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....... 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......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...

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

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

    Research and International Trade Policy Negotiations : Knowledge and Power in Latin America. Couverture du livre Research and International Trade Policy Negotiations: Knowledge and Power in Latin America. Directeur(s) : Mercedes Botto. Maison(s) d'édition : Routledge, CRDI. 7 octobre 2009. ISBN : 9780415801911.

  5. 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,

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

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

    2009-10-07

    Oct 7, 2009 ... It will also be useful for decision-makers and policy advisors involved in trade negotiations and the formulation of trade policy. The editor. Mercedes Botto is Senior Researcher at FLACSO, the Facultad Latinoamericana de Ciencias Sociales, in Buenos Aires, Argentina. Related content. Asian outlook: New ...

  7. “Body recognizing mind”? Negotiating knowledge through ...

    African Journals Online (AJOL)

    One of the aims here is to consider how knowledge can be negotiated through engagement with performance-related projects. To do this, I will offer a teaching perspective on how exposure to cultural events as part of group activity can provide strategic interventions which enable a type of border-crossing between social ...

  8. 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.

  9. Negotiation.

    Science.gov (United States)

    Thompson, Leigh L; Wang, Jiunwen; Gunia, Brian C

    2010-01-01

    Negotiation occurs whenever people cannot achieve their own goals without the cooperation of others. Our review highlights recent empirical research that investigates this ubiquitous social activity. We selectively review descriptive research emerging from social psychology and organizational behavior. This research examines negotiation behavior and outcomes at five levels of analysis: intrapersonal, interpersonal, group, organizational, and virtual. At each level, we review research on negotiation processes and outcomes, and we discuss the implications of various processes and outcomes for the two functions of negotiation: value creation (integrative negotiation) and value claiming (distributive negotiation).

  10. 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 key...... 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....

  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. 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 prov......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 approaches to interactive, participatory research. The idea for the case-study is sketched out. The focus of the case-study is how social scientific knowledge is communicated in an interacttive participatory research initiative in Denmark designed to further the production and application of educational...

  13. 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...

  14. Conflict & learning in dispersed communities. Negotiating knowledge claims

    NARCIS (Netherlands)

    Ferguson, J.E.; Taminiau, Y.T.A.

    2014-01-01

    Purpose – The purpose of this article is to analyze how learning occurs in inter-organizational online communities, despite highly diverse even conflicting knowledge claims among participants.Design/methodology/approach – We compared two inter-organizational communities in the domain of development

  15. Children's claims to knowledge regarding their mental health experiences and practitioners' negotiation of the problem.

    Science.gov (United States)

    O'Reilly, Michelle; Lester, Jessica Nina; Muskett, Tom

    2016-06-01

    The objective was to identify how children's knowledge positions were negotiated in child mental health assessments and how this was managed by the different parties. The child psychiatry data consisted of 28 video-recorded assessments. A conversation analysis was undertaken to examine the interactional detail between the children, parents, and practitioners. The findings indicated that claims to knowledge were managed in three ways. First, practitioners positioned children as 'experts' on their own health and this was sometimes accepted. Second, some children resisted this epistemic position, claiming not to have the relevant knowledge. Third, some children's claims to knowledge were negotiated and sometimes contested by adult parties who questioned their competence to share relevant information about their lives in accordance with the assessment agenda. Through question design, the practitioner was able to position the child as holding relevant knowledge regarding their situation. The child was able to take up this position or resist it in various ways. This has important implications for debates regarding children's competence to contribute to mental health interventions. Children are often treated as agents with limited knowledge, yet in the mental health assessment they are directly questioned about their own lives. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  16. 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.

  17. Knowledge, attitudes and beliefs about contraceptive and sexual consent negotiation among college women.

    Science.gov (United States)

    Fantasia, Heidi Collins; Sutherland, Melissa A; Fontenot, Holly; Ierardi, Janet A

    2014-01-01

    College women have the highest rates of sexual violence, sexually transmitted infections, and unintended pregnancy compared with women in all other age groups. Although much is known about sexual risk behaviors among college women, less is known about how women negotiate consent for contraceptive use during sexual encounters. Therefore, the purpose of this qualitative descriptive study was to explore college women's knowledge, attitudes, and beliefs about contraceptive and sexual consent during dating relationships. Twenty-six women participated in five focus groups on two college campuses in the northeastern United States. Content analysis was used to analyze the data. The three main categories that emerged from the analysis included the influence of alcohol on sexual behaviors, lack of negotiation for sexual consent and contraceptive use, and fear of pregnancy. The results of this study highlight the complex social interactions and norms that college women encounter when making decisions regarding sexual activity and contraceptive use. The results of this study can inform the role of college health providers and forensic nurses to promote sexual health and safety when they interact with college women.

  18. The effectiveness of negotiated agreements and its inspirations for Chinese knowledge mangement

    NARCIS (Netherlands)

    Shi, Hongwei; Wangyu, [Unknown; Bressers, Johannes T.A.; de Bruijn, Theo

    2011-01-01

    Negotiated agreements have become a widely used management model with respective covenants for different social network context in European countries. Negotiated agreements between government and industry in which industry obliges to take 'voluntary' action to help realizing regional management

  19. Situated clinical encounters in the negotiation of religious and spiritual plurality: a critical ethnography.

    Science.gov (United States)

    Pesut, Barbara; Reimer-Kirkham, Sheryl

    2010-07-01

    Despite increasingly diverse, globalized societies, little attention has been paid to the influence of religious and spiritual diversity on clinical encounters within healthcare. The purpose of the study was to analyze the negotiation of religious and spiritual plurality in clinical encounters, and the social, gendered, cultural, historical, economic and political contexts that shape that negotiation. Qualitative: critical ethnography. The study was conducted in Western Canada between 2006 and 2009. Data collection occurred on palliative, hospice, medical and renal in-patient units at two tertiary level hospitals and seven community hospitals. Participants were recruited through purposive sampling and snowball technique. Twenty healthcare professionals, seventeen spiritual care providers, sixteen patients and families and twelve administrators, representing diverse ethnicities and religious affiliations, took part in the study. Data collection included 65 in-depth interviews and over 150h of participant observation. Clinical encounters between care providers and recipients were shaped by how individual identities in relation to religion and spirituality were constructed. Importantly, these identities did not occur in isolation from other lines of social classification such as gender, race, and class. Negotiating difference was a process of seeing spirituality as a point of connection, eliciting the meaning systems of patients and creating safe spaces for the expression of that meaning. The complexity of religious and spiritual identity construction and negotiation raises important questions about language and about professional competence and boundaries in clinical encounters where religion and spirituality are relevant concerns. Copyright 2009 Elsevier Ltd. All rights reserved.

  20. 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

  1. Paying for treatments? Influences on negotiating clinical need and decision-making for dental implant treatment

    OpenAIRE

    Exley, Catherine E; Rousseau, Nikki S; Steele, Jimmy; Finch, Tracy; Field, James; Donaldson, Cam; Thomason, J Mark; May, Carl R; Ellis, Janice S

    2009-01-01

    Abstract Background The aim of this study is to examine how clinicians and patients negotiate clinical need and treatment decisions within a context of finite resources. Dental implant treatment is an effective treatment for missing teeth, but is only available via the NHS in some specific clinical circumstances. The majority of people who receive this treatment therefore pay privately, often at substantial cost to themselves. People are used to paying towards dental treatment costs. However,...

  2. 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.

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

    Science.gov (United States)

    Guell, Cornelia; Mackett, Roger; Ogilvie, David

    2017-01-05

    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. 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. 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 would welcome opportunities to influence research agendas

  4. 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

  5. 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…

  6. 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...

  7. Clinical knowledge governance: the international perspective.

    Science.gov (United States)

    Garde, Sebastian

    2013-01-01

    As a basis for semantic interoperability, ideally, a Clinical Knowledge Resource for a clinical concept should be defined formally and defined once in a way that all clinical professions and all countries can agree on. Clinical Knowledge Governance is required to create high-quality, reusable Clinical Knowledge Resources and achieve this aim. Traditionally, this is a time-consuming and cumbersome process, relying heavily on face-to-face meetings and being able to get sufficient input from clinicians. However, in a national or even international space, it is required to streamline the processes involved in creating Clinical Knowledge Resources. For this, a Web 2.0 tool that supports online collaboration of clinicians during their creation and publishing of Clinical Knowledge Resources has been developed. This tool is named the Clinical Knowledge Manager (CKM) and supports the development, review and publication of Clinical Knowledge Resources. Also, post-publication activities such as adding terminology bindings, translating the Clinical Knowledge Resource into another language and republishing it are supported. The acceptance of Clinical Knowledge Resources depends on their quality and being able to determine their quality, for example it is important to know that a broad umber of reviewers from various clinical disciplines have been involved in the development of the Clinical Knowledge Resource. We are still far from realizing the vision of a global repository of a great number of reusable, high-quality Clinical Knowledge Resources, which can provide the basis for broad semantic interoperability between systems. However progress towards this aim is being made around the world.

  8. 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.

  9. Documenting Art Therapy Clinical Knowledge Using Interviews

    Science.gov (United States)

    Regev, Dafna

    2017-01-01

    Practicing art therapists have vast stores of knowledge and experience, but in most cases, their work is not documented, and their clinical knowledge does not enter the academic discourse. This article proposes a systematic approach to the collection of practice knowledge about art therapy based on conducting interviews with art therapists who…

  10. 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...

  11. 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 ...

  12. 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.…

  13. Negotiating a pathological identity in the clinical dialogue: discourse analysis of a family therapy.

    Science.gov (United States)

    Avdi, Evrinomy

    2005-12-01

    Within the framework of social constructionism, psychotherapy has been re-conceptualized as a semiotic process, which consists of the creative generation of new meanings in the context of collaborative discourse. In recent years, research approaches that draw from social constructionism, such as discourse analysis, have been fruitfully employed in the study of psychotherapy processes, whilst being in line with the contemporary emphasis on language, narrative, and meaning making. This paper aims to further the exploration of the usefulness of discourse analysis in the study of psychotherapy processes, and in particular, in situations where the medical discourse is powerfully implicated in the construction of a person's identity. It is based on the analysis of a family therapy with a family whose child has a diagnosis of autism. The analysis focuses on two features of the family's talk, namely shifts in the flexibility of employment of a diverse range of discourses and subject positions, and shifts in the ways agency is constructed and discursively negotiated in the clinical conversations. It is suggested that these shifts can be used as indications of change in the family's network of meanings. The analysis suggests that an important aspect in clinical work with families with a member with a psychiatric diagnosis lies in decentring, or deconstructing, the dominant, pathology-maintaining accounts, and allowing for a wider range of less problematic narratives and subject positions to emerge.

  14. 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...

  15. The Alchemy of Learning and Work: Negotiating Learner Knowledge in a Global Society

    Science.gov (United States)

    Dabic, Snezana

    2008-01-01

    This article explores issues of literacy and identity of skilled migrants in an educational context in Australia as a learning society. First, it concentrates on forms of knowledge imposed on the learner and looks at how new discourses shape the self. Next, it tests the validity of the four pillars of education in the life of the learner. The…

  16. Power and Knowledge-Building in Teacher Inquiry: Negotiating Interpersonal and Ideational Difference

    Science.gov (United States)

    Spicer, David H. Eddy

    2011-01-01

    Professional collaboration in schools features prominently in contemporary approaches to educational change. Advocates highlight the importance of situated knowledge to continuous teacher learning, sustained school reform and improved student learning. Critics portray collaboration as an invisible and coercive means of official control. The…

  17. 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…

  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...... variable. Generation of trial databases and/or biobanks originating in large randomized clinical trials has successfully increased the knowledge obtained from those trials. At the 10th Cardiovascular Trialist Workshop, possibilities and pitfalls in designing and accessing clinical trial databases were...... discussed by a group of trialists. This review focuses on the arguments for conducting posttrial database studies and presents examples of studies in which posttrial knowledge generation has been substantial. Possible strategies to ensure successful trial database or biobank generation are discussed...

  19. '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.

  20. Paying for treatments? Influences on negotiating clinical need and decision-making for dental implant treatment.

    Science.gov (United States)

    Exley, Catherine E; Rousseau, Nikki S; Steele, Jimmy; Finch, Tracy; Field, James; Donaldson, Cam; Thomason, J Mark; May, Carl R; Ellis, Janice S

    2009-01-12

    The aim of this study is to examine how clinicians and patients negotiate clinical need and treatment decisions within a context of finite resources. Dental implant treatment is an effective treatment for missing teeth, but is only available via the NHS in some specific clinical circumstances. The majority of people who receive this treatment therefore pay privately, often at substantial cost to themselves. People are used to paying towards dental treatment costs. However, dental implant treatment is much more expensive than existing treatments--such as removable dentures. We know very little about how dentists make decisions about whether to offer such treatments, or what patients consider when deciding whether or not to pay for them. Mixed methods will be employed to provide insight and understanding into how clinical need is determined, and what influences people's decision making processes when deciding whether or not to pursue a dental implant treatment. Phase 1 will use a structured scoping questionnaire with all the General dental practitioners (GDPs) in three Primary Care Trust areas (n = 300) to provide base-line data about existing practice in relation to dental implant treatment, and to provide data to develop a systematic sampling procedure for Phase 2. Phases 2 (GDPs) and 3 (patients) use qualitative focused one to one interviews with a sample of these practitioners (up to 30) and their patients (up to 60) to examine their views and experiences of decision making in relation to dental implant treatment. Purposive sampling for phases 2 and 3 will be carried out to ensure participants represent a range of socio-economic circumstances, and choices made. Most dental implant treatment is conducted in primary care. Very little information was available prior to this study about the quantity and type of treatment carried out privately. It became apparent during phase 2 that ISOD treatment was an unusual treatment in primary care. We thus extended our sample

  1. Paying for treatments? Influences on negotiating clinical need and decision-making for dental implant treatment

    Directory of Open Access Journals (Sweden)

    Thomason J Mark

    2009-01-01

    Full Text Available Abstract Background The aim of this study is to examine how clinicians and patients negotiate clinical need and treatment decisions within a context of finite resources. Dental implant treatment is an effective treatment for missing teeth, but is only available via the NHS in some specific clinical circumstances. The majority of people who receive this treatment therefore pay privately, often at substantial cost to themselves. People are used to paying towards dental treatment costs. However, dental implant treatment is much more expensive than existing treatments – such as removable dentures. We know very little about how dentists make decisions about whether to offer such treatments, or what patients consider when deciding whether or not to pay for them. Methods/Design Mixed methods will be employed to provide insight and understanding into how clinical need is determined, and what influences people's decision making processes when deciding whether or not to pursue a dental implant treatment. Phase 1 will use a structured scoping questionnaire with all the General dental practitioners (GDPs in three Primary Care Trust areas (n = 300 to provide base-line data about existing practice in relation to dental implant treatment, and to provide data to develop a systematic sampling procedure for Phase 2. Phases 2 (GDPs and 3 (patients use qualitative focused one to one interviews with a sample of these practitioners (up to 30 and their patients (up to 60 to examine their views and experiences of decision making in relation to dental implant treatment. Purposive sampling for phases 2 and 3 will be carried out to ensure participants represent a range of socio-economic circumstances, and choices made. Discussion Most dental implant treatment is conducted in primary care. Very little information was available prior to this study about the quantity and type of treatment carried out privately. It became apparent during phase 2 that ISOD treatment was an

  2. [Clinical knowledge as anthropological knowledge: Reflections on the care pact].

    Science.gov (United States)

    Rovaletti, María L

    2017-01-01

    A discomfort pervades current Psychiatry: striving to be linked and identifed with Neurology, it cannot however ignore the subjectivity of patients. Moreover, the practice of Psychiatry as a Know-How, should also be subject to a political and ethical dimension. It must rely on justice and politics to the extent that it receives social demands, articulating the attention to vulnerable people with fair institutions (Ricoeur), but also it has to include them in society through their abilities. In this ethical dimension, it should seek to reform assistance institutions so that patients are protected and their rights respected. In this sense, it is necessary to consider the concept of therapeutic alliance (Paul Ricoeur), alliance that is only possible if it takes the form of a mutual promise, from both the therapist and the patient. It is a pact of care, even in situations where the skills and abilities are disproportionate. Clinical knowledge is somehow an anthropological knowledge about man as subject of disease, as homo patiens, but also about he who wants to accompany him in his suffering.

  3. Negotiating Aid

    DEFF Research Database (Denmark)

    Whitfield, Lindsay; Fraser, Alastair

    2011-01-01

    which investigated the strategies these states have adopted in talks with aid donors, the sources of leverage they have been able to bring to bear in negotiations, and the differing degrees of control that they have been able to exercise over the policies agreed in negotiations and those implemented......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...

