prognostic judgments, comparing them with specific forms of abductive reasoning. The main thesis is that creative abduction regarding clinical hypotheses in diagnostic process is very unlikely to occur, whereas this seems to be often the case for prognostic judgments. The reasons behind this distinction are due to the different types of uncertainty involved in diagnostic and prognostic judgments. © 2016 John Wiley & Sons, Ltd.

  2. Types of unethical tactics in negotiation between buyer and supplier

    Directory of Open Access Journals (Sweden)

    Božidar

    2014-06-01

    Full Text Available Research Question (RQ: This article researches the kinds of unethical tactics, which can use customers or suppliers to achieve better negotiating outcome. Purpose: Determine which tactics they used, from where they rise from and what the other authors about resulting of using unethical tactics. Method: Analysis of articles from Ebsco and ProQuest databases. Results: Getting of ethical knowledge, types of unethical negotiation tactics and awareness of the limits of ethics in the negotiations process between suppliers and customers. Organization: Managers can gain the recognition of unethical tactics, their using in the negotiation process and the construction of negotiating temperament or even competence. The research contributes to a better achievement of the performance of the organization. The results of this article can contribute to the negotiators decision-making on the use of unethical tactics. Society: Ethical negotiation helps to improve the reputation and respect of the organization, which represents the negotiator. Originality: In a review of existing articles and searches we have not found similar studies to investigate the unethical negotiating tactics. Limitations/Future Research: The article is limited to fifteen articles and three books.

  3. A Swarm Optimization approach for clinical knowledge mining.

    Science.gov (United States)

    Christopher, J Jabez; Nehemiah, H Khanna; Kannan, A

    2015-10-01

    Rule-based classification is a typical data mining task that is being used in several medical diagnosis and decision support systems. The rules stored in the rule base have an impact on classification efficiency. Rule sets that are extracted with data mining tools and techniques are optimized using heuristic or meta-heuristic approaches in order to improve the quality of the rule base. In this work, a meta-heuristic approach called Wind-driven Swarm Optimization (WSO) is used. The uniqueness of this work lies in the biological inspiration that underlies the algorithm. WSO uses Jval, a new metric, to evaluate the efficiency of a rule-based classifier. Rules are extracted from decision trees. WSO is used to obtain different permutations and combinations of rules whereby the optimal ruleset that satisfies the requirement of the developer is used for predicting the test data. The performance of various extensions of decision trees, namely, RIPPER, PART, FURIA and Decision Tables are analyzed. The efficiency of WSO is also compared with the traditional Particle Swarm Optimization. Experiments were carried out with six benchmark medical datasets. The traditional C4.5 algorithm yields 62.89% accuracy with 43 rules for liver disorders dataset where as WSO yields 64.60% with 19 rules. For Heart disease dataset, C4.5 is 68.64% accurate with 98 rules where as WSO is 77.8% accurate with 34 rules. The normalized standard deviation for accuracy of PSO and WSO are 0.5921 and 0.5846 respectively. WSO provides accurate and concise rulesets. PSO yields results similar to that of WSO but the novelty of WSO lies in its biological motivation and it is customization for rule base optimization. The trade-off between the prediction accuracy and the size of the rule base is optimized during the design and development of rule-based clinical decision support system. The efficiency of a decision support system relies on the content of the rule base and classification accuracy. Copyright

  4. Development of traditional Chinese medicine clinical data warehouse for medical knowledge discovery and decision support.

    Science.gov (United States)

    Zhou, Xuezhong; Chen, Shibo; Liu, Baoyan; Zhang, Runsun; Wang, Yinghui; Li, Ping; Guo, Yufeng; Zhang, Hua; Gao, Zhuye; Yan, Xiufeng

    2010-01-01

    Traditional Chinese medicine (TCM) is a scientific discipline, which develops the related theories from the long-term clinical practices. The large-scale clinical data are the core empirical knowledge source for TCM research. This paper introduces a clinical data warehouse (CDW) system, which incorporates the structured electronic medical record (SEMR) data for medical knowledge discovery and TCM clinical decision support (CDS). We have developed the clinical reference information model (RIM) and physical data model to manage the various information entities and their relationships in TCM clinical data. An extraction-transformation-loading (ETL) tool is implemented to integrate and normalize the clinical data from different operational data sources. The CDW includes online analytical processing (OLAP) and complex network analysis (CNA) components to explore the various clinical relationships. Furthermore, the data mining and CNA methods are used to discover the valuable clinical knowledge from the data. The CDW has integrated 20,000 TCM inpatient data and 20,000 outpatient data, which contains manifestations (e.g. symptoms, physical examinations and laboratory test results), diagnoses and prescriptions as the main information components. We propose a practical solution to accomplish the large-scale clinical data integration and preprocessing tasks. Meanwhile, we have developed over 400 OLAP reports to enable the multidimensional analysis of clinical data and the case-based CDS. We have successfully conducted several interesting data mining applications. Particularly, we use various classification methods, namely support vector machine, decision tree and Bayesian network, to discover the knowledge of syndrome differentiation. Furthermore, we have applied association rule and CNA to extract the useful acupuncture point and herb combination patterns from the clinical prescriptions. A CDW system consisting of TCM clinical RIM, ETL, OLAP and data mining as the core

  5. Familiarity knowledge in student nurses' clinical studies: exemplified by student nurses in palliative care.

    Science.gov (United States)

    Haugan, Grethe; Hanssen, Ingrid

    2012-01-01

    In this article based on a literary study, the form of knowledge named familiarity knowledge is examined. Although rooted in the philosophical tradition of Wittgenstein and Polanyi, the development of familiarity knowledge is tied in with clinical practice and particular patients and contexts while paying attention to the framework factors influencing the setting as a whole as well as with theoretical knowledge relevant to the situation at hand. Palliative care makes a backdrop for some of the discussion. Familiarity knowledge can never be context free and attends to that which is unique in every nurse-patient relationship. Both assertive and familiarity knowledge are needed to care for dying patients in a competent, sensitive, and truly caring manner. Mentors need to help students synthesize assertive knowledge and familiarity knowledge during their clinical studies to enrich both kinds of knowledge and deepen their understanding. Student nurses expertly mentored and tutored while caring for dying patients living at home become, for instance, less apprehensive about facing dying patients than students not so mentored. Nurses need to understand the complexity of nursing care to be able to see the uniqueness of the situation and approach the individual patient on the bases of experience and insight.

  6. Synthesis maps: visual knowledge translation for the CanIMPACT clinical system and patient cancer journeys.

    Science.gov (United States)

    Jones, P H; Shakdher, S; Singh, P

    2017-04-01

    Salient findings and interpretations from the canimpact clinical cancer research study are visually represented in two synthesis maps for the purpose of communicating an integrated presentation of the study to clinical cancer researchers and policymakers. Synthesis maps integrate evidence and expertise into a visual narrative for knowledge translation and communication. A clinical system synthesis map represents the current Canadian primary care and cancer practice systems, proposed as a visual knowledge translation from the mixed-methods canimpact study to inform Canadian clinical research, policy, and practice discourses. Two synthesis maps, drawn together from multiple canimpact investigations and sources, were required to articulate critical differences between the clinical system and patient perspectives. The synthesis map of Canada-wide clinical cancer systems illustrates the relationships between primary care and the full cancer continuum. A patient-centred map was developed to represent the cancer (and primary care) journeys as experienced by breast and colorectal cancer patients.

  7. Closing the gap between knowledge and clinical application: challenges for genomic translation.

    Science.gov (United States)

    Burke, Wylie; Korngiebel, Diane M

    2015-01-01

    Despite early predictions and rapid progress in research, the introduction of personal genomics into clinical practice has been slow. Several factors contribute to this translational gap between knowledge and clinical application. The evidence available to support genetic test use is often limited, and implementation of new testing programs can be challenging. In addition, the heterogeneity of genomic risk information points to the need for strategies to select and deliver the information most appropriate for particular clinical needs. Accomplishing these tasks also requires recognition that some expectations for personal genomics are unrealistic, notably expectations concerning the clinical utility of genomic risk assessment for common complex diseases. Efforts are needed to improve the body of evidence addressing clinical outcomes for genomics, apply implementation science to personal genomics, and develop realistic goals for genomic risk assessment. In addition, translational research should emphasize the broader benefits of genomic knowledge, including applications of genomic research that provide clinical benefit outside the context of personal genomic risk.

  8. Factors shaping how clinical educators use their educational knowledge and skills in the clinical workplace: a qualitative study.

    Science.gov (United States)

    Kumar, Koshila; Greenhill, Jennene

    2016-02-18

    In order to consolidate their educational knowledge and skills and develop their educational role, many clinicians undertake professional development in clinical education and supervision. It is well established that these educationally-focussed professional development activities have a positive impact. However, it is less clear what factors within the clinical workplace can shape how health professionals may use and apply their educational knowledge and skills and undertake their educational role. Looking through the lens of workplace affordances, this paper draws attention to the contextual, personal and interactional factors that impact on how clinical educators integrate their educational knowledge and skills into the practice setting, and undertake their educational role. Data were gathered via a survey of 387 clinical educators and semi-structured interviews with 12 clinical educators and 6 workplace managers. In this paper, we focus on analysing and reporting the qualitative data gathered in this study. This qualitative data were subject to a thematic analysis and guided by theoretical constructs related to workplace affordances. Three key themes were identified including contextual, personal and interactional factors. Contextual elements referred to organisational structures and systems that impact on participants' educational role, how participants' clinical education role was articulated and configured within the organisation, and how the organisation shaped the educational opportunities available to clinicians. Personal factors encompassed clinicians' personal motivations and goals to teach and be involved in education, develop their own educational skills and function as a role model for students. Interactional factors referred to the professional interactions and networks through which clinicians shared their educational knowledge and skills and further consolidated their profile as educational advocates in their workplace. There are a number of

  9. Synthesis maps: visual knowledge translation for the CanIMPACT clinical system and patient cancer journeys

    OpenAIRE

    Jones, P.H.; Shakdher, S.; Singh, P.

    2017-01-01

    Salient findings and interpretations from the canimpact clinical cancer research study are visually represented in two synthesis maps for the purpose of communicating an integrated presentation of the study to clinical cancer researchers and policymakers. Synthesis maps integrate evidence and expertise into a visual narrative for knowledge translation and communication. A clinical system synthesis map represents the current Canadian primary care and cancer practice systems, proposed as a visu...

  10. Interaction as Negotiation

    DEFF Research Database (Denmark)

    Kristensen, Jannie Friis; Nielsen, Christina

    In this paper we discuss recent developments in interaction design principles for ubiquitous computing environments, specifically implications related to situated and mobile aspects of work. We present 'Interaction through Negotiation' as a general Human-Computer Interaction (HCI) paradigm, aimed...... at ubiquitous/pervasive technology and environments, with focus on facilitating negotiation in and between webs of different artifacts, humans and places. This approach is concerned with the way technology presents itself to us, both as physical entities and as conceptual entities, as well as the relations...... on several extensive empirical case studies, as well as co-operative design-sessions, we present a reflective analysis providing insights into results of the "Interaction through Negotiation" design approach in action. A very promising area of application is exception handling in pervasive computing...

  11. Negotiating Life Chances

    DEFF Research Database (Denmark)

    Korzenevica, Marina

    to and negotiate both educational and labour mobility - both of which are associated with the chance of a better life. This thesis is about young people (aged 16-31): How they negotiate their life chances and how they contribute to transformations of the socio-political space of their communities in two villages...... becoming. Aspirations prevail over political interests: young people navigate and negotiate their engagement in party and community politics by making calculations concerning their own mobility, life strategies and obligations to kin. In this way, young men engage in, but also balance and shift......, conversely, can only aspire to educational mobility due to gender norms. Furthermore, many of their hopes of ‘becoming somebody’ collapse upon marriage. Women find that they cannot continue their education, nor use the skills they have acquired in local politics, as they need to follow traditional...

  12. The hostage experience: implications for negotiation strategies

    NARCIS (Netherlands)

    Giebels, Ellen; Noelanders, Sigrid; Vervaeke, Geert

    2005-01-01

    From a clinical and social psychological perspective, this exploratory study aims at relating the hostage experience to hostage negotiation strategies. Therefore, we conducted 11 semi-structured and in-depth interviews with victims of two types of hostage-taking: sieges and kidnappings. The results

  13. The hostage experience : Implications for negotiation strategies

    NARCIS (Netherlands)

    Giebels, E; Noelanders, S; Vervaeke, G

    2005-01-01

    From a clinical and social psychological perspective, this exploratory study aims at relating the hostage experience to hostage negotiation strategies. Therefore, we conducted 11 semi-structured and in-depth interviews with victims of two types of hostage-taking: sieges and kidnappings. The results

  14. Procesos de autogestión del conocimiento orientado hacia una Educación Integral Pluricultural Self-negotiation of knowledge guided towards a pluricultural integral education

    Directory of Open Access Journals (Sweden)

    Jaime Alfonso Sánchez Garza

    2005-08-01

    Full Text Available A mediados de la década de los noventa, se inició a acuñar con mayor fuerza la definición de esta nueva generación la cual se le reconoce como la “generación de la información y el conocimiento” en donde gracias a la tecnología y a los grandes avances de las comunicaciones la información fluye a una gran velocidad al grado que las noticias las vemos en el mismo momento en que están sucediendo, así también el intercambio de información y conocimientos se da de manera paralela; gracias al Internet, las personas pueden comunicarse en tiempo real con personas que se localizan en otras latitudes. Por otro lado, el crecimiento de los acuerdos comerciales surge simultáneamente, lo que origina procesos de transculturación, dependencia y vinculación comercial entre los países socios. La educación no puede mantenerse al margen de estos procesos, lo que orienta a las instituciones de educación a realizar procesos de internacionalización y de igual forma guía a estas al desarrollo de procesos de autogestión del aprendizaje, cuidando en los educandos los valores sociales y culturales de sus países de origen. Pero; permitiendo en estos un intercambio pluricultural en donde se fortalezcan las habilidades y competencias que les permitan tener ventajas competitivasBy the middle of the ninety decade, began with more force the definition of this new generation which is recognized as the “generation of the information and the knowledge” where thanks to the technology and to the big advances of the communications the information flows by a high speed to such a grade that the news we see at the asme moment they are happening, likewise the exchange of information and knowledge is given in a parallel way, thanks to internet people can communicate in real time with people that are located in other latitudes. On the other hand, the growth of the commercial agreements emerges simultaneously, with originates transculturation processes

  15. Hegemonic structure of basic, clinical and patented knowledge on Ebola research: a US army reductionist initiative

    OpenAIRE

    Fajardo-Ortiz, David; Ortega-S?nchez-de-Tagle, Jos?; Casta?o, Victor M

    2015-01-01

    Background Ebola hemorrhagic fever (Ebola) is still a highly lethal infectious disease long affecting mainly neglected populations in sub-Saharan Africa. Moreover, this disease is now considered a potential worldwide threat. In this paper, we present an approach to understand how the basic, clinical and patent knowledge on Ebola is organized and intercommunicated and what leading factor could be shaping the evolution of the knowledge translation process for this disease. Methodology A combina...

  16. The gap between available knowledge and its use in clinical psychiatry

    DEFF Research Database (Denmark)

    Munk-Jørgensen, P; Blanner Kristiansen, C; Uwawke, R

    2015-01-01

    OBJECTIVE: The time span between knowledge becoming available and its integration into daily clinical routine is lengthy. This phenomenon is explored in this study. METHOD: We used the outcomes of our activities for investigating and strengthening the research-based activities to improve physical...... health in the routines of clinical psychiatric wards as examples for our analyses. RESULTS: The time span between new knowledge becoming available and its implementation into general clinical treatment is very long. However, a shortening of this time span is seen through active leadership backup...... is needed in all professions to increase evidence-based practice. Leaders must take responsibility for implementing new knowledge into the routines of the department and must support staff in these activities on a daily basis....

  17. Newly graduated nurses use of knowledge sources in clinical decison-making - a qualitative study

    DEFF Research Database (Denmark)

    Voldbjerg, Siri

    of clinical decisions, based on transparent, articulate and reflective use of knowledge sources. Furthermore, it is implied that nurses are able to retrieve, asses, implement and evaluate research evidence. To meet these requirements, nursing educations around the world have organised curricula to educate...... graduated nurses do not work within a framework of evidence-based practice. The overall aim of this thesis was to explore which knowledge sources newly graduated nurses’ use in their clinical decision-making and why they use them in order to understand why newly graduated nurses use research and components...... within evidence-based practice to a limited extent. The thesis is based on a synthesis of findings from two studies. The aim of the first study was to explore which knowledge sources newly graduated nurses use in clinical decision making as reported within international qualitative research. The purpose...

  18. How employees negotiate : job autonomy and negotiation self-efficacy related to integrative negotiation and negotiation results in employment relationships

    NARCIS (Netherlands)

    Oeij, P.

    2006-01-01

    To assess whether satisfaction with psychological contract breach does more depend on good negotiation skills or on a well-designed job, we first investigated the effect of negotiation self-efficacy and task autonomy on integrative negotiation with survey data from employees of a telecom company. We

  19. Negotiations in Supply Chain Management

    DEFF Research Database (Denmark)

    Zachariassen, Frederik

    2008-01-01

    negotiation literature. Subsequently, an empirical case study is presented, which explicitly aims at exploring the role of negotiations between members of a supply chain. Based on the findings, the paper concludes on specific, normative guidelines for negotiations for improved supply chain competitiveness...

  20. Acceptance conditions in automated negotiation

    NARCIS (Netherlands)

    Baarslag, T.; Hindriks, K.V.; Jonker, C.M.

    2011-01-01

    In every negotiation with a deadline, one of the negotiating parties has to accept an offer to avoid a break off. A break off is usually an undesirable outcome for both parties, therefore it is important that a negotiator employs a proficient mechanism to decide under which conditions to accept.

  1. Negotiation for Strategic Video Games

    OpenAIRE

    Afiouni, Einar Nour; Øvrelid, Leif Julian

    2013-01-01

    This project aims to examine the possibilities of using game theoretic concepts and multi-agent systems in modern video games with real time demands. We have implemented a multi-issue negotiation system for the strategic video game Civilization IV, evaluating different negotiation techniques with a focus on the use of opponent modeling to improve negotiation results.

  2. Developing genomic knowledge bases and databases to support clinical management: current perspectives.

    Science.gov (United States)

    Huser, Vojtech; Sincan, Murat; Cimino, James J

    2014-01-01

    Personalized medicine, the ability to tailor diagnostic and treatment decisions for individual patients, is seen as the evolution of modern medicine. We characterize here the informatics resources available today or envisioned in the near future that can support clinical interpretation of genomic test results. We assume a clinical sequencing scenario (germline whole-exome sequencing) in which a clinical specialist, such as an endocrinologist, needs to tailor patient management decisions within his or her specialty (targeted findings) but relies on a genetic counselor to interpret off-target incidental findings. We characterize the genomic input data and list various types of knowledge bases that provide genomic knowledge for generating clinical decision support. We highlight the need for patient-level databases with detailed lifelong phenotype content in addition to genotype data and provide a list of recommendations for personalized medicine knowledge bases and databases. We conclude that no single knowledge base can currently support all aspects of personalized recommendations and that consolidation of several current resources into larger, more dynamic and collaborative knowledge bases may offer a future path forward.

  3. Knowledge of risk factors and the periodontal disease-systemic link in dental students' clinical decisions.

    Science.gov (United States)

    Friesen, Lynn Roosa; Walker, Mary P; Kisling, Rebecca E; Liu, Ying; Williams, Karen B

    2014-09-01

    This study evaluated second-, third-, and fourth-year dental students' ability to identify systemic conditions associated with periodontal disease, risk factors most important for referral, and medications with an effect on the periodontium and their ability to apply this knowledge to make clinical decisions regarding treatment and referral of periodontal patients. A twenty-one question survey was administered at one U.S. dental school in the spring semester of 2012 to elicit the students' knowledge and confidence regarding clinical reasoning. The response rate was 86 percent. Periodontal risk factors were accurately selected by at least 50 percent of students in all three classes; these were poorly controlled diabetes, ≥6 mm pockets posteriorly, and lack of response to previous non-surgical therapy. Confidence in knowledge, knowledge of risk factors, and knowledge of medications with an effect on the periodontium improved with training and were predictive of better referral decision making. The greatest impact of training was seen on the students' ability to make correct decisions about referral and treatment for seven clinical scenarios. Although the study found a large increase in the students' abilities from the second through fourth years, the mean of 4.6 (out of 7) for the fourth-year students shows that, on average, those students missed correct treatment or referral on more than two of seven clinical cases. These results suggest that dental curricula should emphasize more critical decision making with respect to referral and treatment criteria in managing the periodontal patient.

  4. Towards Ubiquitous Peer Review Strategies to Sustain and Enhance a Clinical Knowledge Management Framework

    Science.gov (United States)

    Rocha, Roberto A.; Bradshaw, Richard L.; Bigelow, Sharon M.; Hanna, Timothy P.; Fiol, Guilherme Del; Hulse, Nathan C.; Roemer, Lorrie K.; Wilkinson, Steven G.

    2006-01-01

    Widespread cooperation between domain experts and front-line clinicians is a key component of any successful clinical knowledge management framework. Peer review is an established form of cooperation that promotes the dissemination of new knowledge. The authors describe three peer collaboration scenarios that have been implemented using the knowledge management infrastructure available at Intermountain Healthcare. Utilization results illustrating the early adoption patterns of the proposed scenarios are presented and discussed, along with succinct descriptions of planned enhancements and future implementation efforts. PMID:17238422

  5. Moments of Negotiation

    NARCIS (Netherlands)

    Pieters, Jurgen

    2001-01-01

    'Moments of Negotiation' offers the first book-length and indepth analysis of the New Historicist reading method, which the American Shakespeare-scolar Stephen Greenblatt introduced at the beginning of the 1980s. Ever since, Greenblatt has been hailed as the prime representative of this movement,

  6. Nurses experience of using scientific knowledge in clinical practice: a grounded theory study.

    Science.gov (United States)

    Renolen, Åste; Hjälmhult, Esther

    2015-12-01

    Guidelines recommend the use of evidence-based practice in nursing. Nurses are expected to give patients care and treatment based on the best knowledge available. They may have knowledge and positive attitudes, but this does not mean that they are basing their work on evidence-based practice. Knowledge is still lacking about what is needed to successfully implement evidence-based practice. The aim of this study was to gain more knowledge about what nurses perceive as the most important challenge in implementing evidence-based practice and to explain how they act to face and overcome this challenge. We used classical grounded theory methodology and collected data through four focus groups and one individual interview in different geographical locations in one large hospital trust in Norway. Fourteen registered clinical practice nurses participated. We analysed the data in accordance with grounded theory, using the constant comparative method. Contextual balancing of knowledge emerged as the core category and explains how the nurses dealt with their main concern, how to determine what types of knowledge they could trust. The nurses' main strategies were an inquiring approach, examining knowledge and maintaining control while taking care of patients. They combined their own experienced-based knowledge and the guidelines of evidence-based practice with a sense of control in the actual situation. The grounded theory contextual balancing of knowledge may help us to understand how nurses detect what types of knowledge they can trust in clinical practice. The nurses needed to rely on what they did, and they seemed to rely on their own experience rather than on research. © 2015 Nordic College of Caring Science.

  7. WE-F-BRB-01: The Power of Ontologies and Standardized Terminologies for Capturing Clinical Knowledge

    Energy Technology Data Exchange (ETDEWEB)

    Gabriel, P. [University of Pennsylvania (United States)

    2015-06-15

    Advancements in informatics in radiotherapy are opening up opportunities to improve our ability to assess treatment plans. Models on individualizing patient dose constraints from prior patient data and shape relationships have been extensively researched and are now making their way into commercial products. New developments in knowledge based treatment planning involve understanding the impact of the radiation dosimetry on the patient. Akin to radiobiology models that have driven intensity modulated radiotherapy optimization, toxicity and outcome predictions based on treatment plans and prior patient experiences may be the next step in knowledge based planning. In order to realize these predictions, it is necessary to understand how the clinical information can be captured, structured and organized with ontologies and databases designed for recall. Large databases containing radiation dosimetry and outcomes present the opportunity to evaluate treatment plans against predictions of toxicity and disease response. Such evaluations can be based on dose volume histogram or even the full 3-dimensional dose distribution and its relation to the critical anatomy. This session will provide an understanding of ontologies and standard terminologies used to capture clinical knowledge into structured databases; How data can be organized and accessed to utilize the knowledge in planning; and examples of research and clinical efforts to incorporate that clinical knowledge into planning for improved care for our patients. Learning Objectives: Understand the role of standard terminologies, ontologies and data organization in oncology Understand methods to capture clinical toxicity and outcomes in a clinical setting Understand opportunities to learn from clinical data and its application to treatment planning Todd McNutt receives funding from Philips, Elekta and Toshiba for some of the work presented.

  8. WE-F-BRB-01: The Power of Ontologies and Standardized Terminologies for Capturing Clinical Knowledge

    International Nuclear Information System (INIS)

    Gabriel, P.

    2015-01-01

    Advancements in informatics in radiotherapy are opening up opportunities to improve our ability to assess treatment plans. Models on individualizing patient dose constraints from prior patient data and shape relationships have been extensively researched and are now making their way into commercial products. New developments in knowledge based treatment planning involve understanding the impact of the radiation dosimetry on the patient. Akin to radiobiology models that have driven intensity modulated radiotherapy optimization, toxicity and outcome predictions based on treatment plans and prior patient experiences may be the next step in knowledge based planning. In order to realize these predictions, it is necessary to understand how the clinical information can be captured, structured and organized with ontologies and databases designed for recall. Large databases containing radiation dosimetry and outcomes present the opportunity to evaluate treatment plans against predictions of toxicity and disease response. Such evaluations can be based on dose volume histogram or even the full 3-dimensional dose distribution and its relation to the critical anatomy. This session will provide an understanding of ontologies and standard terminologies used to capture clinical knowledge into structured databases; How data can be organized and accessed to utilize the knowledge in planning; and examples of research and clinical efforts to incorporate that clinical knowledge into planning for improved care for our patients. Learning Objectives: Understand the role of standard terminologies, ontologies and data organization in oncology Understand methods to capture clinical toxicity and outcomes in a clinical setting Understand opportunities to learn from clinical data and its application to treatment planning Todd McNutt receives funding from Philips, Elekta and Toshiba for some of the work presented

  9. Climate negotiators' and scientists' assessments of the climate negotiations

    Science.gov (United States)

    Dannenberg, Astrid; Zitzelsberger, Sonja; Tavoni, Alessandro

    2017-06-01

    Climate negotiation outcomes are difficult to evaluate objectively because there are no clear reference scenarios. Subjective assessments from those directly involved in the negotiations are particularly important, as this may influence strategy and future negotiation participation. Here we analyse the perceived success of the climate negotiations in a sample of 656 experts involved in international climate policy. Respondents were pessimistic when asked for specific assessments of the current approach centred on voluntary pledges, but were more optimistic when asked for general assessments of the outcomes and usefulness of the climate negotiations. Individuals who were more involved in the negotiation process tended to be more optimistic, especially in terms of general assessments. Our results indicate that two reinforcing effects are at work: a high degree of involvement changes individuals' perceptions and more optimistic individuals are more inclined to remain involved in the negotiations.

  10. Knowledge bases, clinical decision support systems, and rapid learning in oncology.

    Science.gov (United States)

    Yu, Peter Paul

    2015-03-01

    One of the most important benefits of health information technology is to assist the cognitive process of the human mind in the face of vast amounts of health data, limited time for decision making, and the complexity of the patient with cancer. Clinical decision support tools are frequently cited as a technologic solution to this problem, but to date useful clinical decision support systems (CDSS) have been limited in utility and implementation. This article describes three unique sources of health data that underlie fundamentally different types of knowledge bases which feed into CDSS. CDSS themselves comprise a variety of models which are discussed. The relationship of knowledge bases and CDSS to rapid learning health systems design is critical as CDSS are essential drivers of rapid learning in clinical care. Copyright © 2015 by American Society of Clinical Oncology.

  11. A New Clinical Pain Knowledge Test for Nurses: Development and Psychometric Evaluation.

    Science.gov (United States)

    Bernhofer, Esther I; St Marie, Barbara; Bena, James F

    2017-08-01

    All nurses care for patients with pain, and pain management knowledge and attitude surveys for nurses have been around since 1987. However, no validated knowledge test exists to measure postlicensure clinicians' knowledge of the core competencies of pain management in current complex patient populations. To develop and test the psychometric properties of an instrument designed to measure pain management knowledge of postlicensure nurses. Psychometric instrument validation. Four large Midwestern U.S. hospitals. Registered nurses employed full time and part time August 2015 to April 2016, aged M = 43.25 years; time as RN, M = 16.13 years. Prospective survey design using e-mail to invite nurses to take an electronic multiple choice pain knowledge test. Content validity of initial 36-item test "very good" (95.1% agreement). Completed tests that met analysis criteria, N = 747. Mean initial test score, 69.4% correct (range 27.8-97.2). After revision/removal of 13 unacceptable questions, mean test score was 50.4% correct (range 8.7-82.6). Initial test item percent difficulty range was 15.2%-98.1%; discrimination values range, 0.03-0.50; final test item percent difficulty range, 17.6%-91.1%, discrimination values range, -0.04 to 1.04. Split-half reliability final test was 0.66. A high decision consistency reliability was identified, with test cut-score of 75%. The final 23-item Clinical Pain Knowledge Test has acceptable discrimination, difficulty, decision consistency, reliability, and validity in the general clinical inpatient nurse population. This instrument will be useful in assessing pain management knowledge of clinical nurses to determine gaps in education, evaluate knowledge after pain management education, and measure research outcomes. Copyright © 2017 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  12. Case-based Reasoning in Conflict Negotiation in Concurrent Engineering

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    Case-based reasoning (CBR) is a kind of analogous reasoning that is widely used in artificial intelligence. Conflicts are pervasive in Concurrent Engineering design environment. Conflict negotiation is necessary when conflicts occur. It is difficult to resolve conflicts due to several reasons. An approach to resolving conflicts by case-based reasoning is proposed in this paper. The knowledge representation of conflict negotiation cases, the judgment of case similarity, the retrieval model of cases, the management of case bases, and the process of case-based conflict negotiation are studied. The implementation structure of the Case-based Conflict Solving System (CCSS) is also given.

  13. Assessing the Knowledge and Attitudes of Medical Students and Graduates about Clinical Governance

    Directory of Open Access Journals (Sweden)

    Rana Gholamzadeh nikjoo

    2015-08-01

    Full Text Available Background and Objectives : In order to implement clinical governance successfully, it should be perceived positively and there must be a positive attitude towards it. The current policy of the Ministry of Health and Medical Education about clinical governance requires assessing the knowledge and attitudes of medical students to identify their educational needs and the necessary steps needed to be taken in educational planning, designing and modification of the courses. This study aimed to evaluate the knowledge and attitudes of medical students and graduates about clinical governance in 1391. Materials and Methods : This is a descriptive–analytic study. This research was conducted on 159 students from different medical fields simple random sampling method. For data collecting, a researcher-made questionnaire was used which its validity was confirmed by using content validity and construct validity. To determine the reliability of the questionnaire, internal consistency and Cronbach's Alpha were used for field of knowledge (0.78 and attitude (0.68. For data analysis, SPSS version 11.5 software was applied using exploratory factor analysis method. Results : 64% of the participants were female and 36% were male. 71% of the participants were in the health care management field and 29% from other medical fields. Mean and standard deviation of knowledge and attitude scores were 64.2 ± 5.8 and 13.06 ± 3.02 respectively. Comparing the students' and graduates’ knowledge and attitudes with their educational level showed no significant correlation. (P> 0.05 Although, there was a significant correlation between educational level and attitude (P = 0.001. In higher levels of education, students' attitude towards clinical governance reduced. Conclusion : The knowledge of medical students and graduates was estimated average to high about clinical governance but their attitude was very poor. This reflects negative views of medical students despite the

  14. Academics and the Negotiation of Local Knowledge.

    Science.gov (United States)

    Ervin, Elizabeth

    1999-01-01

    Examines the debate over creation and evolution in Wilmington, North Carolina's principal newspapers in order to consider the ways in which this debate exemplifies patterns of public discussion among academics and non academics, including conflicting attitudes about education, authority, and persuasion. Proposes ways to read and intervene in such…

  15. Research and International Trade Policy Negotiations: Knowledge ...

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

    7 oct. 2009 ... The editor. Mercedes Botto is Senior Researcher at FLACSO, the Facultad Latinoamericana de Ciencias Sociales, in Buenos Aires, Argentina. Contenus connexes. Politiques d'innovation régionales dans la zone Mercosur - obstacles et possibilités. Cette subvention soutiendra l'exécution d'une étude des ...

  16. Research and International Trade Policy Negotiations : Knowledge ...

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

    7 oct. 2009 ... Telework and the Disabled (Latin America) ... of information and communication technologies (ICTs) have opened up many opportunities for people with disabilities, such as building solidarity, pursuing employment and.

  17. The negotiation of knowledge for coastal governance

    CSIR Research Space (South Africa)

    Celliers, Louis

    2012-09-01

    Full Text Available , the Global Ocean Observing System, the  Integrated Ocean Observing System, and the  University of Washington.  The details of the  workshop,  list  of  parƟcipants,  agenda  and  the  eventual  outcomes will  be  available  on  the workshop website.     This...

  18. The gap between available knowledge and its use in clinical psychiatry.

    Science.gov (United States)

    Munk-Jørgensen, P; Blanner Kristiansen, C; Uwawke, R; Larsen, J I; Okkels, N; Christiansen, B; Hjorth, P

    2015-12-01

    The time span between knowledge becoming available and its integration into daily clinical routine is lengthy. This phenomenon is explored in this study. We used the outcomes of our activities for investigating and strengthening the research-based activities to improve physical health in the routines of clinical psychiatric wards as examples for our analyses. The time span between new knowledge becoming available and its implementation into general clinical treatment is very long. However, a shortening of this time span is seen through active leadership backup and clinical research experience among psychiatrists and staff in the wards. In particular, the involvement of medical students interested in clinical research activities seems to have a positive impact. Academia needs to be re-implemented into clinical psychiatry. Staff with research experience is needed in all professions to increase evidence-based practice. Leaders must take responsibility for implementing new knowledge into the routines of the department and must support staff in these activities on a daily basis. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Familiarity, knowledge, and attitudes towards epilepsy among attendees of a family clinic in Amman, Jordan.

    Science.gov (United States)

    Masri, Amira T; Shakhatreh, Farouq M; Yasein, Nada A; Barghouti, Farihan F; Al-Qudah, Abdelkarim A

    2008-01-01

    To investigate the present familiarity, knowledge, and attitudes of Jordanians towards epilepsy. This is a cross-sectional study that was conducted over a 6-month period, from April 2006 to October 2006 at the family clinic of Jordan University Hospital, Amman, Jordan. A face-to-face questionnaire interview was conducted with 600 non-epileptic adults who visited the clinic during the study period. The sample matched the overall Jordanian population for literacy rate, however, included a higher proportion of females, and consequently findings may be taken as being only moderately representative of the Jordanian population. Ninety-eight percent of the respondents had heard about epilepsy, 47.3% knew someone with epilepsy, and 39.7% had witnessed a seizure. The major source of knowledge was word of mouth; knowledge about causes and treatment were far below the results reported in western countries. In addition, negative attitudes were present with regard to marriage and employment of epileptic patients (86.8% objected to marriage and 50.8% objected to employment). Eighty-three percent of respondents admitted that their knowledge of epilepsy was not satisfactory and were willing to learn more about epilepsy. The television was believed to be the most efficient and preferred way to disseminate knowledge about epilepsy. Although this study does not represent the whole Jordanian population, however, it demonstrated lack of knowledge and emphasized the extent of negative as well as positive attitudes towards epilepsy in Jordan.

  20. The International Certification of Addiction Medicine: Validating Clinical Knowledge across Borders

    Science.gov (United States)

    el-Guebaly, Nady; Violato, Claudio

    2011-01-01

    The experience of the International Society of Addiction Medicine in setting up the first international certification of clinical knowledge is reported. The steps followed and the results of a psychometric analysis of the tests from the first 65 candidates are reported. Lessons learned in the first 5 years and challenges for the future are…

  1. Knowledge and attitude about relining of complete dentures in clinical practice: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Akhil Rathi

    2018-01-01

    Conclusion: Awareness and scientific knowledge about the relining materials and procedure should be enhanced within general dental practitioners through CDE program and workshops. Steps should be taken to include relining procedure as a part of undergraduate clinical curriculum as well as internship program.

  2. Knowledge, perceptions and clinical application of the shortened dental arch concept among Malaysian government dentists.

    Science.gov (United States)

    Kasim, Siti Kamilah Mohd; Razak, Ishak Abdul; Yusof, Zamros Yuzadi Mohd

    2018-02-01

    To assess the knowledge and perceptions of Malaysian government dentists regarding the shortened dental arch (SDA) concept and its application in clinical practice. The SDA concept refers to a specific type of dentition with intact anterior teeth and a reduction in posterior occlusal pairs. Dentists' knowledge and perceptions of the SDA concept can influence its application in clinical practice. A self-administered questionnaire on the SDA concept was distributed to 326 government dentists in the states of Selangor and Kuala Lumpur, Malaysia. The data were analysed using SPSS version 22 software. The response rate was 84.0%. The majority of respondents had good knowledge on five of six knowledge items and good attitudes towards 10 of 17 perception items. However, only one-fifth (20.4%) reported having applied the SDA concept in the clinic. A larger number of participants who graduated locally than who graduated abroad perceived that patients 5 years of work experience perceived that the SDA concept enables simpler treatment planning (P concept, it is not widely applied in the clinic. Concerted efforts in SDA training of dentists are needed to help to shorten denture waiting lists and reduce costs. © 2017 FDI World Dental Federation.

  3. Clinical cultural competency and knowledge of health disparities among pharmacy students.

    Science.gov (United States)

    Okoro, Olihe N; Odedina, Folakemi T; Reams, Romonia R; Smith, W Thomas

    2012-04-10

    To evaluate the level of competency and knowledge about health disparities among third-year doctor of pharmacy (PharmD) students at 2 Florida public colleges of pharmacy and to explore the demographic correlates of these variables. A cross-sectional survey study design was used to collect data from participants. The students had low health-disparities knowledge and moderate skills in dealing with sociocultural issues and cross-cultural encounters. Speaking a language(s) other than English and having exposure to cultural-competency instruction were the demographic variables found to be most significantly associated with clinical cultural competency and/or knowledge of health disparities. Clinical cultural competency and health-disparities instruction may not be adequately incorporated into the pharmacy school curricula in the institutions studied. Relevant education and training are necessary to enhance cultural competency among pharmacy students.

  4. Knowledge and attitudes of low back pain in physicians based in clinical practice guidelines

    Directory of Open Access Journals (Sweden)

    Jorge Ruiz Sabido

    2014-01-01

    Full Text Available Objective: To determine the level of knowledge and attitudes of physicians in Tijuana based on Clinical Practice Guidelines (CPG for the prevention, diagnosis and treatment of Nonspecific Low Back Pain (NLBP. Methods: Prospective, cross-sectional, descriptive study. Data were obtained from doctors who practice in clinics, private surgeries, and/or government institutions. Results: Of a total of 56 doctors surveyed, 37 were men and 19 women. None of the doctors said they had not seen a patient with Back Pain. 49% knew the GPC, and 51% did not know of its existence. Conclusions: Although some physicians reported knowledge of the GPC, according to the results, there was a lack of full knowledge of, and adherence to these guidelines. Not knowing the GPC did not make it impossible to complete the questionnaire. The doctors felt more connected to the health system, but with less confidence in the management of cases of NLBP.

  5. Incommensurability in Cross-Disciplinary Research: A Call for Cultural Negotiation

    Directory of Open Access Journals (Sweden)

    Anne MacCleave

    2006-06-01

    Full Text Available What happens when a clinical psychologist, a grounded theorist, an ethnographer, and a phenomenologist meet to collaborate on an interdisciplinary grant proposal on childhood loneliness? Excerpts of an imaginary dialogue reveal how different disciplines can be thought of as different “cultures,” because each has its own way of doing things, deeply embedded assumptions about knowledge and the construction/representation of reality, and different specialized languages. Some of these differences might be incommensurable and call for cultural negotiation if a coherent approach is to be adopted. Cultural negotiation helps to make differences more accessible and understandable rather than creating inflexible or polarized ideological camps. This process might help methodologists think about researching across disciplines in new and more effective ways.

  6. Knowledges

    DEFF Research Database (Denmark)

    Berling, Trine Villumsen

    2012-01-01

    Scientific knowledge in international relations has generally focused on an epistemological distinction between rationalism and reflectivism over the last 25 years. This chapter argues that this distinction has created a double distinction between theory/reality and theory/practice, which works...... and reflectivism. Bourdieu, on the contrary, lets the challenge to the theory/reality distinction spill over into a challenge to the theory/practice distinction by thrusting the scientist in the foreground as not just a factor (discourse/genre) but as an actor. In this way, studies of IR need to include a focus...... as a ghost distinction structuring IR research. While reflectivist studies have emphasised the impossibility of detached, objective knowledge production through a dissolution of the theory/reality distinction, the theory/practice distinction has been left largely untouched by both rationalism...

  7. Using Best Practices to Extract, Organize, and Reuse Embedded Decision Support Content Knowledge Rules from Mature Clinical Systems.

    Science.gov (United States)

    DesAutels, Spencer J; Fox, Zachary E; Giuse, Dario A; Williams, Annette M; Kou, Qing-Hua; Weitkamp, Asli; Neal R, Patel; Bettinsoli Giuse, Nunzia

    2016-01-01

    Clinical decision support (CDS) knowledge, embedded over time in mature medical systems, presents an interesting and complex opportunity for information organization, maintenance, and reuse. To have a holistic view of all decision support requires an in-depth understanding of each clinical system as well as expert knowledge of the latest evidence. This approach to clinical decision support presents an opportunity to unify and externalize the knowledge within rules-based decision support. Driven by an institutional need to prioritize decision support content for migration to new clinical systems, the Center for Knowledge Management and Health Information Technology teams applied their unique expertise to extract content from individual systems, organize it through a single extensible schema, and present it for discovery and reuse through a newly created Clinical Support Knowledge Acquisition and Archival Tool (CS-KAAT). CS-KAAT can build and maintain the underlying knowledge infrastructure needed by clinical systems.

  8. Using Best Practices to Extract, Organize, and Reuse Embedded Decision Support Content Knowledge Rules from Mature Clinical Systems

    Science.gov (United States)

    DesAutels, Spencer J.; Fox, Zachary E.; Giuse, Dario A.; Williams, Annette M.; Kou, Qing-hua; Weitkamp, Asli; Neal R, Patel; Bettinsoli Giuse, Nunzia

    2016-01-01

    Clinical decision support (CDS) knowledge, embedded over time in mature medical systems, presents an interesting and complex opportunity for information organization, maintenance, and reuse. To have a holistic view of all decision support requires an in-depth understanding of each clinical system as well as expert knowledge of the latest evidence. This approach to clinical decision support presents an opportunity to unify and externalize the knowledge within rules-based decision support. Driven by an institutional need to prioritize decision support content for migration to new clinical systems, the Center for Knowledge Management and Health Information Technology teams applied their unique expertise to extract content from individual systems, organize it through a single extensible schema, and present it for discovery and reuse through a newly created Clinical Support Knowledge Acquisition and Archival Tool (CS-KAAT). CS-KAAT can build and maintain the underlying knowledge infrastructure needed by clinical systems. PMID:28269846

  9. The Waste Negotiator's mission

    International Nuclear Information System (INIS)

    Bataille, Christian

    1993-01-01

    The mission of the Waste Negotiator is to seek out sites for deep underground laboratories to study their potential for disposal of high level radioactive waste. Although appointed by the government, he acts independently. In 1990, faced by severe public criticism at the way that the waste disposal was being handled, and under increasing pressure to find an acceptable solution, the government stopped the work being carried out by ANDRA (Agence nationale pour la gestion des dechets radioactifs) and initiated a full review of the issues involved. At the same time, parliament also started its own extensive investigation to find a way forward. These efforts finally led to the provision of a detailed framework for the management of long lived radioactive waste, including the construction of two laboratories to investigate possible repository sites. The Waste Negotiator was appointed to carry out a full consultative process in the communities which are considering accepting an underground laboratory. (Author)

  10. Negotiating meaning through artefacts

    DEFF Research Database (Denmark)

    Tavella, Elena

    2015-01-01

    This research contributes to the domain of strategy making, specifically to unpacking the complexity of sociomateriality in strategy discourse. Scholars have emphasized the potential of artefacts to enhance sensemaking during strategizing. However there is a lack of insight into how artefacts...... and conversational aspects are linked at the micro‑level of discourse, also how artefacts and sensemaking shape one another. This research addresses this gap by empirically analyzing strategy discourse within a facilitated modelling workshop. Considering strategizing as a socially constructed activity, the author...... analyzes a workshop transcript to assess the extent to which stakeholders’ appropriation of artefacts supports them in engaging in negotiation of meaning with action implications. Moreover, how artefacts and negotiation of meaning shape one another is identified. The data suggest that appropriating...

  11. Negotiating Efficient PPP Contracts

    DEFF Research Database (Denmark)

    Tvarnø, Christina D.

    . An opportunity the member states should consider using when procuring a PPP. This paper looks at the negotiation and contracting of a PPP in an economic theoretical and EU public procurement perspective and discusses how to establish an efficient PPP contract under a strong public law doctrine. Governments......This paper concerns Public Private Partnership (PPP) contracts in concern to the coming new 2014/24IEU public procurement directive. The new EU public procurement directive gives the public authority the opportunity to negotiate PPPs much more when they are implemented in national law...... procurement law. Furthermore, the paper seeks to establish a connection between public law, private law and the efficient PPP contract by drawing upon economic theory and empirical contract data from UK, US and Danish partnering contracts from the construction industry and the aim of contracting joint utility...

  12. Negotiating Family Tracking

    DEFF Research Database (Denmark)

    Albrechtslund, Anders; Bøge, Ask Risom; Sonne Damkjær, Maja

    This presentation explores the question: What motivates the use of tracking technologies in families, and how does the use transform the relations between parent and child? The purpose is to investigate why tracking technologies are used in families and how these technologies potentially change...... the relation between parents and children. The use of tracking technologies in families implicate negotiations about the boundaries of trust and intimacy in parent-child relations which can lead to strategies of resistance or modification (Fotel and Thomsen, 2004; Rooney, 2010; Steeves and Jones, 2010......). In the presentation, we report from a qualitative study that focuses on intergenerational relations. The study draws on empirical data from workshops with Danish families as well as individual and group interviews. We aim to gain insights about the sharing habits and negotiations in intimate family relations...

  13. Learning as Negotiating Identities

    DEFF Research Database (Denmark)

    Jørgensen, Kenneth Mølbjerg; Keller, Hanne Dauer

    The paper explores the contribution of Communities of Practice (COP) to Human Resource Development (HRD). Learning as negotiating identities captures the contribution of COP to HRD. In COP the development of practice happens through negotiation of meaning. The learning process also involves modes...... of belonging constitutive of our identities. We suggest that COP makes a significant contribution by linking learning and identification. This means that learning becomes much less instrumental and much more linked to fundamental questions of being. We argue that the COP-framework links learning with the issue...... of time - caught in the notion of trajectories of learning - that integrate past, present and future. Working with the learners' notion of time is significant because it is here that new learning possibilities become visible and meaningful for individuals. Further, we argue that the concept of identity...

  14. Newly graduated nurses' use of knowledge sources in clinical decision-making

    DEFF Research Database (Denmark)

    Voldbjerg, Siri Lygum; Grønkjaer, Mette; Wiechula, Rick

    2017-01-01

    AIMS AND OBJECTIVES: To explore which knowledge sources newly graduated nurses' use in clinical decision-making and why and how they are used. BACKGROUND: In spite of an increased educational focus on skills and competencies within evidence based practice newly graduated nurses' ability to use...... approaches to strengthen the knowledgebase used in clinical decision-making. DESIGN AND METHODS: Ethnographic study using participant-observation and individual semi-structured interviews of nine Danish newly graduated nurses in medical and surgical hospital settings. RESULTS: Newly graduates use...... in clinical decision-making. If newly graduates are to be supported in an articulate and reflective use of a variety of sources, they have to be allocated to experienced nurses who model a reflective, articulate and balanced use of knowledge sources. This article is protected by copyright. All rights reserved....

  15. Suffering Beyond Negotiation

    DEFF Research Database (Denmark)

    Bertelsen, Olav W.