  4. Negotiations '84.

    Science.gov (United States)

    Whalen, Garry M.; And Others

    This document provides an update on legal developments affecting negotiations between school boards and school district employees in New Jersey and discusses trends in union and board proposals and tactics. In the opening section, the available literature on bargaining is briefly reviewed. Section 2 defines the scope of negotiations for New…

  5. 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

  6. THE NEGOTIATION OF KNOWLEDGE AS A STRATEGY TO INNOVATE IN DIRECT AND VIRTUAL EDUCATIONAL COMMUNITIES / LA GESTIÓN DEL CONOCIMIENTO COMO ESTRATEGIA PARA INNOVAR EN LAS COMUNIDADES EDUCATIVAS PRESENCIALES Y VIRTUALES

    Directory of Open Access Journals (Sweden)

    José Antonio Ortega Carrillo

    2011-07-01

    Full Text Available The present work outlines a systematic reflection on the processes of creation and negotiation of professional and curricular knowledge in direct and virtual educational communities. Such processes can favor the curricular innovation grace to the sharing of tacit knowledge with other professionals that well systematized, it becomes into explicit knowledge that when flowing does not grow old, in such a way, it is avoided to transforms into obsolete and useless. It highlights the importance of negotiating active cycle of the curricular and professional knowledge that emerges from the nets of practical communities, by means of actions such as to articulate and to organize the existent knowledge, to renovate and to enlarge the knowledge of the members of the nets, to transform knowledge into active capital of the net and to synchronize and to align the strategies of the net with the capacities and competitions of its members and the characteristics of the cultural contexts in which they interact.

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

    African Journals Online (AJOL)

    Course learning design also focused on drug use evaluation, monitoring plans, and reaching clinical evidence- ... Conclusion: The findings indicate that pharmacist's self-confidence to perform clinical assessment activities is low. Lack of ... reproduction in any medium, provided the original work is properly credited. Tropical ...

  8. 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...

  9. Email Negotiation

    DEFF Research Database (Denmark)

    Bülow, Anne Marie

    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 revisablity, the email format allows selective attention to the other party’s arguments, which can be shown...

  10. 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.

  11. 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.

  12. 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 and employ......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...... 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...... context in which the planning and implementation of lean projects take place. Lean implementation is not a neutral and value-free activity; it is fluid and open for multiple interpretations, interests, and logics. Research limitations/implications – The project is based on qualitative data from lean...

  13. Negotiating choices

    Indian Academy of Sciences (India)

    Lawrence

    lished work tends to be ignored or under-cited. On the other hand, the absence of a high-pressure, grant-driven research environment, typical of the US, has meant that I have had considerable freedom to work on problems of my choice. The complexities of negotiating gender and professional roles tend to become most ...

  14. Negotiating Statehood

    DEFF Research Database (Denmark)

    of bureaucratic organizations in society, the symbolic and material dimensions of statehood and the importance of legitimacy. A heuristic framework entitled ‘negotiating statehood’ is proposed, referring to the dynamic and partly undetermined processes of state formation and failure by a multitude of social...

  15. 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.

  16. 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…

  17. 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.

  18. A Framework for a Clinical Reasoning Knowledge Warehouse

    DEFF Research Database (Denmark)

    Vilstrup Pedersen, Klaus; Boye, Niels

    2004-01-01

    , 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......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...

  19. 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.

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

    OpenAIRE

    Omar, R.; Hailstone, J. C.; Warren, J. E.; Crutch, S. J.; Warren, J. D.

    2010-01-01

    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 o...

  1. Semi-automated entry of clinical temporal-abstraction knowledge.

    Science.gov (United States)

    Shahar, Y; Chen, H; Stites, D P; Basso, L V; Kaizer, H; Wilson, D M; Musen, M A

    1999-01-01

    The authors discuss the usability of an automated tool that supports entry, by clinical experts, of the knowledge necessary for forming high-level concepts and patterns from raw time-oriented clinical data. Based on their previous work on the RESUME system for forming high-level concepts from raw time-oriented clinical data, the authors designed a graphical knowledge acquisition (KA) tool that acquires the knowledge required by RESUME. This tool was designed using Protégé, a general framework and set of tools for the construction of knowledge-based systems. The usability of the KA tool was evaluated by three expert physicians and three knowledge engineers in three domains-the monitoring of children's growth, the care of patients with diabetes, and protocol-based care in oncology and in experimental therapy for AIDS. The study evaluated the usability of the KA tool for the entry of previously elicited knowledge. The authors recorded the time required to understand the methodology and the KA tool and to enter the knowledge; they examined the subjects' qualitative comments; and they compared the output abstractions with benchmark abstractions computed from the same data and a version of the same knowledge entered manually by RESUME experts. Understanding RESUME required 6 to 20 hours (median, 15 to 20 hours); learning to use the KA tool required 2 to 6 hours (median, 3 to 4 hours). Entry times for physicians varied by domain-2 to 20 hours for growth monitoring (median, 3 hours), 6 and 12 hours for diabetes care, and 5 to 60 hours for protocol-based care (median, 10 hours). An increase in speed of up to 25 times (median, 3 times) was demonstrated for all participants when the KA process was repeated. On their first attempt at using the tool to enter the knowledge, the knowledge engineers recorded entry times similar to those of the expert physicians' second attempt at entering the same knowledge. In all cases RESUME, using knowledge entered by means of the KA tool

  2. 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.…

  3. Negotiating Protection

    DEFF Research Database (Denmark)

    Bille, Mikkel

    of architecture, the social use of luminosity, prophylactic items, saint veneration, Qur'anic items, and heritage production. The thesis challenges the preoccupation with "meaning" in material culture studies, by focusing on conceptualizations of "presence" and "absence" as equally important to protective...... strategies are confirming their efficacy, and act as material anchors for negotiating Bedouin identities in response to a rapid transformation from nomadic pastoralists to sedentary wageworkers. The tensions surrounding the materiality of protection, along with the role of the past in the present is further...... investigated through the contested public representations of Ammarin culture, along with a detailed study of the process leading to the protection of Bedouin culture by UNESCO Intangible Cultural Heritage. The overall conclusion of this research is that negotiating efficacious protection against perceived...

  4. 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 ...

  5. 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...

  6. "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.

  7. 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.

  8. Collective Bargaining: What's Negotiable.

    Science.gov (United States)

    Howe, Jonathan T.

    Negotiations with school employees should be limited to salaries, fringe benefits, and negotiation procedures, at least until the parties become familiar with the process of negotiation. It is better to delineate specifically those items that are negotiable. Boards, in defining negotiable subject matter, should be cautioned in agreeing to any…

  9. [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.

  10. Negotiated interactive observation:

    DEFF Research Database (Denmark)

    Wind, Gitte

    2008-01-01

    In this paper I discuss the possibilities and limitations of the ethnographer participating in the different on-going activities and events in highly specialised healthcare systems. The concept of participant observation is based on a number of assumptions, particularly that the ethnographer will...... observation and I propose negotiated interactive observation as a more appropriate way to describe ethnographic fieldwork in a setting such as the hospital or the clinic....

  11. 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…

  12. Farm and clinical records, pig handlers' knowledge and ...

    African Journals Online (AJOL)

    This study investigated the farm/clinical records of scours occurrence and the pig handlers knowledge and management of scours in twenty swine production units in Ejisu-Juaben Municipal area, Ashanti Region of Ghana in order to recommend strategic measures for the control. Information on the occurrence was obtained ...

  13. 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.

  14. Assessment of semantic knowledge: use of feedback and clinical interviewing.

    Science.gov (United States)

    Peña, E D

    2001-01-01

    Assessment of semantic knowledge is particularly challenging for clinicians working with children from culturally and linguistically diverse backgrounds. Vocabulary often reflects individual experiences, home language, and familiarity with school curriculum. Research demonstrates that children from nonmainstream backgrounds often score poorly on vocabulary tests yet may possess knowledge that is not evident in the kinds of tests that they take. Thus, a single word vocabulary test may not adequately capture the scope of such children's semantic knowledge. It is important that, before a diagnosis of language impairment is made, clinicians gain insight into children's semantic knowledge. This article describes the use of two procedures, feedback and the clinical interview, that can be utilized to probe children's language abilities.

  15. 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.

  16. 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.

  17. 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.

  18. Negotiation for physicians.

    Science.gov (United States)

    Hill, Micah J; DeCherney, Alan H

    2013-05-01

    Physicians are involved in negotiations on a daily basis. Interactions with patients, support staff, nurses, fellow physicians, administrators, lawyers, and third parties all can occur within the context of negotiation. This article reviews the basic principles of negotiation and negotiation styles, models, and practical tools. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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

    Directory of Open Access Journals (Sweden)

    Ghazaleh Eslamian

    2013-09-01

    Full Text Available 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.

  20. [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.

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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...

  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. 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’.

  9. 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.

  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. Impact of clinical teaching on students knowledge acquisition.

    Science.gov (United States)

    Manzar, Shabih

    2003-08-01

    We are in the process of curriculum revision and for that we need to know the strengths and weaknesses of the current teaching program and the venue that may need more attention. To proceed with this aim, we conducted this study. The study was conducted on 2 groups of students rotating through nursery as a part of Pediatrics clerkship at King Faisal University, Dammam, KSA, during a 2 month study, April through to May 2001. A 15 item questionnaire was developed for testing. By using a pre-test post-test model, we looked at the scores achieved by the students on the questionnaire before and after 2 weeks of intensive clinical teaching. In the first group of students, the mean percentage of correctly answered questions were higher in the post-test (78%) as compared to pre-test (64%), which was statistically significant, p=0.02. A similar trend was noted in the second group, the mean percentage of correctly answered questions were higher in the post-test (64%) as compared to pre-test (78%), which was also statistically significant, p=0.004. We concluded that our method of clinical teaching followed during nursery rotation was effective in increasing students knowledge. However, attention is needed on some topics in which students are noted to be relatively weak.

  12. 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.

  13. 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.

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

    African Journals Online (AJOL)

    Conclusion: Although Nigerian dental students exhibited good knowledge and positive attitude concerning HIV/AIDS, this study showed that knowledge of laboratory investigations and infection control measures were poor. These areas need emphasis in the dental school curriculum. Keywords: Knowledge, attitude, dental ...

  15. 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...

  16. 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...... conventions supporting cooperation and learning in this industry. The case draws attention to how issues of institutional context can frustrate collaboration and limit the scope of learning; simultaneously, it illustrates interventions that permitted the negotiation between situated and context......-specific understandings on the one hand and the development of shared understandings and common conventions for action within the industry on the other. In sum, the article sheds light on the institutional work required to mobilize situated forms of knowledge and the important bridging functions that institutional...

  17. One False Move: Training Deployers in Cross-Cultural Negotiations

    Science.gov (United States)

    2016-02-28

    violence. These seemingly minor infractions fall under the category of cross - cultural communication . An added layer to this happens when U.S. forces are...taking cross - cultural communication skills and incorporating them with solid negotiating practices. However having a firm understanding of culture and...All of this knowledge of cross - cultural communication is then bridged with the study of negotiation. The Air Force teaches a negotiation approach

  18. 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.

  19. Negotiating meaning through artefacts

    DEFF Research Database (Denmark)

    Tavella, Elena

    2015-01-01

    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...

  20. 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

  1. 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...

  2. Study Mode Negotiation.

    Science.gov (United States)

    Vasan, Mani Le; Sargunan, Rajeswary

    This paper outlines a model of study mode negotiation between clients and English Language Training providers that has been developed at the University of Malaya, specifically related to English language writing skills as taught to corporate clients. Negotiation is used to reach decisions concerning the goals and methodology of learning to ensure…

  3. 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.

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

    OpenAIRE

    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 developed a measuring instrument for negotiation self-efficacy. Subsequently, we examined the relationship between integrative negotiation with psychological contract breach. Employees negotiate m...

  5. 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.

  6. World championship in negotiation?

    DEFF Research Database (Denmark)

    Smolinski, Remigiusz; Kesting, Peter

    2013-01-01

    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 nego......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...

  7. Respiratory clinical guidelines inform ward-based nurses’ clinical skills and knowledge required for evidence-based care

    OpenAIRE

    Alisha M. Johnson; Sheree M.S. Smith

    2016-01-01

    Respiratory clinical guidelines provide clinicians with evidence-based guidance for practice. ­Clinical guidelines also provide an opportunity to identify the knowledge and technical and non-technical skills required by respiratory ward-based registered nurses. The aim of this review was to use a systematic process to establish the core technical and non-technical skills and knowledge ­identified in evidence-based clinical guidelines that enable the care of hospitalised adult respiratory pati...

  8. 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.

  9. 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....

  10. Clinical audit of knowledge and practice of epidural labour ...

    African Journals Online (AJOL)

    Epidural analgesia (EA) is the most ideal method for pain relief during labour. We sought to highlight the current knowledge and practice of the obstetricians regarding epidural labour analgesia (ELA). An audit was conducted amongst obstetricians in two teaching hospitals in the south west of Nigeria. Most of our ...

  11. 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 ...

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

    African Journals Online (AJOL)

    Background: Observation has shown a preponderance of irrelevant, unjustified and perhaps unnecessary radiological requests in the study area. The consequences of this on the patients' doses and population collective dose may be dire. Objective: To assess Clinicians/Referrers' knowledge of radiation doses of patients ...

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

    African Journals Online (AJOL)

    2015-11-19

    Nov 19, 2015 ... presented with diabetes compared with males, type 2 diabetes is commonerthan type 1 and there is a highassociation of the disease ... Health education about a disease should be planned to address beliefs and knowledge of patients about their medical condition to ... their culture and societal values.[13].

  14. Power-Knowledge and Tour Guide Training: Capitalistic Domination, Utopian Visions and the Creation and Negotiation of UNESCO’s Homo Turismos in Macao

    NARCIS (Netherlands)

    Ong, C.E.; Ryan, C.; McIntosh, A.M.

    2014-01-01

    This paper offers insights into the power-knowledge situations within tour guide training in Macao and queries the associated embedded capitalistic domination and utopian pressures. Drawing upon a tour guide trainer’s autoethnography, ethnography within the classroom, life and work history

  15. 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

  16. 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

  17. 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.

  18. Respiratory clinical guidelines inform ward-based nurses’ clinical skills and knowledge required for evidence-based care

    Directory of Open Access Journals (Sweden)

    Alisha M. Johnson

    2016-09-01

    Full Text Available Respiratory clinical guidelines provide clinicians with evidence-based guidance for practice. ­Clinical guidelines also provide an opportunity to identify the knowledge and technical and non-technical skills required by respiratory ward-based registered nurses. The aim of this review was to use a systematic process to establish the core technical and non-technical skills and knowledge ­identified in evidence-based clinical guidelines that enable the care of hospitalised adult respiratory patients. 17 guidelines were identified in our systematic review. The quality assessment demonstrated variability in these guidelines. Common core knowledge and technical and non-technical skills were identified. These include pathophysiology, understanding of physiological measurements and monitoring, education, counselling, and ward and patient management. The knowledge and skills extracted from respiratory clinical guidelines may inform a curriculum for ward-based respiratory nursing to ensure optimal care of adult patients.

  19. Respiratory clinical guidelines inform ward-based nurses' clinical skills and knowledge required for evidence-based care.

    Science.gov (United States)

    Johnson, Alisha M; Smith, Sheree M S

    2016-09-01

    Respiratory clinical guidelines provide clinicians with evidence-based guidance for practice. Clinical guidelines also provide an opportunity to identify the knowledge and technical and non-technical skills required by respiratory ward-based registered nurses. The aim of this review was to use a systematic process to establish the core technical and non-technical skills and knowledge identified in evidence-based clinical guidelines that enable the care of hospitalised adult respiratory patients. 17 guidelines were identified in our systematic review. The quality assessment demonstrated variability in these guidelines. Common core knowledge and technical and non-technical skills were identified. These include pathophysiology, understanding of physiological measurements and monitoring, education, counselling, and ward and patient management. The knowledge and skills extracted from respiratory clinical guidelines may inform a curriculum for ward-based respiratory nursing to ensure optimal care of adult patients.

  20. Partitioning knowledge bases between advanced notification and clinical decision support systems.

    Science.gov (United States)

    Borlawsky, Tara; Li, Jianrong; Jalan, Srikant; Stern, Edie; Williams, Rose; Lussier, Yves A

    2005-01-01

    Due to the varying rates of change of ephemeral administrative and enduring clinical knowledge in decision support systems (DSSs), the functional partition of knowledge base (KB) components can lead to more efficient and cost-effective system implementation and maintenance. Our prototype loosely couples a clinical event monitor developed by Columbia University Medical Center (CUMC) with a secure notification service proxy developed by IBM Research to form a novel and complex clinical event communication service.

  1. 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...... 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......, it presents the method for analysing and drawing conclusions....

  2. Management of low back pain: knowledge and adherence to clinical ...

    African Journals Online (AJOL)

    Objective: The therapeutic management of patients with Low Back Pain (LBP) has long been characterized by considerable variation among physiotherapists within and between countries. Over the past decade, systematic reviews have been written, and clinical practice guidelines have been made available. However ...

  3. 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.

  4. Drug-drug interactions : from knowledge base to clinical impact

    OpenAIRE

    Andersson, Marine

    2014-01-01

    Drug usage has increased steadily, and the more drugs used, the higher the risk for adverse effects or loss of effect due to drug-drug interactions. For drug prescribers it is difficult to know what drugs a patient is taking and whether they interact. Computerizing of health care records has made it possible to connect patients’ drug lists to clinical decision support systems giving the prescriber information about e.g. drug-drug interactions, duplicated prescriptions and ...

  5. Essential Elements in International Contract Negotiations

    National Research Council Canada - National Science Library

    Theodosiou, Ioannis

    2006-01-01

    .... The thesis examines the role of culture in cross-border negotiations and describes major effects from negotiation definitions, selection of negotiators, protocol, communication, time, risk propensity...

  6. 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...... dispositions and frequently to cope with the migration of a husband. Overall, this thesis shows that mobility as a life chance has re-defined the position of rural young people as both change-makers and as people who are under a constant necessity to change themselves...