    2014-01-01

    In this paper we argue that design in therapeutic domains (in a broad sense) depends on an understanding of the background for the engagement of the various users involved. It is specifically argued that an understanding of the life transforming process, or trajectory as opposed to design process...... center stage that is not based in the negotiation between rationalities. The paper draws examples from design based research projects over the last 5 years....

  16. Persuasion through negotiation

    OpenAIRE

    Elosua, Miguel

    2013-01-01

    A building about to be demolished near the ancient town of Ciqikou (磁器口). The process of expropriation forces authorities to negotiate with the residents on a case-by-case basis. In this photo, some residents have already left apartments vacant, while others still remain in their homes wishing to better their compensation package. The gentrification of the neighbourhood is guaranteed since high prices will force most, if not all, former residents to move out of the community.

  17. Eating disorders in the context of preconception care: fertility specialists' knowledge, attitudes, and clinical practices.

    Science.gov (United States)

    Rodino, Iolanda S; Byrne, Susan M; Sanders, Katherine A

    2017-02-01

    To gauge fertility specialists' knowledge, clinical practices, and training needs in regard to eating disorders. Cross-sectional study. Fertility clinics. Eighty Australian and New Zealand fertility specialists who were members of the Fertility Society of Australia. None. Responses to an anonymously completed online questionnaire. Approximately 54% of doctors correctly identified the body mass index relevant to anorexia nervosa, and 30% identified menstrual disturbances for anorexia, while 63.8% of doctors incorrectly nominated maladaptive weight control behaviors as a characteristic of binge eating disorder. While clinicians (83.7%) agreed it was important to screen for eating disorders during preconception assessments, 35% routinely screened for eating disorders and 8.8% indicated that their clinics had clinical practice guidelines for management of eating disorders. A minority of participants (13.8%) felt satisfied with their level of university training in eating disorders, 37.5% of doctors felt confident in their ability to recognize symptoms of an eating disorder, and 96.2% indicated a need for further education and clinical guidelines. On most items examined, knowledge and clinical practices regarding eating disorders did not differ according to doctor gender or years of clinical experience working as a fertility specialist. Knowledge about eating disorders in the context of fertility treatment is important. This study highlights the uncertainty among fertility specialists in detecting features of eating disorders. The findings point to the importance of further education and training, including the development of clinical guidelines specific to fertility health care providers. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  18. Forms of Knowledge Incorporated in Clinical Decision-making among Newly-Graduated Nurses: A Metasynthesis

    DEFF Research Database (Denmark)

    Voldbjerg, Siri; Elgaard Sørensen, Erik; Grønkjær, Mette

    2014-01-01

    Clinical-decision-making is of decisive importance to how evidence-based practice is put into practice. Schools of Nursing have a responsibility to teach and train nursing students to make clinical decisions within a frame of evidence-based practice. Clinical decision-making among nurses has been...... explored from numerous angles using a diversity of methodologies. Existing research has mainly focused on promoting and inhibiting factors for implementation of evidence-based practice and incorporation of research evidence in the clinical-decision. Little attention has been given to the nurses' behavior......, including the knowledge that actually informs the newly graduated nurses’ clinical decision. The aim of the study is to combine and synthesize results from qualitative research. Noblit and Hare’s meta-ethnographic approach is used to conduct a metasynthesis of qualitative research that has studied...

  19. Exploring Culture Theory Global Leadership and OrganizationalBehaviour Effectiveness in Cross-cultural Communication inAsian Business Negotiations

    OpenAIRE

    Hoo, Pin Lick Soo

    2016-01-01

    While certain In international business negotiations, having the knowledge of cross-cultural communication is essential especially in global business environments and thus, many researchers have spent numerous years to investigate how culture influences Asian business negotiation which has contributed to negotiation outcome. This article provides critical insight into the theoretical link of cultural dimensions of culture for international business negotiations. The proposed model suggested i...

  20. Integrating complex business processes for knowledge-driven clinical decision support systems.

    Science.gov (United States)

    Kamaleswaran, Rishikesan; McGregor, Carolyn

    2012-01-01

    This paper presents in detail the component of the Complex Business Process for Stream Processing framework that is responsible for integrating complex business processes to enable knowledge-driven Clinical Decision Support System (CDSS) recommendations. CDSSs aid the clinician in supporting the care of patients by providing accurate data analysis and evidence-based recommendations. However, the incorporation of a dynamic knowledge-management system that supports the definition and enactment of complex business processes and real-time data streams has not been researched. In this paper we discuss the process web service as an innovative method of providing contextual information to a real-time data stream processing CDSS.

  1. Importance of clinical toxicology teaching and its impact in improving knowledge: sharing experience from a workshop

    International Nuclear Information System (INIS)

    Khan, N.U.; Fayyaz, J.; Khan, U.R.; Feroze, A.

    2013-01-01

    Objective: To assess the impact of a one-day clinical toxicology workshop in improving knowledge. Methods: A one-day clinical toxicology workshop was conducted as a pre-conference workshop of the Annual Emergency Medicine Conference at the Aga Khan University Hospital, Karachi, in April 2012. The course was composed of poisoning-related common clinical scenarios. The pre-test and post-test understanding was used to assess the impact of the course in improving knowledge. The participants also evaluated the workshop as a whole thorough written evaluation forms. SPSS 19 was used for statistical analysis of the data. Result: There were 22 participants in the course. The pre-test mean score was 31.6+-15.1% (95% CI; 24-40; n=19) compared to the post-test the mean score of 56.0+-10.8% (95% CI; 47- 61; n=17). The positive difference was also statistically significant (p<0.001). The overall workshop was evaluated as excellent by 08 (47.46%) and very good by 10 (52.63%) participants. Conclusion: Short training in clinical toxicology improved knowledge of the participants. (author)

  2. Knowledge creation through total clinical outcomes management: a practice-based evidence solution to address some of the challenges of knowledge translation.

    Science.gov (United States)

    Lyons, John S

    2009-02-01

    The challenges of knowledge translation in behavioural health care are unique to this field for a variety of reasons including the fact that effective treatment is invariably embedded in a strong relationship between practitioners and the people they serve. Practitioners' knowledge gained from experience and intuition become an even more important consideration in the knowledge translation process since clinicians are, in fact, a component of most treatments. Communication of findings from science must be conceptualized with sensitivity to this reality. Considering knowledge translation as a communication process suggests the application of contemporary theories of communication which emphasize the creation of shared meaning over the transmission of knowledge from one person to the next. In this context outcomes management approaches to create a learning environment within clinical practices that facilitate the goals of knowledge transfer while respecting that the scientific enterprise is neither the sole nor primary repository of knowledge.

  3. Improved knowledge retention among clinical pharmacy students using an anthropology classroom assessment technique.

    Science.gov (United States)

    Whitley, Heather P; Parton, Jason M

    2014-09-15

    To adapt a classroom assessment technique (CAT) from an anthropology course to a diabetes module in a clinical pharmacy skills laboratory and to determine student knowledge retention from baseline. Diabetes item stems, focused on module objectives, replaced anthropology terms. Answer choices, coded to Bloom's Taxonomy, were expanded to include higher-order thinking. Students completed the online 5-item probe 4 times: prelaboratory lecture, postlaboratory, and at 6 months and 12 months after laboratory. Statistical analyses utilized a single factor, repeated measures design using rank transformations of means with a Mann-Whitney-Wilcoxon test. The CAT revealed a significant increase in knowledge from prelaboratory compared to all postlaboratory measurements (panthropology assessment tool was effectively adapted using Bloom's Taxonomy as a guide and, when used repeatedly, demonstrated knowledge retention. Minimal time was devoted to application of the probe making it an easily adaptable CAT.

  4. From dental science to clinical practice: Knowledge translation and evidence-based dentistry principles

    Directory of Open Access Journals (Sweden)

    Kelvin I. Afrashtehfar

    2017-07-01

    Full Text Available It has been claimed that in order to decrease the gap between what we know and what we do, research findings must be translated from knowledge to action. Such practices better enable dentists to make evidence-based decisions instead of personal ideas and judgments. To this end, this literature review aims to revisit the concepts of knowledge translation and evidence-based dentistry (EBD and depict their role and influence within dental education. It addresses some possible strategies to facilitate knowledge translation (KT, encourage dental students to use EBD principles, and to encourage dental educators to create an environment in which students become self-directed learners. It concludes with a call to develop up-to-date and efficient online platforms that could grant dentists better access to EBD sources in order to more efficiently translate research evidence into the clinic.

  5. Sexual behaviour and HIV knowledge among Dermatology cum Genitourinary Clinic attendees, Johor Bahru, Malaysia.

    Science.gov (United States)

    Choon, S E; Sapiah, W; Ismail, Z; Balan, V

    1997-12-01

    A study was conducted in the Dermatology cum Genitourinary Clinic, Hospital Sultanah Aminah Johor Bahru to determine a local population's knowledge of HIV and their sexual behaviour in relation to it. A total of 231 men and 217 women were interviewed. The sexual culture seen is one of relatively late age of first sexual intercourse, low level of partner change and low level of condom use. Men reported a higher involvement in risk behaviour. Nearly all the respondents (95.8%) have heard of HIV/AIDS but had incorrect perceptions of its mode of transmission and its associations with risk groups. This study enable us to gain background information about our patients sexual behaviour and HIV knowledge. There is a need to continue HIV education to improve our public's HIV knowledge and the results of this study provides a baseline against which future educational interventions can be gauged.

  6. From dental science to clinical practice: Knowledge translation and evidence-based dentistry principles.

    Science.gov (United States)

    Afrashtehfar, Kelvin I; Assery, Mansour K

    2017-07-01

    It has been claimed that in order to decrease the gap between what we know and what we do, research findings must be translated from knowledge to action. Such practices better enable dentists to make evidence-based decisions instead of personal ideas and judgments. To this end, this literature review aims to revisit the concepts of knowledge translation and evidence-based dentistry (EBD) and depict their role and influence within dental education. It addresses some possible strategies to facilitate knowledge translation (KT), encourage dental students to use EBD principles, and to encourage dental educators to create an environment in which students become self-directed learners. It concludes with a call to develop up-to-date and efficient online platforms that could grant dentists better access to EBD sources in order to more efficiently translate research evidence into the clinic.

  7. Medical and psychology students' knowledge of and attitudes towards mindfulness as a clinical intervention.

    Science.gov (United States)

    McKenzie, Stephen P; Hassed, Craig S; Gear, Jacqui L

    2012-01-01

    Mindfulness is a technique for training people to pay full attention and to fully accept the reality of what they are paying attention to. The clinical efficacy of mindfulness has been increasingly demonstrated during the last two decades. Very little research, however, has been undertaken on health professionals' and students of health professions' knowledge of and attitudes towards mindfulness. These may affect the current and future level of use of a technique that offers important clinical advantages. We aimed to compare knowledge of and attitudes towards mindfulness of medical students without exposure to it in their training with psychology students without exposure and with medical students with exposure to mindfulness in their training. A total of 91 medical students from Monash University, 49 medical students from Deakin University, and 31 psychology students from Deakin University were given a questionnaire that elicited quantitative and qualitative responses about level of knowledge of mindfulness and willingness to administer or recommend it to their future patients. Psychology students without exposure to mindfulness in their training have a greater knowledge of it and are more likely to administer it or recommend it than are medical students without exposure to it in their training. Medical students with exposure to mindfulness in their course have a greater knowledge of it and are more likely to administer it or recommend it than are medical students without exposure. Knowledge of mindfulness is positively correlated with students' willingness to use or recommend it. Possible implications of the findings of this study are that if future doctors are routinely instructed in mindfulness as a clinical intervention they may be more likely to form a more positive attitude towards it, that is more consistent with that of nonmedical health professions such as psychologists, and that they therefore may be more likely to administer it or refer its use. The

  8. An RDF/OWL knowledge base for query answering and decision support in clinical pharmacogenetics.

    Science.gov (United States)

    Samwald, Matthias; Freimuth, Robert; Luciano, Joanne S; Lin, Simon; Powers, Robert L; Marshall, M Scott; Adlassnig, Klaus-Peter; Dumontier, Michel; Boyce, Richard D

    2013-01-01

    Genetic testing for personalizing pharmacotherapy is bound to become an important part of clinical routine. To address associated issues with data management and quality, we are creating a semantic knowledge base for clinical pharmacogenetics. The knowledge base is made up of three components: an expressive ontology formalized in the Web Ontology Language (OWL 2 DL), a Resource Description Framework (RDF) model for capturing detailed results of manual annotation of pharmacogenomic information in drug product labels, and an RDF conversion of relevant biomedical datasets. Our work goes beyond the state of the art in that it makes both automated reasoning as well as query answering as simple as possible, and the reasoning capabilities go beyond the capabilities of previously described ontologies.

  9. The critical success factors and impact of prior knowledge to nursing students when transferring nursing knowledge during nursing clinical practise.

    Science.gov (United States)

    Tsai, Ming-Tien; Tsai, Ling-Long

    2005-11-01

    Nursing practise plays an important role in transferring nursing knowledge to nursing students. From the related literature review, prior knowledge will affect how learners gain new knowledge. There has been no direct examination of the prior knowledge interaction effect on students' performance and its influence on nursing students when evaluating the knowledge transfer success factors. This study explores (1) the critical success factors in transferring nursing knowledge, (2) the impact of prior knowledge when evaluating the success factors for transferring nursing knowledge. This research utilizes in-depth interviews to probe the initial success factor phase. A total of 422 valid questionnaires were conducted by the authors. The data were analysed by comparing the mean score and t-test between two groups. Seventeen critical success factors were identified by the two groups of students. Twelve items were selected to examine the diversity in the two groups. Students with prior knowledge were more independent than the other group. They also preferred self-directed learning over students without prior knowledge. Students who did not have prior knowledge were eager to take every opportunity to gain experience and more readily adopted new knowledge.

  10. Knowledge and Perception about Clinical Research Shapes Behavior: Face to Face Survey in Korean General Public.

    Science.gov (United States)

    Choi, Yun Jung; Beck, Sung-Ho; Kang, Woon Yong; Yoo, Soyoung; Kim, Seong-Yoon; Lee, Ji Sung; Burt, Tal; Kim, Tae Won

    2016-05-01

    Considering general public as potential patients, identifying factors that hinder public participation poses great importance, especially in a research environment where demands for clinical trial participants outpace the supply. Hence, the aim of this study was to evaluate knowledge and perception about clinical research in general public. A total of 400 Seoul residents with no previous experience of clinical trial participation were selected, as representative of population in Seoul in terms of age and sex. To minimize selection bias, every fifth passer-by was invited to interview, and if in a cluster, person on the very right side was asked. To ensure the uniform use of survey, written instructions have been added to the questionnaire. Followed by pilot test in 40 subjects, the survey was administered face-to-face in December 2014. To investigate how perception shapes behavior, we compared perception scores in those who expressed willingness to participate and those who did not. Remarkably higher percentage of responders stated that they have heard of clinical research, and knew someone who participated (both, P perceptions and lack of knowledge will be effective in enhancing public engaged in clinical research.

  11. Knowledge Mining from Clinical Datasets Using Rough Sets and Backpropagation Neural Network

    Directory of Open Access Journals (Sweden)

    Kindie Biredagn Nahato

    2015-01-01

    Full Text Available The availability of clinical datasets and knowledge mining methodologies encourages the researchers to pursue research in extracting knowledge from clinical datasets. Different data mining techniques have been used for mining rules, and mathematical models have been developed to assist the clinician in decision making. The objective of this research is to build a classifier that will predict the presence or absence of a disease by learning from the minimal set of attributes that has been extracted from the clinical dataset. In this work rough set indiscernibility relation method with backpropagation neural network (RS-BPNN is used. This work has two stages. The first stage is handling of missing values to obtain a smooth data set and selection of appropriate attributes from the clinical dataset by indiscernibility relation method. The second stage is classification using backpropagation neural network on the selected reducts of the dataset. The classifier has been tested with hepatitis, Wisconsin breast cancer, and Statlog heart disease datasets obtained from the University of California at Irvine (UCI machine learning repository. The accuracy obtained from the proposed method is 97.3%, 98.6%, and 90.4% for hepatitis, breast cancer, and heart disease, respectively. The proposed system provides an effective classification model for clinical datasets.

  12. Negotiation in academic medicine: narratives of faculty researchers and their mentors.

    Science.gov (United States)

    Sambuco, Dana; Dabrowska, Agata; Decastro, Rochelle; Stewart, Abigail; Ubel, Peter A; Jagsi, Reshma

    2013-04-01

    Few researchers have explored the negotiation experiences of academic medical faculty even though negotiation is crucial to their career success. The authors sought to understand medical faculty researchers' experiences with and perceptions of negotiation. Between February 2010 and August 2011, the authors conducted semistructured, in-depth telephone interviews with 100 former recipients of National Institutes of Health mentored career development awards and 28 of their mentors. Purposive sampling ensured a diverse range of viewpoints. Multiple analysts thematically coded verbatim transcripts using qualitative data analysis software. Participants described the importance of negotiation in academic medical careers but also expressed feeling naïve and unprepared for these negotiations, particularly as junior faculty. Award recipients focused on power, leverage, and strategy, and they expressed a need for training and mentorship to learn successful negotiation skills. Mentors, by contrast, emphasized the importance of flexibility and shared interests in creating win-win situations for both the individual faculty member and the institution. When faculty construed negotiation as adversarial and/or zero-sum, participants believed it required traditionally masculine traits and perceived women to be at a disadvantage. Academic medical faculty often lack the skills and knowledge necessary for successful negotiation, especially early in their careers. Many view negotiation as an adversarial process of the sort that experts call "hard positional bargaining." Increasing awareness of alternative negotiation techniques (e.g., "principled negotiation," in which shared interests, mutually satisfying options, and fair standards are emphasized) may encourage the success of medical faculty, particularly women.

  13. A scalable architecture for incremental specification and maintenance of procedural and declarative clinical decision-support knowledge.

    Science.gov (United States)

    Hatsek, Avner; Shahar, Yuval; Taieb-Maimon, Meirav; Shalom, Erez; Klimov, Denis; Lunenfeld, Eitan

    2010-01-01

    Clinical guidelines have been shown to improve the quality of medical care and to reduce its costs. However, most guidelines exist in a free-text representation and, without automation, are not sufficiently accessible to clinicians at the point of care. A prerequisite for automated guideline application is a machine-comprehensible representation of the guidelines. In this study, we designed and implemented a scalable architecture to support medical experts and knowledge engineers in specifying and maintaining the procedural and declarative aspects of clinical guideline knowledge, resulting in a machine comprehensible representation. The new framework significantly extends our previous work on the Digital electronic Guidelines Library (DeGeL) The current study designed and implemented a graphical framework for specification of declarative and procedural clinical knowledge, Gesher. We performed three different experiments to evaluate the functionality and usability of the major aspects of the new framework: Specification of procedural clinical knowledge, specification of declarative clinical knowledge, and exploration of a given clinical guideline. The subjects included clinicians and knowledge engineers (overall, 27 participants). The evaluations indicated high levels of completeness and correctness of the guideline specification process by both the clinicians and the knowledge engineers, although the best results, in the case of declarative-knowledge specification, were achieved by teams including a clinician and a knowledge engineer. The usability scores were high as well, although the clinicians' assessment was significantly lower than the assessment of the knowledge engineers.

  14. The Research of Clinical Decision Support System Based on Three-Layer Knowledge Base Model

    Directory of Open Access Journals (Sweden)

    Yicheng Jiang

    2017-01-01

    Full Text Available In many clinical decision support systems, a two-layer knowledge base model (disease-symptom of rule reasoning is used. This model often does not express knowledge very well since it simply infers disease from the presence of certain symptoms. In this study, we propose a three-layer knowledge base model (disease-symptom-property to utilize more useful information in inference. The system iteratively calculates the probability of patients who may suffer from diseases based on a multisymptom naive Bayes algorithm, in which the specificity of these disease symptoms is weighted by the estimation of the degree of contribution to diagnose the disease. It significantly reduces the dependencies between attributes to apply the naive Bayes algorithm more properly. Then, the online learning process for parameter optimization of the inference engine was completed. At last, our decision support system utilizing the three-layer model was formally evaluated by two experienced doctors. By comparisons between prediction results and clinical results, our system can provide effective clinical recommendations to doctors. Moreover, we found that the three-layer model can improve the accuracy of predictions compared with the two-layer model. In light of some of the limitations of this study, we also identify and discuss several areas that need continued improvement.

  15. Clinician Survey to Determine Knowledge of Dengue and Clinical Management Practices, Texas, 2014.

    Science.gov (United States)

    Adam, Jessica K; Abeyta, Roman; Smith, Brian; Gaul, Linda; Thomas, Dana L; Han, George; Sharp, Tyler M; Waterman, Stephen H; Tomashek, Kay M

    2017-03-01

    AbstractDengue, a mosquito-borne viral disease, is increasingly being identified as a cause of outbreaks in the United States. During July-December 2013, a total of three south Texas counties reported 53 laboratory-confirmed dengue cases; 26 were locally acquired, constituting the largest outbreak in Texas since 2005. Because dengue outbreaks are expected to continue in south Texas and early case identification and timely treatment can reduce mortality, we sought to determine clinicians' knowledge of dengue and its clinical management. A survey was sent to 2,375 south Texas clinicians; 217 (9%) completed the survey. Approximately half of participants demonstrated knowledge needed to identify dengue cases, including symptoms (56%), early indicators of shock (54%), or timing of thrombocytopenia (48%). Fewer than 20% correctly identified all prevention messages, severe dengue warning signs, or circumstances in which a dengue patient should return for care. Knowledge of clinical management was limited; few participants correctly identified scenarios when plasma leakage occurred (10%) or a crystalloid solution was indicated (7%); however, 45% correctly identified when a blood transfusion was indicated. Because of the ongoing threat of dengue, we recommend clinicians in south Texas receive dengue clinical management training.

  16. Clinician Survey to Determine Knowledge of Dengue and Clinical Management Practices, Texas, 2014

    Science.gov (United States)

    Adam, Jessica K.; Abeyta, Roman; Smith, Brian; Gaul, Linda; Thomas, Dana L.; Han, George; Sharp, Tyler M.; Waterman, Stephen H.; Tomashek, Kay M.

    2017-01-01

    Dengue, a mosquito-borne viral disease, is increasingly being identified as a cause of outbreaks in the United States. During July–December 2013, a total of three south Texas counties reported 53 laboratory-confirmed dengue cases; 26 were locally acquired, constituting the largest outbreak in Texas since 2005. Because dengue outbreaks are expected to continue in south Texas and early case identification and timely treatment can reduce mortality, we sought to determine clinicians' knowledge of dengue and its clinical management. A survey was sent to 2,375 south Texas clinicians; 217 (9%) completed the survey. Approximately half of participants demonstrated knowledge needed to identify dengue cases, including symptoms (56%), early indicators of shock (54%), or timing of thrombocytopenia (48%). Fewer than 20% correctly identified all prevention messages, severe dengue warning signs, or circumstances in which a dengue patient should return for care. Knowledge of clinical management was limited; few participants correctly identified scenarios when plasma leakage occurred (10%) or a crystalloid solution was indicated (7%); however, 45% correctly identified when a blood transfusion was indicated. Because of the ongoing threat of dengue, we recommend clinicians in south Texas receive dengue clinical management training. PMID:28138048

  17. Development, validation and clinical assessment of a short questionnaire to assess disease-related knowledge in inflammatory bowel disease patients.

    LENUS (Irish Health Repository)

    Keegan, Denise

    2013-02-01

    Only two inflammatory bowel disease (IBD) knowledge scales are available, both primarily aimed at evaluating the effectiveness of clinical education programs. The aim of this study was to develop and validate a short knowledge questionnaire for clinical and academic research purposes.

  18. A pilot study of distributed knowledge management and clinical decision support in the cloud.

    Science.gov (United States)

    Dixon, Brian E; Simonaitis, Linas; Goldberg, Howard S; Paterno, Marilyn D; Schaeffer, Molly; Hongsermeier, Tonya; Wright, Adam; Middleton, Blackford

    2013-09-01

    Implement and perform pilot testing of web-based clinical decision support services using a novel framework for creating and managing clinical knowledge in a distributed fashion using the cloud. The pilot sought to (1) develop and test connectivity to an external clinical decision support (CDS) service, (2) assess the exchange of data to and knowledge from the external CDS service, and (3) capture lessons to guide expansion to more practice sites and users. The Clinical Decision Support Consortium created a repository of shared CDS knowledge for managing hypertension, diabetes, and coronary artery disease in a community cloud hosted by Partners HealthCare. A limited data set for primary care patients at a separate health system was securely transmitted to a CDS rules engine hosted in the cloud. Preventive care reminders triggered by the limited data set were returned for display to clinician end users for review and display. During a pilot study, we (1) monitored connectivity and system performance, (2) studied the exchange of data and decision support reminders between the two health systems, and (3) captured lessons. During the six month pilot study, there were 1339 patient encounters in which information was successfully exchanged. Preventive care reminders were displayed during 57% of patient visits, most often reminding physicians to monitor blood pressure for hypertensive patients (29%) and order eye exams for patients with diabetes (28%). Lessons learned were grouped into five themes: performance, governance, semantic interoperability, ongoing adjustments, and usability. Remote, asynchronous cloud-based decision support performed reasonably well, although issues concerning governance, semantic interoperability, and usability remain key challenges for successful adoption and use of cloud-based CDS that will require collaboration between biomedical informatics and computer science disciplines. Decision support in the cloud is feasible and may be a reasonable

  19. Use of Tablet Computers to Promote Physical Therapy Students' Engagement in Knowledge Translation During Clinical Experiences

    Science.gov (United States)

    Loeb, Kathryn; Barbosa, Sabrina; Jiang, Fei; Lee, Karin T.

    2016-01-01

    Background and Purpose: Physical therapists strive to integrate research into daily practice. The tablet computer is a potentially transformational tool for accessing information within the clinical practice environment. The purpose of this study was to measure and describe patterns of tablet computer use among physical therapy students during clinical rotation experiences. Methods: Doctor of physical therapy students (n = 13 users) tracked their use of tablet computers (iPad), loaded with commercially available apps, during 16 clinical experiences (6-16 weeks in duration). Results: The tablets were used on 70% of 691 clinic days, averaging 1.3 uses per day. Information seeking represented 48% of uses; 33% of those were foreground searches for research articles and syntheses and 66% were for background medical information. Other common uses included patient education (19%), medical record documentation (13%), and professional communication (9%). The most frequently used app was Safari, the preloaded web browser (representing 281 [36.5%] incidents of use). Users accessed 56 total apps to support clinical practice. Discussion and Conclusions: Physical therapy students successfully integrated use of a tablet computer into their clinical experiences including regular activities of information seeking. Our findings suggest that the tablet computer represents a potentially transformational tool for promoting knowledge translation in the clinical practice environment. Video Abstract available for more insights from the authors (see Supplemental Digital Content 1, http://links.lww.com/JNPT/A127). PMID:26945431

  20. Does clinical experience affect knowledge regarding hepatitis-B among male medical students at a private university

    International Nuclear Information System (INIS)

    Nisar, N.

    2009-01-01

    To assess the knowledge of male medical students about Hepatitis-B in their preclinical and clinical years and to investigate the self reported vaccination status of these students. In the year of 2007, 187 male students of Isra University Hyderabad Sindh Pakistan were selected by convenient sampling and surveyed with a self reported questionnaire comprising of questions regarding knowledge about hepatitis B. Data gathered was analyzed by SPSS V. 16. Knowledge between preclinical and clinical students were compared by Pearson's coefficient chi square test, p value < 0.005 was considered significant. Out of 187 students interviewed, 73 (39%) and 114 (61%) were from preclinical and clinical years respectively. Significant difference was found in clinical and preclinical students regarding basic knowledge about hepatitis B. and mode of transmission of disease (P= 0.004) and (P=< 0.001) respectively. Significant difference was found in the knowledge of both preclinical and clinical male medical students. (JPMA 59:808; 2009). (author)

  1. Nosocomial infections: knowledge and source of information among clinical health care students in Ghana

    Directory of Open Access Journals (Sweden)

    Bello AI

    2011-08-01

    Full Text Available Ajediran I Bello1, Eunice N Asiedu1, Babatunde OA Adegoke2, Jonathan NA Quartey1, Kwadwo O Appiah-Kubi1, Bertha Owusu-Ansah11Department of Physiotherapy, School of Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana; 2Department of Physiotherapy, College of Medicine, University of Ibadan, Ibadan, NigeriaBackground: This study determined and compared the knowledge of nosocomial infections among clinical health care students at the College of Health Sciences, University of Ghana.Methods: Two hundred undergraduate health care students from four academic programs participated in the study. The study sample was drawn from each academic program by a simple random sampling technique using the class directory from each course. The Infection Control Standardized Questionnaire (ICSQ was used to assess the knowledge of students about three main domains, ie, hand hygiene, nosocomial infections, and standard precautions. A maximum score of 50 was obtainable, and respondents with scores ≥70% were classified as having a satisfactory knowledge. The response on each item was coded numerically to generate data for statistical analysis. Comparison of knowledge on the domains among categories of students was assessed using the Kruskal–Wallis test, while associations between courses of study and knowledge about nosocomial infections were determined using the Chi-square test. All statistical tests had a significant level of 5% (P < 0.05Results: Overall mean percentage score of the participants on ICSQ was 65.4 ± 2.58, with medical, physiotherapy, radiography, and nursing students recording mean percentage scores of 70.58 ± 0.62, 65.02 ± 2.00, 64.74 ± 1.19, and 61.31 ± 2.35, respectively. The main source of information about the prevention of nosocomial infections as cited by participants was their routine formal training in class. There was no significant association (P > 0.05 between course of study and knowledge of

  2. Tacit knowledge as the unifying factor in evidence based medicine and clinical judgement.

    Science.gov (United States)

    Thornton, Tim

    2006-03-17

    The paper outlines the role that tacit knowledge plays in what might seem to be an area of knowledge that can be made fully explicit or codified and which forms a central element of Evidence Based Medicine. Appeal to the role the role of tacit knowledge in science provides a way to unify the tripartite definition of Evidence Based Medicine given by Sackett et al: the integration of best research evidence with clinical expertise and patient values. Each of these three elements, crucially including research evidence, rests on an ineliminable and irreducible notion of uncodified good judgement. The paper focuses on research evidence, drawing first on the work of Kuhn to suggest that tacit knowledge contributes, as a matter of fact, to puzzle solving within what he calls normal science. A stronger argument that it must play a role in research is first motivated by looking to Collins' first hand account of replication in applied physics and then broader considerations of replication in justifying knowledge claims in scientific research. Finally, consideration of an argument from Wittgenstein shows that whatever explicit guidelines can be drawn up to guide judgement the specification of what counts as correctly following them has to remain implicit.Overall, the paper sets out arguments for the claim that even though explicit guidelines and codifications can play a practical role in informing clinical practice, they rest on a body of tacit or implicit skill that is in principle ineliminable. It forms the bedrock of good judgement and unites the integration of research, expertise and values.

  3. 1988 coal price negotiation

    Energy Technology Data Exchange (ETDEWEB)

    Senmura, Akira

    1988-12-01

    In the negotiation on raw coal price for 1988, which began at the end of 1987, Australia requested price rise of 4 - 5 dollars for the reason of rise of Australian dollars, conditions of mines, price drop in the past five years, and world supply/demand of coal. Japan insisted to maintain the price of preceding year. The talk ended in a dead lock which could last a long time. Negotiation on the Canadian coal price also encountered difficulties but an agreement was obtained in March as Japan accepted the increased price. After which, Japan and Australia agreed to raise the price by 2.90 dollars and an increase over last year. Producing countries also requested a wide price rise as 7.50 dollars for general coal, making in this area very difficult to progress. Finally, they agreed to raise the price by 6.30 dollars and the electric power utility in Japan responded by importing of U.S. coal, which has a lower heat output but is also cheaper. It depends on Australia for 70% of coal supply but started to diversify the source. 3 tabs.

  4. Dynamic Communication Resource Negotiations

    Science.gov (United States)

    Chow, Edward; Vatan, Farrokh; Paloulian, George; Frisbie, Steve; Srostlik, Zuzana; Kalomiris, Vasilios; Apgar, Daniel

    2012-01-01

    Today's advanced network management systems can automate many aspects of the tactical networking operations within a military domain. However, automation of joint and coalition tactical networking across multiple domains remains challenging. Due to potentially conflicting goals and priorities, human agreement is often required before implementation into the network operations. This is further complicated by incompatible network management systems and security policies, rendering it difficult to implement automatic network management, thus requiring manual human intervention to the communication protocols used at various network routers and endpoints. This process of manual human intervention is tedious, error-prone, and slow. In order to facilitate a better solution, we are pursuing a technology which makes network management automated, reliable, and fast. Automating the negotiation of the common network communication parameters between different parties is the subject of this paper. We present the technology that enables inter-force dynamic communication resource negotiations to enable ad-hoc inter-operation in the field between force domains, without pre-planning. It also will enable a dynamic response to changing conditions within the area of operations. Our solution enables the rapid blending of intra-domain policies so that the forces involved are able to inter-operate effectively without overwhelming each other's networks with in-appropriate or un-warranted traffic. It will evaluate the policy rules and configuration data for each of the domains, then generate a compatible inter-domain policy and configuration that will update the gateway systems between the two domains.

  5. Semantics-based plausible reasoning to extend the knowledge coverage of medical knowledge bases for improved clinical decision support

    OpenAIRE

    Mohammadhassanzadeh, Hossein; Van Woensel, William; Abidi, Samina Raza; Abidi, Syed Sibte Raza

    2017-01-01

    Background Capturing complete medical knowledge is challenging-often due to incomplete patient Electronic Health Records (EHR), but also because of valuable, tacit medical knowledge hidden away in physicians? experiences. To extend the coverage of incomplete medical knowledge-based systems beyond their deductive closure, and thus enhance their decision-support capabilities, we argue that innovative, multi-strategy reasoning approaches should be applied. In particular, plausible reasoning mech...

  6. Genetic counselors’ (GC) knowledge, awareness, and understanding of clinical next-generation sequencing (NGS) genomic testing

    Science.gov (United States)

    Boland, PM; Ruth, K; Matro, JM; Rainey, KL; Fang, CY; Wong, YN; Daly, MB; Hall, MJ

    2014-01-01

    Genomic tests are increasingly complex, less expensive, and more widely available with the advent of next-generation sequencing (NGS). We assessed knowledge and perceptions among genetic counselors pertaining to NGS genomic testing via an online survey. Associations between selected characteristics and perceptions were examined. Recent education on NGS testing was common, but practical experience limited. Perceived understanding of clinical NGS was modest, specifically concerning tumor testing. Greater perceived understanding of clinical NGS testing correlated with more time spent in cancer-related counseling, exposure to NGS testing, and NGS-focused education. Substantial disagreement about the role of counseling for tumor-based testing was seen. Finally, a majority of counselors agreed with the need for more education about clinical NGS testing, supporting this approach to optimizing implementation. PMID:25523111

  7. Genetic counselors' (GC) knowledge, awareness, understanding of clinical next-generation sequencing (NGS) genomic testing.

    Science.gov (United States)

    Boland, P M; Ruth, K; Matro, J M; Rainey, K L; Fang, C Y; Wong, Y N; Daly, M B; Hall, M J

    2015-12-01

    Genomic tests are increasingly complex, less expensive, and more widely available with the advent of next-generation sequencing (NGS). We assessed knowledge and perceptions among genetic counselors pertaining to NGS genomic testing via an online survey. Associations between selected characteristics and perceptions were examined. Recent education on NGS testing was common, but practical experience limited. Perceived understanding of clinical NGS was modest, specifically concerning tumor testing. Greater perceived understanding of clinical NGS testing correlated with more time spent in cancer-related counseling, exposure to NGS testing, and NGS-focused education. Substantial disagreement about the role of counseling for tumor-based testing was seen. Finally, a majority of counselors agreed with the need for more education about clinical NGS testing, supporting this approach to optimizing implementation. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Introduction: Negotiation in intergroup conflict

    NARCIS (Netherlands)

    Demoulin, S.; de Dreu, C.K.W.

    2010-01-01

    Although conflicts most often occur between groups, research and theory on conflict management and negotiation have largely focused on the interpersonal system and ignored how groups negotiate a solution to their intergroup conflict. Thus we have a thorough understanding of the motivational,

  9. The cancer precision medicine knowledge base for structured clinical-grade mutations and interpretations

    Science.gov (United States)

    Huang, Linda; Fernandes, Helen; Zia, Hamid; Tavassoli, Peyman; Rennert, Hanna; Pisapia, David; Imielinski, Marcin; Sboner, Andrea; Rubin, Mark A; Kluk, Michael

    2017-01-01

    Objective: This paper describes the Precision Medicine Knowledge Base (PMKB; https://pmkb.weill.cornell.edu), an interactive online application for collaborative editing, maintenance, and sharing of structured clinical-grade cancer mutation interpretations. Materials and Methods: PMKB was built using the Ruby on Rails Web application framework. Leveraging existing standards such as the Human Genome Variation Society variant description format, we implemented a data model that links variants to tumor-specific and tissue-specific interpretations. Key features of PMKB include support for all major variant types, standardized authentication, distinct user roles including high-level approvers, and detailed activity history. A REpresentational State Transfer (REST) application-programming interface (API) was implemented to query the PMKB programmatically. Results: At the time of writing, PMKB contains 457 variant descriptions with 281 clinical-grade interpretations. The EGFR, BRAF, KRAS, and KIT genes are associated with the largest numbers of interpretable variants. PMKB’s interpretations have been used in over 1500 AmpliSeq tests and 750 whole-exome sequencing tests. The interpretations are accessed either directly via the Web interface or programmatically via the existing API. Discussion: An accurate and up-to-date knowledge base of genomic alterations of clinical significance is critical to the success of precision medicine programs. The open-access, programmatically accessible PMKB represents an important attempt at creating such a resource in the field of oncology. Conclusion: The PMKB was designed to help collect and maintain clinical-grade mutation interpretations and facilitate reporting for clinical cancer genomic testing. The PMKB was also designed to enable the creation of clinical cancer genomics automated reporting pipelines via an API. PMID:27789569

  10. Hegemonic structure of basic, clinical and patented knowledge on Ebola research: a US army reductionist initiative.

    Science.gov (United States)

    Fajardo-Ortiz, David; Ortega-Sánchez-de-Tagle, José; Castaño, Victor M

    2015-04-19

    Ebola hemorrhagic fever (Ebola) is still a highly lethal infectious disease long affecting mainly neglected populations in sub-Saharan Africa. Moreover, this disease is now considered a potential worldwide threat. In this paper, we present an approach to understand how the basic, clinical and patent knowledge on Ebola is organized and intercommunicated and what leading factor could be shaping the evolution of the knowledge translation process for this disease. A combination of citation network analysis; analysis of Medical heading Subject (MeSH) and Gene Ontology (GO) terms, and quantitative content analysis for patents and scientific literature, aimed to map the organization of Ebola research was carried out. We found six putative research fronts (i.e. clusters of high interconnected papers). Three research fronts are basic research on Ebola virus structural proteins: glycoprotein, VP40 and VP35, respectively. There is a fourth research front of basic research papers on pathogenesis, which is the organizing hub of Ebola research. A fifth research front is pre-clinical research focused on vaccines and glycoproteins. Finally, a clinical-epidemiology research front related to the disease outbreaks was identified. The network structure of patent families shows that the dominant design is the use of Ebola virus proteins as targets of vaccines and other immunological treatments. Therefore, patents network organization resembles the organization of the scientific literature. Specifically, the knowledge on Ebola would flow from higher (clinical-epidemiology) to intermediated (cellular-tissular pathogenesis) to lower (molecular interactions) levels of organization. Our results suggest a strong reductionist approach for Ebola research probably influenced by the lethality of the disease. On the other hand, the ownership profile of the patent families network and the main researches relationship with the United State Army suggest a strong involvement of this military

  11. A Multi-Agent Environment for Negotiation

    Science.gov (United States)

    Hindriks, Koen V.; Jonker, Catholijn M.; Tykhonov, Dmytro

    In this chapter we introduce the System for Analysis of Multi-Issue Negotiation (SAMIN). SAMIN offers a negotiation environment that supports and facilitates the setup of various negotiation setups. The environment has been designed to analyse negotiation processes between human negotiators, between human and software agents, and between software agents. It offers a range of different agents, different domains, and other options useful to define a negotiation setup. The environment has been used to test and evaluate a range of negotiation strategies in various domains playing against other negotiating agents as well as humans. We discuss some of the results obtained by means of these experiments.

  12. Expanding the basic science debate: the role of physics knowledge in interpreting clinical findings.

    Science.gov (United States)

    Goldszmidt, Mark; Minda, John Paul; Devantier, Sarah L; Skye, Aimee L; Woods, Nicole N

    2012-10-01

    Current research suggests a role for biomedical knowledge in learning and retaining concepts related to medical diagnosis. However, learning may be influenced by other, non-biomedical knowledge. We explored this idea using an experimental design and examined the effects of causal knowledge on the learning, retention, and interpretation of medical information. Participants studied a handout about several respiratory disorders and how to interpret respiratory exam findings. The control group received the information in standard "textbook" format and the experimental group was presented with the same information as well as a causal explanation about how sound travels through lungs in both the normal and disease states. Comprehension and memory of the information was evaluated with a multiple-choice exam. Several questions that were not related to the causal knowledge served as control items. Questions related to the interpretation of physical exam findings served as the critical test items. The experimental group outperformed the control group on the critical test items, and our study shows that a causal explanation can improve a student's memory for interpreting clinical details. We suggest an expansion of which basic sciences are considered fundamental to medical education.

  13. Knowledge, attitudes and awareness regarding fertility preservation among oncologists and clinical practitioners in Lebanon.

    Science.gov (United States)

    Ghazeeri, Ghina; Zebian, Dina; Nassar, Anwar H; Harajly, Sally; Abdallah, Alain; Hakimian, Stephanie; Skaiff, Bassem; Abbas, Hussein A; Awwad, Johnny

    2016-06-01

    Fertility preservation (FP) aims to help individuals overcome the infertility associated with cancer treatments such as chemotherapy and radiation. The objective of this study was to assess the awareness, attitudes and knowledge of oncologists' and clinical practitioners' (CPs) about fertility preservation and its options in Lebanon. This was a cross-sectional study with surveys carried out between March 2012 and February 2013 on CPs at the American University of Beirut Medical Centre and Saint Jude's Children Cancer Centre as well as all registered oncologists in Lebanon. Ninety percent of CPs (n = 88) and 94% of oncologists (n = 53) agreed that fertility preservation should be discussed with patient before their cancer treatment. Our data showed a gender bias in relation to patients being informed of their FP options, as well as conflicting knowledge of FP options available in Lebanon among oncologists. The CPs were more likely to have accurate knowledge of FP options and treatment than oncologists. A proactive approach is required to: (1) increase the awareness and knowledge of FP; (2) improve attitudes towards FP; and (3) encourage its communication between CPs, oncologists and patients in Lebanon. Increased education programs, awareness campaigns and development of dedicated FP centres are needed.

  14. Factors impacting on nurses' transference of theoretical knowledge of holistic care into clinical practice.

    Science.gov (United States)

    Henderson, Saras

    2002-12-01

    Since nurse education moved to universities, a reoccurring concern of health consumers, health administrators, and some practising nurses is that nurses are not able to transfer the theoretical knowledge of holistic care into practice. Much has been written about this concern usually under the heading of the theory-practice gap. A common reason that has been highlighted as the cause of this gap is that the theoretical knowledge that nurses learn in academia is predicated on concepts such as humanism and holistic caring. In contrast, the bureaucratic organisation where nurses provide care tends to be based on management concepts where cost containment and outcome measures are more acceptable. Hence nurses' learned values of holistic caring are pitted against the reality of the practice setting. So what is this practice reality? This paper attempts to provide an insider view of why the theoretical knowledge of holistic care may be difficult to enact in the clinical setting. In-depth taped interviews with nurses and participant observation were conducted in acute care hospitals in Western Australia. The interviews were transcribed verbatim and analysed using the constant comparative method. The findings indicated that utilitarian nursing and role models had impacted on the transference of theoretical knowledge of holistic care into practice. The paper outlines some measures that nurses themselves can undertake to ensure the narrowing of the theory-practice gap in this area.

  15. PARTAKE Survey of Public Knowledge and Perceptions of Clinical Research in India

    Science.gov (United States)

    Burt, Tal; Dhillon, Savita; Sharma, Pooja; Khan, Danish; MV, Deepa; Alam, Sazid; Jain, Sarika; Alapati, Bhavana; Mittal, Sanjay; Singh, Padam

    2013-01-01

    Background A public that is an informed partner in clinical research is important for ethical, methodological, and operational reasons. There are indications that the public is unaware or misinformed, and not sufficiently engaged in clinical research but studies on the topic are lacking. PARTAKE – Public Awareness of Research for Therapeutic Advancements through Knowledge and Empowerment is a program aimed at increasing public awareness and partnership in clinical research. The PARTAKE Survey is a component of the program. Objective To study public knowledge and perceptions of clinical research. Methods A 40-item questionnaire combining multiple-choice and open-ended questions was administered to 175 English- or Hindi-speaking individuals in 8 public locations representing various socioeconomic strata in New Delhi, India. Results Interviewees were 18–84 old (mean: 39.6, SD±16.6), 23.6% female, 68.6% employed, 7.3% illiterate, 26.3% had heard of research, 2.9% had participated and 58.9% expressed willingness to participate in clinical research. The following perceptions were reported (% true/% false/% not aware): ‘research benefits society’ (94.1%/3.5%/2.3%), ‘the government protects against unethical clinical research’ (56.7%/26.3%/16.9%), ‘research hospitals provide better care’ (67.2%/8.7%/23.9%), ‘confidentiality is adequately protected’ (54.1%/12.3%/33.5%), ‘participation in research is voluntary’ (85.3%/5.8%/8.7%); ‘participants treated like ‘guinea pigs’’ (20.7%/53.2%/26.0%), and ‘compensation for participation is adequate’ (24.7%/12.9%/62.3%). Conclusions Results suggest the Indian public is aware of some key features of clinical research (e.g., purpose, value, voluntary nature of participation), and supports clinical research in general but is unaware of other key features (e.g., compensation, confidentiality, protection of human participants) and exhibits some distrust in the conduct and reporting of clinical trials

  16. PARTAKE survey of public knowledge and perceptions of clinical research in India.

    Directory of Open Access Journals (Sweden)

    Tal Burt

    Full Text Available BACKGROUND: A public that is an informed partner in clinical research is important for ethical, methodological, and operational reasons. There are indications that the public is unaware or misinformed, and not sufficiently engaged in clinical research but studies on the topic are lacking. PARTAKE - Public Awareness of Research for Therapeutic Advancements through Knowledge and Empowerment is a program aimed at increasing public awareness and partnership in clinical research. The PARTAKE Survey is a component of the program. OBJECTIVE: To study public knowledge and perceptions of clinical research. METHODS: A 40-item questionnaire combining multiple-choice and open-ended questions was administered to 175 English- or Hindi-speaking individuals in 8 public locations representing various socioeconomic strata in New Delhi, India. RESULTS: Interviewees were 18-84 old (mean: 39.6, SD ± 16.6, 23.6% female, 68.6% employed, 7.3% illiterate, 26.3% had heard of research, 2.9% had participated and 58.9% expressed willingness to participate in clinical research. The following perceptions were reported (% true/% false/% not aware: 'research benefits society' (94.1%/3.5%/2.3%, 'the government protects against unethical clinical research' (56.7%/26.3%/16.9%, 'research hospitals provide better care' (67.2%/8.7%/23.9%, 'confidentiality is adequately protected' (54.1%/12.3%/33.5%, 'participation in research is voluntary' (85.3%/5.8%/8.7%; 'participants treated like 'guinea pigs'' (20.7%/53.2%/26.0%, and 'compensation for participation is adequate' (24.7%/12.9%/62.3%. CONCLUSIONS: Results suggest the Indian public is aware of some key features of clinical research (e.g., purpose, value, voluntary nature of participation, and supports clinical research in general but is unaware of other key features (e.g., compensation, confidentiality, protection of human participants and exhibits some distrust in the conduct and reporting of clinical trials. Larger, cross

  17. Personalized cancer therapy—leveraging a knowledge base for clinical decision-making

    Science.gov (United States)

    Dumbrava, Ecaterina Ileana; Meric-Bernstam, Funda

    2018-01-01

    Next-generation sequencing (NGS), also known as massively parallel sequencing, is rapidly being incorporated into oncology practice. Interpretation of genomic reports and selecting treatments based on the tumor's genomic analysis becomes more and more complicated for the treating oncologist because of the use of larger panels covering dozens to hundreds of genes and the amount of rapidly emerging clinical/translational data. To help guide personalized treatments in oncology, The Sheikh Khalifa Bin Zayed Al Nahyan Institute for Personalized Cancer Therapy (IPCT) at MD Anderson Cancer Center has developed a knowledge base, available at https://personalizedcancertherapy.org or https://pct.mdanderson.org (PCT). This knowledge base provides information on the function of common genomic alterations and their therapeutic implications. Here, we describe how such genomic information can be used by health-care providers to identify genomically matched therapies. PMID:29212833

  18. Knowledgeable Neighbors: a mobile clinic model for disease prevention and screening in underserved communities.

    Science.gov (United States)

    Hill, Caterina; Zurakowski, David; Bennet, Jennifer; Walker-White, Rainelle; Osman, Jamie L; Quarles, Aaron; Oriol, Nancy

    2012-03-01

    The Family Van mobile health clinic uses a "Knowledgeable Neighbor" model to deliver cost-effective screening and prevention activities in underserved neighborhoods in Boston, MA. We have described the Knowledgeable Neighbor model and used operational data collected from 2006 to 2009 to evaluate the service. The Family Van successfully reached mainly minority low-income men and women. Of the clients screened, 60% had previously undetected elevated blood pressure, 14% had previously undetected elevated blood glucose, and 38% had previously undetected elevated total cholesterol. This represents an important model for reaching underserved communities to deliver proven cost-effective prevention activities, both to help control health care costs and to reduce health disparities.