  7. 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.

  8. 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.

  9. 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...... 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...

  10. Glycosylation of extracellular vesicles: current knowledge, tools and clinical perspectives.

    Science.gov (United States)

    Williams, Charles; Royo, Felix; Aizpurua-Olaizola, Oier; Pazos, Raquel; Boons, Geert-Jan; Reichardt, Niels-Christian; Falcon-Perez, Juan M

    2018-01-01

    It is now acknowledged that extracellular vesicles (EVs) are important effectors in a vast number of biological processes through intercellular transfer of biomolecules. Increasing research efforts in the EV field have yielded an appreciation for the potential role of glycans in EV function. Indeed, recent reports show that the presence of glycoconjugates is involved in EV biogenesis, in cellular recognition and in the efficient uptake of EVs by recipient cells. It is clear that a full understanding of EV biology will require researchers to focus also on EV glycosylation through glycomics approaches. This review outlines the major glycomics techniques that have been applied to EVs in the context of the recent findings. Beyond understanding the mechanisms by which EVs mediate their physiological functions, glycosylation also provides opportunities by which to engineer EVs for therapeutic and diagnostic purposes. Studies characterising the glycan composition of EVs have highlighted glycome changes in various disease states, thus indicating potential for EV glycans as diagnostic markers. Meanwhile, glycans have been targeted as molecular handles for affinity-based isolation in both research and clinical contexts. An overview of current strategies to exploit EV glycosylation and a discussion of the implications of recent findings for the burgeoning EV industry follows the below review of glycomics and its application to EV biology.

  11. 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

  12. 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

  13. [Clinical diagnosis of overtraining using blood tests: current knowledge].

    Science.gov (United States)

    Petibois, C; Cazorla, G; Déléris, G; Gin, H

    2001-08-01

    Overtraining results from an imbalance between training load-induced fatigue and organism's recovery abilities. Its etiology is complex and to date there is no useful clinical diagnostic tool. The purpose of this review is to discuss the blood chemistry parameters potentially useful for diagnosing overtraining in athletes. Chronic alterations of the myocyte structure may cause high plasma concentration increases of myoglobin, troponin I and creatine kinase enzyme, resulting in chemical and/or mechanical aggression. Monitoring reactive oxygen species' activity appears to be a good tool for evaluation of the metabolic stress level experienced by skeletal muscles. In energetic metabolism, a succession of chronic glycogen depletions might change the use of amino acids and lipids, inducing transient but severe hypoglycemia during exercise. A higher oxidation of circulating glutamine might cause immunosuppression (lower reactivity to inflammations and cellular traumatisms), inhibiting alarm signals during acute training. A higher branched-chain amino acid oxidation might favor free tryptophan's entry into the cerebral area, enhancing serotonin synthesis. As a consequence, asthenia and a loss of sensitivity to muscular and tendon traumatism might appear. Exercise anemia might also be a worsening factor of the physiological situation of the tired athlete, inducing predisposition to overtraining by the lower inflammation reactivity of depleted hepatic and muscular proteins. Early diagnosis of overtraining diagnosis may be established only from a battery of analyses, which should include the whole of the potential parameters. These remain unpredictable and do not allow systematic determination of new cases. Only a longitudinal study of the physiological situation appears to allow the necessary conditions for detecting overtraining in the early stages of its process for each subject.

  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. 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

  16. Multidisciplinary teams, and parents, negotiating common ground in shared-care of children with long-term conditions: a mixed methods study.

    Science.gov (United States)

    Swallow, Veronica M; Nightingale, Ruth; Williams, Julian; Lambert, Heather; Webb, Nicholas J A; Smith, Trish; Wirz, Lucy; Qizalbash, Leila; Crowther, Laura; Allen, Davina

    2013-07-08

    Limited negotiation around care decisions is believed to undermine collaborative working between parents of children with long-term conditions and professionals, but there is little evidence of how they actually negotiate their respective roles. Using chronic kidney disease as an exemplar this paper reports on a multi-method study of social interaction between multidisciplinary teams and parents as they shared clinical care. Phases 1 and 2: a telephone survey mapping multidisciplinary teams' parent-educative activities, and qualitative interviews with 112 professionals (Clinical-psychologists, Dietitians, Doctors, Nurses, Play-specialists, Pharmacists, Therapists and Social-workers) exploring their accounts of parent-teaching in the 12 British children's kidney units. Phase 3: six ethnographic case studies in two units involving observations of professional/parent interactions during shared-care, and individual interviews. We used an analytical framework based on concepts drawn from Communities of Practice and Activity Theory. Professionals spoke of the challenge of explaining to each other how they are aware of parents' understanding of clinical knowledge, and described three patterns of parent-educative activity that were common across MDTs: Engaging parents in shared practice; Knowledge exchange and role negotiation, and Promoting common ground. Over time, professionals had developed a shared repertoire of tools to support their negotiations with parents that helped them accomplish common ground during the practice of shared-care. We observed mutual engagement between professionals and parents where a common understanding of the joint enterprise of clinical caring was negotiated. For professionals, making implicit knowledge explicit is important as it can provide them with a language through which to articulate more clearly to each other what is the basis of their intuition-based hunches about parents' support needs, and may help them to negotiate with parents

  17. Negotiating the morass

    DEFF Research Database (Denmark)

    Jensen, Mads Christian Dagnis

    2014-01-01

    This contribution examines the co-ordination mechanisms which central governments have established to develop positions and cast votes in negotiations in the European Union (EU). Conceptually, the contribution discusses how different traits of EU co-ordination mechanisms can be defined and measured...

  18. Negotiating with emotion.

    Science.gov (United States)

    Leary, Kimberlyn; Pillemer, Julianna; Wheeler, Michael

    2013-01-01

    Some people are practically phobic about going to the bargaining table. If their minimum needs are met, they'll sign on the dotted line just to end the stress of dealing with people who have different agendas and styles. But that can be an expensive aversion, the authors write. When you're facing an important negotiation, rigorous preparation--running the numbers, scouting the marketplace, developing a plan B--is essential. But it's only half the story. The truth is that your passions matter in real-life deal making and dispute resolution. You need to understand, channel, and learn from your emotions in order to adapt to the situation at hand and engage others successfully. The authors studied 20 seasoned negotiators to explore their thoughts and feelings about the process. They invited their participants to find and combine pictures that metaphorically depicted those feelings and to describe in in-depth interviews the collages they'd created. Three reasons for the stressfulness of the negotiation experience emerged: lack of control, unpredictability, and the absence of feedback. This article includes a six-step warm-up exercise to help you prepare emotionally to negotiate effectively.

  19. 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.

  20. 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

  1. 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...

  2. 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.

  3. 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

  4. Knowledge Author: facilitating user-driven, domain content development to support clinical information extraction.

    Science.gov (United States)

    Scuba, William; Tharp, Melissa; Mowery, Danielle; Tseytlin, Eugene; Liu, Yang; Drews, Frank A; Chapman, Wendy W

    2016-06-23

    Clinical Natural Language Processing (NLP) systems require a semantic schema comprised of domain-specific concepts, their lexical variants, and associated modifiers to accurately extract information from clinical texts. An NLP system leverages this schema to structure concepts and extract meaning from the free texts. In the clinical domain, creating a semantic schema typically requires input from both a domain expert, such as a clinician, and an NLP expert who will represent clinical concepts created from the clinician's domain expertise into a computable format usable by an NLP system. The goal of this work is to develop a web-based tool, Knowledge Author, that bridges the gap between the clinical domain expert and the NLP system development by facilitating the development of domain content represented in a semantic schema for extracting information from clinical free-text. Knowledge Author is a web-based, recommendation system that supports users in developing domain content necessary for clinical NLP applications. Knowledge Author's schematic model leverages a set of semantic types derived from the Secondary Use Clinical Element Models and the Common Type System to allow the user to quickly create and modify domain-related concepts. Features such as collaborative development and providing domain content suggestions through the mapping of concepts to the Unified Medical Language System Metathesaurus database further supports the domain content creation process. Two proof of concept studies were performed to evaluate the system's performance. The first study evaluated Knowledge Author's flexibility to create a broad range of concepts. A dataset of 115 concepts was created of which 87 (76 %) were able to be created using Knowledge Author. The second study evaluated the effectiveness of Knowledge Author's output in an NLP system by extracting concepts and associated modifiers representing a clinical element, carotid stenosis, from 34 clinical free-text radiology

  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. The Chinese negotiation.

    Science.gov (United States)

    Graham, John L; Lam, N Mark

    2003-10-01

    Most Westerners preparing for a business trip to China like to arm themselves with a list of etiquette how-tos. "Carry a boatload of business cards," tipsters say. "Bring your own interpreter." "Speak in short sentences." "Wear a conservative suit." Such advice can help get companies in the door and even through the first series of business transactions. But it won't sustain the prolonged, year-in, year-out associations Chinese and Western businesses can now achieve. The authors' work with dozens of companies and thousands of American and Chinese executives over the past 20 years has demonstrated that a superficial adherence to etiquette rules gets executives only so far. They have witnessed communication breakdowns between American and Chinese businesspeople time and time again. The root cause: the American side's failure to understand the much broader context of Chinese culture and values, a problem that too often leaves Western negotiators flummoxed and flailing. American and Chinese approaches often appear incompatible. Americans see Chinese negotiators as inefficient, indirect, and even dishonest, while the Chinese see American negotiators as aggressive, impersonal, and excitable. Such perceptions have deep cultural origins. Yet those who know how to navigate these differences can develop thriving, mutually profitable, and satisfying business relationships. Four cultural threads have bound the Chinese people together for some 5,000 years, and these show through in Chinese business negotiations. They are agrarianism, morality, the Chinese pictographic language, and wariness of strangers. Most Western businesspeople often find those elements mysterious and confusing. But ignore them at any time during the negotiation process, and the deal can easily fall apart.

  7. Knowledge.

    Science.gov (United States)

    Online-Offline, 1999

    1999-01-01

    This theme issue on knowledge includes annotated listings of Web sites, CD-ROMs and computer software, videos, books, and additional resources that deal with knowledge and differences between how animals and humans learn. Sidebars discuss animal intelligence, learning proper behavior, and getting news from the Internet. (LRW)

  8. 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.

  9. 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

  10. 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 ...

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

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

    7 oct. 2009 ... Le directeur. Mercedes Botto est chercheure principale à la Facultad Latinoamericana de Ciencias Sociales (FLACSO) à Buenos Aires, en Argentine. Related content. Six world-class research teams to investigate overcoming therapeutic resistance in high fatality cancers. The world-class research teams ...

  12. Negotiated knowledge positions : communication in trauma teams

    OpenAIRE

    Härgestam, Maria

    2015-01-01

    Background Within trauma teams, effective communication is necessary to ensure safe and secure care of the patient. Deficiencies in communication are one of the most important factors leading to patient harm. Time is an essential factor for rapid and efficient disposal of trauma teams to increase patients’ survival and prevent morbidity. Trauma team training plays an important role in improving the team’s performance, while the leader of the trauma team faces the challenge of coordinating and...

  13. The negotiation of knowledge for coastal governance

    CSIR Research Space (South Africa)

    Celliers, Louis

    2012-09-01

    Full Text Available In May 2011, the CSIR (Natural Resources and the Environment), in partnership with University of KwaZulu-Natal’s (UKZN) School of Development Studies (SDS, now School of Built Environment and Development Studies – SBEDS) submitted a proposal...

  14. Negotiating Efficient PPP Contracts

    DEFF Research Database (Denmark)

    Tvarnø, Christina D.

    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....... 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...... 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...

  15. 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...

  16. 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....

  17. 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.

  18. Chinese Commercial Negotiating Style.

    Science.gov (United States)

    1982-01-01

    Sino-American cultural differences. The first is that Chinese culture traditionally shuns legal considerations and instead stresses ethical and...failure to show, legal vs. ethical and moral 80 principles, 20-23 Empathy, 75-76 role in negotiations, 20-23 Ethical /moral principles, 20 Cultural...roots in anthropology, psy- chology, and psychoanalysis , as well as political science, Professor Pye has compared the political behavior and political

  19. Negotiating Efficient PPP Contracts

    DEFF Research Database (Denmark)

    Tvarnø, Christina D.

    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. An opportu......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....... 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...... 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...

  20. 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.

  1. 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.

  2. 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.

  3. How writing records reduces clinical knowledge: a field study of psychiatric hospital wards.

    Science.gov (United States)

    Buus, Niels

    2009-04-01

    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 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 to the social organization at the wards.

  4. 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.

  5. 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

  6. 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.

  7. 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...

  8. Acquiring Knowledge Within and Across Firm Boundaries: Evidence from Clinical Development

    OpenAIRE

    Pierre Azoulay

    2003-01-01

    Considerable evidence suggests that information is acquired more easily within than across firm boundaries. I explore why this is observed in the setting of clinical development. Since the mid-1980s, pharmaceutical firms have partly contracted out the operational aspects of clinical trials to Contract Research Organizations (CROs). Using detailed project-level data for 53 firms, I document that even after controlling for a number of alternative explanations, knowledge-intensive projects are m...

  9. Submillisievert Radiation Dose Coronary CT Angiography: Clinical Impact of the Knowledge-Based Iterative Model Reconstruction.

    Science.gov (United States)

    Iyama, Yuji; Nakaura, Takeshi; Kidoh, Masafumi; Oda, Seitaro; Utsunomiya, Daisuke; Sakaino, Naritsugu; Tokuyasu, Shinichi; Osakabe, Hirokazu; Harada, Kazunori; Yamashita, Yasuyuki

    2016-11-01

    The purpose of this study was to evaluate the noise and image quality of images reconstructed with a knowledge-based iterative model reconstruction (knowledge-based IMR) in ultra-low dose cardiac computed tomography (CT). We performed submillisievert radiation dose coronary CT angiography on 43 patients. We also performed a phantom study to evaluate the influence of object size with the automatic exposure control phantom. We reconstructed clinical and phantom studies with filtered back projection (FBP), hybrid iterative reconstruction (hybrid IR), and knowledge-based IMR. We measured effective dose of patients and compared CT number, image noise, and contrast noise ratio in ascending aorta of each reconstruction technique. We compared the relationship between image noise and body mass index for the clinical study, and object size for phantom study. The mean effective dose was 0.98 ± 0.25 mSv. The image noise of knowledge-based IMR images was significantly lower than those of FBP and hybrid IR images (knowledge-based IMR: 19.4 ± 2.8; FBP: 126.7 ± 35.0; hybrid IR: 48.8 ± 12.8, respectively) (P knowledge-based IMR images was significantly higher than those of FBP and hybrid IR images (knowledge-based IMR: 29.1 ± 5.4; FBP: 4.6 ± 1.3; hybrid IR: 13.1 ± 3.5, respectively) (P knowledge-based IMR (r = 0.27, P knowledge-based IMR offers significant noise reduction and improvement in image quality in submillisievert radiation dose cardiac CT. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  10. 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

  11. 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 age, without molar support, can attain acceptable chewing function and that SDA treatment does not lead to loss of occlusal vertical dimension (P 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.

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

    DEFF Research Database (Denmark)

    Voldbjerg, Siri

    into a clinical setting influences the use of knowledge sources among newly graduated nurses. In study 1, meta-ethnography as described by Noblit and Hare was applied as method of synthesis of international qualitative research. Based on iterative literature search in the databases CINAHL, PubMed, SCOPUS...

  13. 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…

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

    DEFF Research Database (Denmark)

    Munk-Jørgensen, Povl; Blanner Kristiansen, Christina; 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...

  15. 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

    the knowledge that informs clinical decision-making among newly-graduated nurses. Qualitative studies were retrieved from CINAHL, PubMed, SCOPE, ERIC and GOOGLE-Scholar and subsequently selected by pre-defined inclusion criteria and critically appraised using CASP. Metaphors identified in the analytical process...

  16. Newly Graduated Nurses' use of Knowledge Sources in Clinical Decision Making

    DEFF Research Database (Denmark)

    Lygum Voldbjerg, Siri

    -based practice. It also underlines a need for a greater concurrence on how knowledge sources are articulated and used in nursing education and clinical practice. This study may inform interventions as to how newly graduated nurses can be supported in their use of knowledge, skills and competencies within......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...

  17. Knowledge systems, health care teams, and clinical practice: a study of successful change.

    Science.gov (United States)

    Olson, Curtis A; Tooman, Tricia R; Alvarado, Carla J

    2010-10-01

    Clinical teams are of growing importance to healthcare delivery, but little is known about how teams learn and change their clinical practice. We examined how teams in three US hospitals succeeded in making significant practice improvements in the area of antimicrobial resistance. This was a qualitative cross-case study employing Soft Knowledge Systems as a conceptual framework. The purpose was to describe how teams produced, obtained, and used knowledge and information to bring about successful change. A purposeful sampling strategy was used to maximize variation between cases. Data were collected through interviews, archival document review, and direct observation. Individual case data were analyzed through a two-phase coding process followed by the cross-case analysis. Project teams varied in size and were multidisciplinary. Each project had more than one champion, only some of whom were physicians. Team members obtained relevant knowledge and information from multiple sources including the scientific literature, experts, external organizations, and their own experience. The success of these projects hinged on the teams' ability to blend scientific evidence, practical knowledge, and clinical data. Practice change was a longitudinal, iterative learning process during which teams continued to acquire, produce, and synthesize relevant knowledge and information and test different strategies until they found a workable solution to their problem. This study adds to our understanding of how teams learn and change, showing that innovation can take the form of an iterative, ongoing process in which bits of K&I are assembled from multiple sources into potential solutions that are then tested. It suggests that existing approaches to assessing the impact of continuing education activities may overlook significant contributions and more attention should be given to the role that practical knowledge plays in the change process in addition to scientific knowledge.