  19. E-Learning through gaming: Unfolding children’s negotiation skills

    NARCIS (Netherlands)

    Geuze, Jeroen; van den Broek, Egon; Stankov, S.; Glavinić, V.; Rosić, M.

    A generic theoretical framework on teaching children to negotiate is presented, founded on Piaget’s child development and Thompson and Hastie’s negotiation theories and validated through an experiment. The framework was implemented as CLIPS knowledge base, the back-end of an Intelligent Tutoring

  20. Negotiating Cluster Boundaries

    DEFF Research Database (Denmark)

    Giacomin, Valeria

    2017-01-01

    Palm oil was introduced to Malay(si)a as an alternative to natural rubber, inheriting its cluster organizational structure. In the late 1960s, Malaysia became the world’s largest palm oil exporter. Based on archival material from British colonial institutions and agency houses, this paper focuses...... on the governance dynamics that drove institutional change within this cluster during decolonization. The analysis presents three main findings: (i) cluster boundaries are defined by continuous tug-of-war style negotiations between public and private actors; (ii) this interaction produces institutional change...... within the cluster, in the form of cumulative ‘institutional rounds’ – the correction or disruption of existing institutions or the creation of new ones; and (iii) this process leads to a broader inclusion of local actors in the original cluster configuration. The paper challenges the prevalent argument...

  1. Prescribing safety, negotiating expertise

    International Nuclear Information System (INIS)

    Rolina, Gregory

    2010-01-01

    Owing to their presumed impact on the safety of high-risk installations, the interactions between regulators and the regulated are a major but seldom explored subject of research in risk management. A study by experts on human and organizational factors in nuclear safety sheds light on the various phases (and their effects) of the process whereby experts produce assessments. Light is shed on a 'negotiated expertise' typical of the French style of safety regulations in nuclear installations. It is based on an ongoing technical dialog between experts and operators ('French cooking' for Anglo-Saxons). This analysis of 'expertise' and thus of the 'logics of action' implemented by experts proposes a typology of actions that can be transposed to other sorts of risk or other fields of activity. It hands us the keys for understanding a very contemporary activity. (author)

  2. Identity negotiations in meetings

    DEFF Research Database (Denmark)

    Asmuß, Birte; Oshima, Sae

    of the company, and all members know (and display) that he holds some information that the rest don’t have access to. Our analysis shows that the participants evoke various identities of the manager, sometimes orienting to the structure of the organization, and other times orienting to wider social categories......Meetings are places, where identity negotiation is a central activity and where members’ local practices recurrently inform and are informed by larger categories (Antaki and Widdicombe 1998). Correspondingly, the approach to understanding organization (macro) by way of identity work (micro) has...... company, and in the data recorded over 10 days, the employees frequently complain about the many changes that have taken place. Our focus lies in a unique occasion where one of the managers makes an unusual appearance at the lunchroom. In this situation, he is the only one that is on the business side...

  3. Emergency nurses' knowledge, attitude and clinical decision making skills about pain.

    Science.gov (United States)

    Ucuzal, Meral; Doğan, Runida

    2015-04-01

    Pain is the most common reason that patients come to the emergency department. Emergency nurses have an indispensable role in the management of this pain. The aim of this study was to examine emergency nurses' knowledge, attitude and clinical decision-making skills about pain. This descriptive study was conducted in a state and a university hospital between September and October 2012 in Malatya, Turkey. Of 98 nurses working in the emergency departments of these two hospitals, 57 returned the questionnaires. The response rate was 58%. Data were collected using the Demographic Information Questionnaire, Knowledge and Attitude Questionnaire about Pain and Clinical Decision Making Survey. Frequency, percentage, mean and standard deviation were used to evaluate data. 75.4% of participant nurses knew that patients' own statement about their pain was the most reliable indicator during pain assessment. Almost half of the nurses believed that patients should be encouraged to endure the pain as much as possible before resorting to a pain relief method. The results also indicate that most of nurses think that a sleeping patient does not have any pain and pain relief should be postponed as it can influence the diagnosis negatively. It is determined that the pain scale was not used frequently. Only 35.1% of nurses reported keeping records of pain. Despite all the recommendations of substantial past research the results of this study indicate that emergency nurses continue to demonstrate inadequate knowledge, clinical decision-making skills and negative attitudes about pain. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Smoking cessation advice: Knowledge, attitude, and practice among clinical dental students'

    Directory of Open Access Journals (Sweden)

    Allama Prabhu

    2017-01-01

    Full Text Available Background: Smoking is the single most important public health challenge facing the National Health Service. The detrimental effects on the general health of tobacco smoking are well documented. Smoking is a primary risk factor for oral cancer and many oral diseases. Dental professional scan plays an important role in preventing adverse health effects by promoting smoking cessation. Objective: To assess the knowledge, attitude, and practice among clinical dental students in giving smoking cessation advice and to explore the barriers to this activity. Materials and Methods: A total of 262 clinical dental trainee of two dental colleges (College of Dental Sciences and Bapuji Dental College of Davangere city were included in the survey. A self-administered questionnaire was administered to assess the knowledge, attitude, and practice toward Tobacco Cessation Advise. Results: Among the 262 participants in the study, around 51% said they know about Nicotine Replacement Therapy, and among them, only 4.6% were aware of the options available in the market. When asked about 5A's of tobacco cessation, only 35.5% were aware of it. Similarly, when asked about 5R's of tobacco cessation, 48.5% were unaware of it. Conclusions: The respondents did not have sufficient knowledge regarding tobacco cessation advice. With patient's disinterest and lack of time being quoted as the important barriers in providing tobacco cessation advice, it is highly recommended that there is need to incorporate few chapters on tobacco, its effect and cessation of habit in the undergraduate dental curriculum with simultaneous application of the same in clinical practice.

  5. Knowledge of and attitudes toward clinical depression among health providers in Gujarat, India.

    Science.gov (United States)

    Almanzar, Santiago; Shah, Nirsarg; Vithalani, Suril; Shah, Sandip; Squires, James; Appasani, Raghu; Katz, Craig L

    2014-01-01

    Clinical depression is a major leading cause of morbidity and mortality but it is oftentimes overlooked and undertreated. The negative perception and lack of understanding of this condition prevents millions of people from seeking appropriate and on-time medical help, leading to distress and increased burden for affected people and their families. The implementation of public education campaigns and training of non-psychiatric health professionals on mental health and clinical depression has been neglected in several countries, including India, which is the second most populous country in the world with a population of more than 1.2 billion people, almost one-fifth of the world's population. This study sought to explore the knowledge and attitudes toward the diagnosis and treatment of clinical depression in nonpsychiatric health care providers in Vadodara, Gujarat, India. A cross-sectional survey was conducted over a 4-week period In Gujarat, India among resident physicians and community health workers about their knowledge and views on clinical depression. We found considerable stigma and misinformation about depression especially among health care workers in India. Most of the community health workers had a great deal of difficulty when defining clinical depression, and a large majority said that they never heard about depression or its definition and although the overwhelming majority of respondents did not believe that clinical depression results from a punishment from God (82% disagreed or strongly disagreed with this belief) or evil spirits (77.5%), a much smaller proportion disagreed with the assertions that depression was either solely due to difficult circumstances (38.2%) or that sufferers only had themselves to blame (47.2%). Meanwhile, only 32.6% disagreed with the position that clinical depression is a sign of weakness and 39.4% disagreed with the statement that suicide was a sign of weakness. Our findings underscore the considerable public health

  6. Negotiation Decision Support Systems: Analysing Negotiations under the Conditions of Risk

    OpenAIRE

    Nipun Agarwal

    2014-01-01

    Negotiation Theory is a research area with emphasis from three different research streams being game theory, psychology and negotiation analysis. Recently, negotiation theory research has moved towards the combination of game theory and psychology negotiation theory models that could be called Integrated Negotiation Theory (INT). As, negotiations are often impacted by external factors, there is risk associated with achieving the expected outcomes. Prospect theory and Negotiation theory are co...

  7. EXACKTE2: Exploiting the clinical consultation as a knowledge transfer and exchange environment: a study protocol

    Directory of Open Access Journals (Sweden)

    Ouimet Mathieu

    2009-03-01

    Full Text Available Abstract Background While the evidence suggests that the way physicians provide information to patients is crucial in helping patients decide upon a course of action, the field of knowledge translation and exchange (KTE is silent about how the physician and the patient influence each other during clinical interactions and decision-making. Consequently, based on a novel relationship-centered model, EXACKTE2 (EXploiting the clinicAl Consultation as a Knowledge Transfer and Exchange Environment, this study proposes to assess how patients and physicians influence each other in consultations. Methods We will employ a cross-sectional study design involving 300 pairs of patients and family physicians from two primary care practice-based research networks. The consultation between patient and physician will be audio-taped and transcribed. Following the consultation, patients and physicians will complete a set of questionnaires based on the EXACKTE2 model. All questionnaires will be similar for patients and physicians. These questionnaires will assess the key concepts of our proposed model based on the essential elements of shared decision-making (SDM: definition and explanation of problem; presentation of options; discussion of pros and cons; clarification of patient values and preferences; discussion of patient ability and self-efficacy; presentation of doctor knowledge and recommendation; and checking and clarifying understanding. Patients will be contacted by phone two weeks later and asked to complete questionnaires on decisional regret and quality of life. The analysis will be conducted to compare the key concepts in the EXACKTE2 model between patients and physicians. It will also allow the assessment of how patients and physicians influence each other in consultations. Discussion Our proposed model, EXACKTE2, is aimed at advancing the science of KTE based on a relationship process when decision-making has to take place. It fosters a new KTE

  8. Collaboration in a competitive healthcare system: negotiation 101 for clinicians.

    Science.gov (United States)

    Clay-Williams, Robyn; Johnson, Andrew; Lane, Paul; Li, Zhicheng; Camilleri, Lauren; Winata, Teresa; Klug, Michael

    2018-04-09

    Purpose The purpose of this paper is to evaluate the effectiveness of negotiation training delivered to senior clinicians, managers and executives, by exploring whether staff members implemented negotiation skills in their workplace following the training, and if so, how and when. Design/methodology/approach This is a qualitative study involving face-to-face interviews with 18 senior clinicians, managers and executives who completed a two-day intensive negotiation skills training course. Interviews were transcribed verbatim, and inductive interpretive analysis techniques were used to identify common themes. Research setting was a large tertiary care hospital and health service in regional Australia. Findings Participants generally reported positive affective and utility reactions to the training, and attempted to implement at least some of the skills in the workplace. The main enabler was provision of a Negotiation Toolkit to assist in preparing and conducting negotiations. The main barrier was lack of time to reflect on the principles and prepare for upcoming negotiations. Participants reported that ongoing skill development and retention were not adequately addressed; suggestions for improving sustainability included provision of refresher training and mentoring. Research limitations/implications Limitations include self-reported data, and interview questions positively elicited examples of training translation. Practical implications The training was well matched to participant needs, with negotiation a common and daily activity for most healthcare professionals. Implementation of the skills showed potential for improving collaboration and problem solving in the workplace. Practical examples of how the skills were used in the workplace are provided. Originality/value To the authors' knowledge, this is the first international study aimed at evaluating the effectiveness of an integrative bargaining negotiation training program targeting executives, senior

  9. Toward a normalized clinical drug knowledge base in China-applying the RxNorm model to Chinese clinical drugs.

    Science.gov (United States)

    Wang, Li; Zhang, Yaoyun; Jiang, Min; Wang, Jingqi; Dong, Jiancheng; Liu, Yun; Tao, Cui; Jiang, Guoqian; Zhou, Yi; Xu, Hua

    2018-04-04

    In recent years, electronic health record systems have been widely implemented in China, making clinical data available electronically. However, little effort has been devoted to making drug information exchangeable among these systems. This study aimed to build a Normalized Chinese Clinical Drug (NCCD) knowledge base, by applying and extending the information model of RxNorm to Chinese clinical drugs. Chinese drugs were collected from 4 major resources-China Food and Drug Administration, China Health Insurance Systems, Hospital Pharmacy Systems, and China Pharmacopoeia-for integration and normalization in NCCD. Chemical drugs were normalized using the information model in RxNorm without much change. Chinese patent drugs (i.e., Chinese herbal extracts), however, were represented using an expanded RxNorm model to incorporate the unique characteristics of these drugs. A hybrid approach combining automated natural language processing technologies and manual review by domain experts was then applied to drug attribute extraction, normalization, and further generation of drug names at different specification levels. Lastly, we reported the statistics of NCCD, as well as the evaluation results using several sets of randomly selected Chinese drugs. The current version of NCCD contains 16 976 chemical drugs and 2663 Chinese patent medicines, resulting in 19 639 clinical drugs, 250 267 unique concepts, and 2 602 760 relations. By manual review of 1700 chemical drugs and 250 Chinese patent drugs randomly selected from NCCD (about 10%), we showed that the hybrid approach could achieve an accuracy of 98.60% for drug name extraction and normalization. Using a collection of 500 chemical drugs and 500 Chinese patent drugs from other resources, we showed that NCCD achieved coverages of 97.0% and 90.0% for chemical drugs and Chinese patent drugs, respectively. Evaluation results demonstrated the potential to improve interoperability across various electronic drug systems

  10. [Historical evolution of some clinical and epidemiological knowledge of coccidioidomycosis in the Americas].

    Science.gov (United States)

    Negroni, R

    2008-01-01

    Coccidioidomycosis is a systemic endemic mycosis caused by two dimorphic fungi of the Coccidioides genus: Coccidioides immitis and Coccidioides posadasii. This fungal infection is only endemic in the American Continent. The majority of the epidemiological, pathogenic, clinical, mycological and therapeutical findings were obtained in the U.S.A. Coccidioidomycosis was discovered in Argentina, at the end of the XIXth century by Alejandro Posadas. In the last two decades, a new endemic zone was found in the northeast of Brazil. Several countries of the region such as Mexico, Guatemala, Honduras, Venezuela and Argentina have performed epidemiological studies which allowed a better knowledge of the endemic areas and of the clinical characteristics of this mycosis.

  11. Assessment of the knowledge and attitudes regarding HIV/AIDS among pre-clinical medical students in Israel

    Science.gov (United States)

    2014-01-01

    Background Today’s medical students are the future physicians of people living with HIV/AIDS (PLWHA). It is therefore essential that medical students possess the appropriate knowledge and attitudes regarding PLWHA. This study aims to evaluate knowledge and attitudes of pre-clinical Israeli medical students and to assess whether their knowledge and attitudes change throughout their pre-clinical studies. Methods A cross-sectional study was conducted among all pre-clinical medical students from the four medical schools in Israel during the academic year of 2010/2011 (a total of 1,470 students). A self-administered questionnaire was distributed. The questionnaire sought student responses pertaining to knowledge of HIV transmission and non-transmission routes, basic knowledge of HIV/AIDS treatment and attitudes towards HIV/AIDS. Results The study’s response rate was 62.24 percent. Knowledge among pre-clinical medical students was generally high and showed a statistically significant improvement as students progressed through their pre-clinical studies. However, there were some misconceptions, mostly regarding HIV transmission via breastfeeding and knowledge of HIV prevention after exposure to the virus. Students’ attitudes were found to include stigmatizing notions. Furthermore, the majority of medical students correlated HIV with shame and fear. In addition, students’ attitudes toward HIV testing and providing confidential medical information were contradictory to health laws, protocols and guidelines. Overall, no positive changes in students’ attitudes were observed during the pre-clinical years of medical school. Conclusion The knowledge of pre-clinical medical students in Israel is generally high, although there are some knowledge inadequacies that require more emphasis in the curricula of the medical schools. Contrary to HIV-related knowledge, medical students’ attitudes are unaffected by their progression through medical school. Therefore, medical

  12. Improving Decision Making about Genetic Testing in the Clinic: An Overview of Effective Knowledge Translation Interventions.

    Science.gov (United States)

    Légaré, France; Robitaille, Hubert; Gane, Claire; Hébert, Jessica; Labrecque, Michel; Rousseau, François

    2016-01-01

    Knowledge translation (KT) interventions are attempts to change behavior in keeping with scientific evidence. While genetic tests are increasingly available to healthcare consumers in the clinic, evidence about their benefits is unclear and decisions about genetic testing are thus difficult for all parties. We sought to identify KT interventions that involved decisions about genetic testing in the clinical context and to assess their effectiveness for improving decision making in terms of behavior change, increased knowledge and wellbeing. We searched for trials assessing KT interventions in the context of genetic testing up to March 2014 in all systematic reviews (n = 153) published by two Cochrane review groups: Effective Practice and Organisation of Care (EPOC) and Consumers and Communication. We retrieved 2473 unique trials of which we retained only 28 (1%). Two EPOC reviews yielded two trials of KT interventions: audit and feedback (n = 1) and educational outreach (n = 1). Both targeted health professionals and the KT intervention they assessed was found to be effective. Four Consumers and Communication reviews yielded 26 trials: decision aids (n = 15), communication of DNA-based disease risk estimates (n = 7), personalized risk communication (n = 3) and mobile phone messaging (n = 1). Among these, 25 trials targeted only health consumers or patients and the KT interventions were found to be effective in four trials, partly effective in seven, and ineffective in four. Lastly, only one trial targeted both physicians and patients and was found to be effective. More research on the effectiveness of KT interventions regarding genetic testing in the clinical context may contribute to patients making informed value-based decisions and drawing the maximum benefit from clinical applications of genetic and genomic innovations.

  13. Improving Decision Making about Genetic Testing in the Clinic: An Overview of Effective Knowledge Translation Interventions.

    Directory of Open Access Journals (Sweden)

    France Légaré

    Full Text Available Knowledge translation (KT interventions are attempts to change behavior in keeping with scientific evidence. While genetic tests are increasingly available to healthcare consumers in the clinic, evidence about their benefits is unclear and decisions about genetic testing are thus difficult for all parties.We sought to identify KT interventions that involved decisions about genetic testing in the clinical context and to assess their effectiveness for improving decision making in terms of behavior change, increased knowledge and wellbeing.We searched for trials assessing KT interventions in the context of genetic testing up to March 2014 in all systematic reviews (n = 153 published by two Cochrane review groups: Effective Practice and Organisation of Care (EPOC and Consumers and Communication.We retrieved 2473 unique trials of which we retained only 28 (1%. Two EPOC reviews yielded two trials of KT interventions: audit and feedback (n = 1 and educational outreach (n = 1. Both targeted health professionals and the KT intervention they assessed was found to be effective. Four Consumers and Communication reviews yielded 26 trials: decision aids (n = 15, communication of DNA-based disease risk estimates (n = 7, personalized risk communication (n = 3 and mobile phone messaging (n = 1. Among these, 25 trials targeted only health consumers or patients and the KT interventions were found to be effective in four trials, partly effective in seven, and ineffective in four. Lastly, only one trial targeted both physicians and patients and was found to be effective.More research on the effectiveness of KT interventions regarding genetic testing in the clinical context may contribute to patients making informed value-based decisions and drawing the maximum benefit from clinical applications of genetic and genomic innovations.

  14. Modeling and Negotiating Service Quality

    Science.gov (United States)

    Benbernou, Salima; Brandic, Ivona; Cappiello, Cinzia; Carro, Manuel; Comuzzi, Marco; Kertész, Attila; Kritikos, Kyriakos; Parkin, Michael; Pernici, Barbara; Plebani, Pierluigi

    In this chapter the research problems of specifying and negotiating QoS and its corresponding quality documents are analyzed. For this reason, this chapter is separated into two main sections, Section 6.1 and 6.2, with each dedicated to one of the two problems, i.e., QoS specification and negotiation, respectively. Each section has a similar structure: they first introduce the problem and then, in the remaining subsections, review related work. Finally, the chapter ends with Section 6.3, which identifies research gaps and presents potential research challenges in QoS modelling, specification and negotiation.

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

    Science.gov (United States)

    Taddio, Anna; Shah, Vibhuti; Leung, Eman; Wang, Jane; Parikh, Chaitya; Smart, Sarah; Hetherington, Ross; Ipp, Moshe; Riddell, Rebecca Pillai; Sgro, Michael; Jovicic, Aleksandra; Franck, Linda

    2013-02-08

    Although numerous evidence-based and feasible interventions are available to treat pain from childhood vaccine injections, evidence indicates that children are not benefitting from this knowledge. Unrelieved vaccination pain puts children at risk for significant long-term harms including the development of needle fears and subsequent health care avoidance behaviours. Parents report that while they want to mitigate vaccination pain in their children, they lack knowledge about how to do so. An evidence-based clinical practice guideline for managing vaccination pain was recently developed in order to address this knowledge-to-care gap. Educational tools (pamphlet and video) for parents were included to facilitate knowledge transfer at the point of care. The objectives of this study were to evaluate usability and effectiveness in terms of knowledge acquisition from the pamphlet and video in parents of newly born infants. Mixed methods design. Following heuristic usability evaluation of the pamphlet and video, parents of newborn infants reviewed revised versions of both tools and participated in individual and group interviews and individual knowledge testing. The knowledge test comprised of 10 true/false questions about the effectiveness of various pain management interventions, and was administered at three time points: at baseline, after review of the pamphlet, and after review of the video. Three overarching themes were identified from the interviews regarding usability of these educational tools: receptivity to learning, accessibility to information, and validity of information. Parents' performance on the knowledge test improved (p≤0.001) from the baseline phase to after review of the pamphlet, and again from the pamphlet review phase to after review of the video. Using a robust testing process, we demonstrated usability and conceptual knowledge acquisition from a parent-directed educational pamphlet and video about management of vaccination pain. Future studies

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

    Directory of Open Access Journals (Sweden)

    Taddio Anna

    2013-02-01

    Full Text Available Abstract Background Although numerous evidence-based and feasible interventions are available to treat pain from childhood vaccine injections, evidence indicates that children are not benefitting from this knowledge. Unrelieved vaccination pain puts children at risk for significant long-term harms including the development of needle fears and subsequent health care avoidance behaviours. Parents report that while they want to mitigate vaccination pain in their children, they lack knowledge about how to do so. An evidence-based clinical practice guideline for managing vaccination pain was recently developed in order to address this knowledge-to-care gap. Educational tools (pamphlet and video for parents were included to facilitate knowledge transfer at the point of care. The objectives of this study were to evaluate usability and effectiveness in terms of knowledge acquisition from the pamphlet and video in parents of newly born infants. Methods Mixed methods design. Following heuristic usability evaluation of the pamphlet and video, parents of newborn infants reviewed revised versions of both tools and participated in individual and group interviews and individual knowledge testing. The knowledge test comprised of 10 true/false questions about the effectiveness of various pain management interventions, and was administered at three time points: at baseline, after review of the pamphlet, and after review of the video. Results Three overarching themes were identified from the interviews regarding usability of these educational tools: receptivity to learning, accessibility to information, and validity of information. Parents’ performance on the knowledge test improved (p≤0.001 from the baseline phase to after review of the pamphlet, and again from the pamphlet review phase to after review of the video. Conclusions Using a robust testing process, we demonstrated usability and conceptual knowledge acquisition from a parent-directed educational

  17. A knowledge translation intervention to enhance clinical application of a virtual reality system in stroke rehabilitation.

    Science.gov (United States)

    Levac, Danielle; Glegg, Stephanie M N; Sveistrup, Heidi; Colquhoun, Heather; Miller, Patricia A; Finestone, Hillel; DePaul, Vincent; Harris, Jocelyn E; Velikonja, Diana

    2016-10-06

    Despite increasing evidence for the effectiveness of virtual reality (VR)-based therapy in stroke rehabilitation, few knowledge translation (KT) resources exist to support clinical integration. KT interventions addressing known barriers and facilitators to VR use are required. When environmental barriers to VR integration are less amenable to change, KT interventions can target modifiable barriers related to therapist knowledge and skills. A multi-faceted KT intervention was designed and implemented to support physical and occupational therapists in two stroke rehabilitation units in acquiring proficiency with use of the Interactive Exercise Rehabilitation System (IREX; GestureTek). The KT intervention consisted of interactive e-learning modules, hands-on workshops and experiential practice. Evaluation included the Assessing Determinants of Prospective Take Up of Virtual Reality (ADOPT-VR) Instrument and self-report confidence ratings of knowledge and skills pre- and post-study. Usability of the IREX was measured with the System Usability Scale (SUS). A focus group gathered therapist experiences. Frequency of IREX use was recorded for 6 months post-study. Eleven therapists delivered a total of 107 sessions of VR-based therapy to 34 clients with stroke. On the ADOPT-VR, significant pre-post improvements in therapist perceived behavioral control (p = 0.003), self-efficacy (p = 0.005) and facilitating conditions (p =0.019) related to VR use were observed. Therapist intention to use VR did not change. Knowledge and skills improved significantly following e-learning completion (p = 0.001) and was sustained 6 months post-study. Below average perceived usability of the IREX (19 th percentile) was reported. Lack of time was the most frequently reported barrier to VR use. A decrease in frequency of perceived barriers to VR use was not significant (p = 0.159). Two therapists used the IREX sparingly in the 6 months following the study. Therapists reported

  18. Knowledge, attitudes and clinical practice of blood products prescribers in Niamey.

    Science.gov (United States)

    Mayaki, Z; Kabo, R; Moutschen, M; Albert, A; Dardenne, N; Sondag, D; Gérard, C

    2016-05-01

    The lack of traceability and monitoring of blood donors and transfused patients constitute a barrier to the most basic rules of haemovigilance and overall good transfusion practices. This study draws up an inventory of knowledge, attitudes and clinical practice of blood prescribers in Niamey. A questionnaire was administered to 180 prescribers of blood products in Niamey in 2011. Questions were related to basic informations on blood transfusion and clinical use of blood. Analyses were performed using SAS 9.3 version. The sample consisted of 180 respondents from several professional categories: 51 physicians (28.33%), 10 medical students (5.56%), 84 nurses (46.67%), 15 anaesthesiologist assistant (8.33%) and 20 midwives (11.11%). Among these, 22.2% received training in blood transfusion safety. Half of the respondents (50.8%) got between 50 and 75% of correct answers, 45.8% got less than 50% correct while 3.35% scored more than 75% correct answers. The overall quality of responses was higher among physicians compared to other prescribers (Ptransfusion safety (Ptransfusion practices is necessary for prescribers of blood products. Accompanying measures to improve transfusion practice must be considered or strengthened through assessments, knowledge update/upgrade (regular, ongoing training) and establishment of active and motivated hospital transfusion committees. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  19. The Immunology of Neuromyelitis Optica-Current Knowledge, Clinical Implications, Controversies and Future Perspectives.

    Science.gov (United States)

    Jasiak-Zatonska, Michalina; Kalinowska-Lyszczarz, Alicja; Michalak, Slawomir; Kozubski, Wojciech

    2016-03-02

    Neuromyelitis optica (NMO) is an autoimmune, demyelinating disorder of the central nervous system (CNS) with typical clinical manifestations of optic neuritis and acute transverse myelitis attacks. Previously believed to be a variant of multiple sclerosis (MS), it is now considered an independent disorder which needs to be differentiated from MS. The discovery of autoantibodies against aquaporin-4 (AQP4-IgGs) changed our understanding of NMO immunopathogenesis and revolutionized the diagnostic process. AQP4-IgG is currently regarded as a specific biomarker of NMO and NMO spectrum disorders (NMOsd) and a key factor in its pathogenesis. Nevertheless, AQP4-IgG seronegativity in 10%-25% of NMO patients suggests that there are several other factors involved in NMO immunopathogenesis, i.e., autoantibodies against aquaporin-1 (AQP1-Abs) and antibodies against myelin oligodendrocyte glycoprotein (MOG-IgGs). This manuscript reviews current knowledge about NMO immunopathogenesis, pointing out the controversial issues and showing potential directions for future research. Further efforts should be made to broaden our knowledge of NMO immunology which could have important implications for clinical practice, including the use of potential novel biomarkers to facilitate an early and accurate diagnosis, and modern treatment strategies improving long-term outcome of NMO patients.

  20. The Immunology of Neuromyelitis Optica—Current Knowledge, Clinical Implications, Controversies and Future Perspectives

    Science.gov (United States)

    Jasiak-Zatonska, Michalina; Kalinowska-Lyszczarz, Alicja; Michalak, Slawomir; Kozubski, Wojciech

    2016-01-01

    Neuromyelitis optica (NMO) is an autoimmune, demyelinating disorder of the central nervous system (CNS) with typical clinical manifestations of optic neuritis and acute transverse myelitis attacks. Previously believed to be a variant of multiple sclerosis (MS), it is now considered an independent disorder which needs to be differentiated from MS. The discovery of autoantibodies against aquaporin-4 (AQP4-IgGs) changed our understanding of NMO immunopathogenesis and revolutionized the diagnostic process. AQP4-IgG is currently regarded as a specific biomarker of NMO and NMO spectrum disorders (NMOsd) and a key factor in its pathogenesis. Nevertheless, AQP4-IgG seronegativity in 10%–25% of NMO patients suggests that there are several other factors involved in NMO immunopathogenesis, i.e., autoantibodies against aquaporin-1 (AQP1-Abs) and antibodies against myelin oligodendrocyte glycoprotein (MOG-IgGs). This manuscript reviews current knowledge about NMO immunopathogenesis, pointing out the controversial issues and showing potential directions for future research. Further efforts should be made to broaden our knowledge of NMO immunology which could have important implications for clinical practice, including the use of potential novel biomarkers to facilitate an early and accurate diagnosis, and modern treatment strategies improving long-term outcome of NMO patients. PMID:26950113

  1. Evolution of the clinical and epidemiological knowledge about Chagas disease 90 years after its discovery

    Directory of Open Access Journals (Sweden)

    Prata Aluízio

    1999-01-01

    Full Text Available Three different periods may be considered in the evolution of knowledge about the clinical and epidemiological aspects of Chagas disease since its discovery: (a early period concerning the studies carried out by Carlos Chagas in Lassance with the collaboration of other investigators of the Manguinhos School. At that time the disease was described and the parasite, transmitters and reservoirs were studied. The coexistence of endemic goiter in the same region generated some confusion about the clinical forms of the disease; (b second period involving uncertainty and the description of isolated cases, which lasted until the 1940 decade. Many acute cases were described during this period and the disease was recognized in many Latin American countries. Particularly important were the studies of the Argentine Mission of Regional Pathology Studies, which culminated with the description of the Romaña sign in the 1930 decade, facilitating the diagnosis of the early phase of the disease. However, the chronic phase, which was the most important, continued to be difficult to recognize; (c period of consolidation of knowledge and recognition of the importance of Chagas disease. Studies conducted by Laranja, Dias and Nóbrega in Bambuí updated the description of Chagas heart disease made by Carlos Chagas and Eurico Villela. From then on, the disease was more easily recognized, especially with the emphasis on the use of a serologic diagnosis; (d period of enlargement of knowledges on the disease. The studies on denervation conducted in Ribeirão Preto by Fritz Köberle starting in the 1950 decade led to a better understanding of the relations between Chagas disease and megaesophagus and other visceral megas detected in endemic areas.

  2. [Physician knowledge and attitudes on the clinical evaluation and treatment of resistant hypertension: The RESIST study].

    Science.gov (United States)

    Coca, A

    Resistant hypertension (RH) is associated with a high risk of cardiovascular and renal complications. The purpose of this study was to assess the knowledge and attitudes of Primary Care physicians, general medicine doctors, and clinical cardiologists on the management of this condition. A multicentre, descriptive, observational study based on an ad hoc questionnaire distributed to Primary Care physicians (n=1017) and general medicine physicians/clinical cardiologists (n=457). To establish the diagnosis of resistant hypertension, 69.1% of physicians confirm that systolic/diastolic blood pressure is above 140/90 mmHg, despite treatment. Furthermore, 64.9% only consider this diagnosis if the patient is treated with at least 3 medications, and 50.3% also requires that one of them is a thiazide diuretic (56.7% among specialists, P=.0004). To establish a definite diagnosis of true RH, 89.6% perform 24-h ambulatory blood pressure monitoring (93.3% of specialists, P=.0017), looking specifically for «white-coat» effect in 70.2% of cases. In addition, 79.3% verify that adherence to treatment is adequate. Between 87 and 95% of physicians indicate examinations to exclude causes of secondary hypertension. Up to 54.3% of physicians (71.3% specialists, P<.0001) consider adding a fourth drug and insisting on lifestyle interventions as a priority therapeutic measure. These data show that physician knowledge regarding the management of patients with RH is good. Interestingly, this knowledge is somewhat higher among specialists than among Primary Care physicians. Copyright © 2016 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Multilateral Mediated Negotiation Protocols with Feedback (abstract)

    NARCIS (Netherlands)

    Aydogan, R.; Hindriks, K.V.; Jonker, C.M.

    2013-01-01

    Much attention has been paid to bilateral negotiation in which the dispute is between only two parties. However, automated multilateral negotiation in which more than two negotiating parties need to reach a joint agreement, has received relatively less attention, even though such negotiations are

  4. 48 CFR 15.405 - Price negotiation.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Price negotiation. 15.405... AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 15.405 Price negotiation. (a) The purpose of performing cost or price analysis is to develop a negotiation position that permits the...

  5. 32 CFR 644.544 - Negotiated sales.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Negotiated sales. 644.544 Section 644.544... ESTATE HANDBOOK Disposal Sale Procedure § 644.544 Negotiated sales. (a) To private parties. Negotiated sales to private parties are not viewed with favor. Generally, such negotiated sales will be approved...

  6. Knowledge in schizophrenia: The Portuguese version of KAST (Knowledge About Schizophrenia Test) and analysis of social-demographic and clinical factors' influence.

    Science.gov (United States)

    Daltio, C S; Attux, C; Ferraz, M B

    2015-10-01

    Schizophrenia is a complex disorder, and the knowledge about it can have a positive impact. The purpose of this study was to make the translation and cultural adaptation of the Knowledge About Schizophrenia Test (KAST) into Portuguese and determine the influence of clinical and socio-demographic factors on knowledge. The test was applied to 189 caregivers of patients enrolled in Schizophrenia Program of the Federal University of São Paulo, 30 caregivers of clinical patients of the General Outpatient Clinic of the same University, and 30 health professionals. The face and content validity of the test was established. The mean value (SD) obtained with the application of the final version to caregivers of schizophrenic patients was 12.96 (2.45) - maximum 17. Level of knowledge increased considering the following order: caregivers of clinical patients, caregivers of patients with schizophrenia and mental health professionals. The intraclass correlation coefficient (0.592) obtained in the test-retest was statistically significant. An influence of social class, race, gender and education of the caregiver on the test was observed, and the last two factors were more relevant. The KAST translated and adapted into Portuguese is a valid instrument and can be used as an evaluation tool on psychoeducational interventions. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. EFL Learners’ Negotiation of Meaning

    Directory of Open Access Journals (Sweden)

    Samira Saeed Rashid Al Hosni

    2014-01-01

    Full Text Available This study aimed at investigating EFL learners’ frequency of negotiation of meaning when performing focused and unfocused communication tasks. The sample consists of thirty learners divided into ten groups. Three research instruments were used to collect data; communication tasks, field notes and interviews. Data analysis revealed that there is no significant difference in the frequency of negotiation of meaning between the two task types. This is due to the fact that, learners performed both task types as unfocused tasks and they were able to use some communication strategies to keep communication flowing and to go round the target structure. Amazingly, despite the existence of the trigger of negotiation, the indicator of misunderstanding, an important negotiation phase, was absent in many cases from the conversations in both task types. Subsequently, the research findings suggest providing learners with opportunities that urge them to perform as language users rather than language learners.

  8. Negotiation platform for personalised advertising

    OpenAIRE

    Sousa, Luís Ventura de; Malheiro, Benedita; Foss, Jerry

    2012-01-01

    This paper describes a multi-agent brokerage platform for near real time advertising personalisation organised in three layers: user interface, agency and marketplace. The personalisation is based on the classification of viewer profiles and advertisements (ads). The goal is to provide viewers with a personalised advertising alignment during programme intervals. The enterprise interface agents upload new ads and negotiation profiles to producer agents and new user and negotiation profiles to ...

  9. Breast-conserving therapy as a model for creating new knowledge in clinical oncology

    International Nuclear Information System (INIS)

    Harris, Jay R.

    1995-01-01

    New knowledge can be derived from various kinds of studies. Studies of innovative approaches are the basis for progress. Some advances in treatment are so obvious that they do not need formal testing; e.g., penicillin for pneumococcal infection. For comparing interventions with small differences in efficacy or in groups without predictable outcome, prospective randomized trials are the 'gold standard'. However, randomized trials are cumbersome, expensive, and potentially difficult for both patients and physicians. Retrospective studies are less valid scientifically because they are more likely to suffer from bias, misclassification, confounding variables, and the use of multiple comparisons. Retrospective studies can be made more valid by first specifying the study design and analysis, but are generally most useful to generate hypotheses to be tested more formally. Retrospective studies can be particularly useful in improving outcome by identifying 'problems' and their causes. An important issue for radiation oncologists in doing retrospective studies is the difficulty of assessing an effect on local tumor control in diseases in which there are competing risks of local and distant failure. Many of these points will be illustrated in studies from the Joint Center for Radiation Therapy. Studies of innovative approaches, retrospective reviews and prospective randomized clinical trials have all been useful in establishing breast-conserving therapy as a safe and effective treatment for patients with early-stage breast cancer. Several studies of innovative breast-conserving therapy beginning in the 1960's showed favorable results. Based on this experience, a series of randomized clinical trials were initiated, beginning in the early 1970's, formally comparing mastectomy and breast-conserving therapy. These trials firmly established that the two forms of local treatment provide equivalent survival. Additional retrospective studies have also been useful in establishing

  10. Negotiation without Justice

    Directory of Open Access Journals (Sweden)

    Luis Eduardo Hoyos

    2006-04-01

    Full Text Available Resumen:El artículo propone una reflexión filosófica inspirada en la actual situación de fragilidad institucional colombiana. Se arguye en él: (1 Que hay un elemento pragmático y uno normativo en la idea de que las instituciones políticas y sociales establecen y aseguran la vida humana y la hacen duradera. (2 Que la tradición de la negociación con agentes armados en Colombia en los últimos años se ha caracterizado por la ruptura del equilibrio entre este elemento pragmático y el normativo.Abstract:The paper presents a philosophical reflection inspired by Colombia’s ongoing institutional fragility. It argues: (1 that the idea of political and social institutions for establishing and safeguarding human life contains both a pragmatic and a normative element, and (2 that Colombia’s tradition of negotiation with armed actors has been characterized in the last years by a breakdown in the balance between these pragmatic and normative elements.

  11. Knowledge-based verification of clinical guidelines by detection of anomalies.

    Science.gov (United States)

    Duftschmid, G; Miksch, S

    2001-04-01

    As shown in numerous studies, a significant part of published clinical guidelines is tainted with different types of semantical errors that interfere with their practical application. The adaptation of generic guidelines, necessitated by circumstances such as resource limitations within the applying organization or unexpected events arising in the course of patient care, further promotes the introduction of defects. Still, most current approaches for the automation of clinical guidelines are lacking mechanisms, which check the overall correctness of their output. In the domain of software engineering in general and in the domain of knowledge-based systems (KBS) in particular, a common strategy to examine a system for potential defects consists in its verification. The focus of this work is to present an approach, which helps to ensure the semantical correctness of clinical guidelines in a three-step process. We use a particular guideline specification language called Asbru to demonstrate our verification mechanism. A scenario-based evaluation of our method is provided based on a guideline for the artificial ventilation of newborn infants. The described approach is kept sufficiently general in order to allow its application to several other guideline representation formats.

  12. Newly graduated nurses use of knowledge sources in clinical decison-making - a qualitative study

    DEFF Research Database (Denmark)

    Voldbjerg, Siri

    Evidence-based practice has been introduced internationally as a standard for healthcare delivery to improve the quality of care, thus ensuring safe care and treatment. Evidence-based practice calls for a decision-making that specifically requires nurses to place the patient at the centre...... of clinical decisions, based on transparent, articulate and reflective use of knowledge sources. Furthermore, it is implied that nurses are able to retrieve, asses, implement and evaluate research evidence. To meet these requirements, nursing educations around the world have organised curricula to educate...... and support future nurses, enabling them to work within a framework of evidence-based practice. Recent studies underline that despite curricula interventions, newly graduated nurses’ use of research evidence and components within evidence-based practice is limited. However, it is unclear why the newly...

  13. Key principles for a national clinical decision support knowledge sharing framework: synthesis of insights from leading subject matter experts.

    Science.gov (United States)

    Kawamoto, Kensaku; Hongsermeier, Tonya; Wright, Adam; Lewis, Janet; Bell, Douglas S; Middleton, Blackford

    2013-01-01

    To identify key principles for establishing a national clinical decision support (CDS) knowledge sharing framework. As part of an initiative by the US Office of the National Coordinator for Health IT (ONC) to establish a framework for national CDS knowledge sharing, key stakeholders were identified. Stakeholders' viewpoints were obtained through surveys and in-depth interviews, and findings and relevant insights were summarized. Based on these insights, key principles were formulated for establishing a national CDS knowledge sharing framework. Nineteen key stakeholders were recruited, including six executives from electronic health record system vendors, seven executives from knowledge content producers, three executives from healthcare provider organizations, and three additional experts in clinical informatics. Based on these stakeholders' insights, five key principles were identified for effectively sharing CDS knowledge nationally. These principles are (1) prioritize and support the creation and maintenance of a national CDS knowledge sharing framework; (2) facilitate the development of high-value content and tooling, preferably in an open-source manner; (3) accelerate the development or licensing of required, pragmatic standards; (4) acknowledge and address medicolegal liability concerns; and (5) establish a self-sustaining business model. Based on the principles identified, a roadmap for national CDS knowledge sharing was developed through the ONC's Advancing CDS initiative. The study findings may serve as a useful guide for ongoing activities by the ONC and others to establish a national framework for sharing CDS knowledge and improving clinical care.

  14. Spinal Cord Injury Clinical Registries: Improving Care across the SCI Care Continuum by Identifying Knowledge Gaps.

    Science.gov (United States)

    Dvorak, Marcel F; Cheng, Christiana L; Fallah, Nader; Santos, Argelio; Atkins, Derek; Humphreys, Suzanne; Rivers, Carly S; White, Barry A B; Ho, Chester; Ahn, Henry; Kwon, Brian K; Christie, Sean; Noonan, Vanessa K

    2017-10-15

    Timely access and ongoing delivery of care and therapeutic interventions is needed to maximize recovery and function after traumatic spinal cord injury (tSCI). To ensure these decisions are evidence-based, access to consistent, reliable, and valid sources of clinical data is required. The Access to Care and Timing Model used data from the Rick Hansen SCI Registry (RHSCIR) to generate a simulation of healthcare delivery for persons after tSCI and to test scenarios aimed at improving outcomes and reducing the economic burden of SCI. Through model development, we identified knowledge gaps and challenges in the literature and current health outcomes data collection throughout the continuum of SCI care. The objectives of this article were to describe these gaps and to provide recommendations for bridging them. Accurate information on injury severity after tSCI was hindered by difficulties in conducting neurological assessments and classifications of SCI (e.g., timing), variations in reporting, and the lack of a validated SCI-specific measure of associated injuries. There was also limited availability of reliable data on patient factors such as multi-morbidity and patient-reported measures. Knowledge gaps related to structures (e.g., protocols) and processes (e.g., costs) at each phase of care have prevented comprehensive evaluation of system performance. Addressing these knowledge gaps will enhance comparative and cost-effectiveness evaluations to inform decision-making and standards of care. Recommendations to do so were: standardize data element collection and facilitate database linkages, validate and adopt more outcome measures for SCI, and increase opportunities for collaborations with stakeholders from diverse backgrounds.

  15. Intravenous to oral conversion of fluoroquinolones: knowledge versus clinical practice patterns.

    Science.gov (United States)

    Conort, Ornella; Gabardi, Steven; Didier, Marie-Pauline; Hazebroucq, Georges; Cariou, Alain

    2002-04-01

    To assess the knowledge of prescribers regarding intravenous to oral conversions of fluoroquinolones, the frequency and time until conversion, and to compare prescriber knowledge with the data collected concerning the reasons stated for continuation of intravenous fluoroquinolones. Prospective chart review and questionnaire. Large teaching hospital in Paris, France. Fifty-one males and females. Data were collected on in-patients receiving intravenous fluoroquinolone for at least three days and hospitalized in one of six in-patient units. Patients receiving intravenous fluoroquinolone for less than three days were excluded. A questionnaire to assess the awareness of a potential conversion was distributed to those practitioners who had patients reviewed during the data-collection phase. The questionnaire revealed the ten most common reasons for continuing intravenous administration for more than three days. However, the physicians agreed that most patients should be converted as soon as possible. Practice patterns differed, with only 17 of 51 patients actually converted to oral therapy. In theory, the clinicians were aware of when to perform the conversion. However, in practice, the frequency of conversion was lower than optimum. Changes in clinical practice are needed to decrease the costs of intravenous therapy, without jeopardizing quality of care.

  16. The problem-oriented system, problem-knowledge coupling, and clinical decision making.

    Science.gov (United States)

    Weed, L L; Zimny, N J

    1989-07-01

    The information tool to aid us in making the clinical decisions discussed in this presentation is called the PKC. Our goal with patients should be to couple the knowledge of the unique patient to the knowledge in the literature and get the best possible match. This approach requires combinatorial versus probabilistic thinking. In the real world, ideal matches are not found. Therefore, it is critical to exhaust the patient's uniqueness first and only then use probabilities to settle further uncertainties. It is an error to teach people how to deal with uncertainty instead of teaching them to clean up a great deal of the uncertainty first. Patients must be involved in this endeavor. In essence, they have a PhD in their own uniqueness, and it is this uniqueness that is very powerful in solving complex problems. This method of patient evaluation and management cannot be used with the unaided mind. It requires new and powerful information tools like the PKC. All information that is relevant to a problem should be included in the coupler. It should encompass differing points of view, and the rationale should be made explicit to clinician and patient alike. When complete, the coupler should represent an interdisciplinary compilation of questions and tests that are expected to be collected every time in the clinic for the type of problem the coupler represents. This method will provide a basis for quality control because the contents of the coupler now have defined what we expect to occur in every patient encounter.(ABSTRACT TRUNCATED AT 250 WORDS)

  17. Associations between the decrease in bovine clinical mastitis and changes in dairy farmers' attitude, knowledge, and behavior in the Netherlands

    NARCIS (Netherlands)

    van den Borne, B. H P; Lam, T. J G M; van Schaik, G.

    2014-01-01

    The aim of this study was to associate changes in dairy farmers' self-reported attitude, knowledge, and behavior with the decrease in incidence rate of clinical mastitis (IRCM). Farmer-diagnosed clinical mastitis cases were obtained from two surveys conducted before (July 2004-June 2005) and at the

  18. Associations between the decrease in bovine clinical mastitis and changes in dairy farmers' attitude, knowledge, and behavior in the Netherlands

    NARCIS (Netherlands)

    Borne, van den B.H.P.; Jansen, J.; Lam, T.J.G.M.; Schaik, van G.