  18. Heritage, negotiation and conflict

    Directory of Open Access Journals (Sweden)

    Gilberto Velho

    2006-01-01

    Full Text Available The article examines the issue of cultural heritage, focusing on the process of negotiating reality. It calls attention to the aspects of divergence and conflict derived from the distinct values and interests of the actors involved. A number of examples are cited, such as the registration of the Casa Branca candomblé terreiro in Salvador, Bahia, and the paradigmatic case of Copacabana. It aims to show that public heritage policies cannot be dissociated from the heterogeneity and complexity of social life.

  19. The Danish Negotiated Economy

    DEFF Research Database (Denmark)

    Pedersen, Ove K.

    2012-01-01

    Denmark is characterised by a number of distinct traits: a small and open economy, a stable democratic political system, a high proportion of organised wage earners covered by collective agreements, a political culture marked by social partnership, and a long tradition of institutionalised class...... cooperation. In this sense, Denmark has not only developed from a market to a mixed economy, but from a mixed to a negotiated economy. Because of its political history, the institutional structure in Denmark is hybrid. Market power and state authority are mixed in corporate bodies. Public authority...

  20. Towards symbiosis in knowledge representation and natural language processing for structuring clinical practice guidelines.

    Science.gov (United States)

    Weng, Chunhua; Payne, Philip R O; Velez, Mark; Johnson, Stephen B; Bakken, Suzanne

    2014-01-01

    The successful adoption by clinicians of evidence-based clinical practice guidelines (CPGs) contained in clinical information systems requires efficient translation of free-text guidelines into computable formats. Natural language processing (NLP) has the potential to improve the efficiency of such translation. However, it is laborious to develop NLP to structure free-text CPGs using existing formal knowledge representations (KR). In response to this challenge, this vision paper discusses the value and feasibility of supporting symbiosis in text-based knowledge acquisition (KA) and KR. We compare two ontologies: (1) an ontology manually created by domain experts for CPG eligibility criteria and (2) an upper-level ontology derived from a semantic pattern-based approach for automatic KA from CPG eligibility criteria text. Then we discuss the strengths and limitations of interweaving KA and NLP for KR purposes and important considerations for achieving the symbiosis of KR and NLP for structuring CPGs to achieve evidence-based clinical practice.

  1. 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...... could be used. CONCLUSION AND RELEVANCE TO CLINICAL PRACTICE: Although there is a complexity and variety to knowledge sources used there is an imbalance with the experienced nurse playing a key role, functioning both as predominant source and a role-model as to which sources are valued and used...... 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...

  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

    2013-04-01

    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.

  3. 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.

  4. Physicians in health care management: 10. Managing conflict through negotiation.

    OpenAIRE

    Lemieux-Charles, L

    1994-01-01

    The recent focus on collaborative relationships in health care means that people and groups must cooperate to accomplish clinical and management tasks. This increasing interdependence may also cause increased organizational conflict. The management of conflicts is critical to the effectiveness of an organization. Negotiating strategies, based on Fisher and Ury's method of "principled negotiation," include establishing superordinate goals, separating the people from the problem, focussing on i...

  5. A Solution for Bilateral Negotiations in the Navy Detailing Process: Cognitive Agents Technology Project

    Science.gov (United States)

    2008-09-01

    been applied in previous work in negotiations (Li & Tesauro , 203; Tesauro , 2002), and in other problems such as bidding in double auctions (Gjerstad...Dickhaut, 1998; Tesauro & Bredin, 2002). They can be used to build a basic Bayesian-learning negotiation strategy if no other domain knowledge or... Tesauro , G. (2003). A strategic decision model for multi-attribute bilateral negotiation with alternating offers. In Proceedings of the 4th ACM

  6. 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.

  7. 28 CFR 552.31 - Negotiations.

    Science.gov (United States)

    2010-07-01

    ... negotiation process. Instead, this responsibility is ordinarily assigned to a team of individuals specifically trained in hostage negotiation techniques. (a) Negotiators have no decision-making authority in hostage...

  8. Using domain knowledge and domain-inspired discourse model for coreference resolution for clinical narratives.

    Science.gov (United States)

    Jindal, Prateek; Roth, Dan

    2013-01-01

    This paper presents a coreference resolution system for clinical narratives. Coreference resolution aims at clustering all mentions in a single document to coherent entities. A knowledge-intensive approach for coreference resolution is employed. The domain knowledge used includes several domain-specific lists, a knowledge intensive mention parsing, and task informed discourse model. Mention parsing allows us to abstract over the surface form of the mention and represent each mention using a higher-level representation, which we call the mention's semantic representation (SR). SR reduces the mention to a standard form and hence provides better support for comparing and matching. Existing coreference resolution systems tend to ignore discourse aspects and rely heavily on lexical and structural cues in the text. The authors break from this tradition and present a discourse model for "person" type mentions in clinical narratives, which greatly simplifies the coreference resolution. This system was evaluated on four different datasets which were made available in the 2011 i2b2/VA coreference challenge. The unweighted average of F1 scores (over B-cubed, MUC and CEAF) varied from 84.2% to 88.1%. These experiments show that domain knowledge is effective for different mention types for all the datasets. Error analysis shows that most of the recall errors made by the system can be handled by further addition of domain knowledge. The precision errors, on the other hand, are more subtle and indicate the need to understand the relations in which mentions participate for building a robust coreference system. This paper presents an approach that makes an extensive use of domain knowledge to significantly improve coreference resolution. The authors state that their system and the knowledge sources developed will be made publicly available.

  9. Negotiating Challenges and Climate Change

    NARCIS (Netherlands)

    Gupta, J.

    2012-01-01

    The difficulties in negotiating a post-2012 regime of binding targets and timetables and the decisions of the US, Canada, and Russia on the Kyoto Protocol regime have led to pessimism about the future of the climate regime. Negotiation issues for different coalitions and actors are placed in a wider

  10. Racial Negotiations: Potentials and Limitations.

    Science.gov (United States)

    Chalmers, W. Ellison

    The research focused on two questions: (1) Can blacks use the negotiating process to overcome white resistance to institutional change? How much and what kinds of change can be achieved by their use of the negotiating process? In this approach, can they take advantage of pressures for change that exist either inside or outside the institution? (2)…

  11. 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)

  12. 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.

  13. 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.

  14. Partnership Negotiations: Innovation for Nurse Contract Negotiations During Turbulent Times.

    Science.gov (United States)

    Cullen, Maryalice; Donahue, Moreen

    2016-01-01

    Health care delivery is undergoing rapid change, with frontline nurses at the epicenter. A mind-set requiring innovative collaboration, creativity, flexibility, and openness to new care delivery models is necessary. This article describes an innovative approach to modern world contract negotiations in a 371-bed university-affiliated hospital. The nurses' contract negotiations were scheduled to begin 6 months after a layoff affected nurses and other caregivers. Concurrently, a strike was underway at a hospital in the state with the same union. Contentious negotiations were anticipated. Strategies employed to prepare for negotiations included consultation with a nurse expert, and an agreement between the chief nursing officer and chairman of the Shared Governance Committee to conduct negotiations that would allow for more dialogue between the staff nurse and nursing leadership teams. Sessions opened with a video address by a major health care nurse thought leader who provided an overview of the current health care landscape and future direction of nursing. Joint presentations by staff nurses and nurse leaders on topics of interest were conducted. "Nurses for Nurses" round table sessions took place each day, and valuable work was completed at breakout sessions. Ultimately, the partnership negotiations resulted in a successfully negotiated contract.

  15. 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

  16. The state of the art in clinical knowledge management: An inventory of tools and techniques

    Science.gov (United States)

    Sittig, Dean F.; Wright, Adam; Simonaitis, Linas; Carpenter, James D.; Allen, George O.; Doebbeling, Bradley N.; Sirajuddin, Anwar Mohammad; Ash, Joan S.; Middleton, Blackford

    2009-01-01

    Purpose To explore the need for, and use of, high-quality, collaborative, clinical knowledge management (CKM) tools and techniques to manage clinical decision support content. Methods In order to better understand the current state of the art in CKM, we developed a survey of potential CKM tools and techniques. We conducted an exploratory study by querying a convenience sample of respondents about their use of specific practices in CKM. Results The following tools and techniques should be priorities in organizations interested in developing successful computer-based provider order entry (CPOE) and clinical decision support (CDS) implementations: 1) A multidisciplinary team responsible for creating and maintaining the clinical content; 2) An external organizational repository of clinical content with web-based viewer that allows anyone in the organization to review it; 3) An online, collaborative, interactive, internet-based tool to facilitate content development; 4) An enterprise-wide tool to maintain the controlled clinical terminology concepts. Even organizations that have been successfully using Computer-based Provider Order Entry with advanced Clinical Decision Support features for well over 15 years are not using all of the CKM tools or practices that we identified. Conclusions If we are to further stimulate progress in the area of clinical decision support, we must continue to develop and refine our understanding and use of advanced CKM capabilities. PMID:19828364

  17. 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.

  18. 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.

  19. Negotiating the thumbnail image

    DEFF Research Database (Denmark)

    Thylstrup, Nanna Bonde; Teilmann-Lock, Stina

    2017-01-01

    understand the role of the thumbnail as an attention technology in the digital economy? And what kind of aesthetic does it produce? This paper examines the legal negotiations of the thumbnail image and the ensuing decision to conceptualize the thumbnail as a functional image against the cultural history...... of visual attention technologies and the aesthetics of their connective function. Such an endeavour, we propose, allows us to understand and appreciate the significant digital economy and particular aesthetic of the thumbnail image despite its apparent subtlety.......Thumbnail images are discreet, yet central navigational tools in increasingly complex visual information environments. Indeed, without thumbnail images there would be no image search: they are an inherent part of the information architecture of most digital information platforms. Yet, how might we...

  20. Negotiating work identity

    Directory of Open Access Journals (Sweden)

    Tamsen Saayman

    2011-11-01

    Research purpose: The aim of the study was to investigate identity tensions and demands that mobilise identity work in the work environment. Motivation for the study: The study hoped to improve the understanding of the dynamics of identity construction and negotiation. Research design, approach and method: Using grounded theory methodology in the context of qualitative field research, the researchers conducted two unstructured interviews with 28 employees of a South African manufacturing company. Main findings: The five primary dimensions the data yielded were personal identity, individual agency, social identity, social practice and job. Practical/managerial implications: This study has implications for organisations that want to improve productivity through understanding work identity. Contribution/value-add: The article presents a conceptual model of the demands and tensions that influence work identity.

  1. Negotiating Moral Value

    DEFF Research Database (Denmark)

    Koch, Lene; Svendsen, Mette N.

    2015-01-01

    laboratories. The normal procedure would be to kill research animals after the termination of an experiment; in this case, however, a decision was reached to close down the lab. The moral landscape had changed, and it was no longer considered acceptable to use nonhuman primates in Danish biomedicine. From...... being considered a biological resource serving as a model of man, the monkeys had become moral subjects with a claim to a life suiting their natural needs. Simultaneously, the monkeys became instrumental in creating moral legitimacy for the actors involved in their rescue. What we see is an instance...... of pathfinding in a changing moral landscape where actors negotiate nonhuman primate nature as they create new moral positions for themselves....

  2. 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...

  3. 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.

  4. 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. PMID:21611137

  5. Nursing students’ and clinical mentors’ knowledge and views on working with old people

    Directory of Open Access Journals (Sweden)

    Brigita Skela-Savič

    2014-03-01

    Full Text Available Theoretical background: In the light of the demographic trends, the need for health care of older people is expected to increase. Quality health care for older people can only be achieved by personnel with undergraduate and postgraduate knowledge in working with the elderly and by reducing ageism in the society.Method: Descriptive quantitative study was conducted by the research team of the College of Nursing Jesenice in June 2010, in a convenience sample of nursing students (n = 61 and clinical mentors (n = 40. We used validated and widely used instruments: Palmore’s Facts on Aging Quiz (FAQ1, Kogan’s Attitudes Toward Old People Scale (KAOP, Nolan’s Perceptions of Working with Older People (PWOP. Data were processed with the statistical package SPSS 20.0.Results: We found a low level of general knowledge on old people in our studied sample. Students achieved on average 44.6 % correct responses and clinical mentors 48.7 %. The results have shown the presence of ageism (incorrect responses reflect ageism. 82.1 % of clinical mentors and 55.9 % of students expressed interest to work in nursing of older people. More interest to work with older people was expressed by respondents who had more positive attitude (r = 0.206, p = 0.047 and Master’s students (r = -0,299, p = 0.023. The majority of students (94.5 % had no negative life experience with old people. The more positive experiences they had, the greater was their desire to work with older people (r = -0.297, p = 0.029. We found that clinical mentors were more aware of the importance of specialised training within gerontological nursing .than students.Discussion: Research has shown the lack of knowledge on nursing of older people among respondents and also the presence of ageism. In nursing, specific knowledge and skills in gerontology have to be developed by introducing obligatory and elective courses at all levels of the Bologna study programs

  6. 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.

  7. 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

  8. National survey of China's oncologists' knowledge, attitudes, and clinical practice patterns on complementary and alternative medicine.

    Science.gov (United States)

    Yang, Geliang; Lee, Richard; Zhang, Huiqing; Gu, Wei; Yang, Peiying; Ling, Changquan

    2017-02-21

    It is common for cancer patients to use complementary and alternative medicine (CAM). This study was designed to explore China's oncologists' knowledge, attitudes and clinical practices regarding CAM use by their patients. An online survey was conducted of China's oncologists. Among 11,270 participants who completed the online survey, 6,007 (53.3%) were identified as oncologists. Most were men (75.2%), with a mean age of 33.4 (standard deviation: 6.5) years. The 6,007 oncologists discussed with 36.5% of their patients about CAM. Most of them (75.6%) did not want to initiate discussions due to lack of knowledge on CAM. Oncologists estimated that 40.0% of their patients used CAM treatments. Oncologists reported that 28.7% of their patients underwent anticancer therapy with the concurrent use of CAM. Four out of five of the responding oncologists self-reported inadequate knowledge and only 22.0% reported receiving professional education on CAM. Nearly half (44.9%) of the oncologists believed CAM treatment was effective for symptoms and treatment of cancer. Physician factors associated with initiating discussions with patients about CAM use included sex, age (≥ 33 years), medical license for traditional Chinese medicine, enough knowledge and professional education experience. China's oncologists infrequently discussed with their patients about CAM due to lack of knowledge. Most of the oncologists did not encourage CAM use.

  9. Domestic violence: knowledge, attitudes, and clinical practice of selected UK primary healthcare clinicians.

    Science.gov (United States)

    Ramsay, Jean; Rutterford, Clare; Gregory, Alison; Dunne, Danielle; Eldridge, Sandra; Sharp, Debbie; Feder, Gene

    2012-09-01

    Domestic violence affects one in four women and has significant health consequences. Women experiencing abuse identify doctors and other health professionals as potential sources of support. Primary care clinicians agree that domestic violence is a healthcare issue but have been reluctant to ask women if they are experiencing abuse. To measure selected UK primary care clinicians' current levels of knowledge, attitudes, and clinical skills in this area. Prospective observational cohort in 48 general practices from Hackney in London and Bristol, UK. Administration of the Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS), comprising five sections: responder profile, background (perceived preparation and knowledge), actual knowledge, opinions, and practice issues. Two hundred and seventy-two (59%) clinicians responded. Minimal previous domestic violence training was reported by participants. Clinicians only had basic knowledge about domestic violence but expressed a positive attitude towards engaging with women experiencing abuse. Many clinicians felt poorly prepared to ask relevant questions about domestic violence or to make appropriate referrals if abuse was disclosed. Forty per cent of participants never or seldom asked about abuse when a woman presented with injuries. Eighty per cent said that they did not have an adequate knowledge of local domestic violence resources. GPs were better prepared and more knowledgeable than practice nurses; they also identified a higher number of domestic violence cases. Primary care clinicians' attitudes towards women experiencing domestic violence are generally positive but they only have basic knowledge of the area. Both GPs and practice nurses need more comprehensive training on assessment and intervention, including the availability of local domestic violence services.