    2014-01-01

    The aim of this study was to associate changes in dairy farmers' self-reported attitude, knowledge, and behavior with the decrease in incidence rate of clinical mastitis (IRCM). Farmer-diagnosed clinical mastitis cases were obtained from two surveys conducted before (July 2004–June 2005) and at the

  19. Optimization of Multiple Related Negotiation through Multi-Negotiation Network

    Science.gov (United States)

    Ren, Fenghui; Zhang, Minjie; Miao, Chunyan; Shen, Zhiqi

    In this paper, a Multi-Negotiation Network (MNN) and a Multi- Negotiation Influence Diagram (MNID) are proposed to optimally handle Multiple Related Negotiations (MRN) in a multi-agent system. Most popular, state-of-the-art approaches perform MRN sequentially. However, a sequential procedure may not optimally execute MRN in terms of maximizing the global outcome, and may even lead to unnecessary losses in some situations. The motivation of this research is to use a MNN to handle MRN concurrently so as to maximize the expected utility of MRN. Firstly, both the joint success rate and the joint utility by considering all related negotiations are dynamically calculated based on a MNN. Secondly, by employing a MNID, an agent's possible decision on each related negotiation is reflected by the value of expected utility. Lastly, through comparing expected utilities between all possible policies to conduct MRN, an optimal policy is generated to optimize the global outcome of MRN. The experimental results indicate that the proposed approach can improve the global outcome of MRN in a successful end scenario, and avoid unnecessary losses in an unsuccessful end scenario.

  20. ADSLANF: A negotiation framework for cloud management systems using a bulk negotiation behavioral learning approach

    OpenAIRE

    RAJAVEL, RAJKUMAR; THANGARATHINAM, MALA

    2017-01-01

    One of the major challenges in cloud computing is the development of a service-level agreement (SLA) negotiation framework using an intelligent third-party broker negotiation strategy. Current frameworks exploit various negotiation strategies using game theoretic, heuristic, and argumentation-based approaches for obtaining optimal negotiation with a better success rate (negotiation commitment). However, these approaches fail to optimize the negotiation round (NR), total negotiatio...

  1. An Evolutionary Approach to the Climate Change Negotiation Game

    Energy Technology Data Exchange (ETDEWEB)

    Courtois, P. [CIRED and University of Paris, Paris (France); Pereau, J.C. [OEP, University of Marne-la-Vallee, Marne-la-Vallee (France); Tazdait, T. [CIRED and OEP, University of Marne-la-Vallee, Marne-la-Vallee (France)

    2001-10-01

    We describe in this paper an evolutionary game theoretic model aiming at representing the climate change negotiation. The model is used to examine the outcome of climate change negotiations in a framework which seeks to closely represent negotiation patterns. Evolutionary setting allows us to consider a decision making structure characterised by agents with bounded knowledge practising mimics and learning from past events and strategies. We show on that framework that a third significant alternative to the binary coordination-defection strategies needs to be considered: a unilateral commitment as precautionary strategy. As a means to widen cooperation, we examine the influence of linking environmental and trade policies via the implementation of a trade penalty on non cooperative behaviours.

  2. An Evolutionary Approach to the Climate Change Negotiation Game

    International Nuclear Information System (INIS)

    Courtois, P.; Pereau, J.C.; Tazdait, T.

    2001-10-01

    We describe in this paper an evolutionary game theoretic model aiming at representing the climate change negotiation. The model is used to examine the outcome of climate change negotiations in a framework which seeks to closely represent negotiation patterns. Evolutionary setting allows us to consider a decision making structure characterised by agents with bounded knowledge practising mimics and learning from past events and strategies. We show on that framework that a third significant alternative to the binary coordination-defection strategies needs to be considered: a unilateral commitment as precautionary strategy. As a means to widen cooperation, we examine the influence of linking environmental and trade policies via the implementation of a trade penalty on non cooperative behaviours

  3. Knowledge and critical thinking skills increase clinical reasoning ability in urogenital disorders: a Universitas Sriwijaya Medical Faculty experience

    Directory of Open Access Journals (Sweden)

    Irfannuddin Irfannuddin

    2009-03-01

    Full Text Available Aim Clinical reasoning is one of the essential competencies for medical practitioners, so that it must be exercised by medical students. Studies on quantitative evidence of factors influencing clinical reasoning abilicy of students are limited. The aim of this study was to determine the influence of knowledge and other factors on the clinical reasoning abiliry ofthe students, which can serve as reference to establish methods for learning ctinical reasoning.Methods This is a cross-sectional study on fourth semester students enrolled in the Competency-based Curriculum of the Medical Faculty, University of Sriwijaya. Data on clinical reasoning abilily and risk factors during urogenital blockwere collected inApril 2008, when the students have just completed the btock. Clinical reasoning abiliry was tested using the Script Concordance test and the risk factors were evaluated based on formative tests, block summative assessments, and student characteristics. Data were analyzed by Cox regression.Results The prevalence of low clinical reasoning ability of the 132 students was 38.6%. The group with low basic knowledge was found to have 63% risk ol low clinical reasoning abiliry when compared to those with high basic knowledge (adjusted RR = 1.63; 95% conidence intewal (Ct: 1.10 -2.42. When compared to students with high critical thinking skitls, those with lory critical thinking skills had 2.3 time to be low clinical reasoning abitity (adjusted RR : 2.30; 95% CI: 1.55 - 3.41.Conclusion Students with low critical thinking skills or with inadequate knowledge had a higher risk of low clinical reasoning ability. (Med J Indones 2009; 18: 53-9Keywords: clinical reasoning, basic knowledge, critical thinking, competency-based curriculum

  4. TrustBuilder2: A Reconfigurable Framework for Trust Negotiation

    Science.gov (United States)

    Lee, Adam J.; Winslett, Marianne; Perano, Kenneth J.

    To date, research in trust negotiation has focused mainly on the theoretical aspects of the trust negotiation process, and the development of proof of concept implementations. These theoretical works and proofs of concept have been quite successful from a research perspective, and thus researchers must now begin to address the systems constraints that act as barriers to the deployment of these systems. To this end, we present TrustBuilder2, a fully-configurable and extensible framework for prototyping and evaluating trust negotiation systems. TrustBuilder2 leverages a plug-in based architecture, extensible data type hierarchy, and flexible communication protocol to provide a framework within which numerous trust negotiation protocols and system configurations can be quantitatively analyzed. In this paper, we discuss the design and implementation of TrustBuilder2, study its performance, examine the costs associated with flexible authorization systems, and leverage this knowledge to identify potential topics for future research, as well as a novel method for attacking trust negotiation systems.

  5. The Developmental Brain Disorders Database (DBDB): a curated neurogenetics knowledge base with clinical and research applications.

    Science.gov (United States)

    Mirzaa, Ghayda M; Millen, Kathleen J; Barkovich, A James; Dobyns, William B; Paciorkowski, Alex R

    2014-06-01

    The number of single genes associated with neurodevelopmental disorders has increased dramatically over the past decade. The identification of causative genes for these disorders is important to clinical outcome as it allows for accurate assessment of prognosis, genetic counseling, delineation of natural history, inclusion in clinical trials, and in some cases determines therapy. Clinicians face the challenge of correctly identifying neurodevelopmental phenotypes, recognizing syndromes, and prioritizing the best candidate genes for testing. However, there is no central repository of definitions for many phenotypes, leading to errors of diagnosis. Additionally, there is no system of levels of evidence linking genes to phenotypes, making it difficult for clinicians to know which genes are most strongly associated with a given condition. We have developed the Developmental Brain Disorders Database (DBDB: https://www.dbdb.urmc.rochester.edu/home), a publicly available, online-curated repository of genes, phenotypes, and syndromes associated with neurodevelopmental disorders. DBDB contains the first referenced ontology of developmental brain phenotypes, and uses a novel system of levels of evidence for gene-phenotype associations. It is intended to assist clinicians in arriving at the correct diagnosis, select the most appropriate genetic test for that phenotype, and improve the care of patients with developmental brain disorders. For researchers interested in the discovery of novel genes for developmental brain disorders, DBDB provides a well-curated source of important genes against which research sequencing results can be compared. Finally, DBDB allows novel observations about the landscape of the neurogenetics knowledge base. © 2014 Wiley Periodicals, Inc.

  6. Knowledge and attitudes on sexuality among nurses in a family planning clinic in Kuala Lumpur.

    Science.gov (United States)

    Mat Saat Baki

    1983-12-01

    The study reported served 2 purposes: 1) to assess the amount of sexual information posessed by a sample of staff nurses working for the National Family Planning Board and the Public Health Dept., and 2) to gather local normative data on the Information Subtest of the Derogatis Sexual Functioning Inventory (DSFI). The subjects for the this study were 2 groups of staff nurses. 10 were employees of the National Family Planning Board currently working in 1 of its clinics and 25 were public health nurses who were at a 1 week training at the clinic. The research was a questionnaire type study. Each subject was given the DSFI. On the Information Subtest of the DSFI the subjects obtained a mean score of 12.7 with a standard deviation of 4.2. This score is much lower than the normative mean (American population) and the sexually dysfunctional women mean. The nurses had inadequate and inaccurate knowledge about anatomy, physiology and psychology of sexual relations. Error analysis revealed that as a group they had poor understanding about male sexuality, the effect of aging on sexuality fertility and menopause, and difficulty in accepting oral-genital sex and sexual fantasies. This study recommends that these nurses, in order to more effective in their work, should be trained in the area of human sexuality. This training must include not only the physiology of sex but also the human aspects of sexual union.

  7. Knowledge, attitude and practice towards child adoption amongst women attending infertility clinics in Lagos State, Nigeria

    Directory of Open Access Journals (Sweden)

    Adenike O. Omosun

    2011-10-01

    Full Text Available Background: Child adoption is a recommended alternative form of infertility management. Infertility is of public health importance in Nigeria and many other developing nations. This is a result of its high prevalence and especially because of its serious social implications as the African society places a passionate premium on procreation in any family setting. Objectives: The aim of this study was to determine the knowledge, attitude and practice of child adoption amongst women attending infertility clinics in teaching hospitals in Lagos State and to determine the factors that influence their attitude and practice towards it. Method: A cross-sectional descriptive design was used. Data were collected by using a structured questionnaire which was interviewer-administered. The study was conducted in the two teaching hospitals in Lagos State (LUTH [Lagos University Teaching Hospital] and LASUTH [Lagos State University Teaching Hospital] from amongst 350 women attending the gynaecological clinics. All the patients under management for infertility at the gynaecology clinics during the period of the study were interviewed. Results: Many respondents (85.7% had heard of child adoption and 59.3% of them knew the correct meaning of the term. More than half of the respondents (68.3% said that they could love an adopted child but less than half of them (33.7% were willing to consider adoption. Only 13.9% has ever adopted a child. The major reason given for their unwillingness to adopt was their desire to have their own biological child. Factors that were favourable towards child adoption were Igbo tribe identity, an age above 40 years, duration of infertility above 15 years, and knowing the correct meaning of child adoption. Conclusion: There is a poor attitude to adoption even amongst infertile couples. Interventions need to be implemented to educate the public on child adoption, to improve their attitude towards adoption and to make it more acceptable.

  8. Pharmacy Students’ Knowledge and Attitude toward Registration Trials and Clinical Research: A Survey in a Japanese University Hospital

    Directory of Open Access Journals (Sweden)

    Natsuko Ise

    2017-12-01

    Full Text Available Clinical research plays a fundamental role in establishing new treatments. Clinical research coordinators are considered essential in clinical research, and medical professionals such as pharmacists often take on this role. Pharmacy students can be considered future candidates for this task. We used questionnaires to survey the knowledge of and attitudes toward registration trials and clinical research of pharmacy students at Tokushima University Hospital. All pharmacy students (103 to whom questionnaires were sent responded. Almost all respondents were aware of registration trials and clinical research. More than 90% were aware of the existence of clinical research coordinators, and about half (48.6% understood their role. In clinical research terminology, most respondents were aware of informed consent and related issues, but fewer than 20% were aware of more practical things. In total, 29.1% and 40.8% of the respondents were willing to carry out and coordinate research. These findings suggest that pharmacy students have basic knowledge of clinical research and that many students are willing to carry out and coordinate clinical research. More practical exposure to clinical research may help to strengthen their future contribution. Further studies may help to determine how to provide education on registration trials and clinical research to pharmacy students.

  9. Comparison of clinical knowledge bases for summarization of electronic health records.

    Science.gov (United States)

    McCoy, Allison B; Sittig, Dean F; Wright, Adam

    2013-01-01

    Automated summarization tools that create condition-specific displays may improve clinician efficiency. These tools require new kinds of knowledge that is difficult to obtain. We compared five problem-medication pair knowledge bases generated using four previously described knowledge base development approaches. The number of pairs in the resulting mapped knowledge bases varied widely due to differing mapping techniques from the source terminologies, ranging from 2,873 to 63,977,738 pairs. The number of overlapping pairs across knowledge bases was low, with one knowledge base having half of the pairs overlapping with another knowledge base, and most having less than a third overlapping. Further research is necessary to better evaluate the knowledge bases independently in additional settings, and to identify methods to integrate the knowledge bases.

  10. Knowledge and attitude toward vasectomy among antenatal clinic attendees in a tertiary health facility in Nigeria

    Directory of Open Access Journals (Sweden)

    Nyengidiki Kennedy Tamunomie

    2016-01-01

    Full Text Available Background: Nigeria is the most populous nation in Africa and has a high fertility rate and low contraceptive prevalence. Various strategies have been developed to reduce the fertility rates, all aimed toward increasing contraceptive prevalence. Male sterilization is a safe, cheap, and effective method of contraception, but female perception and awareness of vasectomy may greatly affect its utilization. Objective: To determine the knowledge and attitude of antenatal patients in a Nigerian tertiary health facility toward vasectomy. Subjects and Methods: A cross-sectional study was conducted among antenatal clinic attendees. The participants were selected via systematic random sampling technique and a structured pretested questionnaire was used to assess their knowledge and attitude toward vasectomy. Data analysis was done using SPSS version 17 statistical software for windows XP and results were expressed in percentages. Results: One hundred and fifty respondents participated in the study, 83 (55.3% were aware of vasectomy, 59 (71.08% accepted it as a method of male contraception, and only 23 (38.98% approved its use for their spouse. The main source of information on vasectomy was from health workers 53 (63.86%. Almost half of the women (47.8% who accepted vasectomy did so because they felt men should also participate in family planning. Most of the women who disapproved of vasectomy cited it as an unpopular method. Conclusion: The approval of use of vasectomy by female partners is poor. Majority of these patients would not recommend it to their spouse as they have wrong perception of the procedure. Re-education of medical workers and wider public education through mass media may improve the approval of vasectomy by women for their spouses.

  11. Negotiation: How to Be Effective.

    Science.gov (United States)

    Weiss, Arnold-Peter C

    2017-01-01

    The art of successful negotiation is not as random or difficult as it might seem at first glance. Most negotiations end up with both sides receiving something of value as well as giving up something valuable in return. It has been said that the best negotiated outcomes occur when both parties walk away a bit disappointed or just a little bit happy. The goal of this short primer is to give some hints as to how to get a slightly better deal than the other party most of the time. There are several points to remember to be able to achieve such an outcome frequently. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  12. Do knowledge brokers facilitate implementation of the stroke guideline in clinical practice?

    Science.gov (United States)

    Willems, Mia; Schröder, Carin; Post, Marcel; van der Weijden, Trudy; Visser-Meily, Anne

    2013-10-23

    The implementation of clinical practice guidelines in rehabilitation practice is often troublesome and incomplete. An intervention to enhance the implementation of guidelines is the knowledge transfer program built around the activities of a knowledge broker (KB).This study investigates the use of KBs to implement guideline recommendations for intensive therapy and physical activity for patients post-stroke in 22 stroke units in hospitals and rehabilitation centers in The Netherlands. This study includes a quantitative evaluation with a non controlled pre-post intervention design and a mixed methods process evaluation. From each stroke unit, enterprising nurses and therapists will be recruited and trained as KB. The KB will work for one year on the implementation of the guideline recommendations in their team. To evaluate the effectiveness of the KB, a questionnaire will be administered to patients, health professionals and KBs at baseline (T0) and after one year (T1). Furthermore, semi structured interviews with 5 KBs will be performed at T1.The primary outcome of this implementation project will be the support health professionals give patients to exercise and be physically active, as reported by patients and health professionals themselves. The support immediately after the intervention is compared with the support at the start of the intervention.Additionally we will explore the influence of socio-demographic characteristics of health professionals and determinants identified in the Theory of Planned Behavior (intention, attitude, subjective norm and perceived behavioral control) on the change of supportive behavior of health professionals. Finally, KBs will complete a questionnaire on their own psychological and social demographic characteristics and on organizational conditions needed for health-care improvement such as time, workforce, sponsoring and support from management. With this study we will gain insight in when and why knowledge brokers seem to be

  13. Three Tier Unified Process Model for Requirement Negotiations and Stakeholder Collaborations

    Science.gov (United States)

    Niazi, Muhammad Ashraf Khan; Abbas, Muhammad; Shahzad, Muhammad

    2012-11-01

    This research paper is focused towards carrying out a pragmatic qualitative analysis of various models and approaches of requirements negotiations (a sub process of requirements management plan which is an output of scope managementís collect requirements process) and studies stakeholder collaborations methodologies (i.e. from within communication management knowledge area). Experiential analysis encompass two tiers; first tier refers to the weighted scoring model while second tier focuses on development of SWOT matrices on the basis of findings of weighted scoring model for selecting an appropriate requirements negotiation model. Finally the results are simulated with the help of statistical pie charts. On the basis of simulated results of prevalent models and approaches of negotiations, a unified approach for requirements negotiations and stakeholder collaborations is proposed where the collaboration methodologies are embeded into selected requirements negotiation model as internal parameters of the proposed process alongside some external required parameters like MBTI, opportunity analysis etc.

  14. Oral health knowledge among pre-clinical students of International Branch of Shiraz University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    2015-01-01

    Full Text Available   Background and Aims: Oral health is an important issue in public health with a great impact on individuals’ general health status. A good access to oral healthcare services and a good knowledge of it play a key role in the oral disease prevention. A better health attitude and practice require a better knowledge. The aims of this study was to evaluate the oral health knowledge among the International students branch (Kish of Shiraz University of Medical Sciences in 2011-12.   Materials and Methods: 159 pre-clinical students in medicine (54 students, dentistry (69 students and pharmacy (36 students participated in this research. A standard questionnaire was used as the main tool of research to evaluate the attitude and knowledge of students about the oral health. Data were analyzed using Chi-square test.   Results: According to the results, dental students had the best level of knowledge and pharmacy students had a better knowledge level compared to the medical students. The results also showed a significant relationship between students’ oral health knowledge and their field and duration of study and the place of their secondary school (P0.05.   Conclusion: The results showed that the students at the International Branch of Shiraz University of Medical Sciences had a relatively good knowledge of oral health. Students’ knowledge level can be improved by providing students with educational materials, organized workshops and seminars.

  15. Commercial negotiations in the foundry engineering

    Directory of Open Access Journals (Sweden)

    L. Wojtynek

    2008-10-01

    Full Text Available The article presents the process of commercial negotiations paying attention to the negotiation itself as well as to its basic elements. The specificity of the Polish foundries’ main negotiation partners from The European Union, who are the deliverers of diverse casting range, was specified. The most important cultural factors, which determine the process of negotiations conducted by the representatives of various cultural groups, were analysed. The understanding of cultural differences and adapting to them while negotiating are important factors which constitute the parties’ negotiation process. The meaning of price in the commercial negotiation process was described. The elements of sale process and the factors which influence the casts price were enumerated. What is more, the main methods of determining price were characterized. The essential problems connected with conducting the price negotiations in foundries were indicated.

  16. The science of culture and negotiation.

    Science.gov (United States)

    Gunia, Brian C; Brett, Jeanne M; Gelfand, Michele J

    2016-04-01

    Recent negotiation research has produced a groundswell of insights about the effects of culture on negotiation. Yet, few frameworks exist to organize the findings. This review integrates recent research using a two-dimensional framework: The first dimension organizes the research into that which has taken: (1) a comparative intracultural approach, versus (2) an intercultural approach. The second dimension organizes the research by its emphasis on: (1) inputs into negotiation, (2) processes of negotiating, and (3) outcomes of negotiation. This framework helps to organize extant research and produces novel insights about the connections between disparate research streams, revealing both commonalities and culture-specificities in negotiation strategy and outcomes and suggesting that intercultural negotiations are difficult but not insurmountable. We conclude by discussing several areas in which more research on culture and negotiation is urgently needed in today's globalizing world. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. International negotiations in the foundry engineering

    Directory of Open Access Journals (Sweden)

    L. Wojtynek

    2008-04-01

    Full Text Available The aim of this paper is to introduce the essence of negotiations in general, which could find it’s application in foundry engineering. The paper is the result of long cooperation of the authors with foundry engineering and their participation in negotiations between the domestic and foreign companies. In this paper the essence and the rules of negotiations have been introduced. It presents also the skills and abilities of the negotiators. The cycle of negotiations and the following stages of negotiations have been also described. The authors have presented the characteristics of negotiations led by the partners from different parts of the world with particular emphasize on Asian and European countries as with these partners the negotiations in Polish foundries are mainly led.

  18. Core competencies for natural resource negotiation

    Science.gov (United States)

    Gillette, S.C.; Lamb, B.L.

    2005-01-01

    Natural resource negotiation often involves multiple parties with overlapping interests and issues that can provide opportunities for mutually beneficial solutions. These opportunities can be missed, however, if negotiators are unable to comprehend the facts of a negotiation, understand the interests of other parties, or accurately evaluate the options that increase the size of the negotiation pie. Through structured personal interviews with more than 60 representatives from seven different hydropower negotiations, respondents identified core competencies that help negotiators succeed at accurately comprehending the facts of a negotiation, comprehending the interests of other parties, and fully understanding the available options and alternatives. We categorized those core competencies into three dimensions of negotiation - interpersonal, organizational, and operational.

  19. 48 CFR 19.808 - Contract negotiation.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Contract negotiation. 19.808 Section 19.808 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION SOCIOECONOMIC....808 Contract negotiation. ...

  20. Enhancing Negotiation Skills Using Foreign Service Simulations

    Science.gov (United States)

    Opt, Susan

    2017-01-01

    Courses: Conflict communication, negotiation, small group. Objective: This activity will enhance students' awareness and critique of their own negotiation behaviors. A list of references and suggested readings is included.

  1. Cultural Differences in International Business Negotiation

    Institute of Scientific and Technical Information of China (English)

    曹悦

    2009-01-01

    This article analyzes the relationship of cultural differences on international business negotiations. And also, it emphases on the importance of understanding and mastering cultural differences in international business negotiations.

  2. Negotiation in Academic Medicine: Narratives of Faculty Researchers and Their Mentors

    Science.gov (United States)

    Sambuco, Dana; Dabrowska, Agata; DeCastro, Rochelle; Stewart, Abigail; Ubel, Peter A.; Jagsi, Reshma

    2013-01-01

    Purpose Few researchers have explored the negotiation experiences of academic medical faculty even though negotiation is crucial to their career success. The authors sought to understand medical faculty researchers' experiences with and perceptions of negotiation. Method Between February 2010 and August 2011, the authors conducted semi-structured, in-depth telephone interviews with 100 former recipients of National Institutes of Health mentored career development awards and 28 of their mentors. Purposive sampling ensured a diverse range of viewpoints. Multiple analysts thematically coded verbatim transcripts using qualitative data analysis software. Results Participants described the importance of negotiation in academic medical careers but also expressed feeling naïve and unprepared for these negotiations, particularly as junior faculty. Award recipients focused on power, leverage, and strategy, and they expressed a need for training and mentorship to learn successful negotiation skills. Mentors, by contrast, emphasized the importance of flexibility and shared interests in creating win-win situations for both the individual faculty member and the institution. When faculty construed negotiation as adversarial and/or zero-sum, participants believed it required traditionally masculine traits and perceived women to be at a disadvantage. Conclusions Academic medical faculty often lack the skills and knowledge necessary for successful negotiation, especially early in their careers. Many view negotiation as an adversarial process of the sort that experts call “hard positional bargaining.” Increasing awareness of alternative negotiation techniques (e.g., “principled negotiation,” in which shared interests, mutually satisfying options, and fair standards are emphasized), may encourage the success of medical faculty, particularly women. PMID:23425992

  3. Sport Concussion Knowledge and Clinical Practices: A Survey of Doctors of Chiropractic With Sports Certification.

    Science.gov (United States)

    Moreau, William J; Nabhan, Dustin C; Walden, Taylor

    2015-09-01

    The purpose of this study is to describe the knowledge base and clinical practices regarding concussion by sports-certified doctors of chiropractic. A 21-item survey was distributed to the 312 attendees of the 2014 American Chiropractic Board of Sports Physicians Sports Sciences Symposium. Results were measured by frequency analysis and descriptive statistics for all surveys completed by sports-certified chiropractors. Seventy-six surveys were returned by sports-certified doctors of chiropractic. All (N = 76) 100% of respondents believe that the evaluation of concussion should be performed by a health care provider with training in concussion. The respondents actively assess and manage concussion in adults (96%), adolescents (95%), and children (75%). A majority (79%) of respondents believe that the Sideline Concussion Assessment Tool-3 represents a current standard of care for the sideline evaluation of the athlete who possibly has sustained a sport concussion. Most respondents agreed or strongly agreed that manual therapies may be appropriate in certain circumstances in adults (80%) and minors (80%). This cross section of certified sports chiropractors strongly believes that the evaluation of concussion should be performed by a health care provider with specific training in concussion. A high percentage of the sports-certified chiropractors who responded assess and manage sport concussion in their practice, and many of them endorse the use of the Sideline Concussion Assessment Tool-3 as a sideline assessment tool.

  4. Interdependence in negotiation : Effects of exit options and social motive on distributive and integrative negotiation

    NARCIS (Netherlands)

    Giebels, E.; de Dreu, C.K W; Van de Vliert, E.

    2000-01-01

    This study extends past research on the impact of alternatives in dyadic negotiation by (a) providing negotiators with the mere possibility to negotiate with an outside party and (b) examining the moderating role of the negotiators' social motive. Business students engaged in face-to-face

  5. A Framework on Impression Management in Negotiation

    DEFF Research Database (Denmark)

    Mathiasen, Ditte Dahl; Esbjerg, Lars

    2014-01-01

    In this paper we develop a dramaturgical framework to provide us with a new understanding of how negotiators use impression management behaviour during the negotiation process to position themselves in an endeavour to reach a desirable outcome.......In this paper we develop a dramaturgical framework to provide us with a new understanding of how negotiators use impression management behaviour during the negotiation process to position themselves in an endeavour to reach a desirable outcome....

  6. UNICEF and automobile CO2 negotiation

    Energy Technology Data Exchange (ETDEWEB)

    Woo, Seok Hun [Korea Energy Management Corporation, Yongin (Korea)

    2000-06-01

    The EU automobile negotiation was very suggestive since it was the first international trade negotiation related with UNFCCC. It generated considerable reactions in association with {sup v}oluntary negotiation{sup i}n semiconductor sector. Most of all, such a new car negotiation shows well that it is hard to free from global environmental responsibilities even for a company in a developing country in UNFCCC.

  7. Clinical intuition versus statistics: different modes of tacit knowledge in clinical epidemiology and evidence-based medicine.

    Science.gov (United States)

    Braude, Hillel D

    2009-01-01

    Despite its phenomenal success since its inception in the early nineteen-nineties, the evidence-based medicine movement has not succeeded in shaking off an epistemological critique derived from the experiential or tacit dimensions of clinical reasoning about particular individuals. This critique claims that the evidence-based medicine model does not take account of tacit knowing as developed by the philosopher Michael Polanyi. However, the epistemology of evidence-based medicine is premised on the elimination of the tacit dimension from clinical judgment. This is demonstrated through analyzing the dichotomy between clinical and statistical intuition in evidence-based medicine's epistemology of clinical reasoning. I argue that clinical epidemiology presents a more nuanced epistemological model for the application of statistical epidemiology to the clinical context. Polanyi's theory of tacit knowing is compatible with the model of clinical reasoning associated with clinical epidemiology, but not evidence-based medicine.

  8. Architecture for knowledge-based and federated search of online clinical evidence.

    Science.gov (United States)

    Coiera, Enrico; Walther, Martin; Nguyen, Ken; Lovell, Nigel H

    2005-10-24

    It is increasingly difficult for clinicians to keep up-to-date with the rapidly growing biomedical literature. Online evidence retrieval methods are now seen as a core tool to support evidence-based health practice. However, standard search engine technology is not designed to manage the many different types of evidence sources that are available or to handle the very different information needs of various clinical groups, who often work in widely different settings. The objectives of this paper are (1) to describe the design considerations and system architecture of a wrapper-mediator approach to federate search system design, including the use of knowledge-based, meta-search filters, and (2) to analyze the implications of system design choices on performance measurements. A trial was performed to evaluate the technical performance of a federated evidence retrieval system, which provided access to eight distinct online resources, including e-journals, PubMed, and electronic guidelines. The Quick Clinical system architecture utilized a universal query language to reformulate queries internally and utilized meta-search filters to optimize search strategies across resources. We recruited 227 family physicians from across Australia who used the system to retrieve evidence in a routine clinical setting over a 4-week period. The total search time for a query was recorded, along with the duration of individual queries sent to different online resources. Clinicians performed 1662 searches over the trial. The average search duration was 4.9 +/- 3.2 s (N = 1662 searches). Mean search duration to the individual sources was between 0.05 s and 4.55 s. Average system time (ie, system overhead) was 0.12 s. The relatively small system overhead compared to the average time it takes to perform a search for an individual source shows that the system achieves a good trade-off between performance and reliability. Furthermore, despite the additional effort required to incorporate the

  9. A Study of the Competency of Third Year Medical Students to Interpret Biochemically Based Clinical Scenarios Using Knowledge and Skills Gained in Year 1 and 2

    Science.gov (United States)

    Gowda, Veena Bhaskar S.; Nagaiah, Bhaskar Hebbani; Sengodan, Bharathi

    2016-01-01

    Medical students build clinical knowledge on the grounds of previously obtained basic knowledge. The study aimed to evaluate the competency of third year medical students to interpret biochemically based clinical scenarios using knowledge and skills gained during year 1 and 2 of undergraduate medical training. Study was conducted on year 3 MBBS…

  10. 48 CFR 1615.070 - Negotiation authority.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Negotiation authority. 1615.070 Section 1615.070 Federal Acquisition Regulations System OFFICE OF PERSONNEL MANAGEMENT FEDERAL EMPLOYEES HEALTH BENEFITS ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION 1615.070 Negotiation authority. Th...

  11. Innovation in international negotiation: content and style

    NARCIS (Netherlands)

    Ulijn, J.M.; Tjosvold, D.

    2004-01-01

    This special issue of International Negotiation is the second in a series on innovation and negotiation. The first issue (Vol. 9, no. 1, 2004) considered innovations in the conduct and process of negotiation, whereas the present issue considers how innovation in the content, style, and strategy of

  12. 48 CFR 2115.070 - Negotiation authority.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Negotiation authority. 2115.070 Section 2115.070 Federal Acquisition Regulations System OFFICE OF PERSONNEL MANAGEMENT, FEDERAL EMPLOYEES GROUP LIFE INSURANCE FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION 2115.070 Negotiation...

  13. 46 CFR 502.56 - Negotiated rulemaking.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 9 2010-10-01 2010-10-01 false Negotiated rulemaking. 502.56 Section 502.56 Shipping FEDERAL MARITIME COMMISSION GENERAL AND ADMINISTRATIVE PROVISIONS RULES OF PRACTICE AND PROCEDURE... its own motion, may establish a negotiated rulemaking committee to negotiate and develop consensus on...

  14. Interdisciplinary Perspectives on Culture, Conflict, and Negotiation

    Science.gov (United States)

    2009-08-28

    negotiator cognition: Judgement accuracy and negotiation processes in individualistic and collectivistic cultures ", Organizational Behavior and Human...2004, Adair, Okumura, and Brett, 2001). Communication sequences are also affected by culture . Negotiators from collectivistic cultures use more... individualistic cultures (Adail and Brett, 2005; Adair, Okumura, and Brett, 2001). Research in DB/psychology has increasingly examined situational factors that

  15. Face and identity management in negotiation

    NARCIS (Netherlands)

    Planken, Brigitte Chantal

    2002-01-01

    This dissertation reports on a comparative study of the verbal behaviour of experienced negotiators (professionals) and inexperienced negotiators (students), negotiating in a lingua franca (English). The study centred around two corpora of speech data generated in a series of intercultural sales

  16. Complexity in electronic negotiation support systems.

    Science.gov (United States)

    Griessmair, Michele; Strunk, Guido; Vetschera, Rudolf; Koeszegi, Sabine T

    2011-10-01

    It is generally acknowledged that the medium influences the way we communicate and negotiation research directs considerable attention to the impact of different electronic communication modes on the negotiation process and outcomes. Complexity theories offer models and methods that allow the investigation of how pattern and temporal sequences unfold over time in negotiation interactions. By focusing on the dynamic and interactive quality of negotiations as well as the information, choice, and uncertainty contained in the negotiation process, the complexity perspective addresses several issues of central interest in classical negotiation research. In the present study we compare the complexity of the negotiation communication process among synchronous and asynchronous negotiations (IM vs. e-mail) as well as an electronic negotiation support system including a decision support system (DSS). For this purpose, transcripts of 145 negotiations have been coded and analyzed with the Shannon entropy and the grammar complexity. Our results show that negotiating asynchronically via e-mail as well as including a DSS significantly reduces the complexity of the negotiation process. Furthermore, a reduction of the complexity increases the probability of reaching an agreement.

  17. 24 CFR 290.13 - Negotiated sales.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Negotiated sales. 290.13 Section... DEVELOPMENT HUD-OWNED PROPERTIES DISPOSITION OF MULTIFAMILY PROJECTS AND SALE OF HUD-HELD MULTIFAMILY MORTGAGES Disposition of Multifamily Projects § 290.13 Negotiated sales. When HUD conducts a negotiated sale...

  18. Step 4: Award Negotiation & Issuance

    Science.gov (United States)

    Before a grant can be awarded and accepted, several pre-award activities must happen to formalize the partnership. Ensuring compliance with federal laws, a review of costs and a negotiation of the appropriate funding level must all happen in order to rece

  19. Teacher Negotiations of Sexual Subjectivities

    Science.gov (United States)

    Ferfolja, Tania

    2007-01-01

    Discrimination often silences and marginalizes those who do not conform to the dominant gender and (hetero)sexual discourses that operate in broader society. This discussion addresses the ways that seventeen self-identified lesbian teachers working in New South Wales (NSW) Australia negotiate their sexual subjectivities at work in order to pass or…

  20. Negotiations on climate in deadlock

    International Nuclear Information System (INIS)

    Mary, Olivier

    2014-01-01

    This article discusses the reasons of the failure of the negotiations on climate which took place in Warsaw in November 2013. Despite some agreements on projects (notably to avoid deforestation), evolutions are being blocked by financial issues. Besides, emerging countries and NGOs largely disagree with the posture of big countries. The future of the carbon market is also put into question again

  1. Negotiating Conventions and Creating Community

    DEFF Research Database (Denmark)

    Cole, Alexander Sasha; Barberá-Tomás, David

    2014-01-01

    This article examines the processes of negotiation and institution building through which transnational networks of learning are fashioned. It does so by examining the case of the European animation industry and the activity of an association, Cartoon, which facilitated the development of common ...

  2. Expanding the use of empiricism in nursing: can we bridge the gap between knowledge and clinical practice?

    Science.gov (United States)

    Giuliano, Karen K

    2003-04-01

    The philosophy of Aristotle and its impact on the process of empirical scientific inquiry has been substantial. The influence of the clarity and orderliness of his thinking, when applied to the acquisition of knowledge in nursing, can not be overstated. Traditional empirical approaches have and will continue to have an important influence on the development of nursing knowledge through nursing research. However, as nursing is primarily a practice discipline, the transition from empirical and syllogistic reasoning is problematic. Other types of inquiry are essential in the application of nursing knowledge obtained by empirical scientific approaches and to understand how that knowledge can best be used in the care of patients. This paper reviews the strengths and limitations of syllogistic reasoning by applying it to a recently published study on temperature measurement in nursing. It then discusses possible ways that the empirical knowledge gained from that study and confirmed in its reasoning by logical analysis could be used in the daily care of critically ill patients. It concludes by highlighting the utility of broader approaches to knowledge development, including interpretative approaches and contemporary empiricism, as a way to bridge the gap between factual empirical knowledge and the practical application of that knowledge in everyday clinical nursing practice.

  3. Patient-mediated knowledge translation (PKT) interventions for clinical encounters: a systematic review.

    Science.gov (United States)

    Gagliardi, Anna R; Légaré, France; Brouwers, Melissa C; Webster, Fiona; Badley, Elizabeth; Straus, Sharon

    2016-02-29

    Patient-mediated knowledge translation (PKT) interventions engage patients in their own health care. Insight on which PKT interventions are effective is lacking. We sought to describe the type and impact of PKT interventions. We performed a systematic review of PKT interventions, defined as strategies that inform, educate and engage patients in their own health care. We searched MEDLINE, EMBASE and the Cochrane Library from 2005 to 2014 for English language studies that evaluated PKT interventions delivered immediately before, during or upon conclusion of clinical encounters to individual patients with arthritis or cancer. Data were extracted on study characteristics, PKT intervention (theory, content, delivery, duration, personnel, timing) and outcomes. Interventions were characterized by type of patient engagement (inform, activate, collaborate). We performed content analysis and reported summary statistics. Of 694 retrieved studies, 16 were deemed eligible (5 arthritis, 11 cancer; 12 RCTs, 4 cohort studies; 7 low, 3 uncertain, 6 high risk of bias). PKT interventions included print material in 10 studies (brochures, booklets, variety of print material, list of websites), electronic material in 10 studies (video, computer program, website) and counselling in 2 studies. They were offered before, during and after consultation in 4, 1 and 4 studies, respectively; as single or multifaceted interventions in 10 and 6 studies, respectively; and by clinicians, health educators, researchers or volunteers in 4, 3, 5 and 1 study, respectively. Most interventions informed or activated patients. All studies achieved positive impact in one or more measures of patient knowledge, decision-making, communication and behaviour. This was true regardless of condition, PKT intervention, timing, personnel, type of engagement or delivery (single or multifaceted). No studies assessed patient harms, or interventions for providers to support PKT intervention delivery. Two studies evaluated

  4. Patient's Knowledge and Perception Towards the use of Non-steroidal Anti-Inflammatory Drugs in Rheumatology Clinic Northern Malaysia.

    Science.gov (United States)

    Sulaiman, Wahinuddin; Seung, Ong Ping; Ismail, Rosli

    2012-11-01

    In Rheumatology, non-steroidal anti-inflammatory drugs (NSAIDs) has been widely prescribed and used. However, despite their clinical benefits in the management of inflammatory and degenerative joint disease, NSAIDs have considerable side effects, mostly affecting the upper gastrointestinal system, which therefore, limit their use. This study was conducted to determine the patients' knowledge and perception regarding the used of NSAIDS. A total of 120 patients who attended the rheumatology clinic Hospital, Raja Permaisuri Bainun, Malaysia, and received NSAIDs more than 3 months were interviewed irrespective of their rheumatological conditions. Patient's knowledge and perception on the side effects of NSAIDs were recorded. Fifty-four percent of the patients obtained information regarding the side effect of NSAIDs either from the rheumatologist, rheumatology staff nurse or other medical staffs (75.4%). The remaining 45.8% were naive of such knowledge. Fifteen percent obtained the information by surfing the internet and 9.2% from printed media. Twenty-four (24.2%) patients, experienced indigestion and/or stomach discomfort attributed to NSAIDs used. Two patients (1.7%) had hematemesis and malena once. This study shows that half of the patients who attended the rheumatology clinic were unaware of the side effect of NSAIDs. Available data showed that most of the knowledgeable patients are more conscience and self-educated. This study also reveals the important roles of clinicians, trained staff nurses as well as the pharmacist in providing the guidance and knowledge of any medication taken by patients.

  5. Development and Analysis of an Instrument to Assess Student Understanding of GOB Chemistry Knowledge Relevant to Clinical Nursing Practice

    Science.gov (United States)

    Brown, Corina E.; Hyslop, Richard M.; Barbera, Jack

    2015-01-01

    The General, Organic, and Biological Chemistry Knowledge Assessment (GOB-CKA) is a multiple-choice instrument designed to assess students' understanding of the chemistry topics deemed important to clinical nursing practice. This manuscript describes the development process of the individual items along with a psychometric evaluation of the…

  6. Handbook of Global and Multicultural Negotiation

    CERN Document Server

    Moore, Christopher W

    2010-01-01

    Handbook of Global and Multicultural Negotiation provides advice and strategies for effective cross-cultural negotiations. Written from a multicultural perspective, this guidebook explores cross-cultural communication for problem solving and negotiations. This resource includes real-life stories and examples compiled from over thirty years of domestic and global experience from both authors, including Chris Moore, a well-known international negotiator and best selling author. This step-by-step guide to negotiation provides practical recommendations, advice, and globally proven strategies to pr

  7. Knowledge Toward Cancer Pain and the Use of Opioid Analgesics Among Medical Students in their Integrated Clinical Clerkship

    Directory of Open Access Journals (Sweden)

    Maria Fidelis C. Manalo

    2008-01-01

    Full Text Available Introduction: Among the focal issues of barriers to pain management include the physicians’ lack of knowledge about cancer pain and negative attitudes towards opioids. Many physicians and educators attribute this, at least in part, to limited exposure to pain and palliative care education during medical school.Aim: The researcher investigated the medical students’ knowledge about cancer pain and the use of opioid analgesics.Methods: The subjects were a sample of 50 students of the University of the Philippines College of Medicine in their integrated clinical clerkship year. Descriptive statistics (frequencies, means, standard deviation, rating scales were used to determine mean knowledge score and level of confidence with opioid use. The study also identified specific areas where students exhibited good or poor knowledge of opioids.Results: Approximately sixty-nine (69% of the study respondents mentioned that pain management was given to them during their Anesthesiology lectures while a few recalled that they had these lectures during their Family Medicine rotation in Supportive, Palliative and Hospice Care. More than a third (35% of the respondents admitted to not being confident with morphine use at present. The top three reasons cited as limitations in choice of opioids for cancer pain include fear of addiction, lack of adequate knowledge and experience and fear of side effects and complications. Out of a maximum of 13 correct answers, the mean knowledge score of the medical students was 6.6 ± 2.9. Less than 16% of the respondents had adequate knowledge on cancer pain and opioid use.Conclusions: The results show that basic knowledge of the role of opioids in cancer pain management among medical students in their integrated clinical clerkship year at the University of the Philippines is poor. The findings imply a need to look into making revisions in the medical curriculum to include a training program that will enable all students to

  8. Institutional dynamics and the negotiation process

    DEFF Research Database (Denmark)

    Kumar, Rajesh; Worm, Verner

    2004-01-01

    The paper develops the argument for analyzing negotiations from an institutional perspective. A major theme of the argument being advanced in the paper is that the institutional perspective provides a more comprehensive understanding of the negotiation process in its entirety. The negotiation...... process can be broken down into three distinct components, namely (a) the pre negotiation phase; (b) the negotiating phase; and (c) the post negotiation evaluation. Each of these phases is critically influenced by a specific component or components of the institutional environment. Scott's distinction...... and their implications for negotiating processes in these countries. Choosing India and China to illustrate the utility of this framework is justified by the fact that India and China are both in the process of transforming their economies and although confronted with similar challenges they have dealt with them in very...

  9. Multilateral negotiations over climate change policy

    Energy Technology Data Exchange (ETDEWEB)

    Costa Pinto, L.M.; Harrison, G.W. [Universidade do Minho, Braga (Portugal). Nucleo de Investigacao em Microeconomia Aplicada, Departmento de Economia

    2000-07-01

    Negotiations in the real world have many features that tend to be ignored in policy modelling. They are often multilateral, involving many negotiating parties with preferences over outcomes that can differ substantially. They are also often multi-dimensional, in the sense that several policies are negotiated over simultaneously. Trade negotiations are a prime example, as are negotiations over environmental policies to abate CO{sub 2}. The authors demonstrate how one can formally model this type of negotiation process. They use a policy-oriented computable general equilibrium model to generate preference functions which are then used in a formal multilateral bargaining game. The case study is on climate change policy, but the main contribution is to demonstrate how one can integrate formal economic models of the impacts of policies with formal bargaining models of the negotiations over those policies. 8 refs., 2 figs., 6 tabs.

  10. Agents That Negotiate Proficiently with People

    Science.gov (United States)

    Kraus, Sarit

    Negotiation is a process by which interested parties confer with the aim of reaching agreements. The dissemination of technologies such as the Internet has created opportunities for computer agents to negotiate with people, despite being distributed geographically and in time. The inclusion of people presents novel problems for the design of autonomous agent negotiation strategies. People do not adhere to the optimal, monolithic strategies that can be derived analytically, as is the case in settings comprising computer agents alone. Their negotiation behavior is affected by a multitude of social and psychological factors, such as social attributes that influence negotiation deals (e.g., social welfare, inequity aversion) and traits of individual negotiators (e.g., altruism, trustworthiness, helpfulness). Furthermore, culture plays an important role in their decision making and people of varying cultures differ in the way they make offers and fulfill their commitments in negotiation.

  11. Effects of team-based learning on problem-solving, knowledge and clinical performance of Korean nursing students.

    Science.gov (United States)

    Kim, Hae-Ran; Song, Yeoungsuk; Lindquist, Ruth; Kang, Hee-Young

    2016-03-01

    Team-based learning (TBL) has been used as a learner-centered teaching strategy in efforts to improve students' problem-solving, knowledge and practice performance. Although TBL has been used in nursing education in Korea for a decade, few studies have studied its effects on Korean nursing students' learning outcomes. To examine the effects of TBL on problem-solving ability and learning outcomes (knowledge and clinical performance) of Korean nursing students. Randomized controlled trial. 63 third-year undergraduate nursing students attending a single university were randomly assigned to the TBL group (n=32), or a control group (n=31). The TBL and control groups attended 2h of class weekly for 3weeks. Three scenarios with pulmonary disease content were employed in both groups. However, the control group received lectures and traditional case study teaching/learning strategies instead of TBL. A questionnaire of problem-solving ability was administered at baseline, prior to students' exposure to the teaching strategies. Students' problem-solving ability, knowledge of pulmonary nursing care, and clinical performance were assessed following completion of the three-week pulmonary unit. After the three-week educational interventions, the scores on problem-solving ability in the TBL group were significantly improved relative to that of the control group (t=10.89, pproblem-solving ability, knowledge and clinical performance. More research on other specific learning outcomes of TBL for nursing students is recommended. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. A Concurrent Multiple Negotiation Protocol Based on Colored Petri Nets.

    Science.gov (United States)

    Niu, Lei; Ren, Fenghui; Zhang, Minjie; Bai, Quan

    2017-11-01

    Concurrent multiple negotiation (CMN) provides a mechanism for an agent to simultaneously conduct more than one negotiation. There may exist different interdependency relationships among these negotiations and these interdependency relationships can impact the outcomes of these negotiations. The outcomes of these concurrent negotiations contribute together for the agent to achieve an overall negotiation goal. Handling a CMN while considering interdependency relationships among multiple negotiations is a challenging research problem. This paper: 1) comprehensively highlights research problems of negotiations at concurrent negotiation level; 2) provides a graph-based CMN model with consideration of the interdependency relationships; and 3) proposes a colored Petri net-based negotiation protocol for conducting CMNs. With the proposed protocol, a CMN can be efficiently and concurrently processed and negotiation agreements can be efficiently achieved. Experimental results indicate the effectiveness and efficiency of the proposed protocol in terms of the negotiation success rate, the negotiation time and the negotiation outcome.

  13. Floodplain conflicts: regulation and negotiation

    Science.gov (United States)

    Pardoe, J.; Penning-Rowsell, E.; Tunstall, S.

    2011-10-01

    In the continuing shift from engineered solutions towards more holistic methods of managing flood risk, spatial planning has become the primary focus of a conflict between land and water, water and people. In attempting to strike a balance between making space for water and making space for people, compromises are required. Through five case studies in the UK, this paper analyses the effectiveness of Planning Policy Statement 25 (PPS 25) and the processes of negotiation that it promotes. This assessment allows us to draw conclusions on the nature of the compromises this kind of negotiation can achieve and the implications of this for flood risk management. What emerges is that the beneficial impacts of decisions to develop floodplain areas are given a proper hearing and sensible conditions imposed, rather than arguments to prevent such development remaining unchallenged.