  10. Domestic violence: knowledge, attitudes, and clinical practice of selected UK primary healthcare clinicians

    Science.gov (United States)

    Ramsay, Jean; Rutterford, Clare; Gregory, Alison; Dunne, Danielle; Eldridge, Sandra; Sharp, Debbie; Feder, Gene

    2012-01-01

    Background Domestic violence affects one in four women and has significant health consequences. Women experiencing abuse identify doctors and other health professionals as potential sources of support. Primary care clinicians agree that domestic violence is a healthcare issue but have been reluctant to ask women if they are experiencing abuse. Aim To measure selected UK primary care clinicians’ current levels of knowledge, attitudes, and clinical skills in this area. Design and setting Prospective observational cohort in 48 general practices from Hackney in London and Bristol, UK. Method Administration of the Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS), comprising five sections: responder profile, background (perceived preparation and knowledge), actual knowledge, opinions, and practice issues. Results Two hundred and seventy-two (59%) clinicians responded. Minimal previous domestic violence training was reported by participants. Clinicians only had basic knowledge about domestic violence but expressed a positive attitude towards engaging with women experiencing abuse. Many clinicians felt poorly prepared to ask relevant questions about domestic violence or to make appropriate referrals if abuse was disclosed. Forty per cent of participants never or seldom asked about abuse when a woman presented with injuries. Eighty per cent said that they did not have an adequate knowledge of local domestic violence resources. GPs were better prepared and more knowledgeable than practice nurses; they also identified a higher number of domestic violence cases. Conclusion Primary care clinicians’ attitudes towards women experiencing domestic violence are generally positive but they only have basic knowledge of the area. Both GPs and practice nurses need more comprehensive training on assessment and intervention, including the availability of local domestic violence services. PMID:22947586

  11. The Impact of New Communicational technologies on Negotiation

    Directory of Open Access Journals (Sweden)

    Lecturer Ph. D. Niculina Vargolici

    2009-05-01

    Full Text Available This article is intended as a continuation of the one published in the previous issue of the magazine, covering the role of e-mail in organizational communication, the advantages and constraints of this communication means. We have shown that electronic message has its rules and its traps, of which we need to be aware, because they can influence the winning or loose of a business. In this article we shall discuss the way in which and the reasons why new communicational technologies can influence both the result of negotiations, and the negotiators’ behavior, while it is of common knowledge the fact that in a negotiation communication implies more than a simple information exchange. The economic crisis places the managerial team in front of various situations both on a financial and psychological level, and that is why the volume of direct negotiations has increased. The success of negotiations under these circumstances highly depends on the communication (and negotiation skills of the manager and his/her team; it also depends on the way in which the manager and his/her team negotiate with the employees, and with those outside the company (customers or suppliers, partners, financers etc..

  12. 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.

  13. 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

  14. 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

  15. 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

  16. 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

  17. A belief revision approach for argumentation-based negotiation agents

    Directory of Open Access Journals (Sweden)

    Pilotti Pablo

    2015-09-01

    Full Text Available Negotiation is an interaction that happens in multi-agent systems when agents have conflicting objectives and must look for an acceptable agreement. A typical negotiating situation involves two agents that cannot reach their goals by themselves because they do not have some resources they need or they do not know how to use them to reach their goals. Therefore, they must start a negotiation dialogue, taking also into account that they might have incomplete or wrong beliefs about the other agent’s goals and resources. This article presents a negotiating agent model based on argumentation, which is used by the agents to reason on how to exchange resources and knowledge in order to achieve their goals. Agents that negotiate have incomplete beliefs about the others, so that the exchange of arguments gives them information that makes it possible to update their beliefs. In order to formalize their proposals in a negotiation setting, the agents must be able to generate, select and evaluate arguments associated with such offers, updating their mental state accordingly. In our approach, we will focus on an argumentation-based negotiation model between two cooperative agents. The arguments generation and interpretation process is based on belief change operations (expansions, contractions and revisions, and the selection process is a based on a strategy. This approach is presented through a high-level algorithm implemented in logic programming. We show various theoretical properties associated with this approach, which have been formalized and proved using Coq, a formal proof management system. We also illustrate, through a case study, the applicability of our approach in order to solve a slightly modified version of the well-known home improvement agents problem. Moreover, we present various simulations that allow assessing the impact of belief revision on the negotiation process.

  18. 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)

  19. 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.

  20. 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

  1. Knowledge of causes, clinical features and diagnosis of common zoonoses among medical practitioners in Tanzania

    Science.gov (United States)

    John, Kunda; Kazwala, Rudovic; Mfinanga, Godfrey S

    2008-01-01

    Background Many factors have been mentioned as contributing to under-diagnosis and under-reporting of zoonotic diseases particularly in the sub-Sahara African region. These include poor disease surveillance coverage, poor diagnostic capacity, the geographical distribution of those most affected and lack of clear strategies to address the plight of zoonotic diseases. The current study investigates the knowledge of medical practitioners of zoonotic diseases as a potential contributing factor to their under-diagnosis and hence under-reporting. Methods The study was designed as a cross-sectional survey. Semi-structured open-ended questionnaire was administered to medical practitioners to establish the knowledge of anthrax, rabies, brucellosis, trypanosomiasis, echinococcosis and bovine tuberculosis in selected health facilities within urban and rural settings in Tanzania between April and May 2005. Frequency data were analyzed using likelihood ratio chi-square in Minitab version 14 to compare practitioners' knowledge of transmission, clinical features and diagnosis of the zoonoses in the two settings. For each analysis, likelihood ratio chi-square p-value of less than 0.05 was considered to be significant. Fisher's exact test was used where expected results were less than five. Results Medical practitioners in rural health facilities had poor knowledge of transmission of sleeping sickness and clinical features of anthrax and rabies in humans compared to their urban counterparts. In both areas the practitioners had poor knowledge of how echinococcosis is transmitted to humans, clinical features of echinococcosis in humans, and diagnosis of bovine tuberculosis in humans. Conclusion Knowledge of medical practitioners of zoonotic diseases could be a contributing factor to their under-diagnosis and under-reporting in Tanzania. Refresher courses on zoonotic diseases should be conducted particularly to practitioners in rural areas. More emphasis should be put on zoonotic

  2. 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... EMPLOYEES GROUP LIFE INSURANCE FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION 2115.070 Negotiation authority. The authority to negotiate FEGLI Program contracts...

  3. 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... EMPLOYEES HEALTH BENEFITS ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION 1615.070 Negotiation authority. The authority to negotiate FEHB contracts is conferred by 5 U.S.C...

  4. 7 CFR 1726.203 - Multiparty negotiation.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 11 2010-01-01 2010-01-01 false Multiparty negotiation. 1726.203 Section 1726.203... negotiation. Multiparty negotiation may only be used where permitted under subpart F of this part or where... negotiation: (a) Selection of qualified bidders. The borrower (acting through its engineer, if applicable...

  5. 5 CFR 9701.519 - Negotiation impasses.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Negotiation impasses. 9701.519 Section... RESOURCES MANAGEMENT SYSTEM Labor-Management Relations § 9701.519 Negotiation impasses. (a) If the... associated with a negotiations dispute, including unfair labor practices, negotiability disputes, and...

  6. The Chinese Approach to International Business Negotiation.

    Science.gov (United States)

    Zhao, Jensen J.

    2000-01-01

    Investigates what Chinese negotiators are trained to do in the global marketplace by examining China's international business negotiation textbooks used in their training programs. Indicates that Chinese negotiators are taught a large variety of communication techniques for negotiation arrayed along a continuum from the relationship-based win-win…

  7. 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.

  8. 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.

  9. Primary care physicians' knowledge of and attitudes toward the eating disorders: do they affect clinical actions?

    Science.gov (United States)

    Currin, Laura; Waller, Glenn; Schmidt, Ulrike

    2009-07-01

    This study examined the influence of primary care physicians' knowledge of and attitudes to eating disorders on their treatment decisions. A sample of primary care physicians completed self-report measures on eating disorders and their attitudes towards such patients. They also indicated their diagnosis and treatment decisions in response to case vignettes. Physicians had substantial gaps in knowledge of the eating disorders. Attitudes to anorexia nervosa clustered differently to those toward patients with bulimia nervosa. However, for both disorders, the factor that explained the most variance was illness duration and consequences. There was no association of knowledge and attitudes, and these variables did not predicted the likelihood of diagnosing an eating disorder. However, those with higher knowledge scores were more likely to ensure that a follow-up appointment took place, particularly when they held the attitude that people with anorexia nervosa had personal control over their problem. There is a need for greater education of primary care physicians regarding the diagnosis and treatment of the eating disorders, and for that information to be more readily accessible when it is needed. Their clinical actions need to be guided by more objective sources of information and protocols.

  10. Student knowledge and confidence in an elective clinical toxicology course using active-learning techniques.

    Science.gov (United States)

    Thomas, Michael C; Macias-Moriarity, Liliairica Z

    2014-06-17

    To measure changes in students' knowledge and confidence scores after completing an elective clinical toxicology course in an accelerated doctor of pharmacy (PharmD) program. Various active-learning techniques were used to create a learner-centered environment. Approximately two-thirds of the course used student-led presentations. Some of those not presenting were assigned to be evaluators, responsible for asking the presenter a question or writing quiz questions based on the presented material. Other learner-centered activities included weekly quizzes and discussions at the conclusion of each presented topic. A test instrument designed to measure students' knowledge and associated level of confidence on each item was administered at the beginning and end of the course. Students' knowledge and confidence scores increased significantly from pretest to posttest. Students' increased confidence and knowledge scores were well correlated after course completion, indicating students were better able to self-assess these areas. These findings suggest that confidence could be an additional measure of students' metacognitive skill development.

  11. 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

  12. 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

  13. Designing m-learning for junior registrars--activation of a theoretical model of clinical knowledge.

    Science.gov (United States)

    Kanstrup, Anne Marie; Boye, Niels; Nøhr, Christian

    2007-01-01

    The MINI-project aims at supporting junior registrars in the learning process of how to utilize their theoretical knowledge from Medical School in everyday clinical reasoning and practice. Due to the nature of the work--concurrent moving, learning and producing--we designed an m-learning application. This paper introduces the possibilities and challenges for design of the m-learning application based on a) analytical findings on learning and mobility as derived from the design case--an emergency medical ward b) theoretical perspectives on medical knowledge, and c) presentation of the design of an m-learning application. The design process was based on user-driven innovation and the paper discusses considerations on how to combine user-drive and generic models.

  14. The Genetics of Ischemic Heart Disease: From Current Knowledge to Clinical Implications.

    Science.gov (United States)

    Elosua, Roberto; Sayols-Baixeras, Sergi

    2017-09-01

    Ischemic heart disease continues to cause high morbidity and mortality. Its prevalence is expected to increase due to population aging, and its prevention is a major goal of health policies. The risk of developing ischemic heart disease is related to a complex interplay between genetic, environmental, and lifestyle factors. In the last decade, considerable progress has been made in knowledge of the genetic architecture of this disease. This narrative review provides an overview of current knowledge of the genetics of ischemic heart disease and of its translation to clinical practice: identification of new therapeutic targets, assessment of the causal relationship between biomarkers and disease, improved risk prediction, and identification of responders and nonresponders to specific drugs (pharmacogenomics). Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  15. Bloom, Hirsch, and Barthes in the Classroom: Negotiating Cultural Literacy.

    Science.gov (United States)

    Law, Joe K.

    1988-01-01

    Argues that the literature classroom is a forum for negotiating and renegotiating the culture and is not merely a means of transmitting knowledge and values to students. Argues that the consumerist attitude of Bloom and Hirsch towards education must be replaced by an adaptation of Barthes' strategy of rereading literature. (RS)

  16. Twelfth ITER negotiation meeting

    International Nuclear Information System (INIS)

    2006-01-01

    Delegations from China, European Union, Japan, the Republic of Korea, the Russian Federation and the United States of America gathered on Jeju Island, Korea, on 6 December 2005, to complete their negotiations on an Agreement on the joint implementation of the ITER international fusion energy project. At the start of the Meeting, the Delegations unanimously and enthusiastically welcomed India as a full Party to the ITER venture. A Delegation from India then joined the Meeting and participated fully in the discussions that followed. The seven ITER Delegations also welcomed to the Meeting the newly designated Nominee Director-General for the prospective ITER Organization, Ambassador Kaname Ikeda, who is to take up his duties as leader of the project. Based on the results of intensive working level meetings held throughout the previous week, the Delegations have succeeded in clearing the remaining key issues such as decision-making, intellectual property and management within the prospective ITER Organization and adjustments to the sharing of resources as a result of India's participation, including in particular cost sharing and in-kind contributions, leaving only a few legal points requiring resolution during the final lawyers' meeting to review the text for coherence and internal consistency

  17. 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.

  18. 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.

  19. Treating patients with dry mouth: general dental practitioners' knowledge, attitudes and clinical management.

    Science.gov (United States)

    Abdelghany, A; Nolan, A; Freeman, R

    2011-11-25

    To assess primary care dental practitioners' knowledge, attitudes and clinical management of patients presenting with dry mouth. A convenience sample of 200 dentists working in primary care in an NHS Health Board in Scotland was obtained. A questionnaire to assess knowledge, attitudes and clinical management of dry mouth patients was sent to all dentists on the NHS primary care service inventory. Ethical approval was obtained. Two hundred questionnaires were sent to the participants and 114 were returned, giving a valid response rate of 58%. Fifty percent were woman and 80% worked in the general dental service. Seventy-nine percent had been taught about xerostomia as undergraduates but only 21% had postgraduate educational experiences of dry mouth. The majority correctly stated that patients with Sjögren's syndrome would have an increased risk of dental caries, oral candidosis, frictional oral ulcers and squamous cell carcinoma. Participants had positive attitudes with regard to the importance of treating dry mouth; that it was not a trivial complaint; it affected patients' quality of life and their general health. The dentists were not confident to manage dry mouth patients. Knowledge, attitudes, confidence and intention to treat were affected by gender and type of primary care practice. Thirty-two percent of the variance of the intention to provide treatment was explained by working in the salaried dental service (SDS), confidence and attitudes regarding severity of the condition. Dentists working in the SDS had positive attitudes and increased confidence which were related to postgraduate educational experiences. Education at both undergraduate and postgraduate levels should be supported by clinical exposure to patients in order to improve dentists' confidence and competence to manage xerostomia and its complications.

  20. 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

  1. 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

  2. Smartphones as multimodal communication devices to facilitate clinical knowledge processes: randomized controlled trial.

    Science.gov (United States)

    Pimmer, Christoph; Mateescu, Magdalena; Zahn, Carmen; Genewein, Urs

    2013-11-27

    speech-only group (group 1: mean 4.08, SD 0.90; group 2: mean 4.73, SD 0.59; group 3: mean 4.93, SD 0.25; F2,39=6.76, P=.003; partial η(2)=0.26, 1-β=.90). However, significant positive effects on the recall and transfer of visually represented medical knowledge were only observed when the smartphone-based communication involved the combination of speech, images, and image annotation (group 3). There were no significant positive effects on the recall and transfer of visually represented knowledge between group 1 (speech only) and group 2 (speech and images). No significant differences were observed between the groups regarding verbally represented medical knowledge. The results show (1) the value of annotation functions for digital and mobile technology for interclinician communication and medical informatics, and (2) the use of guided noticing (the integration of speech, images, and image annotation) leads to significantly improved knowledge gains for visually represented knowledge. This is particularly valuable in situations involving complex visual subject matters, typical in clinical practice.

  3. ELECTRICA: ELEctronic knowledge base for Clinical care, Teaching and Research In Child Abuse.

    Science.gov (United States)

    Offiah, Amaka; Hume, Jessica; Bamsey, Ian; Jenkinson, Howard; Lings, Brian

    2011-11-01

    Child abuse is a highly significant public health issue with 4-16% of children being physically abused. The diagnosis is sensitive and challenging, with many radiologists dissatisfied with current levels of training and support. The literature shows a lack of prospective scientific research in this complex field. An ELEctronic knowledge base for Clinical care, Teaching and Research In Child Abuse (ELECTRICA) should solve many current problems. ELECTRICA will be populated with clinical information, radiographs and radiographic findings in children younger than 3 years of age presenting with injury (accidental or suspected abuse), to form a unique resource. This web-based tool will unify the investigative protocol in suspected abuse and support training and allow multicentre national and international collaborative research and provide robust evidence to support the legal process.

  4. [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.

  5. Identifying best practices for clinical decision support and knowledge management in the field.

    Science.gov (United States)

    Ash, Joan S; Sittig, Dean F; Dykstra, Richard; Wright, Adam; McMullen, Carmit; Richardson, Joshua; Middleton, Blackford

    2010-01-01

    To investigate best practices for implementing and managing clinical decision support (CDS) in community hospitals and ambulatory settings, we carried out a series of ethnographic studies to gather information from nine diverse organizations. Using the Rapid Assessment Process methodology, we conducted surveys, interviews, and observations over a period of two years in eight different geographic regions of the U.S.A. We first utilized a template organizing method for an expedited analysis of the data, followed by a deeper and more time consuming interpretive approach. We identified five major categories of best practices that require careful consideration while carrying out the planning, implementation, and knowledge management processes related to CDS. As more health care organizations implement clinical systems such as computerized provider order entry with CDS, descriptions of lessons learned by CDS pioneers can provide valuable guidance so that CDS can have optimal impact on health care quality.

  6. 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.

  7. 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

  8. Key success factors for clinical knowledge management systems: Comparing physician and hospital manager viewpoints.

    Science.gov (United States)

    Chang, Sho-Fang; Hsieh, Ping-Jung; Chen, Hui-Fang

    2015-01-01

    The study explores the perceptions of physicians and hospital managers regarding the key success factors (KSFs) of a clinical knowledge management system (CKMS). It aims to eliminate the perception gap and gain more insights for a successful CKMS.A survey was conducted in four medical centers in Taiwan. A total of 340 questionnaires, including 15 for hospital managers and 70 for physicians in each hospital, were administered. The effective response rates are 78.3% and 56.1% respectively. Partial least square (PLS) were used to analyze the data.The results identified six KSFs of CKMS including system software and hardware, knowledge quality, system quality, organizational factors, user satisfaction, and policy factors. User satisfaction and policy factors have direct effects on perceived CKMS performance. Knowledge quality is regarded as an antecedent to user satisfaction, while system quality is the antecedent to both user satisfaction and policy factors. System software and hardware was supported only by managers, and organizational factors were supported only by physicians.Among the factors, this study highlighted the policy factor. Besides, the study provides hospital managers additional insights into physician requirements for organizational support. Third, more physician participation and involvement are recommended when introducing and developing a CKMS.

  9. 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

  10. 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.

  11. 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.

  12. [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.

  13. 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

  14. 48 CFR 2515.215-70 - NSF negotiation authorities.

    Science.gov (United States)

    2010-10-01

    ... CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Negotiation Authorities 2515.215-70 NSF... entered into through negotiation rather than formal advertising. The Foundation's contracting officer may...

  15. An automated knowledge-based textual summarization system for longitudinal, multivariate clinical data.

    Science.gov (United States)

    Goldstein, Ayelet; Shahar, Yuval

    2016-06-01

    Design and implement an intelligent free-text summarization system: The system's input includes large numbers of longitudinal, multivariate, numeric and symbolic clinical raw data, collected over varying periods of time, and in different complex contexts, and a suitable medical knowledge base. The system then automatically generates a textual summary of the data. We aim to prove the feasibility of implementing such a system, and to demonstrate its potential benefits for clinicians and for enhancement of quality of care. We have designed a new, domain-independent, knowledge-based system, the CliniText system, for automated summarization in free text of longitudinal medical records of any duration, in any context. The system is composed of six components: (1) A temporal abstraction module generates all possible abstractions from the patient's raw data using a temporal-abstraction knowledge base; (2) The abductive reasoning module infers abstractions or events from the data, which were not explicitly included in the database; (3) The pruning module filters out raw or abstract data based on predefined heuristics; (4) The document structuring module organizes the remaining raw or abstract data, according to the desired format; (5) The microplanning module, groups the raw or abstract data and creates referring expressions; (6) The surface realization module, generates the text, and applies the grammar rules of the chosen language. We have performed an initial technical evaluation of the system in the cardiac intensive-care and diabetes domains. We also summarize the results of a more detailed evaluation study that we have performed in the intensive-care domain that assessed the completeness, correctness, and overall quality of the system's generated text, and its potential benefits to clinical decision making. We assessed these measures for 31 letters originally composed by clinicians, and for the same letters when generated by the CliniText system. We have successfully

  16. 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

  17. STUDY ON SMOKING PATTERN AND KNOWLEDGE OF CESSATION METHODS AMONG PATIENTS ATTENDING A PULMONOLOGY CLINIC

    Directory of Open Access Journals (Sweden)

    Vinod Kumar Viswanathan

    2017-08-01

    Full Text Available BACKGROUND Tobacco is a public health problem globally and an important cause of preventable premature death in middle and low income countries. The government of India has taken several measures to ensure tobacco control and suggested that a systematic surveillance system is a key strategy in tobacco control. However the fact remains that people continue to smoke. This study was undertaken to understand the smoking patterns among patients attending a Pulmonology clinic and to assess their knowledge of smoking cessation methods. Data from this study can be used for planning and resource allocation of a smoking cessation clinic. The aim is to study the smoking patterns and the knowledge of cessation strategies and to analyse the willingness of the patients to quit smoking in patients attending a Pulmonology clinic. MATERIALS AND METHODS Around 489 patients visiting the Pulmonology clinic for 15 days were screened and patients with history of smoking habit were included in the study. 133 such patients were assessed with a structured questionnaire and results were analysed. RESULTS The prevalence of patients with smoking habits was 27.2%. The mean age of smoking initiation was 20.9 years of age. Percentage of beedi smokers (52.6% was much higher than the cigarette smokers (37.6%. The average number of cigarettes or beedis smoked per day was 16.6. Only 12.8% were aware of therapeutic options for nicotine de-addiction. Most of the patients had difficulty in smoking cessation. CONCLUSION Most of the patients lack health education regarding the ill effects of smoking or about smoking cessation strategies. Many of them still have inhibitions and fail to seek health services at the earliest, hence we should be able to bridge the gap and give due importance to information, education and communication (IEC activities. Creation of smoking cessation clinics with trained personnel offering various cessation strategies such as psychological counselling

  18. Enabling health care decisionmaking through clinical decision support and knowledge management.

    Science.gov (United States)

    Lobach, David; Sanders, Gillian D; Bright, Tiffani J; Wong, Anthony; Dhurjati, Ravi; Bristow, Erin; Bastian, Lori; Coeytaux, Remy; Samsa, Gregory; Hasselblad, Vic; Williams, John W; Wing, Liz; Musty, Michael; Kendrick, Amy S

    2012-04-01

    To catalogue study designs used to assess the clinical effectiveness of CDSSs and KMSs, to identify features that impact the success of CDSSs/KMSs, to document the impact of CDSSs/KMSs on outcomes, and to identify knowledge types that can be integrated into CDSSs/KMSs. MEDLINE(®), CINAHL(®), PsycINFO(®), and Web of Science(®). We included studies published in English from January 1976 through December 2010. After screening titles and abstracts, full-text versions of articles were reviewed by two independent reviewers. Included articles were abstracted to evidence tables by two reviewers. Meta-analyses were performed for seven domains in which sufficient studies with common outcomes were included. We identified 15,176 articles, from which 323 articles describing 311 unique studies including 160 reports on 148 randomized control trials (RCTs) were selected for inclusion. RCTs comprised 47.5 percent of the comparative studies on CDSSs/KMSs. Both commercially and locally developed CDSSs effectively improved health care process measures related to performing preventive services (n = 25; OR 1.42, 95% confidence interval [CI] 1.27 to 1.58), ordering clinical studies (n = 20; OR 1.72, 95% CI 1.47 to 2.00), and prescribing therapies (n = 46; OR 1.57, 95% CI 1.35 to 1.82). Fourteen CDSS/KMS features were assessed for correlation with success of CDSSs/KMSs across all endpoints. Meta-analyses identified six new success features: Integration with charting or order entry system. Promotion of action rather than inaction. No need for additional clinician data entry. Justification of decision support via research evidence. Local user involvement. Provision of decision support results to patients as well as providers. Three previously identified success features were confirmed: Automatic provision of decision support as part of clinician workflow. Provision of decision support at time and location of decisionmaking. Provision of a recommendation, not just an assessment. Only 29

  19. 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.

  20. 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.

  1. Distilling or Diluting? Negotiating the Water Research-Policy Interface

    Directory of Open Access Journals (Sweden)

    Frances Cleaver

    2008-06-01

    Full Text Available This article examines some of the tensions in the generation of knowledge about water governance and poverty, and the translation of this knowledge into policy and practice. It draws on the experience of the authors in developing a framework for understanding water governance and poverty, their work on a project in Tanzania and their attempts to engage with policy makers. The authors propose that the negotiation of knowledge is a political process shaped both by power relationships and (often implicit normative values. Such negotiation may be impeded by the contrasting positions of academics as uncertainty creators and policy makers seeking uncertainty reduction. The authors critique instrumental approaches to the generation of knowledge and policy based on the amalgamation of perceived 'success stories' and 'good practice'. They favour instead approaches that attempt to understand water governance arrangements and outcomes for the poor within wider frameworks of negotiations over the allocation of societal resources. This implies the need to rethink the research – policy relationship and to build reflexive knowledge generation into the research-policy interface.

  2. Treatment of temporomandibular disorders - knowledge, attitudes and clinical experience among general practising dentists in Sweden.

    Science.gov (United States)

    Lindfors, Erik; Tegelberg, Åke; Magnusson, Tomas; Ernberg, Malin

    2016-08-01

    The aim of the study was to investigate the self-perceived level of knowledge, attitudes and clinical experience in treatment of temporomandibular disorders (TMD) among general practising dentists (GPDs). A web-based questionnaire was sent to all GPDs in the public dental health service in the County of Uppsala in 2010 (n = 128) and 2014 (n = 113). The GPDs were asked to answer questions in the following categories: Demographic information, Quality assurance, Clinical experience and treatment, Need for specialist resources in the field of TMD and Attitudes. Between the two questionnaires, the GPDs were offered TMD education and an examination template including three TMD questions was introduced in the computer case files. The results were also compared with a previous questionnaire from 2001. The response rate was 71% (2010) and 73% (2014). The majority of the GPDs were women (70% in 2010 and 72% in 2014). The reported frequency of taking a case history of facial pain and headache increased between 2010 and 2014. In 2014, the GPDs were more secure and reported higher frequency of good clinical routines in treatment with jaw exercises and pharmacological intervention compared to 2001. Interocclusal appliance was the treatment with which most dentists felt confident and reported good clinical routines. The GPDs felt more insecure concerning TMD diagnostics, therapy decisions and treatment in children/adolescents compared to adults. There is a high need for orofacial pain/TMD specialists and a majority of the GPDs wants the specialists to offer continuing education in TMD.

  3. Formative evaluation of a patient-specific clinical knowledge summarization tool.

    Science.gov (United States)

    Del Fiol, Guilherme; Mostafa, Javed; Pu, Dongqiuye; Medlin, Richard; Slager, Stacey; Jonnalagadda, Siddhartha R; Weir, Charlene R

    2016-02-01

    To iteratively design a prototype of a computerized clinical knowledge summarization (CKS) tool aimed at helping clinicians finding answers to their clinical questions; and to conduct a formative assessment of the usability, usefulness, efficiency, and impact of the CKS prototype on physicians' perceived decision quality compared with standard search of UpToDate and PubMed. Mixed-methods observations of the interactions of 10 physicians with the CKS prototype vs. standard search in an effort to solve clinical problems posed as case vignettes. The CKS tool automatically summarizes patient-specific and actionable clinical recommendations from PubMed (high quality randomized controlled trials and systematic reviews) and UpToDate. Two thirds of the study participants completed 15 out of 17 usability tasks. The median time to task completion was less than 10s for 12 of the 17 tasks. The difference in search time between the CKS and standard search was not significant (median=4.9 vs. 4.5m in). Physician's perceived decision quality was significantly higher with the CKS than with manual search (mean=16.6 vs. 14.4; p=0.036). The CKS prototype was well-accepted by physicians both in terms of usability and usefulness. Physicians perceived better decision quality with the CKS prototype compared to standard search of PubMed and UpToDate within a similar search time. Due to the formative nature of this study and a small sample size, conclusions regarding efficiency and efficacy are exploratory. Published by Elsevier Ireland Ltd.

  4. Assessment for simulation learning outcomes: a comparison of knowledge and self-reported confidence with observed clinical performance.

    Science.gov (United States)

    Liaw, Sok Ying; Scherpbier, Albert; Rethans, Jan-Joost; Klainin-Yobas, Piyanee

    2012-08-01

    With extensive use of simulation in nursing education, researchers around the world are evaluating learning outcomes from simulation. Numerous studies reported the use of knowledge tests and self-reported measures to evaluate simulation outcomes. To determine whether self-reported confidence and knowledge measures are indicators of clinical performance observed in a simulation-based assessment. Thirty-one third year nursing students were randomized into intervention and control group. The intervention group received a six hour simulation-based programme in care of a patient with physiological deterioration. Pre and post-tests using knowledge test, confidence scale and simulation-based assessment were conducted immediately before and after the simulation program. The intervention group had a significantly higher post-test mean score than the control group for knowledge and clinical performances. Both groups demonstrated a significant improvement on post-test scores from pre-test scores for self-confidence with no significant differences detected among the two groups. Correlation tests indicated no significant correlation between self-confidence and clinical performance, and between knowledge and clinical performance. The study did not provide evidence to support the validity of the knowledge test and self-confidence measures for predicting clinical performance. Most importantly, it revealed potential danger of a simulation-based assessment that could lead toward overestimation of self-confidence. Copyright © 2011. Published by Elsevier Ltd.

  5. 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... PROGRAMS SMALL BUSINESS PROGRAMS Contracting With the Small Business Administration (the 8(a) Program) 19.808 Contract negotiation. ...

  6. 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... SMALL BUSINESS PROGRAMS Contracting with the Small Business Administration (The 8(a) Program) 619.808 Contract negotiation. ...

  7. 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.

  8. Knowledge translation: a case study on pneumonia research and clinical guidelines in a low- income country.

    Science.gov (United States)

    Goyet, Sophie; Barennes, Hubert; Libourel, Therese; van Griensven, Johan; Frutos, Roger; Tarantola, Arnaud

    2014-06-26

    The process and effectiveness of knowledge translation (KT) interventions targeting policymakers are rarely reported. In Cambodia, a low-income country (LIC), an intervention aiming to provide evidence-based knowledge on pneumonia to health authorities was developed to help update pediatric and adult national clinical guidelines. Through a case study, we assessed the effectiveness of this KT intervention, with the goal of identifying the barriers to KT and suggest strategies to facilitate KT in similar settings. An extensive search for all relevant sources of data documenting the processes of updating adult and pediatric pneumonia guidelines was done. Documents included among others, reports, meeting minutes, and email correspondences. The study was conducted in successive phases: an appraisal of the content of both adult and pediatric pneumonia guidelines; an appraisal of the quality of guidelines by independent experts, using the AGREE-II instrument; a description and modeling of the KT process within the guidelines updating system, using the Unified Modeling Language (UML) tools 2.2; and the listing of the barriers and facilitators to KT we identified during the study. The first appraisal showed that the integration of the KT key messages in pediatric and adult guidelines varied with a better efficiency in the pediatric guidelines. The overall AGREE-II quality assessments scored 37% and 44% for adult and pediatric guidelines, respectively. Scores were lowest for the domains of 'rigor of development' and 'editorial independence.' The UML analysis highlighted that time frames and constraints of the involved stakeholders greatly differed and that there were several missed opportunities to translate on evidence into the adult pneumonia guideline. Seventeen facilitating factors and 18 potential barriers to KT were identified. Main barriers were related to the absence of a clear mandate from the Ministry of Health for the researchers and to a lack of synchronization

  9. 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....

  10. Negotiation: a necessary art for dental practice.

    Science.gov (United States)

    Fitzpatrick, William G; Renshaw, John; Batchelor, Paul

    2012-01-01

    This brief paper explains why the art of negotiation has become far more important for general dental practitioners. It explains that negotiations take place with patients, with practice staff, and with funding agencies such as Primary Care Trusts. It sets out the principles for successful negotiation and gives two examples of how they can be applied. It concludes that negotiation is a skill that can be learned and that it will be a key skill as the profession faces future challenges.

  11. 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

  12. 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.

  13. 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.

  14. Can Climate Change Negotiations Succeed?

    Directory of Open Access Journals (Sweden)

    Jon Hovi

    2013-09-01

    Full Text Available More than two decades of climate change negotiations have produced a series of global climate agreements, such as the Kyoto Protocol and the Copenhagen Accords, but have nevertheless made very limited progress in curbing global emissions of greenhouse gases. This paper considers whether negotiations can succeed in reaching an agreement that effectively addresses the climate change problem. To be effective, a climate agreement must cause substantial emissions reductions either directly (in the agreement's own lifetime or indirectly (by paving the way for a future agreement that causes substantial emissions reductions directly. To reduce global emissions substantially, an agreement must satisfy three conditions. Firstly, participation must be both comprehensive and stable. Secondly, participating countries must accept deep commitments. Finally, the agreement must obtain high compliance rates. We argue that three types of enforcement will be crucial to fulfilling these three conditions: (1 incentives for countries to ratify with deep commitments, (2 incentives for countries that have ratified with deep commitments to abstain from withdrawal, and (3 incentives for countries having ratified with deep commitments to comply with them. Based on assessing the constraints that characterize the climate change negotiations, we contend that adopting such three-fold potent enforcement will likely be politically infeasible, not only within the United Nations Framework Convention on Climate Change, but also in the framework of a more gradual approach. Therefore, one should not expect climate change negotiations to succeed in producing an effective future agreement—either directly or indirectly.

  15. 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…

  16. Negotiations in Supply Chain Management

    DEFF Research Database (Denmark)

    Zachariassen, Frederik

    2008-01-01

      This paper explores the role of negotiations in SCM. Research in this topic has been carried out on a previous note, but researchers in the SCM discipline emphasize that an astonishing dearth of research and therefore theory currently exists. This working paper starts by reviewing the extant ne...... that can be effectively employed by purchasers and suppliers....

  17. Meaning Negotiations of Collaborative Governance

    DEFF Research Database (Denmark)

    Plotnikof, Mie; Zandee, Danielle P.

    2016-01-01

    and analytical approaches to unfold discourse-material aspects of the negotiations of meanings and matters of such new governance form in practice. The chapter provides examples based on ethnographic fieldwork in collaborations across actors from the welfare area of education. In conclusion, the author reflects...

  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. Navigating Negotiations in Uncharted Waters

    Science.gov (United States)

    Jaeger, Kurt

    2012-01-01

    It is the best of times because there has never been a greater need for quality school business officials, but it is the worst of times because it has never been more difficult to "be" a school business official. One needs the wisdom of Solomon to balance the foolishness of greed with need. A poorly equipped negotiating team can quickly sink the…

  20. 32 CFR 756.6 - Negotiation.

    Science.gov (United States)

    2010-07-01

    ... INVOLVING NON-APPROPRIATED FUND ACTIVITIES AND THEIR EMPLOYEES § 756.6 Negotiation. (a) General. Claims from... 32 National Defense 5 2010-07-01 2010-07-01 false Negotiation. 756.6 Section 756.6 National... contracted third-party claims administrator (TPA) will normally conduct negotiations with claimants. The TCU...