  14. Floodplain conflicts: regulation and negotiation

    Directory of Open Access Journals (Sweden)

    J. Pardoe

    2011-10-01

    Full Text Available In the continuing shift from engineered solutions towards more holistic methods of managing flood risk, spatial planning has become the primary focus of a conflict between land and water, water and people. In attempting to strike a balance between making space for water and making space for people, compromises are required. Through five case studies in the UK, this paper analyses the effectiveness of Planning Policy Statement 25 (PPS 25 and the processes of negotiation that it promotes. This assessment allows us to draw conclusions on the nature of the compromises this kind of negotiation can achieve and the implications of this for flood risk management. What emerges is that the beneficial impacts of decisions to develop floodplain areas are given a proper hearing and sensible conditions imposed, rather than arguments to prevent such development remaining unchallenged.

  15. The iSCREEN Electronic Diabetes Dashboard: A Tool to Improve Knowledge and Implementation of Pediatric Clinical Practice Guidelines.

    Science.gov (United States)

    Zahanova, Stacy; Tsouka, Alexandra; Palmert, Mark R; Mahmud, Farid H

    2017-12-01

    Clinical practice guidelines (CPG) provide evidence-based recommendations for patient care but may not be optimally applied in clinical settings. As a pilot study, we evaluated the impact of a computerized, point-of-care decision support system (CDSS) on guideline knowledge and adherence in our diabetes clinic. iSCREEN, a CDSS, integrated with a province-wide electronic health record, was designed based on the Canadian Diabetes Association 2013 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. Evaluation data were gathered by retrospective chart review and clinician questionnaire prior to and after implementation of iSCREEN. Records of patients with type 1 diabetes, 14 to 18 years of age, were assessed for appropriate screening for complications and comorbidities. To assess guideline adherence, 50 charts were reviewed at 2 time periods (25 before and 25 after launch of iSCREEN). Results revealed improved frequency of appropriate screening for diabetic nephropathy (p=0.03) and retinopathy (p=0.04), accompanied by a decrease in under- and overscreening for these outcomes. To assess guideline knowledge, 58 surveys were collected (31 prior to and 27 after the launch of iSCREEN) from care providers in the field of pediatric diabetes. There was a trend toward improved guideline knowledge in all team members (p=0.06). Implementation of a de novo CDSS was associated with improved rates of appropriate screening for diabetes-related complications. A trend toward improvement in health professionals' knowledge of the guidelines was also observed. Evaluation of this point-of-care computerized decision support tool suggests that it may facilitate diabetes care by optimizing complication screening and CPG knowledge, with the potential for broader implementation. Copyright © 2017 Diabetes Canada. Published by Elsevier Inc. All rights reserved.

  16. Predicting United States Medical Licensure Examination Step 2 clinical knowledge scores from previous academic indicators

    Directory of Open Access Journals (Sweden)

    Monteiro KA

    2017-06-01

    Full Text Available Kristina A Monteiro, Paul George, Richard Dollase, Luba Dumenco Office of Medical Education, The Warren Alpert Medical School of Brown University, Providence, RI, USA Abstract: The use of multiple academic indicators to identify students at risk of experiencing difficulty completing licensure requirements provides an opportunity to increase support services prior to high-stakes licensure examinations, including the United States Medical Licensure Examination (USMLE Step 2 clinical knowledge (CK. Step 2 CK is becoming increasingly important in decision-making by residency directors because of increasing undergraduate medical enrollment and limited available residency vacancies. We created and validated a regression equation to predict students’ Step 2 CK scores from previous academic indicators to identify students at risk, with sufficient time to intervene with additional support services as necessary. Data from three cohorts of students (N=218 with preclinical mean course exam score, National Board of Medical Examination subject examinations, and USMLE Step 1 and Step 2 CK between 2011 and 2013 were used in analyses. The authors created models capable of predicting Step 2 CK scores from academic indicators to identify at-risk students. In model 1, preclinical mean course exam score and Step 1 score accounted for 56% of the variance in Step 2 CK score. The second series of models included mean preclinical course exam score, Step 1 score, and scores on three NBME subject exams, and accounted for 67%–69% of the variance in Step 2 CK score. The authors validated the findings on the most recent cohort of graduating students (N=89 and predicted Step 2 CK score within a mean of four points (SD=8. The authors suggest using the first model as a needs assessment to gauge the level of future support required after completion of preclinical course requirements, and rescreening after three of six clerkships to identify students who might benefit from

  17. North Korean nuclear negotiation drama

    International Nuclear Information System (INIS)

    Kim, Jai Bok

    1995-06-01

    This book reports negotiation on North Korean nuclear among South Korea, North Korea and U. S. It includes an account about international issues on North Korean nuclear activities, a new aspect on the problems of North Korean nuclear, pressure on North Korea and startup for dialogue trying to solve problems by communication, investigation by IAEA, IAEA resolution and high tension on Korean peninsula with North Korean nuclear.

  18. North Korean nuclear negotiation drama

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jai Bok

    1995-06-15

    This book reports negotiation on North Korean nuclear among South Korea, North Korea and U. S. It includes an account about international issues on North Korean nuclear activities, a new aspect on the problems of North Korean nuclear, pressure on North Korea and startup for dialogue trying to solve problems by communication, investigation by IAEA, IAEA resolution and high tension on Korean peninsula with North Korean nuclear.

  19. The Negotiation of Basel III

    DEFF Research Database (Denmark)

    Just, Sine Nørholm

    2015-01-01

    While the Basel Accords of 1988 and 2004 (Basel I and Basel II) ostensibly set out to regulate bank risk at the international level, they were effectively in the grip of neoliberal beliefs in the self-regulating potential of free markets. In 2009–2011, the Basel Accords were revised once more wit...... agency, the empirical argument is substantiated through textual–intertextual analysis of the rhetorical circulation of affective signs in the Basel III negotiations....

  20. Negotiating a deal in Iraq

    International Nuclear Information System (INIS)

    Fletcher, J.E.

    2002-01-01

    The legal and diplomatic environment surrounding oil production negotiations in Iraq was discussed with reference to the essential terms generally negotiated for upstream contracts between oil companies and the Iraqi Ministry of Oil. Legal considerations were discussed for the following upstream contracts: production sharing contracts, a risk service contract, a modified buy-back contract, a technical service contract, and a joint venture company. It was noted that negotiations in Iraq require a great amount of diplomacy as projects are very high profile and attract significant international attention. Information sharing is critical in gaining valuable government support. The main problem for interested investors in Iraq is predicting when the UN sanctions will be lifted. Once lifted, the Ministry of Oil's Development Plan is to increase oil production through the co-operative assistance of foreign oil companies. While the sanctions remain in place, Iraq is allowed to sell oil on a renewable basis every 6 months under the oil-for-food programme, which permits Iraq to spend US$600 million every 6 months for spare parts to upgrade its oil industry. 9 figs

  1. Climate geopolitics. Negotiations, strategies, impacts

    International Nuclear Information System (INIS)

    Gemenne, Francois

    2015-01-01

    As countries are not equal in front of the climate change issue (some contribute more than the others, some will be more heavily impacted, some are more dependent on fossil energies, some could be affected by population movements related to the degradation of their environment), and as countries are to adopt measures for a more sustainable development while facing huge geopolitical challenges which affect international negotiations, this book aims at describing and analysing these issues which illustrate serious imbalances between countries. These issues relate to the development of energy policies, to geographical and demographic constraints. The author describes how the climate has become an international political issue, and a field of complex interactions with international relationships. After having recalled the origins of greenhouse gas emissions and their main expected impacts, he analyses the various responsibilities, describes these different impacts, outlines how global warming is basically unfair: the less responsible countries will be more impacted than the responsible ones. He also discusses mechanisms of international cooperation which have been implemented to address this issue: adaptation and mitigation policies, associated negotiations. He notices that the strongest mitigation efforts are, the least necessary adaptation efforts will be. He discusses the issue of financing and necessary financial and technological transfers to help southern countries in reducing their emissions without compromising their development. He highlights the current status of negotiations, their organisation, the present actors and forces, and their main point of tension

  2. How Can a Clinical Research Approach Contribute to Knowledge-Building for the Teaching Profession?

    Science.gov (United States)

    Bulterman-Bos, Jacquelien

    2017-01-01

    This article explains what clinical research is and why it is necessary. The term "clinical" refers to an academic way of solving practical problems. Clinical research starts from a view of science that not only acknowledges the value of rational analysis and empirical research, but also acknowledges the need for human skills and…

  3. Assessment of Genetics Knowledge and Skills in Medical Students: Insight for a Clinical Neurogenetics Curriculum

    Science.gov (United States)

    Pearl, Phillip L.; Pettiford, Jennifer M.; Combs, Susan E.; Heffron, Ari; Healton, Sean; Hovaguimian, Alexandra; Macri, Charles J.

    2011-01-01

    The pace of discovery in biochemistry and genetics and its effect on clinical medicine places new curricular challenges in medical school education. We sought to evaluate students' understanding of neurogenetics and its clinical applications to design a pilot curriculum into the clinical neurology clerkship. We utilized a needs assessment and a…

  4. The role of encapsulated knowledge in clinical case representations of medical students and family doctors

    NARCIS (Netherlands)

    Rikers, Remy MJP; Loyens, Sofie MM; Schmidt, Henk G

    2004-01-01

    BACKGROUND: Previous studies on the development of medical expertise, predominantly using measures of free recall and pathophysiological explanations, have shown ambiguous results concerning the relationship between expertise level and encapsulated knowledge. PURPOSE: To investigate differences in

  5. The Gap in Knowledge of Clinical Practice Guidelines by Mental Health Residents in Buenos Aires (Argentina

    Directory of Open Access Journals (Sweden)

    Javier Fabrissin

    2014-05-01

    Full Text Available The aim of this pilot study was to evaluate if the residents of psychiatry and clinical psychology from the city of Buenos Aires knew any of the existing mental health Clinical Practice and Treatment Guidelines (CPTGs. We asked residents their opinion about CPTGs and, also, if they followed their recommendations in clinical practice. We asked 59 mental health residents (28 physicians and 29 psychologists with different years of clinical training to fill a questionnaire to know their opinion about CPTGs and also if they follow the CPTG recommendations in their clinical practice. We found that 79.31% of residents did not know any CPTG. Eighty percent of the residents who did know any CPTG have a positive opinion about CPTGs. Finally, the American Psychiatric Association Guidelines were the most known CPTGs. The authors emphasize the need for a clinical guidelines diffusion policy in Buenos Aires city and particularly as a clinical and training resource for mental health residents.

  6. Defining the effect and mediators of two knowledge translation strategies designed to alter knowledge, intent and clinical utilization of rehabilitation outcome measures: a study protocol [NCT00298727

    Directory of Open Access Journals (Sweden)

    Law Mary

    2006-07-01

    Full Text Available Abstract Background A substantial number of valid outcome measures have been developed to measure health in adult musculoskeletal and childhood disability. Regrettably, national initiatives have merely resulted in changes in attitude, while utilization remains unacceptably low. This study will compare the effectiveness and mediators of two different knowledge transfer (KT interventions in terms of their impact on changing knowledge and behavior (utilization and clinical reasoning related to health outcome measures. Method/Design Physical and occupational therapists (n = 144 will be recruited in partnership with the national professional associations to evaluate two different KT interventions with the same curriculum: 1 Stakeholder-Hosted Interactive Problem-Based Seminar (SHIPS, and 2 Online Problem-Based course (e-PBL. SHIPS will consist of face-to-face problem-based learning (PBL for 2 1/2 days with outcome measure developers as facilitators, using six problems generated in consultation with participants. The e-PBL will consist of a 6-week web-based course with six generic problems developed by content experts. SHIPS will be conducted in three urban centers in Canada. Participants will be block-allocated by a minimization procedure to either of the two interventions to minimize any prognostic differences. Trained evaluators at each site will conduct chart audits and chart-stimulated recall. Trained interviewers will conduct semi-structured interviews focused on identifying critical elements in KT and implementing practice changes. Interviews will be transcribed verbatim. Baseline predictors including demographics, knowledge, attitudes/barriers regarding outcome measures, and Readiness to Change will be assessed by self-report. Immediately post-intervention and 6 months later, these will be re-administered. Primary qualitative and quantitative evaluations will be conducted 6-months post-intervention to assess the relative effectiveness of KT

  7. Optimizing Negotiation Conflict in the Cloud Service Negotiation Framework Using Probabilistic Decision Making Model

    Directory of Open Access Journals (Sweden)

    Rajkumar Rajavel

    2015-01-01

    Full Text Available Optimization of negotiation conflict in the cloud service negotiation framework is identified as one of the major challenging issues. This negotiation conflict occurs during the bilateral negotiation process between the participants due to the misperception, aggressive behavior, and uncertain preferences and goals about their opponents. Existing research work focuses on the prerequest context of negotiation conflict optimization by grouping similar negotiation pairs using distance, binary, context-dependent, and fuzzy similarity approaches. For some extent, these approaches can maximize the success rate and minimize the communication overhead among the participants. To further optimize the success rate and communication overhead, the proposed research work introduces a novel probabilistic decision making model for optimizing the negotiation conflict in the long-term negotiation context. This decision model formulates the problem of managing different types of negotiation conflict that occurs during negotiation process as a multistage Markov decision problem. At each stage of negotiation process, the proposed decision model generates the heuristic decision based on the past negotiation state information without causing any break-off among the participants. In addition, this heuristic decision using the stochastic decision tree scenario can maximize the revenue among the participants available in the cloud service negotiation framework.

  8. Optimizing Negotiation Conflict in the Cloud Service Negotiation Framework Using Probabilistic Decision Making Model.

    Science.gov (United States)

    Rajavel, Rajkumar; Thangarathinam, Mala

    2015-01-01

    Optimization of negotiation conflict in the cloud service negotiation framework is identified as one of the major challenging issues. This negotiation conflict occurs during the bilateral negotiation process between the participants due to the misperception, aggressive behavior, and uncertain preferences and goals about their opponents. Existing research work focuses on the prerequest context of negotiation conflict optimization by grouping similar negotiation pairs using distance, binary, context-dependent, and fuzzy similarity approaches. For some extent, these approaches can maximize the success rate and minimize the communication overhead among the participants. To further optimize the success rate and communication overhead, the proposed research work introduces a novel probabilistic decision making model for optimizing the negotiation conflict in the long-term negotiation context. This decision model formulates the problem of managing different types of negotiation conflict that occurs during negotiation process as a multistage Markov decision problem. At each stage of negotiation process, the proposed decision model generates the heuristic decision based on the past negotiation state information without causing any break-off among the participants. In addition, this heuristic decision using the stochastic decision tree scenario can maximize the revenue among the participants available in the cloud service negotiation framework.

  9. Knowledge of Radiation Hazards, Radiation Protection Practices and Clinical Profile of Health Workers in a Teaching Hospital in Northern Nigeria.

    Science.gov (United States)

    Awosan, K J; Ibrahim, Mto; Saidu, S A; Ma'aji, S M; Danfulani, M; Yunusa, E U; Ikhuenbor, D B; Ige, T A

    2016-08-01

    Use of ionizing radiation in medical imaging for diagnostic and interventional purposes has risen dramatically in recent years with a concomitant increase in exposure of patients and health workers to radiation hazards. To assess the knowledge of radiation hazards, radiation protection practices and clinical profile of health workers in UDUTH, Sokoto, Nigeria. A cross-sectional study was conducted among 110 Radiology, Radiotherapy and Dentistry staff selected by universal sampling technique. The study comprised of administration of standardized semi-structured pre-tested questionnaire (to obtain information on socio-demographic characteristics, knowledge of radiation hazards, and radiation protection practices of participants), clinical assessment (comprising of chest X-ray, abdominal ultrasound and laboratory investigation on hematological parameters), and evaluation of radiation exposure of participants (extracted from existing hospital records on their radiation exposure status). The participants were aged 20 to 65 years (mean = 34.04 ± 8.83), most of them were males (67.3%) and married (65.7%). Sixty five (59.1%) had good knowledge of radiation hazards, 58 (52.7%) had good knowledge of Personal Protective Devices (PPDs), less than a third, 30 (27.3%) consistently wore dosimeter, and very few (10.9% and below) consistently wore the various PPDs at work. The average annual radiation exposure over a 4 year period ranged from 0.0475mSv to 1.8725mSv. Only 1 (1.2%) of 86 participants had abnormal chest X-ray findings, 8 (9.4%) of 85 participants had abnormal abdominal ultrasound findings; while 17 (15.5%) and 11 (10.0%) of 110 participants had anemia and leucopenia respectively. This study demonstrated poor radiation protection practices despite good knowledge of radiation hazards among the participants, but radiation exposure and prevalence of abnormal clinical conditions were found to be low. Periodic in-service training and monitoring on radiation safety was

  10. Knowledge and perception regarding clinical trials among doctors of government medical colleges: A questionnaire-based study

    Directory of Open Access Journals (Sweden)

    Supriyo Choudhury

    2016-01-01

    Full Text Available Aims: By virtue of being a specialized field by itself, the science of clinical trials (CTs may not be well understood by doctors who are not specifically trained in it. A lack of knowledge may translate to a negative perception toward CT. With the idea of getting a situational snapshot, we estimated the knowledge and perception of CTs among doctors from government medical colleges of West Bengal who are not trained on CT in their postgraduate curriculum. Several determinants of knowledge and perception regarding CT were also evaluated. Methods: We have quantified the knowledge and perception of CTs by a structured validated questionnaire. Development and validation of the questionnaire was performed prior to the study. Results: Among 133 participants, 7.5% received focused training on CT and 16.5% participated in CTs as investigators. Majority of the doctors were unfamiliar with the basic terminologies such as, “adverse event” and “good clinical practice.” Encouragingly, 93.3% doctors advised that a detailed discussion of CT methodology should be incorporated in the under graduate medical science curriculum. They had an overall positive attitude toward CTs conducted in India, with a mean score that is 72.6% of the maximum positive score. However, a large number of the doctors were skeptical about the primary motivation and operations of pharmaceutical industry sponsored CTs, with 45% of them believing that patients are exploited in these sponsored CTs. Conclusion: Participant doctors had a basic knowledge of CT methodology. The study has revealed specific areas of deficient knowledge, which might be emphasized while designing focused training on CT methodology.

  11. Knowledge, attitudes and practices about sun exposure and photoprotection in outpatients attending dermatology clinics at four hospitals in Lima, Peru.

    Science.gov (United States)

    Thomas-Gavelan, Elizabeth; Sáenz-Anduaga, Eliana; Ramos, Willy; Sánchez-Saldaña, Leonardo; Sialer, María del Carmen

    2011-01-01

    To establish the knowledge, about sun exposure and photoprotection in outpatients treated at the dermatology clinics in four hospitals in Lima, Peru. A cross-sectional study was conducted involving a sample of 364 patients selected using a systematic random sampling process in the four participating hospitals. The selected patients were interviewed to determine their knowledge, behavior and practices in relation to sun exposure and photoprotection. The chi-square test was used to identify any significant differences between knowledge and practices. The mean age of the patients in this sample was 45.1 ± 21.4 years. Of the 364 patients, 55.9% were women and 54.8% had skin phototype IV. The principal risks related to sun exposure were skin cancer (80.5%) and sunburn (77.8%). Knowledge regarding sun protection was more evident in individuals with university/college education (pphotoprotection, 38.4% used these products daily, while 61.6% used them only occasionally. The use of photo-protectors differed significantly in accordance with the individual's education level (psolar protection. The level of awareness of the outpatients treated at the dermatology clinics in these four hospitals in Lima, Peru about the risks of sun exposure is acceptable; however, a large proportion fail to incorporate regular solar protection as a practice in their daily life.

  12. Negotiating refusal in primary care consultations: a qualitative study.

    Science.gov (United States)

    Walter, Alex; Chew-Graham, Carolyn; Harrison, Stephen

    2012-08-01

    How GPs negotiate patient requests is vital to their gatekeeper role but also a source of potential conflict, practitioner stress and patient dissatisfaction. Difficulties may arise when demands of shared decision-making conflict with resource allocation, which may be exacerbated by new commissioning arrangements, with GPs responsible for available services. To explore GPs' accounts of negotiating refusal of patient requests and their negotiation strategies. A qualitative design was employed with two focus groups of GPs and GP registrars followed by 20 semi-structured interviews. Participants were sampled by gender, experience, training/non-training, principal versus salaried or locum. Thematic content analysis proceeded in parallel with interviews and further sampling. The setting was GP practices within an English urban primary care trust. Sickness certification, antibiotics and benzodiazepines were cited most frequently as problematic patient requests. GP trainees reported more conflict within interactions than experienced GPs. Negotiation strategies, such as blaming distant third parties such as the primary care organization, were designed to prevent conflict and preserve the doctor-patient relationship. GPs reported patients' expectations being strongly influenced by previous encounters with other health care professionals. The findings reiterate the prominence of the doctor-patient relationship in GPs' accounts. GPs' relationships with colleagues and the wider National Health Service (NHS) are particular of relevance in light of provisions in the Health and Social Care Bill for clinical commissioning consortia. The ability of GPs to offset blame for rationing decisions to third parties will be undermined if the same GPs commission services.

  13. AN EDUCATIONAL GAME IN CONSTRUCTION PROCUREMENT NEGOTIATION

    Directory of Open Access Journals (Sweden)

    Ren-Jye Dzeng

    2013-06-01

    Full Text Available Project managers are frequently required to negotiate during the procurement of construction materials and drawing up of contractual agreements. Training in negotiation training requires hands-on experience and interaction with multiple parties. However, in the conventional curriculum on construction management, negotiation is taught merely through lectures and case studies. This study addressed that shortcoming by developing a portfolio negotiation game in which students play different roles and actively make decisions while proceeding through a simulated negotiation process in a competitive context. The proposed game would be the first negotiation game within the domain of the construction industry. During the pilot study, 46 students (with or without industrial working experience played the game; the results showed an increase in learning interest, satisfaction, and effectiveness.

  14. Negotiated risks. International talks on hazardous issues

    International Nuclear Information System (INIS)

    Avenhaus, Rudolf; Sjoestedt, Gunnar

    2009-01-01

    This book fills a major gap in the risk literature, as it brings together two research strands: risks, to which IIASA's research programs have contributed significantly over the years, culminating in the Risk and Vulnerability Program, and international negotiations, on which there is an abundance of published work, much of it resulting from the work of IIASA's Processes of International Negotiations Program. Throughout the book, it is pointed out that there are actor-driven risks, namely those posed by international negotiations themselves, and issue-driven risks which are caused by large-scale human activities. In fact, negotiated risks deal with some of the most serious risks facing humanity: climate change, nuclear activities, and weapons of mass destruction. The book contains both scientific analyses on the nature of internationally negotiated risks and analyses of concrete risks, both of which are of immense practical relevance in the larger context of international negotiations. (orig.)

  15. Automated Bilateral Negotiation and Bargaining Impasse

    Science.gov (United States)

    Lopes, Fernando; Novais, A. Q.; Coelho, Helder

    The design and implementation of autonomous negotiating agents involve the consideration of insights from multiple relevant research areas to integrate different perspectives on negotiation. As a starting point for an interdisciplinary research effort, this paper employs game-theoretic techniques to define equilibrium strategies for the bargaining game of alternating offers and formalizes a set of negotiation strategies studied in the social sciences. This paper also shifts the emphasis to negotiations that are "difficult" to resolve and can hit an impasse. Specifically, it analyses a situation where two agents bargain over the division of the surplus of several distinct issues to demonstrate how a procedure to avoid impasses can be utilized in a specific negotiation setting. The procedure is based on the addition of new issues to the agenda during the course of negotiation and the exploration of the differences in the valuation of these issues to capitalize on Pareto optimal agreements.

  16. Office of the US Nuclear Waste Negotiator

    International Nuclear Information System (INIS)

    Leroy, D.H.

    1991-01-01

    The Office of the US Nuclear Waste Negotiator was created as an independent federal agency by the US Congress pursuant to the 1987 amendments to the Nuclear Waste Policy Act of 1982. The office, which was authorized by Congress for 5 years following the enactment of the 1987 amendments, is headquartered in Boise, Idaho, and maintains a liaison office in Washington DC. The negotiator is charged with the responsibility of attempting to find a state or Indian tribe willing to host a repository or monitored retrievable storage (MRS) facility at a technically qualified site on reasonable terms. The negotiator is instructed to negotiate with any state or Indian tribe that expresses an interest in hosting a repository or MRS facility. The negotiator will formally submit the negotiated agreement and environmental assessment to Congress, and the agreement will become effective when acted on by Congress and signed by the President into law

  17. Condom negotiation: findings and future directions.

    Science.gov (United States)

    Peasant, Courtney; Parra, Gilbert R; Okwumabua, Theresa M

    2015-01-01

    The aim of this review was to summarize factors associated with condom negotiation among heterosexual men. Literature searches were conducted using multiple databases spanning several disciplines. Studies examining psychological, demographic, relational, communication, and environmental factors related to condom negotiation are described, and a three-dimensional framework of condom negotiation is proposed. This framework of condom negotiation may aid researchers in operationalizing this construct, organizing this literature, and facilitating measurement development. We used this three-dimensional framework to articulate the influence of gender, ethnicity, relationship type, partner characteristics, trauma history, post-traumatic stress, and alcohol use on condom negotiation. Areas for future research are outlined. More research is needed to understand how these factors interact to influence condom negotiation, as well as the interaction between gender and the identified factors.

  18. The polarizing effect of arousal on negotiation.

    Science.gov (United States)

    Brown, Ashley D; Curhan, Jared R

    2013-10-01

    In this research, we examined the impact of physiological arousal on negotiation outcomes. Conventional wisdom and the prescriptive literature suggest that arousal should be minimized given its negative effect on negotiations, whereas prior research on misattribution of arousal suggests that arousal might polarize outcomes, either negatively or positively. In two experiments, we manipulated arousal and measured its effect on subjective and objective negotiation outcomes. Our results support the polarization effect. When participants had negative prior attitudes toward negotiation, arousal had a detrimental effect on outcomes, whereas when participants had positive prior attitudes toward negotiation, arousal had a beneficial effect on outcomes. These effects occurred because of the construal of arousal as negative or positive affect, respectively. Our findings have important implications not only for negotiation, but also for research on misattribution of arousal, which previously has focused on the target of evaluation, in contrast to the current research, which focused on the critical role of the perceiver.

  19. Knowledge-based immunosuppressive therapy for kidney transplant patients--from theoretical model to clinical integration.

    Science.gov (United States)

    Seeling, Walter; Plischke, Max; de Bruin, Jeroen S; Schuh, Christian

    2015-01-01

    Immunosuppressive therapy is a risky necessity after a patient received a kidney transplant. To reduce risks, a knowledge-based system was developed that determines the right dosage of the immunosuppresive agent Tacrolimus. A theoretical model, to classify medication blood levels as well as medication adaptions, was created using data from almost 500 patients, and over 13.000 examinations. This model was then translated into an Arden Syntax knowledge base, and integrated directly into the hospital information system of the Vienna General Hospital. In this paper we give an overview of the construction and integration of such a system.

  20. Phronesis: practical wisdom the role of professional practice knowledge in the clinical reasoning of Bobath instructors.

    Science.gov (United States)

    Vaughan-Graham, Julie; Cott, Cheryl

    2017-10-01

    Clinical reasoning is an essential aspect of clinical practice, however is largely ignored in the current rehabilitation sciences evidence base. Literature related to clinical reasoning and clinical expertise has evolved concurrently although rehabilitation reasoning frameworks remain relatively generic. The purpose of this study was to explicate the clinical reasoning process of Bobath instructors of a widely used neuro-rehabilitation approach, the Bobath concept. A qualitative interpretive description approach consisting of stimulated recall using video-recorded treatment sessions and in-depth interviews. Purposive sampling was used to recruit members of the International Bobath Instructors Training Association (IBITA). Interview transcripts were transcribed verbatim providing the raw data. Data analysis was progressive, iterative, and inductive. Twenty-two IBITA instructors from 7 different countries participated. Ranging in clinical experience from 12 to 40 years, and instructor experience from 1 to 35 years. Three themes were developed, (a) a Bobath clinical framework, (b) person-centered, and (c) a Bobath reasoning approach, highlighting the role of practical wisdom, phronesis in the clinical reasoning process. In particular the role of visuospatial-kinesthetic perception, an element of technical expertise, was illuminated as an integral aspect of clinical reasoning in this expert group. This study provides an interpretive understanding of the clinical reasoning process used by IBITA instructors illustrating an inactive embodied view of clinical reasoning, specifically the role of phronesis, requiring further investigation in nonexpert Bobath therapists, as well as in novice and experienced therapists in other specialty areas. © 2016 John Wiley & Sons, Ltd.

  1. Negotiation strategies in Supply Chain Management

    DEFF Research Database (Denmark)

    Zachariassen, Frederik

    2008-01-01

    Purpose - This paper seeks to explore the impact of different negotiation strategies on then negotiation setting in different buyer-supplier relationships. So far, the extant supply chain management (SCM) literature has only briefly touched this subject, though such a study has been advocated...... to reject or confirm the reached conclusions. Originality/value - The paper is the first to specifically investigate the role of negotiation strategies in the academic discipline of SCM from a qualitative angle using participant observations and interviews....

  2. The Effect of Clinical Simulation with Debriefing for Meaningful Learning in Courses of Nursing Theory and Practicum on Student Knowledge and Perception of Instruction

    Science.gov (United States)

    Shea, Kathleen

    2015-01-01

    Nursing students are expected to apply knowledge from lectures and laboratories to the clinical setting. One major challenge of nursing educators is facilitating the transfer of knowledge to the clinical-practice setting. Simulation-based education provides students with an experiential-learning activity within the context of a simulated clinical…

  3. The Chief Clinical Informatics Officer (CCIO): AMIA Task Force Report on CCIO Knowledge, Education, and Skillset Requirements.

    Science.gov (United States)

    Kannry, Joseph; Sengstack, Patricia; Thyvalikakath, Thankam Paul; Poikonen, John; Middleton, Blackford; Payne, Thomas; Lehmann, Christoph U

    2016-01-01

    The emerging operational role of the "Chief Clinical Informatics Officer" (CCIO) remains heterogeneous with individuals deriving from a variety of clinical settings and backgrounds. The CCIO is defined in title, responsibility, and scope of practice by local organizations. The term encompasses the more commonly used Chief Medical Informatics Officer (CMIO) and Chief Nursing Informatics Officer (CNIO) as well as the rarely used Chief Pharmacy Informatics Officer (CPIO) and Chief Dental Informatics Officer (CDIO). The American Medical Informatics Association (AMIA) identified a need to better delineate the knowledge, education, skillsets, and operational scope of the CCIO in an attempt to address the challenges surrounding the professional development and the hiring processes of CCIOs. An AMIA task force developed knowledge, education, and operational skillset recommendations for CCIOs focusing on the common core aspect and describing individual differences based on Clinical Informatics focus. The task force concluded that while the role of the CCIO currently is diverse, a growing body of Clinical Informatics and increasing certification efforts are resulting in increased homogeneity. The task force advised that 1.) To achieve a predictable and desirable skillset, the CCIO must complete clearly defined and specified Clinical Informatics education and training. 2.) Future education and training must reflect the changing body of knowledge and must be guided by changing day-to-day informatics challenges. A better defined and specified education and skillset for all CCIO positions will motivate the CCIO workforce and empower them to perform the job of a 21st century CCIO. Formally educated and trained CCIOs will provide a competitive advantage to their respective enterprise by fully utilizing the power of Informatics science.

  4. EXACKTE2: Exploiting the clinical consultation as a knowledge transfer and exchange environment: a study protocol.

    NARCIS (Netherlands)

    Legare, F.; Stewart, M.; Frosch, D.; Grimshaw, J.; Labrecque, M.; Magnan, M.; Ouimet, M.; Rousseau, M.; Stacey, D.; Weijden, G.D.E.M. van der; Elwyn, G.

    2009-01-01

    ABSTRACT: BACKGROUND: While the evidence suggests that the way physicians provide information to patients is crucial in helping patients decide upon a course of action, the field of knowledge translation and exchange (KTE) is silent about how the physician and the patient influence each other during

  5. The Interface of Clinical Decision-Making With Study Protocols for Knowledge Translation From a Walking Recovery Trial.

    Science.gov (United States)

    Hershberg, Julie A; Rose, Dorian K; Tilson, Julie K; Brutsch, Bettina; Correa, Anita; Gallichio, Joann; McLeod, Molly; Moore, Craig; Wu, Sam; Duncan, Pamela W; Behrman, Andrea L

    2017-01-01

    Despite efforts to translate knowledge into clinical practice, barriers often arise in adapting the strict protocols of a randomized, controlled trial (RCT) to the individual patient. The Locomotor Experience Applied Post-Stroke (LEAPS) RCT demonstrated equal effectiveness of 2 intervention protocols for walking recovery poststroke; both protocols were more effective than usual care physical therapy. The purpose of this article was to provide knowledge-translation tools to facilitate implementation of the LEAPS RCT protocols into clinical practice. Participants from 2 of the trial's intervention arms: (1) early Locomotor Training Program (LTP) and (2) Home Exercise Program (HEP) were chosen for case presentation. The two cases illustrate how the protocols are used in synergy with individual patient presentations and clinical expertise. Decision algorithms and guidelines for progression represent the interface between implementation of an RCT standardized intervention protocol and clinical decision-making. In each case, the participant presents with a distinct clinical challenge that the therapist addresses by integrating the participant's unique presentation with the therapist's expertise while maintaining fidelity to the LEAPS protocol. Both participants progressed through an increasingly challenging intervention despite their own unique presentation. Decision algorithms and exercise progression for the LTP and HEP protocols facilitate translation of the RCT protocol to the real world of clinical practice. The two case examples to facilitate translation of the LEAPS RCT into clinical practice by enhancing understanding of the protocols, their progression, and their application to individual participants.Video Abstract available for more insights from the authors (see Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A147).

  6. Knowledge of complications of diabetes mellitus among patients visiting the diabetes clinic at Sampa Government Hospital, Ghana: a descriptive study

    Directory of Open Access Journals (Sweden)

    Yaa Obirikorang

    2016-07-01

    Full Text Available Abstract Background Diabetes mellitus (DM appears to be a global epidemic and an increasingly major non-communicable disease threatening both affluent and non-affluent society. The study aimed to determine the knowledge of diabetic complications among diabetes mellitus clients visiting the Diabetic Clinical at Sampa Government Hospital, Ghana. Method This questionnaire-based descriptive study recruited a total 630 patients visiting the Diabetes Clinic at the Sampa Government Hospital. Structured questionnaire was used to obtain information such as socio-demographic and knowledge on complications of diabetes. Results Out of a total of 630 participants, 325 (51.5 % knew diabetic foot as the most common complication followed by hypertension 223(35.4 %, neuropathy 184 (29.2 %, hypoactive sexual arousal 160(25.4 %, arousal disorder 135(21.5 %, eye diseases 112(17.7 %, heart disease 58(9.2 %, and renal disease 34(5.4 %. Comprehensive assessment of level of knowledge on the complications showed that majority 378(60.0 % of T2D patients did not have knowledge on diabetes complications, 169(26.9 % had inadequate knowledge on diabetics complication while 82(13.1 % had adequate knowledge. The risk factors associated with the level of knowledge of diabetic complications were female gender adjusted odd ratio (AOR =2.31 (1.56–3.41 married participants AOR = 3.37 (1.44–7.93, widowed AOR = 2.98 (1.10–8.08, basic level of education AOR =0.18 (0.082–0.50, Junior High School (JHS and above of education level AOR = 0.035(0.017–0.75, 5–9 years of T2D duration AOR = 0.31(0.018–0.57, ≥10 years T2D duration AOR = 0.042 (0.02–0.10 and urban dwellers AOR = 0.36 (0.22–0.68 respectively. Conclusion Participants knew the individual complication of diabetic mellitus but lack an in-depth knowledge on the complications. Further expansion of diabetic educative programs like using mass media and involving national curriculum

  7. Knowledge of complications of diabetes mellitus among patients visiting the diabetes clinic at Sampa Government Hospital, Ghana: a descriptive study.

    Science.gov (United States)

    Obirikorang, Yaa; Obirikorang, Christian; Anto, Enoch Odame; Acheampong, Emmanuel; Batu, Emmanuella Nsenbah; Stella, Agyemang Duah; Constance, Omerige; Brenya, Peter Kojo

    2016-07-26

    Diabetes mellitus (DM) appears to be a global epidemic and an increasingly major non-communicable disease threatening both affluent and non-affluent society. The study aimed to determine the knowledge of diabetic complications among diabetes mellitus clients visiting the Diabetic Clinical at Sampa Government Hospital, Ghana. This questionnaire-based descriptive study recruited a total 630 patients visiting the Diabetes Clinic at the Sampa Government Hospital. Structured questionnaire was used to obtain information such as socio-demographic and knowledge on complications of diabetes. Out of a total of 630 participants, 325 (51.5 %) knew diabetic foot as the most common complication followed by hypertension 223(35.4 %), neuropathy 184 (29.2 %), hypoactive sexual arousal 160(25.4 %), arousal disorder 135(21.5 %), eye diseases 112(17.7 %), heart disease 58(9.2 %), and renal disease 34(5.4 %). Comprehensive assessment of level of knowledge on the complications showed that majority 378(60.0 %) of T2D patients did not have knowledge on diabetes complications, 169(26.9 %) had inadequate knowledge on diabetics complication while 82(13.1 %) had adequate knowledge. The risk factors associated with the level of knowledge of diabetic complications were female gender adjusted odd ratio (AOR) =2.31 (1.56-3.41) married participants AOR = 3.37 (1.44-7.93), widowed AOR = 2.98 (1.10-8.08), basic level of education AOR =0.18 (0.082-0.50), Junior High School (JHS) and above of education level AOR = 0.035(0.017-0.75), 5-9 years of T2D duration AOR = 0.31(0.018-0.57), ≥10 years T2D duration AOR = 0.042 (0.02-0.10) and urban dwellers AOR = 0.36 (0.22-0.68) respectively. Participants knew the individual complication of diabetic mellitus but lack an in-depth knowledge on the complications. Further expansion of diabetic educative programs like using mass media and involving national curriculum of education can improve self-regulatory awareness of

  8. Modeling Negotiation Using "Narrative Grammar": Exploring the Evolution of Meaning in a Simulated Negotiation

    NARCIS (Netherlands)

    Cobb, S.; Laws, D.; Sluzki, C.

    2013-01-01

    Negotiation research, drawing on rational choice theory, provides a wealth of findings about how people negotiate successfully, as well as descriptions of some of the many pitfalls associated to negotiation failures. Building on narrative theory, this paper attempts to expand the theoretical base of

  9. Beach or Office? Where shall we negotiate? : The impact of location on negotiation strategies

    NARCIS (Netherlands)

    van der Wijst, Per; Hong, Alain

    2017-01-01

    The central question in this study was to what extent the formality of the location where the negotiation takes place influences the negotiation strategies used. We studied the role of formality in an experimental setting, where a negotiation simulation took place either in an office room or at the

  10. A social negotiation of hope

    DEFF Research Database (Denmark)

    Ungruhe, Christian; Esson, James

    2017-01-01

    This article examines the present-day perception among boys and young men in West Africa that migration through football offers a way of achieving social standing and improving their life chances. Drawing on ethnographic fieldwork among footballers in urban southern Ghana between 2010 and 2016, we...... argue that young people’s efforts to make it abroad and “become a somebody” through football is not merely an individual fantasy; it is rather a social negotiation of hope to overcome widespread social immobility in the region. It is this collective practice among a large cohort of young males...

  11. Endodontic radiology, practice, and knowledge of radiation biology, hazard, and protection among clinical dental students and interns

    Directory of Open Access Journals (Sweden)

    Joan Emien Enabulele

    2015-01-01

    Full Text Available Objective: To evaluate the practice and knowledge of endodontic radiology as well as assess the knowledge of radiation biology, hazard, and protection among clinical dental students and interns. Materials and Methods: Cross-sectional study of clinical dental students and interns at University of Benin and University of Benin Teaching hospital respectively. Data was collected using a questionnaire which covered practice and knowledge of endodontic radiography, knowledge of radiation biology, hazard, and protection. Data was analyzed using Statistical Package for Social Sciences (SPSS version 17.0. Result: Seventy participants were included in the study, 40% were final year students and 24.3% house officers. Majority (95.7% agreed that they exposed radiographs as part of endodontic treatment. Only 18.6% knew that the apices of teeth should be 3mm from the border of the X-ray film, while 24.3% knew that 3mm of periapical bone should be visible on X-ray. Less than half (31.4% knew that paralleling technique was the technique of choice for endodontic radiography and this was statistically Significant in relationship to the status of the of the respondents. A few (4.3% of the respondents had knowledge of new horizons in endodontic imaging. Half of the respondents knew that damage by X-rays is mainly due to formation of free radicals. The most frequently reported radiation hazards was reduced salivary flow, while the least reported was rampant caries. Most knew how to protect patients, themselves, and other persons while exposing radiographs. Conclusion: There is need for inclusion of endodontic radiography in the undergraduate curriculum to ensure proper and correct radiographs during endodontic procedure.

  12. Effect of a drug allergy educational program and antibiotic prescribing guideline on inpatient clinical providers' antibiotic prescribing knowledge.

    Science.gov (United States)

    Blumenthal, Kimberly G; Shenoy, Erica S; Hurwitz, Shelley; Varughese, Christy A; Hooper, David C; Banerji, Aleena

    2014-01-01

    Inpatient providers have varying levels of knowledge in managing patients with drug and/or penicillin (PCN) allergy. Our objectives were (1) to survey inpatient providers to ascertain their baseline drug allergy knowledge and preparedness in caring for patients with PCN allergy, and (2) to assess the impact of an educational program paired with the implementation of a hospital-based clinical guideline. We electronically surveyed 521 inpatient providers at a tertiary care medical center at baseline and again 6 weeks after an educational initiative paired with clinical guideline implementation. The guideline informed providers on drug allergy history taking and antibiotic prescribing for inpatients with PCN or cephalosporin allergy. Of 323 unique responders, 42% (95% CI, 37-48%) reported no prior education in drug allergy. When considering those who responded to both surveys (n = 213), we observed a significant increase in knowledge about PCN skin testing (35% vs 54%; P allergy over time (54% vs 80%; P allergy was severe significantly improved (77% vs 92%; P = .03). Other areas, including understanding absolute contraindications to receiving a drug again and PCN cross-reactivity with other antimicrobials, did not improve significantly. Inpatient providers have drug allergy knowledge deficits but are interested in tools to help them care for inpatients with drug allergies. Our educational initiative and hospital guideline implementation were associated with increased PCN allergy knowledge in several crucial areas. To improve care of inpatients with drug allergy, more research is needed to evaluate hospital policies and sustainable educational tools. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  13. The Use of Clinical Interviews to Develop Inservice Secondary Science Teachers' Nature of Science Knowledge and Assessment of Student Nature of Science Knowledge

    Science.gov (United States)

    Peters-Burton, Erin E.

    2013-01-01

    To fully incorporate nature of science knowledge into classrooms, teachers must be both proficient in their own nature of science knowledge, but also skillful in translating their knowledge into a learning environment which assesses student knowledge. Twenty-eight inservice teachers enrolled in a graduate course which in part required a clinical…

  14. Use of e-learning in clinical clerkships: effects on acquisition of dermatological knowledge and learning processes

    Science.gov (United States)

    Martens, Herm; Nagtzaam, Ivo; Heeneman, Sylvia

    2018-01-01

    Objectives To obtain a deeper understanding of how the e-learning program, Education in Dermatology (ED), affects the acquisition of dermatological knowledge and the underlying learning processes of medical students in their clinical phase. Methods The study used a mixed method design with a convergent parallel collection of data. Medical students (n=62) from Maastricht University (The Netherlands) were randomized to either a conventional teaching group (control group n=30) or conventional teaching plus the e-learning program (application on smartphone) group (e-learning group n=32). Pre- and post-intervention knowledge test results were analysed using an independent t-test. Individual semi-structured interviews (n=9) were conducted and verbatim-transcribed recordings were analysed using King’s template analysis. Results The e-learning program positively influenced students’ level of knowledge and their process of learning. A significant difference was found in the post-test scores for the control group (M=51.4, SD=6.43) and the e-learning group (M=73.09, SD=5.12); t(60)=-14.75, pe-learning program stimulated students’ learning as the application promoted the identification and recognition of skin disorders, the use of references, creation of documents and sharing information with colleagues. Conclusions This study demonstrated that use of the e-learning program led to a significant improvement in basic dermatological knowledge. The underlying learning processes indicated that e-learning programs in dermatology filled a vital gap in the understanding of clinical reasoning in dermatology. These results might be useful when developing (clinical) teaching formats with a special focus on visual disciplines.  PMID:29352748

  15. Use of e-learning in clinical clerkships: effects on acquisition of dermatological knowledge and learning processes.

    Science.gov (United States)

    Fransen, Frederike; Martens, Herm; Nagtzaam, Ivo; Heeneman, Sylvia

    2018-01-17

    To obtain a deeper understanding of how the e-learning program, Education in Dermatology (ED), affects the acquisition of dermatological knowledge and the underlying learning processes of medical students in their clinical phase. The study used a mixed method design with a convergent parallel collection of data. Medical students (n=62) from Maastricht University (The Netherlands) were randomized to either a conventional teaching group (control group n=30) or conventional teaching plus the e-learning program (application on smartphone) group (e-learning group n=32). Pre- and post-intervention knowledge test results were analysed using an independent t-test. Individual semi-structured interviews (n=9) were conducted and verbatim-transcribed recordings were analysed using King's template analysis. The e-learning program positively influenced students' level of knowledge and their process of learning. A significant difference was found in the post-test scores for the control group (M=51.4, SD=6.43) and the e-learning group (M=73.09, SD=5.12); t(60)=-14.75, pe-learning program stimulated students' learning as the application promoted the identification and recognition of skin disorders, the use of references, creation of documents and sharing information with colleagues. This study demonstrated that use of the e-learning program led to a significant improvement in basic dermatological knowledge. The underlying learning processes indicated that e-learning programs in dermatology filled a vital gap in the understanding of clinical reasoning in dermatology. These results might be useful when developing (clinical) teaching formats with a special focus on visual disciplines.

  16. Data warehousing: toward knowledge management.

    Science.gov (United States)

    Shams, K; Farishta, M

    2001-02-01

    With rapid changes taking place in the practice and delivery of health care, decision support systems have assumed an increasingly important role. More and more health care institutions are deploying data warehouse applications as decision support tools for strategic decision making. By making the right information available at the right time to the right decision makers in the right manner, data warehouses empower employees to become knowledge workers with the ability to make the right decisions and solve problems, creating strategic leverage for the organization. Health care management must plan and implement data warehousing strategy using a best practice approach. Through the power of data warehousing, health care management can negotiate bettermanaged care contracts based on the ability to provide accurate data on case mix and resource utilization. Management can also save millions of dollars through the implementation of clinical pathways in better resource utilization and changing physician behavior to best practices based on evidence-based medicine.

  17. Nurses' knowledge, clinical practice and attitude towards unconventional medicine: Implications for intercultural healthcare.

    Science.gov (United States)

    Gyasi, Razak Mohammed; Abass, Kabila; Adu-Gyamfi, Samuel; Accam, Burnett Tetteh

    2017-11-01

    The aim of this hospital-based, cross-sectional study was to examine nurses' knowledge, personal and professional practices and attitude towards complementary and alternative medical therapies in urban Ghana. Using convenience sampling technique, cross-sectional data were collected from 210 registered and practicing nurses with self-administered questionnaire based on the Complementary and Alternative Medicine (CAM) Health Belief Questionnaire (CHBQ). Descriptive statistics and the associations between variables were calculated using Pearson's Chi-square test and/or Fisher's exact test with p training curriculum can improve CAM knowledge and professional practice among nurses, and in turn, enhance evidence-based patient care within the framework of intercultural healthcare system in Ghana. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Patient-mediated knowledge translation (PKT) interventions for clinical encounters: a systematic review

    OpenAIRE

    Gagliardi, Anna R.; L?gar?, France; Brouwers, Melissa C.; Webster, Fiona; Badley, Elizabeth; Straus, Sharon

    2016-01-01

    Background Patient-mediated knowledge translation (PKT) interventions engage patients in their own health care. Insight on which PKT interventions are effective is lacking. We sought to describe the type and impact of PKT interventions. Methods We performed a systematic review of PKT interventions, defined as strategies that inform, educate and engage patients in their own health care. We searched MEDLINE, EMBASE and the Cochrane Library from 2005 to 2014 for English language studies that eva...