  1. 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... TRANSPORTATION RULES OF PRACTICE INTRAMODAL RAIL COMPETITION § 1144.1 Negotiation. (a) Timing. At least 5 days... intending to initiate such action must first seek to engage in negotiations to resolve its dispute with the...

  2. 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.

  3. 40 CFR 35.937-5 - Negotiation.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Negotiation. 35.937-5 Section 35.937-5... ASSISTANCE Grants for Construction of Treatment Works-Clean Water Act § 35.937-5 Negotiation. (a) Grantees are responsible for negotiation of their contracts for architectural or engineering services. Contract...

  4. 25 CFR 225.21 - Negotiation procedures.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Negotiation procedures. 225.21 Section 225.21 Indians... SOLID MINERALS AGREEMENTS Minerals Agreements § 225.21 Negotiation procedures. (a) An Indian mineral... information during the negotiation process. The Secretary shall provide advice, assistance, and information to...

  5. 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...Interdisciplinary perspectives on culture, conflict, and negotiation! LYNN IMAI and MICHELE J. GELFAND There is no doubt that many of the greatest...motivation, group dynamics. or globalization. The value - if not the necessity - of interdisciplinary perspectives is indisputable. Organizational

  6. 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

    2011-02-01

    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.

  7. Why do employees negotiate idiosyncratic deals? An exploration of the process of i-deal negotiation

    OpenAIRE

    Bal, P. Matthijs

    2018-01-01

    This study investigated why employees negotiate idiosyncratic deals with their organizations, and interviews with 31 employees who successfully negotiated i-deals showed that three main themes could be identified in the i-deal negotiation process: motives for negotiating (i.e., earned and problem solving), enablers (i.e., relationships and flexibility), and inhibitors (i.e., secrecy, and culture and structure). The study shows that people may have different motives for negotiating i-deals, an...

  8. The Effects of Semantic Difference on Cross-Cultural Business Negotiation: A Japanese and American Case Study.

    Science.gov (United States)

    Adachi, Yumi

    1998-01-01

    This article analyzes how semantic differences between English and Japanese affect the discourse when Japanese speakers engage in negotiation in English, and how and to what degree English-language proficiency affects discourse. Results of the study show the importance of language and cultural knowledge in cross-cultural negotiation. (Auth/JL)

  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. [Pediatric palliative care: a national survey of French pediatric residents' knowledge, education, and clinical experience].

    Science.gov (United States)

    Lefeubvre, C; Viallard, M-L; Schell, M

    2014-08-01

    The need for educational training of healthcare professionals in palliative care is an important issue. Training and practice of pediatric residents in the field of pediatric palliative care (PPC) has never been assessed, although the organization of the medical curriculum in France is currently being revised. This study presents a national survey of pediatric residents, using a computerized anonymous questionnaire. Four different areas were studied: epidemiological data, theoretical and practical knowledge, education, and clinical experience in PPC. The response rate was 39% (n=365/927). Whatever their age or regional location, 25% of residents did not know any details of the French law concerning patients' rights and the end of life. Experience with PPC starts very early since 77% of the first-year pediatric residents experienced at least one child in a palliative care and/or end-of-life situation. During their entire residency, 87% of the residents had experience with PPC and nearly all (96%) end-of-life care. Furthermore, 76% had participated in announcing palliative care (cancer, ICU, etc.) or a serious illness, and 45% had met and discussed with bereaved parents. Furthermore, while 97% of the pediatric residents received training in adult palliative care, mainly before their residency, only 60% received specific PPC training. Ninety-six percent of all French pediatric residents encountered a PPC situation during their residency. That 77% of them had experienced PPC during their first year of residency shows the importance of early training in PPC for pediatric residents. Furthermore, this study points out that there is a significant lack in PPC training since 40% of all residents in the study received no specific PPC training. Progress in education remains insufficient in the dissemination of knowledge on the legal framework and concepts of palliative medicine: while the medical curriculum is being revised, we suggest that training in medical ethics and PPC

  12. 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.

  13. 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

  14. 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

  15. Prevention of ventilator-associated pneumonia: can knowledge and clinical practice be simply assessed in a large institution?

    Science.gov (United States)

    Pérez-Granda, María Jesús; Muñoz, Patricia; Heras, Carmen; Sánchez, Guiomar; Rello, Jordi; Bouza, Emilio

    2013-07-01

    User-friendly scores to assess knowledge of guidelines for prevention of ventilator-associated pneumonia (VAP) are scarce and have mainly evaluated nurses, but not students or physicians. Gaps between knowledge and actual clinical practice have not been sufficiently analyzed. We assessed knowledge of and adherence to guidelines for prevention of VAP among physicians, nurses, and students in adult ICUs. All adult ICU healthcare workers were invited to complete a 20-point questionnaire. The first part assessed personal knowledge of international guidelines for prevention of VAP; the second part assessed daily clinical practice. Personal knowledge and daily practice were scored from 0 to 10 points. We invited 257 ICU healthcare workers to participate in the study, and 167 (65%) accepted (32/54 physicians, 108/176 nurses, and 27/27 students). The median (IQR) personal knowledge scores for physicians, nurses, and students were 6 (5-7), 5 (4-6), and 5 (4-7), respectively. The median scores for daily clinical practice for physicians and nurses were 5 (4-6) and 4 (3-5), respectively. Healthcare workers with more than 1 year of ICU experience scored significantly better in personal knowledge than those with less experience: 6 (5-7) versus 4 (3-6), P = .004. A simple, easy-to-complete questionnaire enabled us to rapidly evaluate personal knowledge and reported clinical practice in prevention of VAP in large teaching institutions. These scores will be used as baseline figures to assess the impact of educational and intervention campaigns.

  16. 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.

  17. 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.

  18. 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...

  19. Improving Clinical Trial Participant Tracking Tools Using Knowledge-anchored Design Methodologies.

    Science.gov (United States)

    Payne, Philip R O; Embi, Peter J; Johnson, Stephen B; Mendonca, Eneida; Starren, Justin

    2010-01-01

    OBJECTIVE: Rigorous human-computer interaction (HCI) design methodologies have not traditionally been applied to the development of clinical trial participant tracking (CTPT) tools. Given the frequent us of iconic HCI models in CTPTs, and prior evidence of usability problems associated with the use of ambiguous icons in complex interfaces, such approaches may be problematic. Presentation Discovery (PD), a knowledge-anchored HCI design method, has been previously demonstrated to improve the design of iconic HCI models. In this study, we compare the usability of a CTPT HCI model designed using PD and an intuitively designed CTPT HCI model. METHODS: An iconic CPTP HCI model was created using PD. The PD-generated and an existing iconic CTPT HCI model were subjected to usability testing, with an emphasis on task accuracy and completion times. Study participants also completed a qualitative survey instrument to evaluate subjective satisfaction with the two models. RESULTS: CTPT end-users reliably and reproducibly agreed on the visual manifestation and semantics of prototype graphics generated using PD. The performance of the PD-generated iconic HCI model was equivalent to an existing HCI model for tasks at multiple levels of complexity, and in some cases superior. This difference was particularly notable when tasks required an understanding of the semantic meanings of multiple icons. CONCLUSION: The use of PD to design an iconic CTPT HCI model generated beneficial results and improved end-user subjective satisfaction, while reducing task completion time. Such results are desirable in information and time intensive domains, such as clinical trials management.

  20. Discovering treatment pattern in Traditional Chinese Medicine clinical cases by exploiting supervised topic model and domain knowledge.

    Science.gov (United States)

    Yao, Liang; Zhang, Yin; Wei, Baogang; Wang, Wei; Zhang, Yuejiao; Ren, Xiaolin; Bian, Yali

    2015-12-01

    In Traditional Chinese Medicine (TCM), the prescription is the crystallization of clinical experience of doctors, which is the main way to cure diseases in China for thousands of years. Clinical cases, on the other hand, describe how doctors diagnose and prescribe. In this paper, we propose a framework which mines treatment patterns in TCM clinical cases by exploiting supervised topic model and TCM domain knowledge. The framework can reflect principle rules in TCM and improve function prediction of a new prescription. We evaluate our method on 3090 real world TCM clinical cases. The experiment validates the effectiveness of our method. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. 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.

  2. Arguing and negotiating in the presence of social influences

    OpenAIRE

    Karunatillake, N. C.; Jennings, N. R.; Rahwan, I.; Norman, Timothy

    2005-01-01

    When agents operate in a society with incomplete information and with diverse and conflicting influences, they may, in certain instances, lack the knowledge, the motivation and/or the capacity to enact all their commitments. However, to function as a coherent society it is important for these agents to have a means to resolve such conflicts and to come to a mutual understanding about their actions. To this end, argumentation-based negotiation provides agents with an effective means to resolve...

  3. 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

  4. Learning by negotiation - Stake and salience in implementing a journal management system

    OpenAIRE

    Özgün, Imre

    2015-01-01

    This research investigates how an international academic journal implements a new journal management system to overcome their knowledge management issues. By adopting a case study approach, the stakeholders involved within the project are identified and their salience for the organisation is mapped. By providing an account of how these stakeholders negotiated each other, the case highlights how these negotiations are learning processes, showing that learning process is not a conflict-free pro...

  5. Negotiating leave in the workplace

    DEFF Research Database (Denmark)

    Bloksgaard, Lotte

    In Denmark leave entitlement is not only regulated by law but is also part of the various collective agreements established in the respective occupational sectors and at the local workplace level. Consequently, Danish fathers have very different leave entitlements, depending on the sector, branch...... and workplace in which they are employed. The paper focuses on fathers’ negotiations of parental leave in three large Danish work places, offering men different opportunities for leave. With a focus on the differences in the work place contexts/opportunities for leave, the aim of the paper is firstly to explore...... men’s negotiations of parental leave at work place level and secondly, to explore and discuss how Danish fathers construct leave practices – and individual male identities – in the workplace....

  6. 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.

  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. 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.

  9. 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.

  10. Salary negotiations the smart way.

    Science.gov (United States)

    Kennedy, M M

    1987-01-01

    No one holds all the cards in a job interview, unless one party to the negotiations gives them to the other. To obtain the salary that you deserve, you have to do some homework to determine your market value and you have to stick to your guns during the bargaining. Taking less than you, and the prospective employer, know you're worth is a sure road to disaster.

  11. 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....

  12. 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

  13. 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

  14. Pharmacogenomic knowledge representation, reasoning and genome-based clinical decision support based on OWL 2 DL ontologies.

    Science.gov (United States)

    Samwald, Matthias; Miñarro Giménez, Jose Antonio; Boyce, Richard D; Freimuth, Robert R; Adlassnig, Klaus-Peter; Dumontier, Michel

    2015-02-22

    Every year, hundreds of thousands of patients experience treatment failure or adverse drug reactions (ADRs), many of which could be prevented by pharmacogenomic testing. However, the primary knowledge needed for clinical pharmacogenomics is currently dispersed over disparate data structures and captured in unstructured or semi-structured formalizations. This is a source of potential ambiguity and complexity, making it difficult to create reliable information technology systems for enabling clinical pharmacogenomics. We developed Web Ontology Language (OWL) ontologies and automated reasoning methodologies to meet the following goals: 1) provide a simple and concise formalism for representing pharmacogenomic knowledge, 2) finde errors and insufficient definitions in pharmacogenomic knowledge bases, 3) automatically assign alleles and phenotypes to patients, 4) match patients to clinically appropriate pharmacogenomic guidelines and clinical decision support messages and 5) facilitate the detection of inconsistencies and overlaps between pharmacogenomic treatment guidelines from different sources. We evaluated different reasoning systems and test our approach with a large collection of publicly available genetic profiles. Our methodology proved to be a novel and useful choice for representing, analyzing and using pharmacogenomic data. The Genomic Clinical Decision Support (Genomic CDS) ontology represents 336 SNPs with 707 variants; 665 haplotypes related to 43 genes; 22 rules related to drug-response phenotypes; and 308 clinical decision support rules. OWL reasoning identified CDS rules with overlapping target populations but differing treatment recommendations. Only a modest number of clinical decision support rules were triggered for a collection of 943 public genetic profiles. We found significant performance differences across available OWL reasoners. The ontology-based framework we developed can be used to represent, organize and reason over the growing wealth of

  15. Dentists' levels of evidence-based clinical knowledge and attitudes about using pit-and-fissure sealants.

    Science.gov (United States)

    Govindaiah, Sirisha; Bhoopathi, Vinodh

    2014-08-01

    Although the prevalence of pit-and-fissure sealants in children in the United States is low, the problem is magnified in low-income children. A small proportion of Florida's low-income children receive any preventive dental services, including sealants. The authors conducted a cross-sectional study to assess whether Florida's dentists provide sealants as a preventive measure in their practices, their attitudes and their levels of evidence-based clinical knowledge about appropriate sealant use according to the American Dental Association (ADA) recommendations. The authors also assessed whether the number of years since graduation and reliance on peers or colleagues for regular clinical information were associated with dentists' knowledge. The authors administered a 25-item pretested questionnaire to a convenience sample of general and pediatric dentists (n = 163) at the 2013 Florida National Dental Convention in Kissimmee, Fla. The authors conducted multivariate linear regression modeling to predict dentists' levels of evidence-based clinical knowledge. Years since graduation (P = .2) and reliance on peers or colleagues for regular clinical information (P = .6) did not predict higher knowledge. Male dentists (P = .003) and those who accepted children enrolled in Medicaid as new patients (P = .01) had significantly more knowledge compared with their counterparts. Most participating dentists used sealants in their practices and had high levels of positive attitudes about using sealants. Overall knowledge regarding the appropriate use of sealants, however, was low. For practicing dental professionals, the authors recommend disseminating evidence-based recommendations for the use of dental sealants via continuing education courses and other possible modalities. They also recommend that dental schools update their existing courses or modules about sealants by integrating the ADA's recommendations.

  16. 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.

  17. The music therapy clinical intern: performance skills, academic knowledge, personal qualities, and interpersonal skills necessary for a student seeking clinical training.

    Science.gov (United States)

    Brookins, L M

    1984-01-01

    The music therapy curriculum consists of two distinct parts: the academic phase and the internship. The music therapy student must apply for a clinical internship during the last year of the academic phase, and the student is expected to evolve from student to professional music therapist during the internship phase. The present study sought to determine the skills, knowledge, and qualities clinical training directors considered most important for a prospective intern to possess. The sample population of the survey consisted of 25 clinical training directors from the Great Lakes Region. Results of the survey indicated that piano skills, knowledge of psychology, emotional maturity, and the ability to express needs and feelings were considered most important for the prospective intern to possess.

  18. 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

  19. The relationships among knowledge, self-efficacy, preparedness, decisional conflict, and decisions to participate in a cancer clinical trial.

    Science.gov (United States)

    Miller, S M; Hudson, S V; Egleston, B L; Manne, S; Buzaglo, J S; Devarajan, K; Fleisher, L; Millard, J; Solarino, N; Trinastic, J; Meropol, N J

    2013-03-01

    Cancer clinical trials (CCTs) are important tools in the development of improved cancer therapies; yet, participation is low. Key psychosocial barriers exist that appear to impact a patient's decision to participate. Little is known about the relationship among knowledge, self-efficacy, preparation, decisional conflict, and patient decisions to take part in CCTs. The purpose of this study was to determine if preparation for consideration of a CCT as a treatment option mediates the relationship between knowledge, self-efficacy, and decisional conflict. We also explored whether lower levels of decisional conflict are associated with greater likelihood of CCT enrollment. In a pre-post test intervention study, cancer patients (N = 105) were recruited before their initial consultation with a medical oncologist. A brief educational intervention was provided for all patients. Patient self-report survey responses assessed knowledge, self-efficacy, preparation for clinical trial participation, decisional conflict, and clinical trial participation. Preparation was found to mediate the relationship between self-efficacy and decisional conflict (p = 0.003 for a test of the indirect mediational pathway for the decisional conflict total score). Preparation had a more limited role in mediating the effect of knowledge on decisional conflict. Further, preliminary evidence indicated that reduced decisional conflict was associated with increased clinical trial enrollment (p = 0.049). When patients feel greater CCT self-efficacy and have more knowledge, they feel more prepared to make a CCT decision. Reduced decisional conflict, in turn, is associated with the decision to enroll in a clinical trial. Our results suggest that preparation for decision-making should be a target of future interventions to improve participation in CCTs. Copyright © 2012 John Wiley & Sons, Ltd.

  20. 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.

  1. 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.

  2. 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.)

  3. 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.

  4. Negotiating: experiences of community nurses when contracting with clients.

    Science.gov (United States)

    Duiveman, Trudie; Bonner, Ann

    2012-04-01

    A community nurse is required to have excellent interpersonal, teaching, collaborative and clinical skills in order to develop effective individualised client care contracts. Using a descriptive qualitative design data was collected from two focus groups of fourteen community nurses to explore the issues surrounding negotiating and contracting client care contracts from the perspective of community nurses. Thematic analysis revealed three themes: 'assessment of needs', 'education towards enablement', and 'negotiation'. 'Assessment of needs' identified that community nurses assess both the client's requirements for health care as well as the ability of the nurse to provide that care. 'Education towards enablement' described that education of the client is a common strategy used by community nurses to establish realistic goals of health care as part of developing an ongoing care plan. The final theme, 'negotiation', involved an informed agreement between the client and the community nurse which forms the origin of the care contract that will direct the partnership between the client and the nurse. Of importance for community nurses is that development of successful person-centred care contracts requires skillful negotiation of care that strikes the balance between the needs of the client and the ability of the nurse to meet those needs.