  19. Knowledge, attitude and practice of type 2 diabetic patients of selected outreach clinic, Dharan, Nepal

    OpenAIRE

    Chitrakala Nepal; Pallavi Vyas; Richha Bhattarai; Bishwanath Acharya; Kanchan Thapa; Jenesh Singh Shrestha; Robin Maskey; Sanjib K. Sharma

    2017-01-01

    Background and Objectives: The burden of type 2 Diabetes Mellitus continues to rise and constitutes a real threat especially in the developing world. A cross sectional study was carried out to determine knowledge, attitude and practices regarding lifestyle modifications on type 2 Diabetes Mellitus. Methods: Face to face interview was carried out using structured questionnaire among 89 of patients. The data was analyzed using SPSS16. Results: The study showed that majority of participants was ...

  20. Using a knowledge translation framework to implement asthma clinical practice guidelines in primary care.

    Science.gov (United States)

    Licskai, Christopher; Sands, Todd; Ong, Michael; Paolatto, Lisa; Nicoletti, Ivan

    2012-10-01

    Quality problem International guidelines establish evidence-based standards for asthma care; however, recommendations are often not implemented and many patients do not meet control targets. Initial assessment Regional pilot data demonstrated a knowledge-to-practice gap. Choice of solutions We engineered health system change in a multi-step approach described by the Canadian Institutes of Health Research knowledge translation framework. Implementation Knowledge translation occurred at multiple levels: patient, practice and local health system. A regional administrative infrastructure and inter-disciplinary care teams were developed. The key project deliverable was a guideline-based interdisciplinary asthma management program. Six community organizations, 33 primary care physicians and 519 patients participated. The program operating cost was $290/patient. Evaluation Six guideline-based care elements were implemented, including spirometry measurement, asthma controller therapy, a written self-management action plan and general asthma education, including the inhaler device technique, role of medications and environmental control strategies in 93, 95, 86, 100, 97 and 87% of patients, respectively. Of the total patients 66% were adults, 61% were female, the mean age was 35.7 (SD = ± 24.2) years. At baseline 42% had two or more symptoms beyond acceptable limits vs. 17% (P< 0.001) post-intervention; 71% reported urgent/emergent healthcare visits at baseline (2.94 visits/year) vs. 45% (1.45 visits/year) (P< 0.001); 39% reported absenteeism (5.0 days/year) vs. 19% (3.0 days/year) (P< 0.001). The mean follow-up interval was 22 (SD = ± 7) months. Lessons learned A knowledge-translation framework can guide multi-level organizational change, facilitate asthma guideline implementation, and improve health outcomes in community primary care practices. Program costs are similar to those of diabetes programs. Program savings offset costs in a ratio of 2.1:1.

  1. Using a knowledge translation framework to implement asthma clinical practice guidelines in primary care

    Science.gov (United States)

    Licskai, Christopher; Sands, Todd; Ong, Michael; Paolatto, Lisa; Nicoletti, Ivan

    2012-01-01

    Quality problem International guidelines establish evidence-based standards for asthma care; however, recommendations are often not implemented and many patients do not meet control targets. Initial assessment Regional pilot data demonstrated a knowledge-to-practice gap. Choice of solutions We engineered health system change in a multi-step approach described by the Canadian Institutes of Health Research knowledge translation framework. Implementation Knowledge translation occurred at multiple levels: patient, practice and local health system. A regional administrative infrastructure and inter-disciplinary care teams were developed. The key project deliverable was a guideline-based interdisciplinary asthma management program. Six community organizations, 33 primary care physicians and 519 patients participated. The program operating cost was $290/patient. Evaluation Six guideline-based care elements were implemented, including spirometry measurement, asthma controller therapy, a written self-management action plan and general asthma education, including the inhaler device technique, role of medications and environmental control strategies in 93, 95, 86, 100, 97 and 87% of patients, respectively. Of the total patients 66% were adults, 61% were female, the mean age was 35.7 (SD = ±24.2) years. At baseline 42% had two or more symptoms beyond acceptable limits vs. 17% (Pabsenteeism (5.0 days/year) vs. 19% (3.0 days/year) (P< 0.001). The mean follow-up interval was 22 (SD = ±7) months. Lessons learned A knowledge-translation framework can guide multi-level organizational change, facilitate asthma guideline implementation, and improve health outcomes in community primary care practices. Program costs are similar to those of diabetes programs. Program savings offset costs in a ratio of 2.1:1 PMID:22893665

  2. Negotiating

    CERN Document Server

    O'Connor, Philip; Scott-Barrett, Fiona

    1993-01-01

    This is part of a series of books, which gives training in key business communication skills. Emphasis is placed on building awareness of language appropriateness and fluency in typical business interactions. This new edition is in full colour.

  3. The role of emotion in the learning and transfer of clinical skills and knowledge.

    Science.gov (United States)

    McConnell, Meghan M; Eva, Kevin W

    2012-10-01

    Medical school and residency are emotional experiences for trainees. Most research examining emotion in medicine has focused on negative moods associated with physician burnout and poor quality of life. However, positive emotional states also may have important influences on student learning and performance. The authors present a review of the literature on the influence of emotion on cognition, specifically how individuals learn complex skills and knowledge and how they transfer that information to new scenarios. From September 2011 to February 2012, the authors searched Medline, PsycInfo, GoogleScholar, ERIC, and Web of Science, as well as the reference lists of relevant articles, for research on the interaction between emotion, learning, and knowledge transfer. They extracted representative themes and noted particularly relevant empirical findings. The authors found articles that show that emotion influences various cognitive processes that are involved in the acquisition and transfer of knowledge and skills. More specifically, emotion influences how individuals identify and perceive information, how they interpret it, and how they act on the information available in learning and practice situations. There are many ways in which emotions may influence medical education. Researchers must further explore the implications of these findings to ensure that learning is not treated simply as a rational, mechanistic process but that trainees are effectively prepared to perform under a wide range of emotional conditions.

  4. Separating Business Logic from Medical Knowledge in Digital Clinical Workflows Using Business Process Model and Notation and Arden Syntax.

    Science.gov (United States)

    de Bruin, Jeroen S; Adlassnig, Klaus-Peter; Leitich, Harald; Rappelsberger, Andrea

    2018-01-01

    Evidence-based clinical guidelines have a major positive effect on the physician's decision-making process. Computer-executable clinical guidelines allow for automated guideline marshalling during a clinical diagnostic process, thus improving the decision-making process. Implementation of a digital clinical guideline for the prevention of mother-to-child transmission of hepatitis B as a computerized workflow, thereby separating business logic from medical knowledge and decision-making. We used the Business Process Model and Notation language system Activiti for business logic and workflow modeling. Medical decision-making was performed by an Arden-Syntax-based medical rule engine, which is part of the ARDENSUITE software. We succeeded in creating an electronic clinical workflow for the prevention of mother-to-child transmission of hepatitis B, where institution-specific medical decision-making processes could be adapted without modifying the workflow business logic. Separation of business logic and medical decision-making results in more easily reusable electronic clinical workflows.

  5. Level of confidence in venepuncture and knowledge in determining causes of blood sample haemolysis among clinical staff and phlebotomists.

    Science.gov (United States)

    Makhumula-Nkhoma, Nellie; Whittaker, Vicki; McSherry, Robert

    2015-02-01

    To investigate the association between confidence level in venepuncture and knowledge in determining causes of blood sample haemolysis among clinical staff and phlebotomists. Various collection methods are used to perform venepuncture, also called phlebotomy, the act of drawing blood from a patient using a needle. The collection method used has an impact on preanalytical blood sample haemolysis. Haemolysis is the breakdown of red blood cells, which makes the sample unsuitable. Despite available evidence on the common causes, extensive literature search showed a lack of published evidence on the association of haemolysis with staff confidence and knowledge. A quantitative primary research design using survey method. A purposive sample of 290 clinical staff and phlebotomists conducting venepuncture in one North England hospital participated in this quantitative survey. A three-section web-based questionnaire comprising demographic profile, confidence and competence levels, and knowledge sections was used to collect data in 2012. The chi-squared test for independence was used to compare the distribution of responses for categorical data. anova was used to determine mean difference in the knowledge scores of staff with different confidence levels. Almost 25% clinical staff and phlebotomists participated in the survey. There was an increase in confidence at the last venepuncture among staff of all categories. While doctors' scores were higher compared with healthcare assistants', p ≤ 0·001, nurses' were of wide range and lowest. There was no statistically significant difference (at the 5% level) in the total knowledge scores and confidence level at the last venepuncture F(2,4·690) = 1·67, p = 0·31 among staff of all categories. Evidence-based measures are required to boost staff knowledge base of preanalytical blood sample haemolysis for standardised and quality service. Monitoring and evaluation of the training, conducting and monitoring haemolysis rate are

  6. Clinical practice guidelines for translating pharmacogenomic knowledge to bedside. Focus on anticancer drugs.

    Directory of Open Access Journals (Sweden)

    José A G Agúndez

    2014-08-01

    Full Text Available The development of clinical practice recommendations or guidelines for the clinical use of pharmacogenomics data is an essential issue for improving drug therapy, particularly for drugs with high toxicity and/or narrow therapeutic index such as anticancer drugs. Although pharmacogenomic-based recommendations have been formulated for over 40 anticancer drugs, the number of clinical practice guidelines available is very low. The guidelines already published indicate that pharmacogenomic testing is useful for patient selection, but final dosing adjustment should be carried out on the basis of clinical or analytical parameters rather than on pharmacogenomic information.Patient selection may seem a modest objective, but it constitutes a crucial improvement with regard to the pre-pharmacogenomics situation and it saves patients’ lives. However we should not overstate the current power of pharmacogenomics. At present the pharmacogenomics of anticancer drugs is not sufficiently developed for dose adjustments based on pharmacogenomics only, and no current guidelines recommend such adjustments without considering clinical and/or analytical parameters.

  7. A theory of international bioethics: the negotiable and the non-negotiable.

    Science.gov (United States)

    Baker, Robert

    1998-09-01

    The preceding article in this issue of the Kennedy Institute of Ethics Journal presents the argument that "moral fundamentalism," the position that international bioethics rests on "basic" or "fundamental" moral prinicples that are universally accepted in all eras and cultures, collapses under a variety of multicultural and postmodern critiques. The present article looks to the contractarian tradition of Hobbes and Locke -- as reinterpreted by David Gauthier, Robert Nozick, and John Rawls -- for an alternative justification for international bioethics. Drawing on the central themes of this tradition, it is argued that international bioethics can be rationally reconstructed as a negotiated moral order that respects culturally and individually defined areas of nonnegotiability. Further, the theory of a negotiated moral order is consistent with traditional ideals about human rights, is flexible enough to absorb the genuine insights of multiculturalism and postmodernism, and yet is strong enough to justify transcultural and transtemporal moral judgments, including the condemnation of the Nazi doctors at Nuremberg. This theory also is consistent with the history of the ethics of human subjects experimentation and offers insights into current controversies such as the controversy over changing the consent rule for experiments in emergency medicine and the controversy over exempting certain clinical trials of inexpensive treatments for preventing the perinatal transmission of AIDS from the ethical standards of the sponsoring country.

  8. 48 CFR 619.808 - Contract negotiation.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Contract negotiation. 619.808 Section 619.808 Federal Acquisition Regulations System DEPARTMENT OF STATE SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS Contracting with the Small Business Administration (The 8(a) Program) 619.808 Contract negotiation...

  9. Supply Chain Sourcing Game: A Negotiation Exercise

    Science.gov (United States)

    Gumus, Mehmet; Love, Ernie C.

    2013-01-01

    This article introduces an exercise that simulates the negotiation process in a dynamic supply chain. The retailer and wholesaler roles are assigned to student groups who negotiate supply contracts in a number of rounds during a class period. Each group makes pricing, inventory, and ordering decision concurrently, and competes with others to…

  10. 49 CFR 1144.1 - Negotiation.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 8 2010-10-01 2010-10-01 false Negotiation. 1144.1 Section 1144.1 Transportation Other Regulations Relating to Transportation (Continued) SURFACE TRANSPORTATION BOARD, DEPARTMENT OF TRANSPORTATION RULES OF PRACTICE INTRAMODAL RAIL COMPETITION § 1144.1 Negotiation. (a) Timing. At least 5 days prior to seeking the prescription of ...

  11. 32 CFR 756.6 - Negotiation.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Negotiation. 756.6 Section 756.6 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY CLAIMS PROCEDURES FOR PROCESSING CLAIMS INVOLVING NON-APPROPRIATED FUND ACTIVITIES AND THEIR EMPLOYEES § 756.6 Negotiation. (a) General. Claims from NAFIs should be processed primarily...

  12. The mind and heart of the negotiator

    CERN Document Server

    Thompson, Leigh L

    2015-01-01

    For undergraduate and graduate-level business courses that cover the skills of negotiation. Delve into the mind and heart of the negotiator in order to enhance negotiation skills. The Mind and Heart of the Negotiator is dedicated to negotiators who want to improve their ability to negotiate-whether in multimillion-dollar business deals or personal interactions. This text provides an integrated view of what to do and what to avoid at the bargaining table, facilitated by an integration of theory, scientific research, and practical examples. This program will provide a better teaching and learning experience-for you and your students. Here's how: *Provide Students with Practical Real-World Examples: Each chapter opens with a case study that illustrates a real business situation.*Offer In-Depth Information on Business Negotiation Skills: This text provides practical take-away points for the manager and executive on integrative negotiation and contains a series of hands-on principles that have been proven to incre...

  13. 28 CFR 552.31 - Negotiations.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Negotiations. 552.31 Section 552.31 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT CUSTODY Hostage... negotiation process. Instead, this responsibility is ordinarily assigned to a team of individuals specifically...

  14. CONTEXTUAL STRATEGIES FOR CONDUCTING EFFECTIVE NEGOTIATION

    Directory of Open Access Journals (Sweden)

    Camelia\tBĂEȘU

    2015-12-01

    Full Text Available Within this paper we try to argue the development of contextual strategies for conducting effective negotiation. Throughout the paper we present that the first motivation which we manage to identify is that we negotiate to improve whatever situation we are involved in. It is of great relevance to identify a few reasons for what we negotiate. Another motivation is that negotiation is an opportunity for creativity and it does allow you to fashion a solution according to, usually different kinds of facts, different fact situation so you may get to express some creativity. Negotiation is perceived as an opportunity where we can also build relationship with the other person. We can also communicate better with the other side about where they are, what they want and where they want to go. Next, we try to identify what makes for successful negotiation during each stage of the negotiation process. According to this paper there are five things which are the essence of business negotiation.

  15. Negotiations in the EU Council of Ministers

    DEFF Research Database (Denmark)

    Smeets, Sandrino

    Insiders and outsiders agree; there is something particular about negotiating in Brussels. This book analyses ten years of continuous negotiations about EU enlargement to the Western Balkans, answering questions such as When and how are decisions typically reached in the European Union? What is t...

  16. Using Cognitive Agents to Train Negotiation Skills

    NARCIS (Netherlands)

    Stevens, Christopher A; Daamen, Jeroen; Gaudrain, Emma; Renkema, Tom; Top, Jakob Dirk; Cnossen, Fokie; Taatgen, Niels A

    2018-01-01

    Training negotiation is difficult because it is a complex, dynamic activity that involves multiple parties. It is often not clear how to create situations in which students can practice negotiation or how to measure students' progress. Some have begun to address these issues by creating artificial

  17. Negotiation Strategies in Supply Chain Management

    DEFF Research Database (Denmark)

    Zachariassen, Frederik

    2008-01-01

    Purpose of this paper This paper seeks to explore the impact of different negotiation strategies on the negotiation setting in different buyer-supplier relationships. So far, the extant SCM literature has only briefly touched this subject, though such a study has been advocated for on previous no...

  18. 40 CFR 35.937-5 - Negotiation.

    Science.gov (United States)

    2010-07-01

    ... procurement including negotiation may be performed by the grantee directly or by another non-Federal governmental body, person or firm retained for the purpose. Contract negotiations may include the services of... be conducted by the grantee under procedures it adopts based upon Public Law 92-582, 40 U.S.C. 541...

  19. 4 CFR 28.122 - Negotiability issues.

    Science.gov (United States)

    2010-01-01

    ... 4 Accounts 1 2010-01-01 2010-01-01 false Negotiability issues. 28.122 Section 28.122 Accounts... Special Procedures; Unfair Labor Practices § 28.122 Negotiability issues. Where the GAO and an exclusive... shall review the arguments, hold a hearing if the administrative judge deems it necessary, and issue a...

  20. Dental student perception and assessment of their clinical knowledge in educating patients about preventive dentistry.

    Science.gov (United States)

    Metz, M J; Miller, C J; Lin, W S; Abdel-Azim, T; Zandinejad, A; Crim, G A

    2015-05-01

    In today's dental school curricula, an increasing amount of time is dedicated to technological advances, and preventive dentistry topics may not be adequately addressed. Freshman (D1) students participated in a new Introduction to Preventive Dentistry course, which consisted of didactic lectures, active learning breakout sessions and case-based studies. The goal of this study was to determine if D1 dental students completing the course had a better knowledge and comfort level with basic preventive dentistry concepts and caries risk assessment than the upcoming graduating senior dental students. Following the completion of the course, D1 students were administered a survey that assessed their comfort level describing preventive dentistry topics to patients. This was immediately followed by an unannounced examination over the same topics. Senior (D4) students, who had not taken a formal course, reported statistically significant higher comfort levels than D1 students. However, the D4s scored significantly lower in all of the examination areas than the D1 students. Higher scores in D1s may have been due to recent exposure to the course material. However, the basic nature of the content-specific questions should be easily answered by novice practitioners educating their patients on oral disease prevention. As the current data shows lower content-specific scores of basic preventive dentistry knowledge amongst graduating D4 students, this may indicate a need for more guidance and education of students during the patient care. This study showed that implementation of a formalised course for D1 students can successfully ameliorate deficiencies in knowledge of preventive dentistry topics. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. An Integrated Intervention for Increasing Clinical Nurses’ Knowledge of HIV/AIDS-Related Occupational Safety

    Directory of Open Access Journals (Sweden)

    Liping He

    2016-11-01

    Full Text Available Background: Approximately 35 new HIV (Human Immunodeficiency Virus, HIV cases and at least 1000 serious infections are transmitted annually to health care workers. In China, HIV prevalence is increasing and nursing personnel are encountering these individuals more than in the past. Contaminated needle-stick injuries represent a significant occupational burden for nurses. Evidence suggests that nurses in China may not fully understand HIV/AIDS (Acquired immunodeficiency syndrome, AIDS and HIV-related occupational safety. At this time, universal protection precautions are not strictly implemented in Chinese hospitals. Lack of training may place nurses at risk for occupational exposure to blood-borne pathogens. Objectives: To assess the effectiveness of integrated interventions on nurses’ knowledge improvement about reducing the risk of occupationally acquired HIV infection. Methods: We audited integrated interventions using 300 questionnaires collected from nurses at the Affiliated Hospital of Xiangnan University, a public polyclinic in Hunan Province. The intervention studied was multifaceted and included appropriate and targeted training content for hospital, department and individual levels. After three months of occupational safety integrated interventions, 234 participants who completed the program were assessed. Results: Of the subjects studied, 94.3% (283/300 were injured one or more times by medical sharp instruments or splashed by body fluids in the last year and 95.3% considered their risk of occupational exposure high or very high. After the intervention, awareness of HIV/AIDS-related knowledge improved significantly (χ2 = 86.34, p = 0.00, and correct answers increased from 67.9% to 82.34%. Correct answers regarding risk perception were significantly different between pre-test (54.4% and post-test (66.6% (χ2 = 73.2, p = 0.00. When coming into contact with patient body fluids and blood only 24.0% of subjects used gloves regularly

  2. Knowledge, Attitudes, and Clinical Practices for Patients With Dementia Among Mental Health Providers in China: City and Town Differences.

    Science.gov (United States)

    Hsiao, Hsin-Yi; Liu, Zhaorui; Xu, Ling; Huang, Yueqin; Chi, Iris

    2016-01-01

    Mental health providers are the major resource families rely on when experiencing the effects of dementia. However, mental health resources and manpower are inadequate and unevenly distributed between cities and towns in China. This study was conducted to examine similarities and differences in knowledge, attitudes, and clinical practices concerning dementia and working with family caregivers from mental health providers' perspectives in city versus town settings. Data were collected during focus group discussions with 40 mental health providers in the Xicheng (city) and Daxing (town) districts in Beijing, China in 2011. Regional disparities between providers' knowledge of early diagnosis of dementia and related counseling skills were identified. Regional similarities included training needs, dementia-related stigma, and low awareness of dementia among family caregivers. Culturally sensitive education specific to dementia for mental health providers and a specialized dementia care model for people with dementia and their family caregivers are urgently needed. Implications for geriatric practitioners and educators are discussed.

  3. [Knowledge and adherence to bio-safety measures and biological accidents by nursing students during their clinical practice].

    Science.gov (United States)

    Merino-de la Hoz, Felicitas; Durá-Ros, María Jesús; Rodríguez-Martín, Elías; González-Gómez, Silvia; Mariano López-López, Luis; Abajas-Bustillo, Rebeca; de la Horra-Gutiérrez, Inmaculada

    2010-01-01

    To identify the degree of knowledge and performance of bio-safety measures by nursing students and knowing the type of biological accidents suffered during their clinical practice. A cross-sectional study was conducted on the students of three Nursing courses held in May of 2008. Data was collected by an anonymous self-administered questionnaire, with a return of 54%. A total of 97% of students seemed to know the standard biosafety measures, and all of them (100%) stated that those measures must be applied to every patient. However, the reality of clinical practice shows that biosafety measures are only partially applied. An average of 60.2% implement the personal hygiene measures, 66.1% use physical barriers, and 44% use sharp materials safely. Around 32.25% of the students have suffered some biological accident, with a greater incidence in the second year: administering injections (24%), drawing blood samples with Venojet needles (18%) and recapping used needles (17%). The high level of knowledge shown by the students on standard precautions is not always shown in clinical practice. There are significant deficiencies in student safety practices: recapping of used needles continues to be one of the most common risk practices carried out. Copyright (c) 2009 Elsevier España, S.L. All rights reserved.

  4. Dentists' perception, knowledge, and clinical management of molar-incisor-hypomineralisation in Kuwait: a cross-sectional study.

    Science.gov (United States)

    Alanzi, Abrar; Faridoun, Anfal; Kavvadia, Katerina; Ghanim, Aghareed

    2018-03-07

    Molar-incisor Hypomineralisation (MIH) is considered as a global dental problem. There is little knowledge of general dental practitioners (GDPs) and dental specialists (DSs) about this condition in different parts of the world, particularly in Gulf Cooperation Council (GCC) countries. Hence, this study has been carried out to assess the knowledge of GDPS and DSs in Kuwait about MIH condition, its clinical presentation and management. Findings would help national school oral health program (SOHP) to promote good oral healthcare. A structured questionnaire was distributed to 310 attendees of the 18th Kuwait Dental Association Scientific Conference, Kuwait. Data concerning demographic variables, prevalence, diagnosis, severity, training demands and clinical management of MIH were collected. A response rate of 71.3% (221/310) was reported. 94% of respondents noticed MIH in their practice. Yellow/brown demarcation has been observed as a common clinical presentation (> 50%). Almost 10-20% of MIH prevalence has been reported by the participants. Resin composite was the dental material often used in treating MIH teeth (~ 65%), and fewer than half would use it for treating moderately affected molars. Most respondents would use preformed metal crowns for severe MIH (63%). Dental journals were the information source for DSs; whereas, the internet was the information source for GDPs. Child's behaviour was the main reported barrier for treatment of MIH affected children. Many GDPs felt unconfident when diagnosing MIH compared to dental specialists. Respondents supported the need to investigate MIH prevalence and to receive a clinical training. Molar incisor hypomineralisation is a recognised dental condition by practitioners in Kuwait. Yellow/brown demarcated opacities were the most reported clinical presentation, and the composite resin was the most preferred dental material for restoring MIH teeth. Most GDPs and dental specialists would use preformed metal crowns for

  5. The mind and heart (literally) of the negotiator: personality and contextual determinants of experiential reactions and economic outcomes in negotiation.

    Science.gov (United States)

    Dimotakis, Nikolaos; Conlon, Donald E; Ilies, Remus

    2012-01-01

    The authors developed and tested a model proposing that negotiator personality interacts with the negotiation situation to influence negotiation processes and outcomes. In 2 studies, the authors found that negotiators high in agreeableness were best suited to integrative negotiations and that negotiators low in agreeableness were best suited to distributive negotiations. Consistent with this person-situation fit argument, in Study 1 the authors found that negotiators whose dispositions were a good fit to their negotiation context had higher levels of physiological (cardiac) arousal at the end of the negotiation compared with negotiators who were "misplaced" in situations inconsistent with their level of agreeableness, and this arousal was in turn related to increased economic outcomes. Study 2 replicated and extended the findings of Study 1, finding that person-situation fit was related to physiological (heart rate), psychological (positive affect), and behavioral activation (persistence) demonstrated during the negotiation, and these measures in turn were related to the economic outcomes achieved by participants.

  6. Building a Bridge or Digging a Pipeline? Clinical Data Mining in Evidence-Informed Knowledge Building

    Science.gov (United States)

    Epstein, Irwin

    2015-01-01

    Challenging the "bridge metaphor" theme of this conference, this article contends that current practice-research integration strategies are more like research-to-practice "pipelines." The purpose of this article is to demonstrate the potential of clinical data-mining studies conducted by practitioners, practitioner-oriented PhD…

  7. Trends in the Medical Knowledge and Clinical Competence of Graduates of Internal Medicine Residency Training Programs.

    Science.gov (United States)

    Norcini, John J.; And Others

    1991-01-01

    A study assessed the effectiveness of medical resident training programs during 1983-88 by evaluating students' certification scores and comparing them to the program's evaluation of students' clinical competence. Results are reported and analyzed for top-rated, university-affiliated, and non-university-affiliated programs, focusing on trends over…

  8. Knowledge, attitudes and practices of HIV-positive patients regarding disclosure of HIV results at Betesda Clinic in Namibia

    Directory of Open Access Journals (Sweden)

    Penelope Tom

    2013-02-01

    Full Text Available Background: This study examined the practices, knowledge, attitudes, and the reasons for disclosure and non-disclosure of HIV-positive patients with regard to the disclosure of HIV results at Betesda Clinic in Windhoek, Namibia.Objectives: The objectives of the study were to determine knowledge, attitudes, and practices of HIV-positive patients regarding the disclosure of HIV status at Betesda Clinic in Namibia, and to determine the reasons for disclosure and non-disclosure.Methods: This was a cross-sectional descriptive study and 263 HIV-positive patients were enrolled in the study.Results: Analyses revealed that knowledge on disclosure was good, with 68% who thought it was important. The majority (73% have disclosed and 60% disclosed within 1 week of receiving their results. The most common reasons for disclosure were that 32% needed help, 25% wanted his or her partner to go for testing, and 20% wanted to let relatives know. Reasons for non-disclosure were mainly the fear of gossip (79%. Seventy-three per cent had disclosed to their partners, and 23% had disclosed to more than one person. People’s reactions were supportive in 43%, whereas 29% understood, 9% accepted and 6% were angry. Upon disclosure 40% received help, 24% of partners were tested, 23% received psychological support and 5% were stigmatised. Disclosure was higher amongst the married and cohabitating.Conclusion: The attitude was positive with regard to knowledge of disclosure, with most participants thinking that disclosure was important and good. The attitudes and actual practices of disclosure were encouraging; however, people are disclosing only to trustedindividuals in the society and the fear of stigma is still present although the actual stigma was very low.

  9. Student self-reported communication skills, knowledge and confidence across standardised patient, virtual and traditional clinical learning environments.

    Science.gov (United States)

    Quail, Michelle; Brundage, Shelley B; Spitalnick, Josh; Allen, Peter J; Beilby, Janet

    2016-02-27

    Advanced communication skills are vital for allied health professionals, yet students often have limited opportunities in which to develop them. The option of increasing clinical placement hours is unsustainable in a climate of constrained budgets, limited placement availability and increasing student numbers. Consequently, many educators are considering the potentials of alternative training methods, such as simulation. Simulations provide safe, repeatable and standardised learning environments in which students can practice a variety of clinical skills. This study investigated students' self-rated communication skill, knowledge, confidence and empathy across simulated and traditional learning environments. Undergraduate speech pathology students were randomly allocated to one of three communication partners with whom they engaged conversationally for up to 30 min: a patient in a nursing home (n = 21); an elderly trained patient actor (n = 22); or a virtual patient (n = 19). One week prior to, and again following the conversational interaction, participants completed measures of self-reported communication skill, knowledge and confidence (developed by the authors based on the Four Habit Coding Scheme), as well as the Jefferson Scale of Empathy - Health Professionals (student version). All three groups reported significantly higher communication knowledge, skills and confidence post-placement (Median d = .58), while the degree of change did not vary as a function of group membership (Median η (2)  communication skill, knowledge and confidence, though not empathy, following a brief placement in a virtual, standardised or traditional learning environment. The self-reported increases were consistent across the three placement types. It is proposed that the findings from this study provide support for the integration of more sustainable, standardised, virtual patient-based placement models into allied health training programs for the training of

  10. Determinants of Complexity of Sovereign Debt Negotiation

    Directory of Open Access Journals (Sweden)

    Lidia Mesjasz

    2016-07-01

    Full Text Available The situation on all kinds of financial markets is determined by their increasing complexity. Negotiation of sovereign debt is also a complex endeavor. Its complexity results both from structural characteristics - number of actors, problems of coordination, communication, cooperation and conflict and from cognitive limitations. The survey of literature on sovereign debt management shows that no research has been done on complexity of sovereign debt management, and sovereign debt negotiation in particular. The aim of the paper is to provide initial framework concepts of complexity of sovereign debt restructuring negotiation referring to a universal collection of characteristics of negotiation. A model of debt restructuring negotiation is elaborated and a set of its complexity- related characteristics is proposed.

  11. Helping UN negotiators protect the poorest

    Energy Technology Data Exchange (ETDEWEB)

    Abeysinghe, Achala Chandani

    2011-07-15

    UN climate change negotiations are beehives of intense activity. Parallel negotiating sessions, contact groups, drafting sessions and side events all contribute to the complexity. During high-stake conferences like the one held in Copenhagen in 2009, negotiators labour through deadlocked all-night meetings. Adaptation, mitigation, technology transfer and finance are just a few of the controversial and technically challenging issues on the table. The UNFCCC process itself imposes an additional labyrinth that participants must learn. To meet these demands and participate in the negotiations effectively, countries need talented teams of negotiators and expert advisors. The most powerful countries send dozens of delegates: Japan's team has 114 members, and the United States has 155. But Gambia, which leads the 48 countries in the least developed countries (LDC) group, has only four. For the poorest countries, the UN provides funds to support just two delegates.

  12. Gender Contrasts in Negotiation Impasse Rates

    Directory of Open Access Journals (Sweden)

    Michael J. Cotter

    2017-03-01

    Full Text Available This study contrasts the rate of impasse in genders in face-to-face negotiations for newly trained women and men. The empirical study analyzed negotiators’ negotiation impasse rates based on gender using a two-tailed t-test. The bargainers were involved in a series of ten high-stakes, zero-sum game negotiations. A total of 4,855 separate negotiations were examined. Overall, there were no statistically significant differences in the impasse rates of men and women The female rate of impasse was lower than the male rate of impasse, but without any significant differences, the results indicate that there are no gender differences in the abilities of negotiators to arrive at a deal.

  13. THE COST OF POSITIONAL NEGOTIATIONS VERSUS COLLABORATIVE OR RELATIONAL NEGOTIATIONS FOR NEGOTIATING COMPLIANCE MILESTONES AT HANFORD WA

    International Nuclear Information System (INIS)

    HOPKINS, A.M.

    2004-01-01

    The Hanford site is subject to the Hanford Federal Facility Agreement and Consent Order (HFFACO), an order on consent signed by the DOE, the U. S. Environmental Protection Agency, (EPA) and the Washington Department of Ecology (WDOE). Under the HFFCCO, negotiations for transition milestones begin within six months after the issuance of a shutdown order. In the case of the PFP, the Nuclear Materials disposition and stabilization activities, a DOE responsibility, were necessary as precursor activities to Transition. This situation precipitated a crisis in the negotiations between the agencies, and formal negotiations initiated in 1997 ended in failure. The negotiations reached impasse on several key regulatory and operational issues. The 1997 negotiation was characterized by a strongly positional style. DOE and the regulatory personnel took hard lines early in the negotiations and were unable to move to resolution of key issues after a year and a half. This resulted in unhappy stakeholders, poor publicity, and work delays as well as wounded relationships between DOE and the regulatory community. The PFP is a former plutonium metal production facility. The operating mission of the PFP ended with a DOE Headquarters shutdown letter in October of 1996. Generally, the receipt of a shutdown letter initiates the start of Transition (as the first step of Decommissioning) of a facility. In the 2000-2001 PFP negotiations, a completely different approach was suggested and eventually initiated: Collaborative or Relational Negotiations. The relational negotiation style resulted in agreement between the agencies on all key issues within 6 months of initiation. All parties were very pleased with the results and all parties were relieved that protracted negotiations sessions were not needed with the new style of working together collaboratively to serve each other's interests without compromising each party's needs. The characteristics of collaborative negotiations included building

  14. Modeling the Construct of an Expert Evidence-Adaptive Knowledge Base for a Pressure Injury Clinical Decision Support System

    Directory of Open Access Journals (Sweden)

    Peck Chui Betty Khong

    2017-07-01

    Full Text Available The selection of appropriate wound products for the treatment of pressure injuries is paramount in promoting wound healing. However, nurses find it difficult to decide on the most optimal wound product(s due to limited live experiences in managing pressure injuries resulting from successfully implemented pressure injury prevention programs. The challenges of effective decision-making in wound treatments by nurses at the point of care are compounded by the yearly release of wide arrays of newly researched wound products into the consumer market. A clinical decision support system for pressure injury (PI-CDSS was built to facilitate effective decision-making and selection of optimal wound treatments. This paper describes the development of PI-CDSS with an expert knowledge base using an interactive development environment, Blaze Advisor. A conceptual framework using decision-making and decision theory, knowledge representation, and process modelling guided the construct of the PI-CDSS. This expert system has incorporated the practical and relevant decision knowledge of wound experts in assessment and wound treatments in its algorithm. The construct of the PI-CDSS is adaptive, with scalable capabilities for expansion to include other CDSSs and interoperability to interface with other existing clinical and administrative systems. The algorithm was formatively evaluated and tested for usability. The treatment modalities generated after using patient-specific assessment data were found to be consistent with the treatment plan(s proposed by the wound experts. The overall agreement exceeded 90% between the wound experts and the generated treatment modalities for the choice of wound products, instructions, and alerts. The PI-CDSS serves as a just-in-time wound treatment protocol with suggested clinical actions for nurses, based on the best evidence available.

  15. Nuclear medicine. Basic knowledge and clinical applications. 6. rev. and upd. ed.

    International Nuclear Information System (INIS)

    Schicha, H.; Schober, O.

    2007-01-01

    The development of imaging techniques like SPECT, SPECT-CT, PET, PET-CT and MRT has advanced rapidly during the past few years, especially in the case of hybrid technology. These techniques have become indispensable in diagnosis, differential diagnosis, therapy follow-up and prevention. This 6th revised and edited version of 'Nuclear Medicine' takes account of these developments. The general section presents fundamentals of physics, radiopharmaceutical chemistry, measuring techniques, nuclear medical examination techniques, and dosimetry. The special section presents detailed descriptions of all relevant nuclear medical techniques by organ systems and clinical pictures. There are many examples and scintiscans of organs to train the diagnostic eye and give a link to clinical practice. This successful textbook presents complex subject matter in a clear and intelligible way. It addresses newcomers and expert doctors that require training in nuclear medical methods. It has also become a standard textbook in university medicine studies and in the training of radiological assistants. (orig.)

  16. Proteomics insights into DNA damage response and translating this knowledge to clinical strategies

    DEFF Research Database (Denmark)

    von Stechow, Louise; Olsen, Jesper V

    2017-01-01

    Genomic instability is a critical driver in the process of cancer formation. At the same time, inducing DNA damage by irradiation or genotoxic compounds constitutes a key therapeutic strategy to kill fast-dividing cancer cells. Sensing of DNA lesions initiates a complex set of signalling pathways......) in the DDR. Finally, we provide an outlook on how proteomics studies of the DDR could aid clinical developments on multiple levels. This article is protected by copyright. All rights reserved....

  17. Location of power stations and measures for local people model analysis concerning location negotiation with local fishery association

    Energy Technology Data Exchange (ETDEWEB)

    Wakatani, Yoshifumi; Yamanaka, Yoshiro (Central Research Inst. of electric Power Industry, Tokyo (Japan))

    1982-05-01

    The recent negotiation of enterprisers and local people concerning the location of power stations tends to extend for long periods because of diversified arguing points and the information exchange of high density, and also to be complicated by the interrelation with other points. It is a large problem to seek the policy of such negotiation for enterprisers to respond to local people. In this study, as the first step, the policy and action appeared in location negotiations and the development of the negotiations were analyzed on the cases of location, and two kinds of the model analysis were carried out, taking fishery compensation negotiation as the object among them. The knowledge was obtained about what response to local fishery associations is effective to promote the location. The classification of location negotiation and the factors affecting the development of negotiation were investigated. It was shown to be effective to divide the process of location negotiation into five stages of advancement. The model analysis was carried out according to game theory and by gaming simulation method. The results are reported.

  18. Location of power stations and measures for local people model analysis concerning location negotiation with local fishery association

    International Nuclear Information System (INIS)

    Wakatani, Yoshifumi; Yamanaka, Yoshiro

    1982-01-01

    The recent negotiation of enterprisers and local people concerning the location of power stations tends to extend for long period because of diversified arguing points and the information exchange of high density, and also to be complicated by the interrelation with other points. It is a large problem to seek the policy of such negotiation for enterprisers to respond to local people. In this study, as the first step, the policy and action appeared in location negotiations and the development of the negotiations were analyzed on the cases of location, and two kinds of the model analysis were carried out, taking fishery compensation negotiation as the object among them. The knowledge was obtained about what response to local fishery associations is effective to promote the location. The classification of location negotiation and the factors affecting the development of negotiation were investigated. It was shown to be effective to divide the process of location negotiation into five stages of advancement. The model analysis was carried out according to game theory and by gaming simulation method. The results are reported. (Kako, I.)

  19. Knowledge, instruction and behavioural change: building a framework for effective eczema education in clinical practice.

    Science.gov (United States)

    Thompson, Deryn Lee; Thompson, Murray John

    2014-11-01

    A discussion on the reasons educational interventions about eczema, by nurses, are successful, with the subsequent development of a theoretical framework to guide nurses to become effective patient educators. Effective child and parent education is the key to successful self-management of eczema. When diagnosed, children and parents should learn to understand the condition through clear explanations, seeing treatment demonstrations and have ongoing support to learn practical skills to control eczema. Dermatology nurses provide these services, but no one has proposed a framework of the concepts underpinning their successful eczema educational interventions. A discussion paper. A literature search of online databases was undertaken utilizing terms 'eczema OR atopic dermatitis', 'education', 'parent', 'nurs*', 'framework', 'knowledge', motivation', in Scopus, CINAHL, Web of Science, Medline and Pubmed. Limits were English language and 2003-2013. The framework can inform discussion on child and parent education, provide a scaffold for future research and guide non-specialist nurses, internationally, in providing consistent patient education about eczema. Founded on an understanding of knowledge, the framework utilizes essential elements of cognitive psychology and social cognitive theory leading to successful self-management of eczema. This framework may prove useful as a basis for future research in child and parent education, globally, in the healthcare community. A framework has been created to help nurses understand the essential elements of the learning processes at the foundation of effective child and parent education. The framework serves to explain the improved outcomes reported in previous nurse-led eczema educational interventions. © 2014 The Authors. Journal of Advanced Nursing Published by John Wiley & Sons Ltd.

  20. A Comparative Study between the Conventional MCQ Scores and MCQ with the CBA Scores at the Standardized Clinical Knowledge Exam for Clinical Medical Students

    Directory of Open Access Journals (Sweden)

    Mahmood Ghadermarzi

    2015-06-01

    Full Text Available Background and purpose: Partial knowledge is one of the main factors to be considered when dealing with the improvement of the administration of Multiple Choice Questions (MCQ in testing. Various strategies have been proposed for this factor in the traditional testing environment. Therefore, this study proposed a Confidence Based Assessment (CBA as a pertinent solution and aims at comparing the effect of the CBA Scoring system with that of the conventional scoring systems (with and without negative score estimation as penalty on the students’ scores and estimating their partial knowledge on clinical studies.Methods: This comparative study was conducted using a standardized clinical knowledge exam for 117 clinical students. After two-step training, both the conventional MCQ and CBA examination was given in a single session simultaneously. The exam included 100 questions and the volunteers were requested to complete a questionnaire regarding their attitude and satisfaction on their first experience of the CBA after exam. A new confidence based marking system was selected for the scoring, which was a hybrid of the UCL and MUK2010 systems. The MCQ-Assistant, SPSS and Microsoft office Excel software were used for scoring and data analysis.Results: The mean age of the volunteers was 27.3±5.47, of whom 43.6% were men and 69.2% were senior medical students. Exam reliability was 0.977. The fit line of the MCQ scores without penalty estimation was R2=0.9816 and Intercept=18.125 or approximately.2 deviation in the low scores. The MCQ scoring with penalty had a fit line approximately parallel to the 45-degree line but on or above it and the CBA scoring fit line was nearer to the 45-degree line, parallel to it and a little below it. These two sets of scores had a significant p value0.037. The response percentage to the CBA is higher (p value=0.0001. The discrimination power of the MCQ and the CBA for the upper and lower 1/3 of the students was not

  1. Negotiating a Systems Development Method

    Science.gov (United States)

    Karlsson, Fredrik; Hedström, Karin

    Systems development methods (or methods) are often applied in tailored version to fit the actual situation. Method tailoring is in most the existing literature viewed as either (a) a highly rational process with the method engineer as the driver where the project members are passive information providers or (b) an unstructured process where the systems developer makes individual choices, a selection process without any driver. The purpose of this chapter is to illustrate that important design decisions during method tailoring are made by project members through negotiation. The study has been carried out using the perspective of actor-network theory. Our narratives depict method tailoring as more complex than (a) and (b) show the driver role rotates between the project members, and design decisions are based on influences from several project members. However, these design decisions are not consensus decisions.

  2. Comparison of three commercial knowledge bases for detection of drug-drug interactions in clinical decision support.

    Science.gov (United States)

    Fung, Kin Wah; Kapusnik-Uner, Joan; Cunningham, Jean; Higby-Baker, Stefanie; Bodenreider, Olivier

    2017-07-01

    To compare 3 commercial knowledge bases (KBs) used for detection and avoidance of potential drug-drug interactions (DDIs) in clinical practice. Drugs in the DDI tables from First DataBank (FDB), Micromedex, and Multum were mapped to RxNorm. The KBs were compared at the clinical drug, ingredient, and DDI rule levels. The KBs were evaluated against a reference list of highly significant DDIs from the Office of the National Coordinator for Health Information Technology (ONC). The KBs and the ONC list were applied to a prescription data set to simulate their use in clinical decision support. The KBs contained 1.6 million (FDB), 4.5 million (Micromedex), and 4.8 million (Multum) clinical drug pairs. Altogether, there were 8.6 million unique pairs, of which 79% were found only in 1 KB and 5% in all 3 KBs. However, there was generally more agreement than disagreement in the severity rankings, especially in the contraindicated category. The KBs covered 99.8-99.9% of the alerts of the ONC list and would have generated 25 (FDB), 145 (Micromedex), and 84 (Multum) alerts per 1000 prescriptions. The commercial KBs differ considerably in size and quantity of alerts generated. There is less variability in severity ranking of DDIs than suggested by previous studies. All KBs provide very good coverage of the ONC list. More work is needed to standardize the editorial policies and evidence for inclusion of DDIs to reduce variation among knowledge sources and improve relevance. Some DDIs considered contraindicated in all 3 KBs might be possible candidates to add to the ONC list. Published by Oxford University Press on behalf of the American Medical Informatics Association 2017. This work is written by US Government employees and is in the public domain in the United States.

  3. Complex Automated Negotiations Theories, Models, and Software Competitions

    CERN Document Server

    Zhang, Minjie; Robu, Valentin; Matsuo, Tokuro

    2013-01-01

    Complex Automated Negotiations are a widely studied, emerging area in the field of Autonomous Agents and Multi-Agent Systems. In general, automated negotiations can be complex, since there are a lot of factors that characterize such negotiations. For this book, we solicited papers on all aspects of such complex automated negotiations, which are studied in the field of Autonomous Agents and Multi-Agent Systems. This book includes two parts, which are Part I: Agent-based Complex Automated Negotiations and Part II: Automated Negotiation Agents Competition. Each chapter in Part I is an extended version of ACAN 2011 papers after peer reviews by three PC members. Part II includes ANAC 2011 (The Second Automated Negotiating Agents Competition), in which automated agents who have different negotiation strategies and implemented by different developers are automatically negotiate in the several negotiation domains. ANAC is an international competition in which automated negotiation strategies, submitted by a number of...

  4. Conventionalized knowledge

    DEFF Research Database (Denmark)

    Buus, Niels

    2006-01-01

    Mental health nurses routinely hand over clinical knowledge at intershift reports. In the present study, field descriptions from prolonged fieldwork and transcripts of audio recordings of handovers were analysed discursively drawing on ethnomethodology and conversation analysis. The analysis...... identified linguistic and social conventions for handing over clinical knowledge; in particular, differences were identified between non-interactional and interactional handovers. The interactional handovers were relatively more substantial but did also bring forth obvious signs of uncertainty regarding...... exact clinical situations. Handing over caused a silencing of the least powerful nurses' voices, generated uncertainty, and promoted knowledge about the patients' clinical situation that was not necessarily precise or up-to-date....

  5. Knowledge, attitudes and practices of HIV-positive patients regarding disclosure of HIV results at Betesda Clinic in Namibia

    Directory of Open Access Journals (Sweden)

    Penelope Tom

    2013-02-01

    Objectives: The objectives of the study were to determine knowledge, attitudes, and practices of HIV-positive patients regarding the disclosure of HIV status at Betesda Clinic in Namibia, and to determine the reasons for disclosure and non-disclosure. Methods: This was a cross-sectional descriptive study and 263 HIV-positive patients were enrolled in the study. Results: Analyses revealed that knowledge on disclosure was good, with 68% who thought it was important. The majority (73% have disclosed and 60% disclosed within 1 week of receiving their results. The most common reasons for disclosure were that 32% needed help, 25% wanted his or her partner to go for testing, and 20% wanted to let relatives know. Reasons for non-disclosure were mainly the fear of gossip (79%. Seventy-three per cent had disclosed to their partners, and 23% had disclosed to more than one person. People’s reactions were supportive in 43%, whereas 29% understood, 9% accepted and 6% were angry. Upon disclosure 40% received help, 24% of partners were tested, 23% received psychological support and 5% were stigmatised. Disclosure was higher amongst the married and cohabitating. Conclusion: The attitude was positive with regard to knowledge of disclosure, with most participants thinking that disclosure was important and good. The attitudes and actual practices of disclosure were encouraging; however, people are disclosing only to trusted individuals in the society and the fear of stigma is still present although the actual stigma was very low.

  6. Knowledge and Practices of Toxoplasmosis among Clinical Laboratory Professionals: A Cross-Sectional Study in Durango, Mexico.

    Science.gov (United States)

    Alvarado-Esquivel, Cosme; Sánchez-Anguiano, Luis Francisco; Berumen-Segovia, Luis Omar; Hernández-Tinoco, Jesús; Rico-Almochantaf, Yazmin Del Rosario; Cisneros-Camacho, Alfredo; Cisneros-Martínez, Jorge Arturo

    2017-11-18

    Background : The aim of this study was to determine the level of knowledge and practices about toxoplasmosis in a sample of clinical laboratory professionals in Mexico. Methods : 192 clinical laboratory professionals were surveyed. They were asked about (1) Toxoplasma gondii ; (2) clinical manifestations, diagnosis, treatment, and epidemiology of toxoplasmosis; and (3) their practices with respect to toxoplasmosis. Results : The range of animals infected by T. gondii was known by 44.8% of participants. Clinical aspects of toxoplasmosis were known by up to 44.3% of subjects. Correct answers about the interpretation of serological markers of T. gondii infection were provided by up to 32.8% of participants. A minority (32.2%) of participants knew about a high number of false positive results of anti- T. gondii IgM antibody tests. Most participants (90.1%) did not know what the anti- T. gondii IgG avidity test was. Up to 55.7% of participants provided incorrect answers about the interpretation of serology tests for the treatment of pregnant women. Common routes of T. gondii infection were known by toxoplasmosis and a limited practice of laboratory tests among the professionals surveyed.

  7. Using knowledge brokers to facilitate the uptake of pediatric measurement tools into clinical practice: a before-after intervention study

    Directory of Open Access Journals (Sweden)

    Cameron Dianne

    2010-11-01

    Full Text Available Abstract Background The use of measurement tools is an essential part of good evidence-based practice; however, physiotherapists (PTs are not always confident when selecting, administering, and interpreting these tools. The purpose of this study was to evaluate the impact of a multifaceted knowledge translation intervention, using PTs as knowledge brokers (KBs to facilitate the use in clinical practice of four evidence-based measurement tools designed to evaluate and understand motor function in children with cerebral palsy (CP. The KB model evaluated in this study was designed to overcome many of the barriers to research transfer identified in the literature. Methods A mixed methods before-after study design was used to evaluate the impact of a six-month KB intervention by 25 KBs on 122 practicing PTs' self-reported knowledge and use of the measurement tools in 28 children's rehabilitation organizations in two regions of Canada. The model was that of PT KBs situated in clinical sites supported by a network of KBs and the research team through a broker to the KBs. Modest financial remuneration to the organizations for the KB time (two hours/week for six months, ongoing resource materials, and personal and intranet support was provided to the KBs. Survey data were collected by questionnaire prior to, immediately following the intervention (six months, and at 12 and 18 months. A mixed effects multinomial logistic regression was used to examine the impact of the intervention over time and by region. The impact of organizational factors was also explored. Results PTs' self-reported knowledge of all four measurement tools increased significantly over the six-month intervention, and reported use of three of the four measurement tools also increased. Changes were sustained 12 months later. Organizational culture for research and supervisor expectations were significantly associated with uptake of only one of the four measurement tools. Conclusions KBs

  8. Knowledge and disclosure of HIV status among adolescents and young adults attending an adolescent HIV clinic in Accra, Ghana.

    Science.gov (United States)

    Kenu, Ernest; Obo-Akwa, Adjoa; Nuamah, Gladys B; Brefo, Anita; Sam, Miriam; Lartey, Margaret

    2014-11-26

    In Ghana it is estimated that 1.2% of HIV infections occur in young people aged 15-24 but the representation in our clinics is small. Adherence to treatment, appointment keeping and knowledge of HIV status remains a challenge. Disclosure has been shown to result in better adherence to therapy, good clinical outcomes, psychological adjustment and reduction in the risk of HIV transmission when the young person becomes sexually active. A baseline study was conducted to ascertain if adolescents and young adults knew their HIV status and their knowledge on HIV. Informed consent and assent were obtained from willing participants. Self-administered questionnaires on general knowledge of HIV, HIV treatment and disclosure were collected and analyzed. Thirty-four young persons participated in the study. The mean age was 16.9±SD 2.5 and 62% (21/32) were female. All of them were still in school. Eighty-five percent were aware that young people their age could fall sick, 91% had heard of HIV, 70% knew someone with HIV and 45% thought that adolescents were not at risk of HIV. On modes of HIV transmission, 66.7% knew HIV was transmitted through sex and 63.6% knew about mother to child transmission. Fifty three percent (18/34) knew their HIV status, 50% (17/34) were on antiretroviral and 35% (6/17) of them admitted to missing ARV doses. One person who said he was HIV negative and another who did not know his status were both on ARVs. Disclosure of HIV status to adolescents and young people is dependent on a complex mix of factors and most practitioners recommend an age and developmentally appropriate disclosure. Thus it is highly individualized. The knowledge and awareness of HIV was 91% compared to 97% of adults in the most recent Ghana Demographic and Health Survey however only about two thirds had acceptable in depth knowledge on HIV. Only half knew their HIV status which was not the best considering their ages. There is the need to strengthen education to young persons with

  9. Using knowledge brokers to facilitate the uptake of pediatric measurement tools into clinical practice: a before-after intervention study.

    Science.gov (United States)

    Russell, Dianne J; Rivard, Lisa M; Walter, Stephen D; Rosenbaum, Peter L; Roxborough, Lori; Cameron, Dianne; Darrah, Johanna; Bartlett, Doreen J; Hanna, Steven E; Avery, Lisa M

    2010-11-23

    The use of measurement tools is an essential part of good evidence-based practice; however, physiotherapists (PTs) are not always confident when selecting, administering, and interpreting these tools. The purpose of this study was to evaluate the impact of a multifaceted knowledge translation intervention, using PTs as knowledge brokers (KBs) to facilitate the use in clinical practice of four evidence-based measurement tools designed to evaluate and understand motor function in children with cerebral palsy (CP). The KB model evaluated in this study was designed to overcome many of the barriers to research transfer identified in the literature. A mixed methods before-after study design was used to evaluate the impact of a six-month KB intervention by 25 KBs on 122 practicing PTs' self-reported knowledge and use of the measurement tools in 28 children's rehabilitation organizations in two regions of Canada. The model was that of PT KBs situated in clinical sites supported by a network of KBs and the research team through a broker to the KBs. Modest financial remuneration to the organizations for the KB time (two hours/week for six months), ongoing resource materials, and personal and intranet support was provided to the KBs. Survey data were collected by questionnaire prior to, immediately following the intervention (six months), and at 12 and 18 months. A mixed effects multinomial logistic regression was used to examine the impact of the intervention over time and by region. The impact of organizational factors was also explored. PTs' self-reported knowledge of all four measurement tools increased significantly over the six-month intervention, and reported use of three of the four measurement tools also increased. Changes were sustained 12 months later. Organizational culture for research and supervisor expectations were significantly associated with uptake of only one of the four measurement tools. KBs positively influenced PTs' self-reported knowledge and self

  10. [Atypical epithelial hyperplasia of the breast: current state of knowledge and clinical practice].

    Science.gov (United States)

    Lavoué, V; Bertel, C; Tas, P; Bendavid, C; Rouquette, S; Foucher, F; Audrain, O; Bouriel, C; Levêque, J

    2010-02-01

    The diagnosis of atypical epithelial hyperplasia (AEH) increases with breast cancer screening. AEH is divided in three groups: atypical ductal hyperplasia, columnar cell lesions with atypia, lobular neoplasia. The management of women with AEH is not consensual because of uncertainty about their diagnosis related to the type of the biopsy sampling (core needle biopsy or surgical excision) and their controversial clinical signification between risk marker and true precursor of breast cancer. A systematic review of published studies was performed. Medline baseline interrogation was performed with the following keywords: atypical ductal hyperplasia, columnar cell lesions with atypia, lobular neoplasia, core needle biopsy, breast cancer, precursor lesion, hormonal replacement therapy. For each breast lesion, identified publications (English or French) were assessed for clinical practise in epidemiology, diagnosis and patient management. With immunohistochemistry and molecular studies, AEH seems to be precursor of breast cancer. But, epidemiological studies show low rate of breast cancer in women with AEH. AEH were still classified as risk factor of breast cancer. Because of high rate of breast cancer underestimation, surgical excision is necessary after the diagnosis of AEH at core needle biopsy. Surgical oncology rules and collaboration with radiologist are required for this surgery. A second operation was not required due to involved margins by AEH (except with pleiomorphic lobular neoplasia) because local control of breast cancer seems to be unchanged. Besides, hormonal replacement therapy for patient with AEH is not recommended because of lack of studies about this subject. Copyright 2009 Elsevier Masson SAS. All rights reserved.

  11. Ageism and its clinical impact in oncogeriatry: state of knowledge and therapeutic leads

    Directory of Open Access Journals (Sweden)

    Schroyen S

    2014-12-01

    Full Text Available Sarah Schroyen,1 Stéphane Adam,1 Guy Jerusalem,2,3 Pierre Missotten1 1University of Liège, Psychology of Aging Unit, 2University of Liège, Laboratory of Medical Oncology, 3CHU Sart Tilman Liege, Department of Medical Oncology, Liège, Belgium Abstract: Cancer is a major health problem that is widespread in elderly people. Paradoxically, older people suffering from cancer are often excluded from clinical trials and are undertreated when compared to younger patients. One explanation for these observations is age stigma (ie, stereotypes linked to age, and thus ageism. These stigmas can result in deleterious consequences for elderly people’s mental and physical health in “normal” aging. What, then, is the impact in a pathological context, such as oncology? Moreover, health care professionals’ attitudes can be tainted with ageism, thus leading to undesirable consequences for patients. To counter these stigmas, we can apply some possible interventions emerging from research on normal aging and from social psychology, such as intergenerational contact, activation of positive stereotypes, self-affirmation, and so on; these tools can improve opinions of aging among the elderly people themselves, as well as health care professionals, thus affecting patients’ mental and physical health. Keywords: oncogeriatry, clinical approaches, stigmatization, ageism

  12. Pathobiology of myomatosis uteri: the underlying knowledge to support our clinical practice.

    Science.gov (United States)

    Torres-de la Roche, Luz Angela; Becker, Sven; Cezar, Cristina; Hermann, Anja; Larbig, Angelika; Leicher, Lasse; Di Spiezio Sardo, Attilio; Tanos, Vasilis; Wallwiener, Markus; Verhoeven, Hugo; De Wilde, Rudy Leon

    2017-10-01

    Uterine myomatosis, a benign condition, is the most common indication for hysterectomies worldwide, affecting the reproductive goals and quality of health of women. However, gynecologists have been provided with interesting insights on its pathobiology, which are the basis for uterine-preserving therapies. The aim of this paper is to discuss the latest evidence on these mechanisms and its importance in the clinical practice. A comprehensive literature search was made in Pubmed, Medline, the Cochrane Library, Orbis plus and Google Scholar for articles related to the epidemiological, biological, and genetic bases. There is extensive evidence that genetic, epigenetic, hormonal, environmental, proinflamatory, angiogenetic, and growing factors are involved in the biology of myomatosis. Such factors are capable of activating and promoting inhibitory signaling pathways leading to initiation, development, and regression of myomata through changes in myometrial cells and myomata fibers, such as cellular proliferation, differentiation, apoptosis, angiogenesis, and changes in the surrounding environment. A good understanding of the pathobiologic mechanisms of myomatosis gives reasons to physicians to elect conservative or combined therapies, and allow affected women to receive an individualized management, according to age, reproduction desire, and clinical condition.

  13. Factors affecting knowledge transfer from continuing professional education to clinical practice: Development and psychometric properties of a new instrument.

    Science.gov (United States)

    Vasli, Parvaneh; Dehghan-Nayeri, Nahid; Khosravi, Laleh

    2018-01-01

    Despite the emphasis placed on the implementation of continuing professional education programs in Iran, researchers or practitioners have not developed an instrument for assessing the factors that affect the knowledge transfer from such programs to clinical practice. The aim of this study was to design and validate such instrument for the Iranian context. The research used a three-stage mix method. In the first stage, in-depth interviews with nurses and content analysis were conducted, after which themes were extracted from the data. In the second stage, the findings of the content analysis and literature review were examined, and preliminary instrument options were developed. In the third stage, qualitative content validity, face validity, content validity ratio, content validity index, and construct validity using exploratory factor analysis was conducted. The reliability of the instrument was measured before and after the determination of construct validity. Primary tool instrument initially comprised 53 items, and its content validity index was 0.86. In the multi-stage factor analysis, eight questions were excluded, thereby reducing 11 factors to five and finally, to four. The final instrument with 43 items consists of the following dimensions: structure and organizational climate, personal characteristics, nature and status of professionals, and nature of educational programs. Managers can use the Iranian instrument to identify factors affecting knowledge transfer of continuing professional education to clinical practice. Copyright © 2017. Published by Elsevier Ltd.

  14. Usability evaluation of pharmacogenomics clinical decision support aids and clinical knowledge resources in a computerized provider order entry system: a mixed methods approach.

    Science.gov (United States)

    Devine, Emily Beth; Lee, Chia-Ju; Overby, Casey L; Abernethy, Neil; McCune, Jeannine; Smith, Joe W; Tarczy-Hornoch, Peter

    2014-07-01

    Pharmacogenomics (PGx) is positioned to have a widespread impact on the practice of medicine, yet physician acceptance is low. The presentation of context-specific PGx information, in the form of clinical decision support (CDS) alerts embedded in a computerized provider order entry (CPOE) system, can aid uptake. Usability evaluations can inform optimal design, which, in turn, can spur adoption. The study objectives were to: (1) evaluate an early prototype, commercial CPOE system with PGx-CDS alerts in a simulated environment, (2) identify potential improvements to the system user interface, and (3) understand the contexts under which PGx knowledge embedded in an electronic health record is useful to prescribers. Using a mixed methods approach, we presented seven cardiologists and three oncologists with five hypothetical clinical case scenarios. Each scenario featured a drug for which a gene encoding drug metabolizing enzyme required consideration of dosage adjustment. We used Morae(®) to capture comments and on-screen movements as participants prescribed each drug. In addition to PGx-CDS alerts, 'Infobutton(®)' and 'Evidence' icons provided participants with clinical knowledge resources to aid decision-making. Nine themes emerged. Five suggested minor improvements to the CPOE user interface; two suggested presenting PGx information through PGx-CDS alerts using an 'Infobutton' or 'Evidence' icon. The remaining themes were strong recommendations to provide succinct, relevant guidelines and dosing recommendations of phenotypic information from credible and trustworthy sources; any more information was overwhelming. Participants' median rating of PGx-CDS system usability was 2 on a Likert scale ranging from 1 (strongly agree) to 7 (strongly disagree). Usability evaluation results suggest that participants considered PGx information important for improving prescribing decisions; and that they would incorporate PGx-CDS when information is presented in relevant and

  15. Beyond Linguistic Proximity: Galicia and Portugal in International Negotiation

    Directory of Open Access Journals (Sweden)

    Ana Belén Fernández-Souto

    2016-04-01

    Full Text Available Studying the actions of several institutions, as well as the popular belief according to which Galician people and Portuguese people have enough common ground as to fully understand each other, this article considers the reality of the matter in the context of international negotiation. We will study the use of the Galician language in international business, and then refute—or not—the hypothesis which indicates that the use of Galician can be the first step in a mutual understanding, but that it is necessary to be more deeply immersed in the language before facing an international negotiation—immersed in a way that also includes cultural knowledge.

  16. Knowledge, Attitude, and Practice Regarding the Risk of Cardiovascular Diseases in Patients Attending Outpatient Clinic in Kuantan, Malaysia.

    Science.gov (United States)

    Mohammad, Nursyafiza B; Rahman, Nor Azlina A; Haque, Mainul

    2018-01-01

    Cardiovascular disease (CVD) is a leading cause of death around the world including Malaysia. Ischemic heart disease (IHD) is the single largest cause of death in the developed countries and is one of the main contributors to the disease burden in developing countries. This was a cross-sectional study conducted to determine knowledge, attitude, and practice (KAP) regarding the risk of CVD in patients attending an outpatient clinic in Kuantan, Malaysia. A total of 100 patients comprising 52 male and 48 female subjects were selected through convenient sampling method. Of the total subjects, 86% were Malays. The mean scores (standard deviation) for KAP were 60.75±4.823, 54.36±8.711, and 33.43±4.046, respectively, whereas the maximum scores obtained by the subjects for KAP were 71, 65, and 43, respectively. Regarding questions related to knowledge, 88% subjects knew irregular eating pattern can cause disease and the benefits of vegetable intake. Most subjects recognized that smoking and obesity were CVD risk factors. Regarding questions related to attitude, 96% agreed that exercise can prevent CVD. More than half of the subjects followed healthy lifestyle. There were statistically significant differences observed in knowledge level between sexes ( P = 0.046) and races ( P = 0.001). Nevertheless, there was no statistically significant difference observed in KAP across different education levels of the subjects regarding the risk of CVD ( P -value = 0.332, 0.185, and 0.160, respectively). This study revealed that patients had good knowledge and attitude regarding CVD risk factors. Yet, the number of smokers is still quite high. Development of better public information system is essential for the well-being of the society.

  17. Knowledge, attitudes and practices among people with chronic hepatitis B attending a hepatology clinic in Malaysia: A cross sectional study

    Directory of Open Access Journals (Sweden)

    Mohamed Rosmawati

    2012-08-01

    Full Text Available Abstract Background Hepatitis B (HBV is the leading cause of cirrhosis and hepatocellular carcinoma worldwide. This study assessed the knowledge, attitudes and practices of people with chronic HBV and the associated factors. Methods This cross-sectional study was conducted at an outpatient adult hepatology clinic at a tertiary hospital in Kuala Lumpur. A self-administered questionnaire was administered on a one-to-one basis to assess knowledge, attitudes, and lifestyle practices of people with chronic HBV. Results The response rate was 89% (n = 483/543. Participants had a mean age of 46.3 (±14.7 years and the mean duration of HBV from time of diagnosis was 12.2 (±8.8 years. The mean knowledge score was 12.57/20 (standard deviation: ±4.4, range: 0–19. Participants aged 30–39 years, with higher educational attainment, employed in professional jobs, longer duration of diagnosis and those without cirrhosis had significantly higher knowledge scores. Age, education level and duration of diagnosis were significant predictors of the knowledge score on standard multiple regression analysis. More than half of the participants were worried of spreading HBV infection to family and friends and worried since the diagnosis. A third of the participants (33.5% were embarrassed to reveal their diagnosis to the public but most of them (93.6% would inform their family. Those who reported feeling worried since their diagnosis were more likely to be middle-aged, of Malay ethnicity, have shorter duration of diagnosis of less than 10 years and have received therapy. About half of the participants (50.6% did not share dining utensils and the majority (93.2% believed that HBV can be transmitted by sharing of eating and drinking utensils. Older patients were significantly less likely to share utensils. Those who felt worried since diagnosis had significant higher knowledge of HBV. Conclusion The findings highlight the stigma and misconceptions that still

  18. Knowledge, attitudes and practices among people with chronic hepatitis B attending a hepatology clinic in Malaysia: a cross sectional study.

    Science.gov (United States)

    Mohamed, Rosmawati; Ng, Chirk Jenn; Tong, Wen Ting; Abidin, Suraya Zainol; Wong, Li Ping; Low, Wah Yun

    2012-08-03

    Hepatitis B (HBV) is the leading cause of cirrhosis and hepatocellular carcinoma worldwide. This study assessed the knowledge, attitudes and practices of people with chronic HBV and the associated factors. This cross-sectional study was conducted at an outpatient adult hepatology clinic at a tertiary hospital in Kuala Lumpur. A self-administered questionnaire was administered on a one-to-one basis to assess knowledge, attitudes, and lifestyle practices of people with chronic HBV. The response rate was 89% (n = 483/543). Participants had a mean age of 46.3 (±14.7) years and the mean duration of HBV from time of diagnosis was 12.2 (±8.8) years. The mean knowledge score was 12.57/20 (standard deviation: ±4.4, range: 0-19). Participants aged 30-39 years, with higher educational attainment, employed in professional jobs, longer duration of diagnosis and those without cirrhosis had significantly higher knowledge scores. Age, education level and duration of diagnosis were significant predictors of the knowledge score on standard multiple regression analysis. More than half of the participants were worried of spreading HBV infection to family and friends and worried since the diagnosis. A third of the participants (33.5%) were embarrassed to reveal their diagnosis to the public but most of them (93.6%) would inform their family. Those who reported feeling worried since their diagnosis were more likely to be middle-aged, of Malay ethnicity, have shorter duration of diagnosis of less than 10 years and have received therapy. About half of the participants (50.6%) did not share dining utensils and the majority (93.2%) believed that HBV can be transmitted by sharing of eating and drinking utensils. Older patients were significantly less likely to share utensils. Those who felt worried since diagnosis had significant higher knowledge of HBV. The findings highlight the stigma and misconceptions that still exist among the HBV patients. More patient and public education about

  19. Pair Negotiation When Developing English Speaking Tasks

    Directory of Open Access Journals (Sweden)

    Ingrid Liliana Bohórquez Suárez

    2011-12-01

    Full Text Available This study analyzes what characterizes the negotiations of seventh graders at a public school in Bogotá when working in pairs to develop speaking tasks in EFL classes. The inquiry is a descriptive case study that follows the qualitative paradigm. As a result of analyzing the data, we obtained four consecutive steps that characterize students’ negotiations: Establishing a connection with a partner to work with, proposing practical alternatives, refusing mates’ propositions, and making practical decisions. Moreover, we found that the constant performance of the process of negotiation provokes students to construct a sociolinguistic identity that allows agreements to emerge.

  20. First formal ITER negotiations make excellent progress

    International Nuclear Information System (INIS)

    Barnard, P.

    2001-01-01

    November 8 and 9 2001 marked the historic beginning of formal negotiations meetings on the ITER project. Delegations from Canada, the European Union, Japan and the Russian Federation met in Toronto, Canada, for the first in a series of Negotiations that is expected to lead, by the end of 2002, to an agreement on the joint implementation of ITER. This agreement will govern, under international law, the construction, operation and decommissioning of ITER. The Negotiations concluded by issuing a joint news release, reflecting a commitment to share the progress reports on the efforts to implement ITER

  1. Negotiation Training Courses for Natural Resource Professionals

    Science.gov (United States)

    Burkardt, Nina; Swann, M. Earlene; Walters, Katherine

    2006-01-01

    FORT's Policy Analysis and Science Assistance Branch (PASA) has been conducting and publishing research on multi-party natural resource negotiation since the 1980s. This research has led to the development of basic and advanced negotiation training courses. Each course is two-and-a-half days. Both courses are a mix of lecture, hands-on training, and discussion. Please join us and other natural resource professionals facing similar problems and share your experiences. Come prepared to candidly discuss examples of successes to embrace, stalemates to recognize, and pitfalls to avoid in natural resource negotiations.

  2. Learning How to Ask: Women and Negotiation.

    Science.gov (United States)

    Fischer, Lauren H; Bajaj, Anureet K

    2017-03-01

    Women are less likely to reach top-level leadership positions, and more likely to leave academic positions, than men, and are likely to earn less money than men. Women are also less likely to initiate a negotiation-a process that is crucial for professional advancement. This reluctance to ask hinders their advancement and can have long-lasting consequences-both financial and professional. The reasons that women do not ask are multifactorial. In this article, we will explore reasons why women are less likely to negotiate, the barriers they face when they do, and strategies that women can apply to improve their negotiation skills.

  3. Decision-Making, Tacit Knowledge, and Motivation in Semi-Professional Practice: Humanizing the Environment through Anthropomorphism in Clinical Laboratory Science

    Science.gov (United States)

    Mortier, Teresa

    2017-01-01

    The clinical laboratory science field requires an abundance of technical knowledge; however, the importance of implicit or tacit knowledge gained through observation and practice is often discounted in this field, even though it is a critical part of reflective thinking, critical thinking, and reflective practice. The "de-skilling" of…

  4. Human papilloma virus testing knowledge and attitudes among women attending colposcopy clinic with ASCUS/LGSIL pap smears.

    Science.gov (United States)

    Le, T; Hicks, W; Menard, C; Boyd, D; Hewson, T; Hopkins, L; Kee Fung, M Fung

    2004-09-01

    To study women's knowledge regarding the role of human papilloma virus (HPV) in cervical intraepithelial neoplasia and their attitudes toward the integration of HPV testing as part of routine follow-up of atypical squamous cell of uncertain significance/low-grade squamous intraepithelial lesion (ASCUS/LGSIL) abnormalities. Over a 12-month period, all women attending the University of Ottawa colposcopy clinic for evaluation and follow-up of ASCUS/LGSIL Pap smears were recruited. Demographic data included age, nature of the Pap smear abnormality, gravidity, parity, occupation and education level, smoking history, previous history of abnormal smears, colposcopic examination and treatment, and current method of contraception. The women were asked to rate their level of concern over their Pap smear abnormality, from 0 (not concerned) to 10 (very concerned). Women's knowledge regarding the role of HPV in cervical intraepithelial neoplasia and the rationale behind the use of HPV testing was assessed by the clinic nurse as being minimal, moderate, or good, as defined by pre-specified criteria. Upon explanation by the nurses of the results of the recent ALTS (ASCUS/LGSIL Triage Study) trial, the women were asked to state whether they preferred to continue with regular colposcopic surveillance every 6 months, or to use the results of the HPV test, if negative, to reduce the number of colposcopy examinations to one annually. Descriptive statistics and logistic regression analysis were used to identify significant demographic factors associated with the women's preference for incorporation of HPV testing in their follow-up. All P values less than.10 were considered to be statistically significant, due to the exploratory nature of the study. Of the 100 women who participated in the study, 42% presented with ASCUS. The mean age (+/- SD) of the women was 33.63 +/- 11.25 years (range, 18-75 years); 66% were office workers with at least a community college degree, 86% reported

  5. Interaction patterns in crisis negotiations: Persuasive arguments and cultural differences

    NARCIS (Netherlands)

    Giebels, Ellen; Taylor, Paul J; Taylor, Paul J.

    2009-01-01

    This research examines cultural differences in negotiators' responses to persuasive arguments in crisis (hostage) negotiations over time. Using a new method of examining cue-response patterns, the authors examined 25 crisis negotiations in which police negotiators interacted with perpetrators from

  6. Virtual reality negotiation training system with virtual cognitions

    NARCIS (Netherlands)

    Ding, D.; Burger, F.; Brinkman, W.P.; Neerincx, M.A.

    2017-01-01

    A number of negotiation training systems have been developed to improve people’s performance in negotiation. They mainly focus on the skills development, and less on negotiation understanding and improving self-efficacy. We propose a virtual reality negotiation training system that exposes users to

  7. 48 CFR 49.110 - Settlement negotiation memorandum.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Settlement negotiation... CONTRACT MANAGEMENT TERMINATION OF CONTRACTS General Principles 49.110 Settlement negotiation memorandum. (a) The TCO shall, at the conclusion of negotiations, prepare a settlement negotiation memorandum...

  8. Paying a Price: Culture, Trust, and Negotiation Consequences

    Science.gov (United States)

    Gunia, Brian C.; Brett, Jeanne M.; Nandkeolyar, Amit K.; Kamdar, Dishan

    2011-01-01

    Three studies contrasting Indian and American negotiators tested hypotheses derived from theory proposing why there are cultural differences in trust and how cultural differences in trust influence negotiation strategy. Study 1 (a survey) documented that Indian negotiators trust their counterparts less than American negotiators. Study 2 (a…

  9. Surgical templates for dental implant positioning; current knowledge and clinical perspectives

    Directory of Open Access Journals (Sweden)

    Mohammed Zaheer Kola

    2015-01-01

    Full Text Available Dental implants have been used in a variety of different forms for many years. Since the mid-20 th century, there has been an increase in interest in the implant process for the replacement of missing teeth. Branemark was one of the initial pioneers who applied scientifically based research techniques to develop an endosseous implant that forms an immobile connection with bone. The need for a dental implant to completely address multiple physical and biological factors imposes tremendous constraints on the surgical and handling protocol. Metallic dental implants have been successfully used for decades, but they have serious shortcomings related to their bony union and the fact that their mechanical properties do not match those of bone. However, anatomic limitation and restorative demands encourage the surgeon to gain precision in planning and surgical positioning of dental implants. Ideal placement of the implant facilitates the establishment of favorable forces on the implants and the prosthetic component as well as ensures an aesthetic outcome. Therefore, it is advisable to establish a logical continuity between the planned restoration and the surgical phases, it is essential to use a transfer device that for sure increases the predictability of success. The surgical guide template is fabricated by a dental technician after the presurgical restorative appointments that primarily include determination of occlusal scheme and implant angulations. Here, authors genuinely attempted to review the evolution and clinical applicability of surgical templates used in the placement of dental implants.

  10. WTO — The knowledge deficit in trade negotiations | IDRC ...

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

    2011-07-22

    Jul 22, 2011 ... Instead, the best and urgent course for developing countries is to correct ... purchasing power, and international marketing reach that tiny firms cannot ... education can be as effective as traditional face-to-face education in ...

  11. Introduction to the special issue : "Cognitive perspectives on group decision and negotiation"

    NARCIS (Netherlands)

    Kolfschoten, G.L.; Reinig, B.A.

    2013-01-01

    Many organizations today rely heavily on their knowledge assets and engage in collaboration to leverage those assets.Managers and decision makers increasingly are forced to forge strategy, negotiate, and make decisions based on a vast amount of complex and dynamic information and expertise.

  12. Fast T Wave Detection Calibrated by Clinical Knowledge with Annotation of P and T Waves

    Directory of Open Access Journals (Sweden)

    Mohamed Elgendi

    2015-07-01

    Full Text Available Background: There are limited studies on the automatic detection of T waves in arrhythmic electrocardiogram (ECG signals. This is perhaps because there is no available arrhythmia dataset with annotated T waves. There is a growing need to develop numerically-efficient algorithms that can accommodate the new trend of battery-driven ECG devices. Moreover, there is also a need to analyze long-term recorded signals in a reliable and time-efficient manner, therefore improving the diagnostic ability of mobile devices and point-of-care technologies. Methods: Here, the T wave annotation of the well-known MIT-BIH arrhythmia database is discussed and provided. Moreover, a simple fast method for detecting T waves is introduced. A typical T wave detection method has been reduced to a basic approach consisting of two moving averages and dynamic thresholds. The dynamic thresholds were calibrated using four clinically known types of sinus node response to atrial premature depolarization (compensation, reset, interpolation, and reentry. Results: The determination of T wave peaks is performed and the proposed algorithm is evaluated on two well-known databases, the QT and MIT-BIH Arrhythmia databases. The detector obtained a sensitivity of 97.14% and a positive predictivity of 99.29% over the first lead of the validation databases (total of 221,186 beats. Conclusions: We present a simple yet very reliable T wave detection algorithm that can be potentially implemented on mobile battery-driven devices. In contrast to complex methods, it can be easily implemented in a digital filter design.

  13. The Influence of an Orthopedic, Manual Therapy Residency Program on Improved Knowledge, Psychomotor Skills, and Clinical Reasoning in Nairobi, Kenya.

    Science.gov (United States)

    Cunningham, Shala; McFelea, Joni

    2017-01-01

    The purpose of this study was to describe the influence of a post-graduate orthopedic manual therapy residency program in Kenya on the development of physical therapists' (PTs) knowledge and clinical reasoning related to the performance of a musculoskeletal examination and evaluation as compared to an experience-matched control group of PTs waiting to enter the program. A cross-sectional design was utilized in which 12 graduating residents and 10 PTs entering the residency program completed a live-patient practical examination to assess the knowledge, clinical reasoning, and psychomotor skills related to the examination and evaluation of musculoskeletal conditions. The assessment utilized was based on the tasks, procedures, and knowledge areas identified as important to advanced clinicians in the US as outlined by the Orthopaedic Description of Specialty Practice. Inclusion criteria included participation in or acceptance to the residency program, practice as a PT between 3 and 25 years, and 50% of workday being involved in direct patient care. Overall pass rates were analyzed using the Pearson chi-square and Fisher's exact tests to determine if the graduating residents achieved significantly higher scores than experience-matched controls consisting of PTs entering the residency program. PTs completing a post-graduate orthopedic manual therapy residency in Nairobi, Kenya, achieved higher scores and passing rates compared to their colleagues who had not completed a residency program as determined by a live-patient practical examination. Graduating residents demonstrated statistically significant higher scores in the categories of examination, evaluation, and diagnosis. The average live-patient practical examination score for PTs without residency training was 38.2%, and their pass rate was 0.0%. The average live-patient practical examination score for residency-trained PTs was 83.4%, and their pass rate was 92.3%. These findings are statistically significant ( p

  14. The negotiated equilibrium model of spinal cord function.

    Science.gov (United States)

    Wolpaw, Jonathan R

    2018-04-16

    The belief that the spinal cord is hardwired is no longer tenable. Like the rest of the CNS, the spinal cord changes during growth and aging, when new motor behaviours are acquired, and in response to trauma and disease. This paper describes a new model of spinal cord function that reconciles its recently appreciated plasticity with its long recognized reliability as the final common pathway for behaviour. According to this model, the substrate of each motor behaviour comprises brain and spinal plasticity: the plasticity in the brain induces and maintains the plasticity in the spinal cord. Each time a behaviour occurs, the spinal cord provides the brain with performance information that guides changes in the substrate of the behaviour. All the behaviours in the repertoire undergo this process concurrently; each repeatedly induces plasticity to preserve its key features despite the plasticity induced by other behaviours. The aggregate process is a negotiation among the behaviours: they negotiate the properties of the spinal neurons and synapses that they all use. The ongoing negotiation maintains the spinal cord in an equilibrium - a negotiated equilibrium - that serves all the behaviours. This new model of spinal cord function is supported by laboratory and clinical data, makes predictions borne out by experiment, and underlies a new approach to restoring function to people with neuromuscular disorders. Further studies are needed to test its generality, to determine whether it may apply to other CNS areas such as the cerebral cortex, and to develop its therapeutic implications. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  15. Love, or negotiation, is in the air

    Energy Technology Data Exchange (ETDEWEB)

    McLean, A. [McCloskey Coal Information Services (Australia)

    2001-10-01

    The columnist considers the issues of whether there will be any Japanese/Australian benchmark price negotiations at all this year, and if so whether Japan will continue to set the world price for coking and steam coal.

  16. Territorial stigmatisation and the negotiation of place

    DEFF Research Database (Denmark)

    Hansen, Kim Toft; Christensen, Jørgen Riber

    2018-01-01

    The article addresses the negotiated meaning of notorious places through a consideration of a recent tendency in Danish TV documentaries where marginalized, often peripheral, places are portrayed and debated. Based partly on sociological research about territorial stigmatisation, partly on location...

  17. Negotiate way out of siting dilemmas

    International Nuclear Information System (INIS)

    Leroy, D.H.; Nadler, T.S.

    1993-01-01

    Can America negotiate itself out of its high-level radioactive waste dilemma by finding communities willing to volunteer as host sites? The authors think such a possibility exists. In fact, they see little other way to successfully locate controversial facilities in the future. A decide-announce-defend strategy only sparks community anger, solidifies opposition, and leads to expensive court battles without achieving results. The Office of Nuclear Waste Negotiator was established by the Nuclear Waste Policy Act to negotiate with states an Indian tribes about hosting a permanent nuclear waste repository and an interim Monitored Retrievable Storage (MRS) facility. Twenty communities and Indian tribes submitted applications for grants to study the possibility of hosting an MRS facility. Whether or not one of these potential hosts decides to make a commitment, the efficacy of negotiation has been demonstrated. Neither courtroom procedures nor administrative flats have engendered similar success

  18. Expressing Intervals in Automated Service Negotiation

    Science.gov (United States)

    Clark, Kassidy P.; Warnier, Martijn; van Splunter, Sander; Brazier, Frances M. T.

    During automated negotiation of services between autonomous agents, utility functions are used to evaluate the terms of negotiation. These terms often include intervals of values which are prone to misinterpretation. It is often unclear if an interval embodies a continuum of real numbers or a subset of natural numbers. Furthermore, it is often unclear if an agent is expected to choose only one value, multiple values, a sub-interval or even multiple sub-intervals. Additional semantics are needed to clarify these issues. Normally, these semantics are stored in a domain ontology. However, ontologies are typically domain specific and static in nature. For dynamic environments, in which autonomous agents negotiate resources whose attributes and relationships change rapidly, semantics should be made explicit in the service negotiation. This paper identifies issues that are prone to misinterpretation and proposes a notation for expressing intervals. This notation is illustrated using an example in WS-Agreement.

  19. Negotiating Rights : Building Coalitions for Improving Maternal ...

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

    Negotiating Rights : Building Coalitions for Improving Maternal Health Services ... the state of maternal health in the country reflects poorly on public health priorities. ... A number of international agencies and civil society organizations are ...

  20. Minority College Women's Views on Condom Negotiation.

    Science.gov (United States)

    McLaurin-Jones, TyWanda; Lashley, Maudry-Beverly; Marshall, Vanessa

    2015-12-22

    This study utilized quantitative and qualitative methods to (1) investigate the relationship between frequency of condom use and negotiation strategies and (2) evaluate experiences with condom negotiations among sexually active, heterosexual, African American college women. One hundred female students from a Historically Black Colleges and Universities (HBCU) completed a questionnaire that included the Condom Influence Strategies Scale (CIS) and participated in a focus group. An ANOVA was conducted to compare differences between never, inconsistent, and consistent condom users. Consistent condom users scored higher than never users on the "withholding sex" subscale of the CIS (4.88 vs. 3.55; p negotiation included deciding the "right timing" of discussion and having a previous history of sexual intercourse without a condom with their partner. Other key concepts that contribute to condom negotiation are the views that condoms are a male's responsibility and stigma of women who carry condoms.

  1. 32 CFR 644.83 - Negotiations.

    Science.gov (United States)

    2010-07-01

    ... be available. He should furnish the landowner a copy of a map indicating the boundaries of that... negotiating patterns, and keeping in mind that counteroffers must be justified as being just and reasonable...

  2. 78 FR 17234 - Negotiated Service Agreement

    Science.gov (United States)

    2013-03-20

    ... (DFS) Negotiated Service Agreement (NSA) to the market dominant product list.\\1\\ After a [[Page 17235... dominant product list.\\2\\ On March 8, 2013, the Postal Service filed an amendment to the DFS NSA with the...

  3. Evaluation of an automated knowledge-based textual summarization system for longitudinal clinical data, in the intensive care domain.

    Science.gov (United States)

    Goldstein, Ayelet; Shahar, Yuval; Orenbuch, Efrat; Cohen, Matan J

    2017-10-01

    To examine the feasibility of the automated creation of meaningful free-text summaries of longitudinal clinical records, using a new general methodology that we had recently developed; and to assess the potential benefits to the clinical decision-making process of using such a method to generate draft letters that can be further manually enhanced by clinicians. We had previously developed a system, CliniText (CTXT), for automated summarization in free text of longitudinal medical records, using a clinical knowledge base. In the current study, we created an Intensive Care Unit (ICU) clinical knowledge base, assisted by two ICU clinical experts in an academic tertiary hospital. The CTXT system generated free-text summary letters from the data of 31 different patients, which were compared to the respective original physician-composed discharge letters. The main evaluation measures were (1) relative completeness, quantifying the data items missed by one of the letters but included by the other, and their importance; (2) quality parameters, such as readability; (3) functional performance, assessed by the time needed, by three clinicians reading each of the summaries, to answer five key questions, based on the discharge letter (e.g., "What are the patient's current respiratory requirements?"), and by the correctness of the clinicians' answers. Completeness: In 13/31 (42%) of the letters the number of important items missed in the CTXT-generated letter was actually less than or equal to the number of important items missed by the MD-composed letter. In each of the MD-composed letters, at least two important items that were mentioned by the CTXT system were missed (a mean of 7.2±5.74). In addition, the standard deviation in the number of missed items in the MD letters (STD=15.4) was much higher than the standard deviation in the CTXT-generated letters (STD=5.3). Quality: The MD-composed letters obtained a significantly better grade in three out of four measured parameters

  4. Analysis of international negotiations and trade agreements

    OpenAIRE

    Górriz Gonzalo, Verónica

    2014-01-01

    This study aims to analyze international trade agreements and negotiations. For that purpose, two agreements made by the United States are chosen to be analyzed. In the first place, the North America Free Trade Agreement (NAFTA) agreement, that was signed by the United States, Canada and Mexico in 1994 in order to create a free trade area. In addition, the Transatlantic Trade and Investment Partnership (TTIP) will be analyze, an agreement that is still being negotiated between the United Stat...

  5. Do Not Shoot, a Personal Negotiation

    Science.gov (United States)

    2010-01-01

    purpose and job with us. The negotiation in this example was forced and physical in nature. Once the elder arrived with an interpreter, things were...Having worked with law enforcement, I was taught that removing the immediate threat, while utilizing the element of surprise with limited physical ...Studies AY10 Coursebook , (Maxwell AFB, AL: Air University Press, August 2009), 130-131. 2 William Zartman, "Negotiation and Conflict Resolution

  6. A Framework for Argumentation-Based Negotiation

    OpenAIRE

    Sierra, C.; Jennings, N. R.; Noriega, P.; Parsons, S.

    1997-01-01

    Many autonomous agents operate in domains in which the cooperation of their fellow agents cannot be guaranteed. In such domains negotiation is essential to persuade others of the value of co-operation. This paper describes a general framework for negotiation in which agents exchange proposals backed by arguments which summarise the reasons why the proposals should be accepted.The argumentation is persuasive because the exchanges are able to alter the mental state of the agents involved. The f...

  7. Modern approaches to agent-based complex automated negotiation

    CERN Document Server

    Bai, Quan; Ito, Takayuki; Zhang, Minjie; Ren, Fenghui; Aydoğan, Reyhan; Hadfi, Rafik

    2017-01-01

    This book addresses several important aspects of complex automated negotiations and introduces a number of modern approaches for facilitating agents to conduct complex negotiations. It demonstrates that autonomous negotiation is one of the most important areas in the field of autonomous agents and multi-agent systems. Further, it presents complex automated negotiation scenarios that involve negotiation encounters that may have, for instance, a large number of agents, a large number of issues with strong interdependencies and/or real-time constraints.

  8. Multilateral negotiations in foreign investment

    Directory of Open Access Journals (Sweden)

    David Orlando Ruiz Castro

    2016-04-01

    Full Text Available Direct foreign investment is one of the most important economic variables in the world. Aspects related to international investment agreements are reaching an outstanding place in economic international diplomacy. Nowadays, in the multilateral level there is not an agreement regarding investment and therefore this study is focused on this particular type of agreement. In order to reach this objective this study shows, first of all, how different attempts have been developed to get a multicultural a agreement regarding investment, and to refuse the general opinion that says that exponential growth of foreign investment flows in recent years has given impulse to launch a multilateral investment agreement. Secondly, this study discusses about regulations related to foreign investment under current WTO regulations, such as investment, measure agreements, and service agreement. Then, it analyzes what has happened inside the WTO from the creation of the investment team at the Singapore Conference to the failed Conference in Cancun. Finally, it analyzes the main arguments against the multilateral agreement and the effects of future possible multilateral negotiations in investment and it ends with some recommendations and conclusions.

  9. Using Cognitive Agents to Train Negotiation Skills

    Directory of Open Access Journals (Sweden)

    Christopher A. Stevens

    2018-02-01

    Full Text Available Training negotiation is difficult because it is a complex, dynamic activity that involves multiple parties. It is often not clear how to create situations in which students can practice negotiation or how to measure students' progress. Some have begun to address these issues by creating artificial software agents with which students can train. These agents have the advantage that they can be “reset,” and played against multiple times. This allows students to learn from their mistakes and try different strategies. However, these agents are often based on normative theories of how negotiators should conduct themselves, not necessarily how people actually behave in negotiations. Here, we take a step toward addressing this gap by developing an agent grounded in a cognitive architecture, ACT-R. This agent contains a model of theory-of-mind, the ability of humans to reason about the mental states of others. It uses this model to try to infer the strategy of the opponent and respond accordingly. In a series of experiments, we show that this agent replicates some aspects of human performance, is plausible to human negotiators, and can lead to learning gains in a small-scale negotiation task.

  10. Managerial Roles and Functions in Negotiation Process

    Directory of Open Access Journals (Sweden)

    Andrzej Kozina

    2014-06-01

    Full Text Available The paper is focused on negotiation processes performed in a company and presents author’s concept of the description of the roles and functions accomplished by managers within those processes and being of significant importance from the point of view of negotiations’ outcomes. Such a concept aims at providing the analysis and conducting of business negotiations with effective support. Firstly (following introduction, the concept, types, and comprehensive model of such negotiations is presented as a useful methodological framework for specifying managerial roles and functions. Secondly, some classic concepts of those roles are reviewed, drawing special attention to the ones that concern negotiation process. Thirdly, general managerial functions within that process are described. Fourthly, those functions are precised by relating them to typical hierarchical levels. Fifthly, peculiar managerial functions within negotiating team are discussed. Finally, specific issue of the role of manager as a mediator is addressed. Summing up the paper, the crucial areas for subsequent research were pointed out. In order to elaborate the presented concept the author carried out the comparative study of negotiation literature as well as developed his original ideas.

  11. Using Cognitive Agents to Train Negotiation Skills.

    Science.gov (United States)

    Stevens, Christopher A; Daamen, Jeroen; Gaudrain, Emma; Renkema, Tom; Top, Jakob Dirk; Cnossen, Fokie; Taatgen, Niels A

    2018-01-01

    Training negotiation is difficult because it is a complex, dynamic activity that involves multiple parties. It is often not clear how to create situations in which students can practice negotiation or how to measure students' progress. Some have begun to address these issues by creating artificial software agents with which students can train. These agents have the advantage that they can be "reset," and played against multiple times. This allows students to learn from their mistakes and try different strategies. However, these agents are often based on normative theories of how negotiators should conduct themselves, not necessarily how people actually behave in negotiations. Here, we take a step toward addressing this gap by developing an agent grounded in a cognitive architecture, ACT-R. This agent contains a model of theory-of-mind, the ability of humans to reason about the mental states of others. It uses this model to try to infer the strategy of the opponent and respond accordingly. In a series of experiments, we show that this agent replicates some aspects of human performance, is plausible to human negotiators, and can lead to learning gains in a small-scale negotiation task.

  12. A randomized trial assessing the impact of written information on outpatients' knowledge about and attitude toward randomized clinical trials. The Info Trial Group

    DEFF Research Database (Denmark)

    Kruse, A Y; Kjaergard, L L; Krogsgaard, K

    2000-01-01

    To improve the patient education process in clinical research, three information materials describing general aspects of design and conduct of randomized clinical trials were developed. The materials varied in length, reading ability level, and reader appeal. Their influence on knowledge about...... and attitude toward randomized clinical trials was assessed in a randomized, parallel group, evaluator-blinded trial among 415 outpatients. The patients were randomized to the following groups: control (no intervention), leaflet, brochure, or booklet. Knowledge was assessed by a 17-item multiple......-choice questionnaire and attitude was assessed by a 32-item Likert questionnaire at entry and 2 weeks after the intervention. The interventions and the questionnaires were pilot tested and power calculations were performed. At entry, the mean knowledge score was 7.9 points. At follow-up, the knowledge scores increased...

  13. Current knowledge and future research on infant feeding in the context of HIV: basic, clinical, behavioral, and programmatic perspectives.

    Science.gov (United States)

    Young, Sera L; Mbuya, Mduduzi N N; Chantry, Caroline J; Geubbels, Eveline P; Israel-Ballard, Kiersten; Cohan, Deborah; Vosti, Stephen A; Latham, Michael C

    2011-05-01

    In 2008, between 129,000 and 194,000 of the 430,000 pediatric HIV infections worldwide were attributable to breastfeeding. Yet in many settings, the health, economic, and social consequences of not breastfeeding would have dire consequences for many more children. In the first part of this review we provide an overview of current knowledge about infant feeding in the context of HIV. Namely, we describe the benefits and risks of breastmilk, the evolution of recommended infant feeding modalities in high-income and low-income countries in the last two decades, and contextualize the recently revised guidelines for infant feeding in the context of HIV current knowledge. In the second section, we suggest areas for future research on the postnatal prevention of mother-to-child transmission of HIV (PMTCT) in developing and industrialized countries. We suggest two shifts in perspective. The first is to evaluate PMTCT interventions more holistically, to include the psychosocial and economic consequences as well as the biomedical ones. The second shift in perspective should be one that contextualizes postnatal PMTCT efforts in the cascade of maternal health services. We conclude by discussing basic, clinical, behavioral, and programmatic research questions pertaining to a number of PMTCT efforts, including extended postnatal ARV prophylaxis, exclusive breastfeeding promotion, counseling, breast milk pasteurization, breast milk banking, novel techniques for making breast milk safer, and optimal breastfeeding practices. We believe the research efforts outlined here will maximize the number of healthy, thriving, HIV-free children around the world.

  14. Current Knowledge and Future Research on Infant Feeding in the Context of HIV: Basic, Clinical, Behavioral, and Programmatic Perspectives12

    Science.gov (United States)

    Young, Sera L.; Mbuya, Mduduzi N. N.; Chantry, Caroline J.; Geubbels, Eveline P.; Israel-Ballard, Kiersten; Cohan, Deborah; Vosti, Stephen A.; Latham, Michael C.

    2011-01-01

    In 2008, between 129,000 and 194,000 of the 430,000 pediatric HIV infections worldwide were attributable to breastfeeding. Yet in many settings, the health, economic, and social consequences of not breastfeeding would have dire consequences for many more children. In the first part of this review we provide an overview of current knowledge about infant feeding in the context of HIV. Namely, we describe the benefits and risks of breastmilk, the evolution of recommended infant feeding modalities in high-income and low-income countries in the last two decades, and contextualize the recently revised guidelines for infant feeding in the context of HIV current knowledge. In the second section, we suggest areas for future research on the postnatal prevention of mother-to-child transmission of HIV (PMTCT) in developing and industrialized countries. We suggest two shifts in perspective. The first is to evaluate PMTCT interventions more holistically, to include the psychosocial and economic consequences as well as the biomedical ones. The second shift in perspective should be one that contextualizes postnatal PMTCT efforts in the cascade of maternal health services. We conclude by discussing basic, clinical, behavioral, and programmatic research questions pertaining to a number of PMTCT efforts, including extended postnatal ARV prophylaxis, exclusive breastfeeding promotion, counseling, breast milk pasteurization, breast milk banking, novel techniques for making breast milk safer, and optimal breastfeeding practices. We believe the research efforts outlined here will maximize the number of healthy, thriving, HIV-free children around the world. PMID:22332055

  15. The knowledge and attitude about HIV/AIDS among Jordanian dental students: (Clinical versus pre clinical students at the University of Jordan

    Directory of Open Access Journals (Sweden)

    Shayyab Mohammad H

    2011-06-01

    Full Text Available Abstract Background The present study aimed to address the suspected deficiency in the level of understanding of HIV/AIDS among clinical and pre clinical dental students at the University of Jordan. In this cross-sectional study, structured questionnaires were distributed to fifth year dental students (n = 121 and to third year dental students (n = 144 in the academic year 2008/2009. Findings Significantly higher percentage of fifth-year students compared to third-year students felt that the teaching they received on cross-infection precautions and barrier dentistry was adequate (P Significantly higher proportion of third-year students compared to fifth-year (39.2% vs. 26.3% thought that HIV patients should be referred to other centers or support groups for treatment (P = 0.04. Conclusions The level of knowledge of Jordanian dental students about HIV and AIDS was generally acceptable; there were inadequacies, however, in their understanding regarding some aspects of AIDS epidemic which demands that dental school curriculum needs some improvement.

  16. Health and nutrition knowledge, attitudes and practices of pregnant women attending and not-attending ANC clinics in Western Kenya: a cross-sectional analysis.

    Science.gov (United States)

    Perumal, Nandita; Cole, Donald C; Ouédraogo, Hermann Z; Sindi, Kirimi; Loechl, Cornelia; Low, Jan; Levin, Carol; Kiria, Christine; Kurji, Jaameeta; Oyunga, Mary

    2013-07-11

    Antenatal care (ANC) is a key strategy to decreasing maternal mortality in low-resource settings. ANC clinics provide resources to improve nutrition and health knowledge and promote preventive health practices. We sought to compare the knowledge, attitude and practices (KAP) among women seeking and not-seeking ANC in rural Kenya. Data from a community-based cross-sectional survey conducted in Western Province, Kenya were used. Nutrition knowledge (NKS), health knowledge (HKS), attitude score (AS), and dietary diversity score (DDS) were constructed indices. χ2 test and Student's t-test were used to compare proportions and means, respectively, to assess the difference in KAP among pregnant women attending and not-attending ANC clinics. Multiple regression analyses were used to assess the impact of the number of ANC visits (none, ANC clinics while 39% had not. The mean (±SD) NKS was 4.6 (1.9) out of 11, HKS was 6.2 (1.7) out of 12, DDS was 4.9 (1.4) out of 12, and AS was 7.4 (2.2) out of 10. Nutrition knowledge, attitudes, and DDS were not significantly different between ANC clinic attending and non-attending women. Among women who attended ANC clinics, 82.6% received malaria and/or antihelmintic treatment, compared to 29.6% of ANC clinic non-attendees. Higher number of ANC clinic visits and higher maternal education level were significantly positively associated with maternal health knowledge. Substantial opportunities exist for antenatal KAP improvement among women in Western Kenya, some of which could occur with greater ANC attendance. Further research is needed to understand multi-level factors that may affect maternal knowledge and practices.

  17. Hostage (crisis) negotiation: the potential role of negotiator personality, decision-making style, coping style and emotional intelligence on negotiator success.

    Science.gov (United States)

    Grubb, Amy; Brown, Sarah

    2012-01-01

    This article explores the potential role of hostage negotiator characteristics and the impact of psychological constructs on negotiator success. It explores the role of Personality, Decision-Making Style, Coping Style, Cognitive Coping Style and Emotion Regulation and Emotional Intelligence within high stress environments and occupations. The findings suggest that certain individual traits and characteristics may play a role in negotiator success, via the mediation of specific styles, which are conducive to effective crisis negotiation skills. It is proposed that these findings have application within the field of hostage/crisis negotiation in the format of guidance regarding the recruitment and selection of hostage negotiators and the identification of potential training needs within individual negotiators in order to maximize their efficacy within the field. In line with this, it is argued that a psychometric tool that assesses these constructs is developed in order to aid the process of hostage negotiation selection.

  18. Plant-Derived Anti-Inflammatory Compounds: Hopes and Disappointments regarding the Translation of Preclinical Knowledge into Clinical Progress

    Directory of Open Access Journals (Sweden)

    Robert Fürst

    2014-01-01

    Full Text Available Many diseases have been described to be associated with inflammatory processes. The currently available anti-inflammatory drug therapy is often not successful or causes intolerable side effects. Thus, new anti-inflammatory substances are still urgently needed. Plants were the first source of remedies in the history of mankind. Since their chemical characterization in the 19th century, herbal bioactive compounds have fueled drug development. Also, nowadays, new plant-derived agents continuously enrich our drug arsenal (e.g., vincristine, galantamine, and artemisinin. The number of new, pharmacologically active herbal ingredients, in particular that of anti-inflammatory compounds, rises continuously. The major obstacle in this field is the translation of preclinical knowledge into evidence-based clinical progress. Human trials of good quality are often missing or, when available, are frequently not suitable to really prove a therapeutical value. This minireview will summarize the current situation of 6 very prominent plant-derived anti-inflammatory compounds: curcumin, colchicine, resveratrol, capsaicin, epigallocatechin-3-gallate (EGCG, and quercetin. We will highlight their clinical potential and/or pinpoint an overestimation. Moreover, we will sum up the planned trials in order to provide insights into the inflammatory disorders that are hypothesized to be beneficially influenced by the compound.

  19. Negotiating power: agenda ordering and the willingness to negotiate in asymmetric intergroup conflicts.

    Science.gov (United States)

    Kteily, Nour; Saguy, Tamar; Sidanius, James; Taylor, Donald M

    2013-12-01

    In this research, we investigated how group power influences the way members of groups in asymmetrical conflict approach intergroup negotiations. Drawing on theories of negotiations and of intergroup power, we predicted that group power would interact with features of the proposed negotiating agenda to influence willingness to come to the table. Based on the negotiation literature, we focused on 2 types of sequential negotiation agendas: 1 beginning with the discussion of consequential issues before less consequential issues (consequential first) and 1 leaving the discussion of consequential issues until after less consequential issues are discussed (consequential later). Because they are motivated to advance changes to their disadvantaged status quo, we expected low-power group members to favor consequential first over consequential later invitations to negotiate. High-power group members, motivated to protect their advantage, were expected to show the reverse preference. Converging evidence from 5 experiments involving real-world and experimental groups supported these predictions. Across studies, participants received an invitation to negotiate from the other group involving either a consequential first or consequential later agenda. Low-power group members preferred consequential first invitations because these implied less stalling of change to the status quo, and high-power group members preferred consequential later invitations because these invitations seemed to pose less threat to their position. Theoretical and practical implications for negotiations research and conflict resolution are discussed. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  20. 78 FR 57571 - Negotiated Rulemaking Committee, Negotiator Nominations and Schedule of Committee Meetings-Title...

    Science.gov (United States)

    2013-09-19

    ... and security reporting requirements in the Jeanne Clery Disclosure of Campus Security Policy and... negotiators who represent key stakeholder constituencies for the issues to be negotiated to serve on the... conversion, gainful employment, changes to the campus safety and security reporting requirements in the Clery...

  1. The Social Negotiation of Risk

    Energy Technology Data Exchange (ETDEWEB)

    Ouzounian, Gerard [ANDRA, Chatenay-Malabry (France); Gaston, Didier; Vindimian, Eric [INERIS, Vemeuil-en-Halatte (France); Brugnot, Gerard [CEMAGREF, St-Martin-d' Heres (France); Masure, Philippe [BRGM, Orleans (France)

    2001-07-01

    The prevention of risk and the necessary protection against its consequences require a sound scientific and technical approach that may only be achieved once all stakeholders mutually agree on the means to be used. Those means depend on a social structure that relies on their accessibility and on the nature of the risks that society is ready to assume. Such a structure raises a series of different questions, all with various connotations: Technical: Do we have solutions to prevent risk and limit its consequences? Scientific: What do we know about risk and to what extent is it possible to foresee an event and its potential consequences? Economical: What financial means can we allocate to risk prevention? Insurance: What types of risk may be covered? Political and ethical: What is the significance of the community concerned? What types of risk are acceptable? Legal: What liabilities stand with regard to risk prevention and protection? Societal and political: What process needs to be adopted? In a democracy, who may hold the responsibility to decide on behalf of the population? Any approach that would restrict unduly any of those parameters would lead inevitably to a series of contentions resulting from neglected aspects - and eventually to failure. That explains why several projects had to be abandoned or rejected in recent decades, simply because of insufficient consultation or interaction. The third phase involves qualitative and quantitative predictions of impacts on relevant targets (human beings, ecosystem, industrial or capital goods). After adopting a probabilistic approach (hierarchisation of causes according to more or less probabilistic scenarios) and rating effects on a severity scale, the assessment may proceed with the fourth phase where risks are evaluated, rated and categorised based on acceptable thresholds that lie at the core of the social negotiation. Once the risk assessment is over, the risk manager is able to take preventive, protective and

  2. The Social Negotiation of Risk

    International Nuclear Information System (INIS)

    Ouzounian, Gerard; Gaston, Didier; Vindimian, Eric; Brugnot, Gerard; Masure, Philippe

    2001-01-01

    The prevention of risk and the necessary protection against its consequences require a sound scientific and technical approach that may only be achieved once all stakeholders mutually agree on the means to be used. Those means depend on a social structure that relies on their accessibility and on the nature of the risks that society is ready to assume. Such a structure raises a series of different questions, all with various connotations: Technical: Do we have solutions to prevent risk and limit its consequences? Scientific: What do we know about risk and to what extent is it possible to foresee an event and its potential consequences? Economical: What financial means can we allocate to risk prevention? Insurance: What types of risk may be covered? Political and ethical: What is the significance of the community concerned? What types of risk are acceptable? Legal: What liabilities stand with regard to risk prevention and protection? Societal and political: What process needs to be adopted? In a democracy, who may hold the responsibility to decide on behalf of the population? Any approach that would restrict unduly any of those parameters would lead inevitably to a series of contentions resulting from neglected aspects - and eventually to failure. That explains why several projects had to be abandoned or rejected in recent decades, simply because of insufficient consultation or interaction. The third phase involves qualitative and quantitative predictions of impacts on relevant targets (human beings, ecosystem, industrial or capital goods). After adopting a probabilistic approach (hierarchisation of causes according to more or less probabilistic scenarios) and rating effects on a severity scale, the assessment may proceed with the fourth phase where risks are evaluated, rated and categorised based on acceptable thresholds that lie at the core of the social negotiation. Once the risk assessment is over, the risk manager is able to take preventive, protective and

  3. The assessment and treatment of unhealthy exercise in adolescents with anorexia nervosa: A Delphi study to synthesize clinical knowledge.

    Science.gov (United States)

    Noetel, Melissa; Dawson, Lisa; Hay, Phillipa; Touyz, Stephen

    2017-04-01

    This study aimed to explore and synthesize expert clinical knowledge on defining and managing unhealthy exercise in adolescents with AN. The Delphi methodology was used. Clinicians (n = 25) considered experts in the treatment of AN in adolescents were recruited internationally to form the panel. The first round of the questionnaires was comprised of five open-ended questions regarding defining, assessing, and treating unhealthy exercise in adolescents with AN. Statements were derived from this data using content analysis, and included as Likert-based items in two subsequent rounds, in which panellists were required to rate their level of agreement for each item. All 25 respondents completed the three rounds of questionnaires. Consensus was achieved for 59.0% of the items included in the second and third round of questionnaires. Although consensus was not achieved, compulsive exercise was the preferred term for the panel when referring to unhealthy exercise in adolescents with AN. The panel clearly delineated features of unhealthy and healthy exercise, and endorsed a number of items considered important to assess for when evaluating exercise in this clinical population. A variety of treatment approaches and strategies reached consensus. Notably, for those who are medically stable and progressing toward recovery, the panel recommended initial exercise restriction practices and reintroducing healthy exercise behaviors, rather than exercise cessation practices. The current findings can serve as preliminary treatment guidelines. A unified approach to labeling and defining unhealthy exercise in the eating disorder literature and clinical settings is required to achieve further progress. © 2017 Wiley Periodicals, Inc.

  4. Pain in hospitalized children: Effect of a multidimensional knowledge translation strategy on pain process and clinical outcomes.

    Science.gov (United States)

    Stevens, Bonnie J; Yamada, Janet; Estabrooks, Carole A; Stinson, Jennifer; Campbell, Fiona; Scott, Shannon D; Cummings, Greta

    2014-01-01

    Hospitalized children frequently receive inadequate pain assessment and management despite substantial evidence to support effective pediatric pain practices. The objective of this study was to determine the effect of a multidimensional knowledge translation intervention, Evidence-based Practice for Improving Quality (EPIQ), on procedural pain practices and clinical outcomes for children hospitalized in medical, surgical and critical care units. A prospective cohort study compared 16 interventions using EPIQ and 16 standard care (SC) units in 8 Canadian pediatric hospitals. Chart reviews at baseline (time 1) and intervention completion (time 2) determined the nature and frequency of painful procedures and of pain assessment and pain management practices. Trained pain experts evaluated pain intensity 6 months post-intervention (time 3) during routine, scheduled painful procedures. Generalized estimating equation models compared changes in outcomes between EPIQ and SC units over time. EPIQ units used significantly more validated pain assessment tools (Ppatients who received analgesics (P=0.03) and physical pain management strategies (P=0.02). Mean pain intensity scores were significantly lower in the EPIQ group (P=0.03). Comparisons of moderate (4-6/10) and severe (7-10/10) pain, controlling for child and unit level factors, indicated that the odds of having severe pain were 51% less for children in the EPIQ group (adjusted OR: 0.49, 95% CI: 0.26-0.83; P=0.009). EPIQ was effective in improving practice and clinical outcomes for hospitalized children. Additional exploration of the influence of contextual factors on research use in hospital settings is required to explain the variability in pain processes and clinical outcomes. Copyright © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  5. The negotiation of writer identity in engineering faculty - writing consultant collaborations

    Directory of Open Access Journals (Sweden)

    Sarah Read

    2011-12-01

    Full Text Available Negotiating faculty-writing consultant collaborations in engineering contexts can be challenging when the writing consultant originates in the humanities. The author found that one of the sites of negotiation in the formation of working relationships is that of writer identity, and disciplinary writer identity in particular. In order to confirm her experiential knowledge, the author interviewed her faculty collaborators to further investigate their attitudes and experiences about writing. Analysis of two excerpts of these interviews makes visible "clashes" between the faculty engineers' and the writing consultant's autobiographical and disciplinary writer identities. Implications of the role of writer identity in faculty-writing consultant collaborations include considering the value of extending this negotiation explicitly to students and the question of how writing curriculum can explicitly engage students in the formation of positive disciplinary writer identities

  6. Health information technology knowledge and skills needed by HIT employers.

    Science.gov (United States)

    Fenton, S H; Gongora-Ferraez, M J; Joost, E

    2012-01-01

    To evaluate the health information technology (HIT) workforce knowledge and skills needed by HIT employers. Statewide face-to-face and online focus groups of identified HIT employer groups in Austin, Brownsville, College Station, Dallas, El Paso, Houston, Lubbock, San Antonio, and webinars for rural health and nursing informatics. HIT employers reported needing an HIT workforce with diverse knowledge and skills ranging from basic to advanced, while covering information technology, privacy and security, clinical practice, needs assessment, contract negotiation, and many other areas. Consistent themes were that employees needed to be able to learn on the job and must possess the ability to think critically and problem solve. Many employers wanted persons with technical skills, yet also the knowledge and understanding of healthcare operations. The HIT employer focus groups provided valuable insight into employee skills needed in this fast-growing field. Additionally, this information will be utilized to develop a statewide HIT workforce needs assessment survey.

  7. Novel insights in agent-based complex automated negotiation

    CERN Document Server

    Lopez-Carmona, Miguel; Ito, Takayuki; Zhang, Minjie; Bai, Quan; Fujita, Katsuhide

    2014-01-01

    This book focuses on all aspects of complex automated negotiations, which are studied in the field of autonomous agents and multi-agent systems. This book consists of two parts. I: Agent-Based Complex Automated Negotiations, and II: Automated Negotiation Agents Competition. The chapters in Part I are extended versions of papers presented at the 2012 international workshop on Agent-Based Complex Automated Negotiation (ACAN), after peer reviews by three Program Committee members. Part II examines in detail ANAC 2012 (The Third Automated Negotiating Agents Competition), in which automated agents that have different negotiation strategies and are implemented by different developers are automatically negotiated in the several negotiation domains. ANAC is an international competition in which automated negotiation strategies, submitted by a number of universities and research institutes across the world, are evaluated in tournament style. The purpose of the competition is to steer the research in the area of bilate...

  8. Culture and Negotiator Cognition: Judgment Accuracy and Negotiation Processes in Individualistic and Collectivistic Cultures.

    Science.gov (United States)

    Gelfand; Christakopoulou

    1999-09-01

    In this paper, we argue that judgment biases in negotiation are perpetuated by underlying cultural values and ideals, and therefore, certain judgment biases will be more prevalent in certain cultural contexts. Based on theory in cultural psychology (Markus & Kitayama, 1991; Triandis, 1989), we considered the notion that fixed pie error, a judgment bias in which negotiators fail to accurately understand their counterparts' interests (Pruitt & Lewis, 1975; Thompson & Hastie, 1990), would be more prevalent at the end of negotiations in the United States, an individualistic culture, than Greece, a collectivistic culture. The results of a 2-week computer-mediated intercultural negotiation experiment, which took place between American students in Illinois and Greek students in Athens, supported this view. Theoretical implications of culture and cognition in negotiation are also discussed. Copyright 1999 Academic Press.

  9. Community Influences on Married Women's Safer Sex Negotiation Attitudes in Bangladesh: A Multilevel Analysis.

    Science.gov (United States)

    Jesmin, Syeda S; Cready, Cynthia M

    2016-02-01

    The influence of disadvantaged or deprived community on individuals' health risk-behaviors is increasingly being documented in a growing body of literature. However, little is known about the effects of community characteristics on women's sexual attitudes and behaviors. To examine community effects on married women's safer sex negotiation attitudes, we analyzed cross-sectional data from the 2011 Bangladesh Demographic and Health Surveys on a sample of 15,134 married women in 600 communities. We estimated two multilevel logistic regression models. Model 1, which included only individual-level variables, showed that women's autonomy/empowerment, age, and HIV knowledge had significant associations with their safer sex negotiation attitudes. We did not find any socioeconomic status gradient in safer sex negotiation attitudes at the individual level. Adding community-level variables in Model 2 significantly improved the fit of the model. Strikingly, we found that higher community-level poverty was associated with greater positive safer sex negotiation attitudes. Prevailing gender norms and overall women's empowerment in the community also had significant effects. While research on community influences calls for focusing on disadvantaged communities, our research highlights the importance of not underestimating the challenges that married women in economically privileged communities may face in negotiating safer sex. To have sufficient and equitable impact on married women's sexual and reproductive health, sexual and reproductive health promotion policies and programs need to be directed to women in wealthier communities as well.

  10. Examining attitudes and knowledge about HPV and cervical cancer risk among female clinic attendees in Johannesburg, South Africa.

    Science.gov (United States)

    Francis, Shelley A; Nelson, Jennifer; Liverpool, Joan; Soogun, Soji; Mofammere, Nokuthula; Thorpe, Roland J

    2010-11-23

    Developing countries account for 85% of the nearly 500,000 yearly cases of cervical cancer worldwide with approximately 250,000 deaths occurring in Sub-Saharan Africa, South Asia, and Latin America. In South Africa, cervical cancer is the 3(rd) leading cause of death among women. Although cervical cancer can be screened for with regular Pap tests, access to preventive screenings may be nearly non-existent in resource poor settings that have limited public health infrastructure and where women may lack basic health education. Therefore, it is important to understand women's attitudes, knowledge, and beliefs about HPV, cervical cancer, and the HPV vaccine, and assess their access to preventive screening in order to mitigate their risk for developing the disease. Eighty-six women, ages 18-44 with at least one child who presented at an antenatal clinic in a township in Johannesburg were recruited to complete a brief questionnaire. Using both descriptive and multivariate statistics, we assessed knowledge of cervical cancer, HPV, and the vaccine; assessed maternal-child communication about sex and STDs, assessed willingness to vaccinate child; and identified barriers to assessing medical care and the vaccine. The majority of participants were unfamiliar with HPV and cervical cancer, were concerned about their child's and their own risk for HPV and cervical cancer, faced numerous barriers to accessing screening, and were willing to vaccinate their child. Our findings indicate that women in developing countries need increased access to screening and education about HPV and cervical cancer prevention. Copyright © 2010 Elsevier Ltd. All rights reserved.

  11. Instruments for public environment policies: The negotiation

    International Nuclear Information System (INIS)

    Sartori, S.; Squillacioti, M.T.

    1990-12-01

    The negotiation starts from the postulate that environmental conflicts are a standing datum in the future of our societies. Environmental instance is based in deep and not reversible manner inside the attitude and value changes and, consequently, inside the quality of life. The different hopes about the environmental consequences constitute an internal element of democratic development and it is not thinkable to ignore or neglect these diversities. With regard to this last point the inadequacy of the present legal systems must be underlined. They are constructed to settle a controversy about 'the facts' and not about 'the values'. Often some environmental disputes may last quite a few years without facing the real essence of the question. The environmental negotiation intends as a 'consensual approach' that should give more possibilities for the conflict solution. It is based on the presupposition to create the terms for final result. In comparison with the legislative acts, the direct negotiation table permits a best exploration of options and a best mobilization of technical competencies. At last, because the negotiators should live together on the basis of obtained agreement, they will have more sensibility for the problems attached to the application than the laymen, for which the process ends with the publication of the law. The strongest argumentation in favor of environmental negotiation is that it is more difficult to avoid the substantial questions as well as often happens inside the legislative acts. (author)

  12. Negotiations at all Points? Interaction and Organization

    Directory of Open Access Journals (Sweden)

    Eva Nadai

    2008-01-01

    Full Text Available A criticism frequently leveled at interactionism—the theoretical basis of much of qualitative research—is that it neglects social structure and is limited to micro-social analysis. Anselm STRAUSS' concept of "negotiated order" is an attempt to overcome these alleged weaknesses and to address the connection between interaction and structure, and between micro-, meso- and macro-level analysis. In his view, negotiations between units of any potential scale, from small groups to nation states, are at the heart of social order and social change. The concept of "negotiated order" has been particularly influential in organization studies. However, it has also met with criticism. In this paper, we explore the potential of the approach for connecting different levels of analysis in qualitative research. We use the example of negotiations on "performance" in businesses to discuss the relationship between micro-level negotiations and organizations and societal discourse respectively. The empirical data were collected in an ethnographic research project which we conducted in three large businesses in Switzerland. URN: urn:nbn:de:0114-fqs0801327

  13. Gender differences in resources and negotiation among highly motivated physician-scientists.

    Science.gov (United States)

    Holliday, Emma; Griffith, Kent A; De Castro, Rochelle; Stewart, Abigail; Ubel, Peter; Jagsi, Reshma

    2015-04-01

    Resources, including space, equipment, funding, personnel, and protected time, are essential in academic medical careers. Negotiation often plays a key role in the distribution of these resources. This study explored gender differences in resources, negotiation behaviors, and negotiation outcomes in a sample of career development awardees. Postal survey of a cohort of 1,708 clinician-researchers with responses from 1,275 (75 % response rate). Researchers who received NIH K08 or K23 awards between 2006 and 2009. We analyzed gender differences in resources, negotiation behaviors, and negotiation outcomes, using regression models adjusted for race, K award type, K award year, degree, academic rank, specialty, and institutional funding. Over one-fifth of respondents reported inadequate access to research space and one-third had asked for increased space or equipment. Perceived adequacy of these physical resources did not differ significantly by gender, but a higher proportion of women reported inadequate access to grants administrators (34.8 %) and statistical support (49.9 %) than men (26.9 %; p = 0.002 and 43.4 %; p = 0.025, respectively). Women were more likely to have asked for reduction in clinical hours (24.1 % vs. 19.3 %; p = 0.02) and to have raised concerns about unfair treatment (50.2 % vs. 38.2 %; p negotiate for increased resources. Gender differences in perceived access to research support personnel exist even in this select cohort of K awardees. Institutions should provide appropriate training in negotiation and ensure adequate and equitable distribution of resources to promote academic success.

  14. A knowledge- and model-based system for automated weaning from mechanical ventilation: technical description and first clinical application.

    Science.gov (United States)

    Schädler, Dirk; Mersmann, Stefan; Frerichs, Inéz; Elke, Gunnar; Semmel-Griebeler, Thomas; Noll, Oliver; Pulletz, Sven; Zick, Günther; David, Matthias; Heinrichs, Wolfgang; Scholz, Jens; Weiler, Norbert

    2014-10-01

    To describe the principles and the first clinical application of a novel prototype automated weaning system called Evita Weaning System (EWS). EWS allows an automated control of all ventilator settings in pressure controlled and pressure support mode with the aim of decreasing the respiratory load of mechanical ventilation. Respiratory load takes inspired fraction of oxygen, positive end-expiratory pressure, pressure amplitude and spontaneous breathing activity into account. Spontaneous breathing activity is assessed by the number of controlled breaths needed to maintain a predefined respiratory rate. EWS was implemented as a knowledge- and model-based system that autonomously and remotely controlled a mechanical ventilator (Evita 4, Dräger Medical, Lübeck, Germany). In a selected case study (n = 19 patients), ventilator settings chosen by the responsible physician were compared with the settings 10 min after the start of EWS and at the end of the study session. Neither unsafe ventilator settings nor failure of the system occurred. All patients were successfully transferred from controlled ventilation to assisted spontaneous breathing in a mean time of 37 ± 17 min (± SD). Early settings applied by the EWS did not significantly differ from the initial settings, except for the fraction of oxygen in inspired gas. During the later course, EWS significantly modified most of the ventilator settings and reduced the imposed respiratory load. A novel prototype automated weaning system was successfully developed. The first clinical application of EWS revealed that its operation was stable, safe ventilator settings were defined and the respiratory load of mechanical ventilation was decreased.

  15. Antibiotic prescribing and resistance: knowledge level of medical students of clinical years of University Sultan Zainal Abidin, Malaysia

    Directory of Open Access Journals (Sweden)

    Haque M

    2016-03-01

    Full Text Available Mainul Haque, Nor Iza A Rahman, Zainal Zulkifli, Salwani Ismail Faculty of Medicine, Universiti Sultan Zainal Abidin, Kuala Terengganu, Terengganu, Malaysia Abstract: The innovation of penicillin by Dr Alexander Fleming in 1928 and its use in clinical practice saved many lives, especially during the Second World War. Tuberculosis still carries a significant public health threat and has re-emerged over the past two decades, even in modern countries where tuberculosis was thought to be eliminated. The World Health Organization defines antimicrobial resistance as the resistance of a microorganism to an antimicrobial drug that was initially effective for treatment of infections caused by the microbe. Therefore, the findings of the current study will provide data to enable the design of a new educational program to better equip our students in confronting antimicrobial resistance. This study was a cross-sectional, questionnaire-based survey, which was undertaken in the Faculty of Medicine, Universiti Sultan Zainal Abidin, Kuala Terengganu, Malaysia. The study participants were students of the Bachelor of Medicine and Bachelor of Surgery program (MBBS of Year III, IV, and V. A total of 142 out of 164 (86% medical students returned the questionnaire. Specifically, the year-wise breakdown of responses was 29% (41, 39% (55, and 32% (45 for Year III, IV, and V, respectively. Among the study respondents, 28% (40 were male, and the remaining 72% (102 were female. In all, 67% of the participants felt more confident in “making an accurate diagnosis of infection/sepsis.” The majority (88% of the study participants stated that they would like more training on antibiotic selection. This research has found that there is a gap between theoretical input and clinical practice; the students are demanding more educational intervention to face the threat of antimicrobial resistance. Keywords: antibiotic, prescribing, resistance, medical students, knowledge

  16. NEGOTIATING PECUNIARY GAINS AND ENVIRONMENT PROTECTION

    Directory of Open Access Journals (Sweden)

    Dacinia Crina PETRESCU

    2016-12-01

    Full Text Available The initiation and development of the negotiation process is the result of the interaction between stimulating and hindering factors, among which there are perceived winning chances and perceived risk of projecting a negative image of himself/ herself. The objectives of the research were to observe the strength of people’s perception regarding these two variables and if they were influenced by the negotiation objective: a pecuniary one vs. an environmental one (both involving self-advocacy: aiming at personal benefits. From the point of view of the analyzed variables, people are good negotiators – they have high trust in winning chances and low fear of negative image, but they do not hold strong environmental concerns. The perceived winning chances were significantly higher (p0.05.

  17. Conflicting Perspectives in Trade and Environmental Negotiations

    International Nuclear Information System (INIS)

    Buchner, B.K.; Roson, R.

    2002-09-01

    International trade negotiations have recently tackled the issue of possible free trade restrictions, justified - among others - on the basis of environmental concerns. Also, some analyses of international environmental agreements (especially in the field of climate change) have highlighted the key role played by changes in the terms of trade in determining the cost of environmental policies. Yet, secondary effects of international trade remain disregarded in many environmental policies, whereas the introduction of environmental trade barriers has been resisted, arguing that this may hide a Trojan horse of a renewed protectionism. This paper reviews the debate on trade and the environment in the two fields of environmental and trade negotiations, highlighting the different and somewhat conflicting approach adopted in the two cases. A numerical general equilibrium model is used to illustrate how different 'perceptions' (translated in terms of alternative model closures) affect the use of instruments, the distributional impact of the various policies, and the strategic interplay between negotiators in international agreements

  18. Behavioral aspects of negotiations on mutual security

    International Nuclear Information System (INIS)

    Druckman, D.; Hopmann, P.T.

    1989-01-01

    This article surveys theory and research about the process of international negotiation. The goal, of this paper is to apply behavioral science research to find ways to negotiate an improved mutual security regime between the nuclear superpowers that would make nuclear war less likely in the years ahead. When President John F. Kennedy presented the first nuclear arms control agreement, the Partial Nuclear Test Ban Treaty, to the U.S. public in 1963 he noted the ancient Chinese proverb: A journey of a thousand miles must begin with a single step. Just as the Partial Nuclear Test Ban Treaty represented for Kennedy the first step on the road to nuclear arms control, so the research reviewed here represents at best the first few steps in a long journey to a better understanding of how to negotiate a regime of mutual security between the nuclear superpowers

  19. An Attempt of Shaping a Framework of Negotiation

    Directory of Open Access Journals (Sweden)

    Raluca Galita

    2011-10-01

    Full Text Available The term negotiation is more and more frequently used nowadays not only in trade or business activities, but also in many other fields of activity. People negotiate in all areas of social life (in the family, at work, in the street, in shops, in a company, in a political party, between states, etc. whenever they seek to resolve differences of opinion or to get what they want. Any kind of negotiation starts from a series of basic conditions (the interdependence of the parties engaged in negotiations, the existence of some differences of opinion, the parties’ joint work to achieve a mutually beneficial agreement. At the same time, any negotiation takes place in a certain setting, bordered by the object of negotiation, its aims and stakes, the place and time of its deployment. Depending on the areas where the process of negotiation appears, one can speak of three general types: the economic negotiation, the political negotiation and the social one. At this level, other classifications can be identified, according to the participants in the negotiations, the parties' interests, the negotiating environment, the time and duration of negotiations and themanner of completion, all in the limits of two extreme poles, the conflict and the cooperation between the parties involved.Keywords: negotiation, participants, conflict, cooperation, communication.

  20. Desire to bargain and negotiation success: Lessons about the need to negotiate from six hydropower disputes

    International Nuclear Information System (INIS)

    Burkardt, N.; Lamb, B.L.; Taylor, J.G.

    1998-01-01

    The authors investigated the notion that successful licensing negotiations require that all parties to the dispute must have a desire to bargain. This desire is most likely to be present when the dispute exhibits ripeness and each party believes a bargained solution is the most cost-effective way to resolve differences. Structured interviews of participants in six Federal Energy Regulatory Commission hydropower licensing consultations were conducted to determine the level of need to negotiate for each party. The findings indicate that a need to negotiate is a necessary, but not sufficient, condition for success. Several factors were associated with a need to negotiate: a weak BATNA (best alternative to a negotiated agreement); a salient issue; participants' sense of efficacy; a sense of inevitability; professional roles encouraging negotiation; and disputes about facts as opposed to disputes about values. Participants' need to negotiate fluctuated throughout the process and intensified when questions were ripe: i.e., critical issues were debated or the regulatory process required action

  1. The Effect of Two Educational Methods on Knowledge and Adherence to Treatment in Hemodialysis Patients: Clinical Trial

    Directory of Open Access Journals (Sweden)

    Kobra Parvan

    2015-03-01

    Full Text Available Introduction: Patients with chronic renal disease (CRD deal with many potential problems with hemodialysis for all their life. Regarding the importance of preventing dialysis adverse effects, which are in close connection with lack of knowledge and report on how to train the patients? This study aims at comparing the impact of two methods of face to face training and training pamphlet on complying and informing of hemodialysis treatments. Methods: This clinical trial study was conducted on 58 hemodialysis patients who visited Shahid Rahnemun Teaching hospital, Yazd, Iran, and had required conditions of the research. Data were collected through a questionnaire including personal-social information, several questions to assess the level of compliance and to inform the treatment method. The quantitative analysis of this study used the Statistical Package for Social Sciences SPSS version 13 and descriptive (frequency, mean, standard deviation and inferential (Chi-square, paired t-test, ANOVA, ANCOVA statistics were employed. Results: The mean scores for informing both groups (face to face and training pamphlet were significantly increased. The mean score for adherence to treatments was also significant.Conclusion: In this research, face to face training was found to be more effective than training pamphlet. It seemed to have more strong effect on increasing the level of information and adherence to treatment. To train these people, face to face training should be, thus, preferred.

  2. Clinical holistic medicine: factors influencing the therapeutic decision-making. From academic knowledge to emotional intelligence and spiritual "crazy" wisdom.

    Science.gov (United States)

    Ventegodt, Søren; Kandel, Isack; Merrick, Joav

    2007-12-10

    Scientific holistic medicine is built on holistic medical theory, on therapeutic and ethical principles. The rationale is that the therapist can take the patient into a state of salutogenesis, or existential healing, using his skills and knowledge. But how ever much we want to make therapy a science it remains partly an art, and the more developed the therapist becomes, the more of his/her decisions will be based on intuition, feeling and even inspiration that is more based on love and human concern and other spiritual motivations than on mental reason and rationality in a simple sense of the word. The provocative and paradoxal medieval western concept of the "truth telling clown", or the eastern concepts of "crazy wisdom" and "holy madness" seems highly relevant here. The problem is how we can ethically justify this kind of highly "irrational" therapeutic behavior in the rational setting of a medical institution. We argue here that holistic therapy has a very high success rate and is doing no harm to the patient, and encourage therapists, psychiatrists, psychologist and other academically trained "helpers" to constantly measure their own success-rate. This paper discusses many of the important factors that influence clinical holistic decision-making. Sexuality could, as many psychoanalysts from Freud to Reich and Searles have believed, be the most healing power that exists and also the most difficult for the mind to comprehend, and thus the most "crazy-wise" tool of therapy.

  3. Professional Interactions: Negotiation and Expression for Future Physicians and Healthcare Providers

    Science.gov (United States)

    Pan, Andrew J.; Pan, Aaron J.; Leary, Kimberlyn R.

    2017-01-01

    The rapid pace of change in medicine requires doctors to be effective conflict mediators and negotiators in the clinical workplace, and a multitude of research connects strong physician-patient communication to improved patient outcomes. Disparities in such skills exist among medical students and professionals, and are neither taught nor evaluated…

  4. Negotiation and Monitoring of Service Level Agreements

    Science.gov (United States)

    Quillinan, Thomas B.; Clark, Kassidy P.; Warnier, Martijn; Brazier, Frances M. T.; Rana, Omer

    Service level agreements (SLAs) provide a means to define specific Quality of Service (QoS) guarantees between providers and consumers of services. Negotiation and definition of these QoS characteristics is an area of significant research. However, defining the actions that take place when an agreement is violated is a topic of more recent focus. This paper discusses recent advances in this field and propose some additional features that can help both consumers and producers during the enactment of services. These features include the ability to (re)negotiate penalties in an agreement, and specifically focuses on the renegotiation of penalties during enactment to reflect ongoing violations.

  5. Communication & Negotiation Skills Workshop for Women I

    Science.gov (United States)

    2016-03-01

    This workshop is designed to provide women physics students and postdocs with the professional skills they need to effectively perform research, including: negotiating a position in academia, industry or at a national lab, interacting positively on teams and with a mentor or advisor, thinking tactically, articulating goals, enhancing their personal presence, and developing alliances. We will discuss negotiation strategies and tactics that are useful for achieving professional goals. This is a highly interactive workshop where participants are invited to bring examples of difficult professional situations to discuss.

  6. Communication & Negotiation Skills Workshop for Women II

    Science.gov (United States)

    2016-03-01

    This workshop is designed to provide women physics students and postdocs with the professional skills they need to effectively perform research, including: negotiating a position in academia, industry or at a national lab, interacting positively on teams and with a mentor or advisor, thinking tactically, articulating goals, enhancing their personal presence, and developing alliances. We will discuss negotiation strategies and tactics that are useful for achieving professional goals. This is a highly interactive workshop where participants are invited to bring examples of difficult professional situations to discuss.

  7. The art of negotiation. A delicate balance.

    Science.gov (United States)

    Rehberg, C; Sullivan, G

    1997-01-01

    Successful negotiation is the art of gentle persuasion, not a "winner-take-all" showdown. Accordingly, it is essential to begin the process with a positive outlook and with the goal of reaching an agreement that is acceptable to all parties involved. Although the term "opponent" is used in this article to describe the person or group with whom you are negotiating, it is not used in the adversarial context. It is important to maintain a non-adversarial relationship, to the extent possible.

  8. Negotiation techniques to resolve western water disputes

    Science.gov (United States)

    Lamb, Berton L.; Taylor, Jonathan G.

    1990-01-01

    There is a growing literature on the resolution of natural resources conflicts. Much of it is practical, focusing on guidelines for hands-on negotiation. This literature can be a guide in water conflicts. This is especially true for negotiations over new environmental values such as instream flow. The concepts of competitive, cooperative, and integrative styles of conflict resolution are applied to three cases of water resource bargaining. Lessons for the effective use of these ideas include: break a large number of parties into small working groups, approach value differences in small steps, be cautious in the presence of an attentive public, keeps decisions at the local level, and understand the opponent's interests.

  9. Effectiveness of asthma principles and practice course in increasing nurse practitioner knowledge and confidence in the use of asthma clinical guidelines.

    Science.gov (United States)

    Taylor-Fishwick, Judith C; Okafor, Maureen; Fletcher, Monica

    2015-04-01

    The Asthma Principle and Practice (APP) course, an evidence-based blended distance-learning educational encounter, was designed to aid in the dissemination of the 2007 asthma clinical guidelines (EPR-3) and priority messages, increase knowledge of content of the guidelines as well as create an environment to enable participants to apply knowledge and skills into clinical practice. Students received a self-study binder 6-week period prior to attendance at an interactive study day. The APP is grounded in adult education principle and practices. A questionnaire was completed before reading the study binder and post study day to measure demographic variables as well as awareness of and changes in knowledge and confidence in key attributes of the clinical guidelines including patient education. The results showed that by taking the APP course confidence levels related to knowledge of asthma and its management increased with specific reference to the asthma clinical guidelines. Confidence in the use of patient education/communication strategies improved as well as the use of pulmonary function tests and the interpretation of test results. Nurse practitioners are an important audience to target in the dissemination of clinical guidelines and benefit from educational materials based on adult education strategies. ©2014 American Association of Nurse Practitioners.

  10. TH-A-9A-08: Knowledge-Based Quality Control of Clinical Stereotactic Radiosurgery Treatment Plans

    International Nuclear Information System (INIS)

    Shiraishi, S; Moore, K L; Tan, J; Olsen, L

    2014-01-01

    Purpose: To develop a quality control tool to reduce stereotactic radiosurgery (SRS) planning variability using models that predict achievable plan quality metrics (QMs) based on individual patient anatomy. Methods: Using a knowledge-based methodology that quantitatively correlates anatomical geometric features to resultant organ-at-risk (OAR) dosimetry, we developed models for predicting achievable OAR dose-volume histograms (DVHs) by training with a cohort of previously treated SRS patients. The DVH-based QMs used in this work are the gradient measure, GM=(3/4pi)^1/3*[V50%^1/3−V100%^1/3], and V10Gy of normal brain. As GM quantifies the total rate of dose fall-off around the planning target volume (PTV), all voxels inside the patient's body contour were treated as OAR for DVH prediction. 35 previously treated SRS plans from our institution were collected; all were planned with non-coplanar volumetric-modulated arc therapy to prescription doses of 12–25 Gy. Of the 35-patient cohort, 15 were used for model training and 20 for model validation. Accuracies of the predictions were quantified by the mean and the standard deviation of the difference between clinical and predicted QMs, δQM=QM-clin−QM-pred. Results: Best agreement between predicted and clinical QMs was obtained when models were built separately for V-PTV<2.5cc and V-PTV>2.5cc. Eight patients trained the V-PTV<2.5cc model and seven patients trained the V-PTV>2.5cc models, respectively. The mean and the standard deviation of δGM were 0.3±0.4mm for the training sets and −0.1±0.6mm for the validation sets, demonstrating highly accurate GM predictions. V10Gy predictions were also highly accurate, with δV10Gy=0.8±0.7cc for the training sets and δV10Gy=0.7±1.4cc for the validation sets. Conclusion: The accuracy of the models in predicting two key SRS quality metrics highlights the potential of this technique for quality control for SRS treatments. Future investigations will seek to determine

  11. World Trade Organization Negotiations: The Doha Development Agenda

    National Research Council Canada - National Science Library

    Fergusson, Ian F

    2008-01-01

    The World Trade Organization's (WTO) Doha Development Round of multilateral trade negotiations resumed in 2007 after being suspended in July 2006 after key negotiating groups failed to break a deadlock on agricultural tariffs and subsidies...

  12. 24 CFR 982.506 - Negotiating rent to owner.

    Science.gov (United States)

    2010-04-01

    ... DEVELOPMENT SECTION 8 TENANT BASED ASSISTANCE: HOUSING CHOICE VOUCHER PROGRAM Rent and Housing Assistance Payment § 982.506 Negotiating rent to owner. The owner and the family negotiate the rent to owner. At the...

  13. New Trends in Agent-Based Complex Automated Negotiations

    CERN Document Server

    Zhang, Minjie; Robu, Valentin; Fatima, Shaheen; Matsuo, Tokuro

    2012-01-01

    Complex Automated Negotiations represent an important, emerging area in the field of Autonomous Agents and Multi-Agent Systems. Automated negotiations can be complex, since there are a lot of factors that characterize such negotiations. These factors include the number of issues, dependencies between these issues,  representation of utilities, the negotiation protocol, the number of parties in the negotiation (bilateral or multi-party), time constraints, etc. Software agents can support automation or simulation of such complex negotiations on the behalf of their owners, and can provide them with efficient bargaining strategies. To realize such a complex automated negotiation, we have to incorporate advanced Artificial Intelligence technologies includes search, CSP, graphical utility models, Bayes nets, auctions, utility graphs, predicting and learning methods. Applications could include e-commerce tools, decision-making support tools, negotiation support tools, collaboration tools, etc. This book aims to pro...

  14. Implementation of resource-negotiating agents in telemanufacturing

    CSIR Research Space (South Africa)

    Van Zyl, TL

    2010-01-01

    Full Text Available the negotiations should be stored to allow future agents to benefit from previous negotiations. The components that are needed to implement the above and the results of the implementation are discussed in this paper....

  15. Next frontier in agent-based complex automated negotiation

    CERN Document Server

    Ito, Takayuki; Zhang, Minjie; Robu, Valentin

    2015-01-01

    This book focuses on automated negotiations based on multi-agent systems. It is intended for researchers and students in various fields involving autonomous agents and multi-agent systems, such as e-commerce tools, decision-making and negotiation support systems, and collaboration tools. The contents will help them to understand the concept of automated negotiations, negotiation protocols, negotiating agents’ strategies, and the applications of those strategies. In this book, some negotiation protocols focusing on the multiple interdependent issues in negotiations are presented, making it possible to find high-quality solutions for the complex agents’ utility functions. This book is a compilation of the extended versions of the very best papers selected from the many that were presented at the International Workshop on Agent-Based Complex Automated Negotiations.

  16. The Doha Negotiations on Trade in Goods: An European Perspective

    OpenAIRE

    Messerlin , Patrick

    2006-01-01

    The note reviews the basic market access issues in the Doha negotiations on trade in goods from an European perspective. First, it shows that some European negotiators are demanding more concessions in manufacturing (NAMA) that the European business community is asking for - adding strong tensions in a context already marked by severe problems in farm talks. Second, the note reveals the European interests really at stake in the agricultural negotiations, before addressing the negotiating issu...

  17. Aging may negatively impact movement smoothness during stair negotiation.

    Science.gov (United States)

    Dixon, P C; Stirling, L; Xu, X; Chang, C C; Dennerlein, J T; Schiffman, J M

    2018-05-26

    Stairs represent a barrier to safe locomotion for some older adults, potentially leading to the adoption of a cautious gait strategy that may lack fluidity. This strategy may be characterized as unsmooth; however, stair negotiation smoothness has yet to be quantified. The aims of this study were to assess age- and task-related differences in head and body center of mass (COM) acceleration patterns and smoothness during stair negotiation and to determine if smoothness was associated with the timed "Up and Go" (TUG) test of functional movement. Motion data from nineteen older and twenty young adults performing stair ascent, stair descent, and overground straight walking trials were analyzed and used to compute smoothness based on the log-normalized dimensionless jerk (LDJ) and the velocity spectral arc length (SPARC) metrics. The associations between TUG and smoothness measures were evaluated using Pearson's correlation coefficient (r). Stair tasks increased head and body COM acceleration pattern differences across groups, compared to walking (p < 0.05). LDJ smoothness for the head and body COM decreased in older adults during stair descent, compared to young adults (p ≤ 0.015) and worsened with increasing TUG for all tasks (-0.60 ≤ r ≤ -0.43). SPARC smoothness of the head and body COM increased in older adults, regardless of task (p < 0.001), while correlations showed improved SPARC smoothness with increasing TUG for some tasks (0.33 ≤ r ≤ 0.40). The LDJ outperforms SPARC in identifying age-related stair negotiation adaptations and is associated with performance on a clinical test of gait. Copyright © 2018 Elsevier B.V. All rights reserved.

  18. 48 CFR 570.105-1 - Contracting by negotiation.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Contracting by negotiation. 570.105-1 Section 570.105-1 Federal Acquisition Regulations System GENERAL SERVICES ADMINISTRATION SPECIAL CONTRACTING PROGRAMS ACQUIRING LEASEHOLD INTERESTS IN REAL PROPERTY General 570.105-1 Contracting by negotiation. Contracting by negotiation...

  19. 48 CFR 970.1504-2 - Price negotiation.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Price negotiation. 970.1504-2 Section 970.1504-2 Federal Acquisition Regulations System DEPARTMENT OF ENERGY AGENCY SUPPLEMENTARY REGULATIONS DOE MANAGEMENT AND OPERATING CONTRACTS Contracting by Negotiation 970.1504-2 Price negotiation. (a) Management and operating contract...

  20. 48 CFR 315.372 - Preparation of negotiation memorandum.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Preparation of negotiation memorandum. 315.372 Section 315.372 Federal Acquisition Regulations System HEALTH AND HUMAN SERVICES CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Source Selection 315.372 Preparation of negotiation memorandum. The Contracting...