  5. Enabling Persistent Peace After Negotiated Settlements

    Science.gov (United States)

    2016-12-01

    Fates and the Duration of the Peace,” Conflict Management and Peace Science 26, no. 4 (September 2009): 348. 11 change , a settlement can become...insurgents. However, it is very important to note when a government should negotiate with terrorists and insurgents. Professionals in negotiations ...THE ENEMY ARE IMPORTANT FACTORS TO AVOID THE RECURRENCE OF WAR On August 26, 2016, negotiators from the Colombian Government and the FARC announced

  6. Knowledge on Alzheimer's Disease among Public Hospitals and Health Clinics Pharmacists in the State of Selangor, Malaysia.

    Science.gov (United States)

    Mat Nuri, Thimarul Huda; Hong, Yet Hoi; Ming, Long Chiau; Mohd Joffry, Suhaidah; Othman, Muhamad Faiz; Neoh, Chin Fen

    2017-01-01

    The prevalence of Alzheimer's disease (AD) has increased with the fast growing of aging population, thereby posing great challenges to provision of care for AD patients. Pharmacists play a vital role in the management of AD; this includes recognizing early symptoms of AD, providing medication counseling to AD patients and their caretakers, and identifying potential adverse drug reactions. A comprehensive understanding of the disease progression, as well as the pharmacological therapy, is essential to provide effective care to AD patients. The level of knowledge about AD among the pharmacists, however, remains unknown. Hence, this study aimed to assess the knowledge on AD among the pharmacists in public hospitals and health clinics and its correlates. A clear picture of the characteristics associated with different levels of knowledge could facilitate the targeted re-training of pharmacists. The 30-item validated Alzheimer disease knowledge scale (ADKS) tool was pilot-tested and used in this cross-sectional study. All pharmacists, from nine public hospitals and seven public health clinics in the State of Selangor, Malaysia, were invited to participate in this cross-sectional survey. The ADKS score was computed and compared across demographics characteristics. A total of 445 pharmacists responded to the survey. These pharmacists had a moderate overall score in ADKS; nevertheless, high scores were recorded in the domains of treatment management and care giving. No difference in AD knowledge was found among pharmacists worked in public hospitals and health clinics, except for the domain of care giving ( p = 0.033). Ethnicity and age group were independent predictors of ADKS score in the current study. The pharmacists in the current study had moderate AD knowledge. On-going education and training programme on AD, in particular the domains other than treatment management and care giving, should be provided to the pharmacists to ensure delivery of quality care to AD

  7. Knowledge on Alzheimer's Disease among Public Hospitals and Health Clinics Pharmacists in the State of Selangor, Malaysia

    Directory of Open Access Journals (Sweden)

    Thimarul Huda Mat Nuri

    2017-10-01

    Full Text Available The prevalence of Alzheimer's disease (AD has increased with the fast growing of aging population, thereby posing great challenges to provision of care for AD patients. Pharmacists play a vital role in the management of AD; this includes recognizing early symptoms of AD, providing medication counseling to AD patients and their caretakers, and identifying potential adverse drug reactions. A comprehensive understanding of the disease progression, as well as the pharmacological therapy, is essential to provide effective care to AD patients. The level of knowledge about AD among the pharmacists, however, remains unknown. Hence, this study aimed to assess the knowledge on AD among the pharmacists in public hospitals and health clinics and its correlates. A clear picture of the characteristics associated with different levels of knowledge could facilitate the targeted re-training of pharmacists. The 30-item validated Alzheimer disease knowledge scale (ADKS tool was pilot-tested and used in this cross-sectional study. All pharmacists, from nine public hospitals and seven public health clinics in the State of Selangor, Malaysia, were invited to participate in this cross-sectional survey. The ADKS score was computed and compared across demographics characteristics. A total of 445 pharmacists responded to the survey. These pharmacists had a moderate overall score in ADKS; nevertheless, high scores were recorded in the domains of treatment management and care giving. No difference in AD knowledge was found among pharmacists worked in public hospitals and health clinics, except for the domain of care giving (p = 0.033. Ethnicity and age group were independent predictors of ADKS score in the current study. The pharmacists in the current study had moderate AD knowledge. On-going education and training programme on AD, in particular the domains other than treatment management and care giving, should be provided to the pharmacists to ensure delivery of quality

  8. 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

  9. 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.

  10. 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

  11. Beyond negotiated outcomes: The hidden costs of anger expression in dyadic negotiation

    NARCIS (Netherlands)

    Wang, L.; Northcraft, G.B.; Van Kleef, G.A.

    2012-01-01

    This paper focuses on the hidden costs of expressing anger in negotiations. Two experimental studies show that an opponent’s expression of anger can elicit both concessionary and retaliatory responses by focal negotiators. In the first study, equal-power negotiators exhibited overt concessionary

  12. 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

  13. The Culturally Intelligent Negotiator: The Impact of Cultural Intelligence (CQ) on Negotiation Sequences and Outcomes

    Science.gov (United States)

    Imai, Lynn; Gelfand, Michele J.

    2010-01-01

    Although scholars and practitioners have repeatedly touted the importance of negotiating effectively across cultures, paradoxically, little research has addressed what predicts intercultural negotiation effectiveness. In this research, we examined the impact of cultural intelligence (CQ) on intercultural negotiation processes and outcomes,…

  14. The intraprofessional and interprofessional relations of neurorehabilitation nurses: a negotiated order perspective.

    Science.gov (United States)

    Miller, Karen-Lee; Kontos, Pia C

    2013-08-01

    To report a study of the negotiation practices of neurorehabilitation nurses with one another and with allied health professionals to understand nursing relations. Negotiated order theory offers a promising theoretical lens with which to explore negotiation between nurses and other professionals. This study is the first to apply the perspective to nurse-nurse and nurse-allied health professional relations. The study is a secondary analysis of findings from a multi-site arts-based intervention to improve patient-centred neurorehabilitation practice. Interviews and ethnographic observations were conducted (2008-2011) in two neurorehabilitation units in Ontario, Canada. Participants (n = 31) included registered and practical nurses, nurse leaders, and allied health professionals from physical, occupational, and recreational therapy, speech language pathology, and social work. Neurorehabilitation nursing is characterized by heavy workload, high patient acuity, and poor interprofessional collaboration. This practice context was negotiated by nurses through two strategies: (1) intraprofessional collegialism, accomplished through tactics including task and knowledge sharing, emotional support, coercive threats, and suppression of dissension; and (2) vying for an autonomous essential nursing role in interprofessional practice, accomplished by claiming unique nursing knowledge based on 24/7 nursing proximity, the expansion of the division of professional labour with allied health professionals and modifying physical therapy care plans. The intraprofessional context and negotiations therein were linked in significant ways to interprofessional negotiations. Understanding this complexity has important implications for improving patient safety and interprofessional practice interventions. © 2012 Blackwell Publishing Ltd.

  15. 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.

  16. Negotiating perspectives and values through soft OR in the context of urban renewal

    DEFF Research Database (Denmark)

    Tavella, Elena; Lami, Isabella

    2018-01-01

    -level content analysis suggests that (no)model use can lead to three different dynamics in which participants discuss different perspectives and values, negotiate their meanings, create knowledge and agree on solutions to tackle the problem situation that are added to model content. Our findings contribute......Negotiating perspectives and values is at the core of using PSMs to tackle complex and uncertain problem situations. Exploring how such negotiations evolve at the micro-level of real-time interactions can help grasp communicative behaviours and workshop structures that influence negotiation...... processes, and the achievement of outcomes. This study reports on an exploratory experiment with three MSc student groups engaged in (i) a Soft Systems Methodology, (ii) a Strategic Choice Approach, and (iii) a non-problem structuring method workshop to make progress with a case of urban renewals. Our micro...

  17. The effect of adult Early Warning Systems education on nurses' knowledge, confidence and clinical performance: A systematic review.

    Science.gov (United States)

    Saab, Mohamad M; McCarthy, Bridie; Andrews, Tom; Savage, Eileen; Drummond, Frances J; Walshe, Nuala; Forde, Mary; Breen, Dorothy; Henn, Patrick; Drennan, Jonathan; Hegarty, Josephine

    2017-11-01

    This review aims to determine the effect of adult Early Warning Systems education on nurses' knowledge, confidence and clinical performance. Early Warning Systems support timely identification of clinical deterioration and prevention of avoidable deaths. Several educational programmes have been designed to help nurses recognize and manage deteriorating patients. Little is known as to the effectiveness of these programmes. Systematic review. Academic Search Complete, CINAHL, MEDLINE, PsycINFO, PsycARTICLES, Psychology and Behavioral Science Collection, SocINDEX and the UK & Ireland Reference Centre, EMBASE, the Turning Research Into Practice database, the Cochrane Central Register of Controlled Trials (CENTRAL) and Grey Literature sources were searched between October and November 2015. This is a quantitative systematic review using Cochrane methods. Studies published between January 2011 - November 2015 in English were sought. The risk of bias, level of evidence and the quality of evidence per outcome were assessed. Eleven articles with 10 studies were included. Nine studies addressed clinical performance, four addressed knowledge and two addressed confidence. Knowledge, vital signs recording and Early Warning Score calculation were improved in the short term. Two interventions had no effect on nurses' response to clinical deterioration and use of communication tools. This review highlights the importance of measuring outcomes using standardized tools and valid and reliable instruments. Using longitudinal designs, researchers are encouraged to investigate the effect of Early Warning Systems educational programmes. These can include interactive e-learning, on-site interdisciplinary Early Warning Scoring systems training sessions and simulated scenarios. © 2017 John Wiley & Sons Ltd.

  18. 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…

  19. 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…

  20. 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

  1. 48 CFR 249.110 - Settlement negotiation memorandum.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Settlement negotiation... Settlement negotiation memorandum. Follow the procedures at PGI 249.110 for preparation of a settlement negotiation memorandum. ...

  2. Comparison of clinical knowledge management capabilities of commercially-available and leading internally-developed electronic health records

    Directory of Open Access Journals (Sweden)

    Nichol W Paul

    2011-02-01

    Full Text Available Abstract Background We have carried out an extensive qualitative research program focused on the barriers and facilitators to successful adoption and use of various features of advanced, state-of-the-art electronic health records (EHRs within large, academic, teaching facilities with long-standing EHR research and development programs. We have recently begun investigating smaller, community hospitals and out-patient clinics that rely on commercially-available EHRs. We sought to assess whether the current generation of commercially-available EHRs are capable of providing the clinical knowledge management features, functions, tools, and techniques required to deliver and maintain the clinical decision support (CDS interventions required to support the recently defined "meaningful use" criteria. Methods We developed and fielded a 17-question survey to representatives from nine commercially available EHR vendors and four leading internally developed EHRs. The first part of the survey asked basic questions about the vendor's EHR. The second part asked specifically about the CDS-related system tools and capabilities that each vendor provides. The final section asked about clinical content. Results All of the vendors and institutions have multiple modules capable of providing clinical decision support interventions to clinicians. The majority of the systems were capable of performing almost all of the key knowledge management functions we identified. Conclusion If these well-designed commercially-available systems are coupled with the other key socio-technical concepts required for safe and effective EHR implementation and use, and organizations have access to implementable clinical knowledge, we expect that the transformation of the healthcare enterprise that so many have predicted, is achievable using commercially-available, state-of-the-art EHRs.

  3. Comparison of clinical knowledge management capabilities of commercially-available and leading internally-developed electronic health records.

    Science.gov (United States)

    Sittig, Dean F; Wright, Adam; Meltzer, Seth; Simonaitis, Linas; Evans, R Scott; Nichol, W Paul; Ash, Joan S; Middleton, Blackford

    2011-02-17

    We have carried out an extensive qualitative research program focused on the barriers and facilitators to successful adoption and use of various features of advanced, state-of-the-art electronic health records (EHRs) within large, academic, teaching facilities with long-standing EHR research and development programs. We have recently begun investigating smaller, community hospitals and out-patient clinics that rely on commercially-available EHRs. We sought to assess whether the current generation of commercially-available EHRs are capable of providing the clinical knowledge management features, functions, tools, and techniques required to deliver and maintain the clinical decision support (CDS) interventions required to support the recently defined "meaningful use" criteria. We developed and fielded a 17-question survey to representatives from nine commercially available EHR vendors and four leading internally developed EHRs. The first part of the survey asked basic questions about the vendor's EHR. The second part asked specifically about the CDS-related system tools and capabilities that each vendor provides. The final section asked about clinical content. All of the vendors and institutions have multiple modules capable of providing clinical decision support interventions to clinicians. The majority of the systems were capable of performing almost all of the key knowledge management functions we identified. If these well-designed commercially-available systems are coupled with the other key socio-technical concepts required for safe and effective EHR implementation and use, and organizations have access to implementable clinical knowledge, we expect that the transformation of the healthcare enterprise that so many have predicted, is achievable using commercially-available, state-of-the-art EHRs.

  4. 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.

  5. Impact of educational intervention on knowledge, attitude and awareness of good clinical practice among health care providers.

    Science.gov (United States)

    Goel, Divya; Walia, Rani; Sharma, Poonam; Kaur, Harmanjeet; Agnihotri, Pallak

    2017-01-01

    Clinical trials play an important role in the generation of evidence-based data in health care practices. To ensure the credibility of data and the safety and well-being of the patients Good clinical practice (GCP) guidelines play an important role. At present, we have little knowledge about awareness of GCP guidelines among health care providers in India. To assess the level of awareness, and perception of the health care providers toward GCP and subsequent change in these after a dayer training session on GCP guidelines. A cross-sectional descriptive questionnaire-based study was conducted amongst health care providers, that is, doctors, dentists, nurses of a Tertiary Health Care and Teaching Institute. Participants were given descriptive questionnaire; they completed the questionnaire before and after undergoing a day training program in GCP guidelines. The impact of the effectiveness of educational intervention among healthcare professionals was evaluated by two-tailed Z-test. Out of 120 participants, 80 were medical doctors, 20 dental doctors, and 20 nurses. A dayse training program on GCP guidelines was found to increase positive attitudes toward various aspects of clinical trials. A day's training program on GCP guidelines may help to increase the knowledge as well as awareness about principles and techniques of clinical research, which will increase the credibility of clinical research in the country.

  6. 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.

  7. 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... should be negotiated at the best terms obtainable and at not less than the appraised fair market value... tax-supported agencies thereof, provided the appraised fair market value of the property and other...

  8. 48 CFR 15.405 - Price negotiation.

    Science.gov (United States)

    2010-10-01

    ... should not become preoccupied with any single element and should balance the contract type, cost, and... Section 15.405 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 15.405 Price negotiation. (a) The...

  9. 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

  10. 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…

  11. Colleges Free to Negotiate Own Contracts.

    Science.gov (United States)

    Farrell, Charles S.

    1984-01-01

    Individual colleges will be able to negotiate their own pacts to televise football games as a result of the Supreme Court ruling that the National College Athletic Association does not have exclusive rights to such negotiations. Well-known football programs will probably benefit the most. (MLW)

  12. 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...

  13. 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...

  14. 78 FR 49784 - Negotiated Service Agreement

    Science.gov (United States)

    2013-08-15

    ... noticing a recent Postal Service filing concerning the modification of Global Plus 1C negotiated service... Commercial ePacket service is available. Notice at 1, Attachment 1 at 2. This Order provides the public with... United States Postal Service of Filing Modification to Global Plus 1C Negotiated Service Agreement...

  15. 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...

  16. 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...

  17. 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...

  18. An Examination of PRC Business Negotiating Behaviors.

    Science.gov (United States)

    Chen, Guo-Ming

    The current rapid economic development in mainland China strongly demands that the world understand the People's Republic of China's (PRC) negotiating behaviors to ensure a successful business transaction. This study examined the PRC business negotiating behaviors by interviewing 16 Hong Kong businesspersons who have experiences in doing business…

  19. 48 CFR 219.808 - Contract negotiations.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Contract negotiations. 219..., DEPARTMENT OF DEFENSE SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS Contracting With the Small Business Administration (The 8(a) Program) 219.808 Contract negotiations. ...

  20. Negotiated Syllabus in EAP Business English Courses.

    Science.gov (United States)

    Boyle, Erlinda R.

    Negotiation of syllabus design and content in college-level business English is discussed, looking at three types: negotiation between teachers of business English, between teachers and students of business English, and between business English and content-area business teachers. Examples of practice from the Chinese University of Hong Kong are…

  1. Negotiating heritage in Danish public housing renovation

    DEFF Research Database (Denmark)

    Martens Gudmand-Høyer, Sidse

    2017-01-01

    questions about how heritage understandings are currently negotiated in a complicated process of interdependent partners promoting different agendas; on what terms this negotiation is made, how and by whom. And not least, it discusses the importance of when the issue of architectural quality...

  2. 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.

  3. 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

  4. 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.

  5. 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.

  6. 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.

  7. 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…

  8. Challenges With Research Contract Negotiations in Community-Based Cancer Research.

    Science.gov (United States)

    Thompson, Michael A; Hurley, Patricia A; Faller, Bryan; Longinette, Jean; Richter, Katie; Stewart, Teresa L; Robert, Nicholas

    2016-06-01

    Community-based research programs face many barriers to participation in clinical trials. Although the majority of people with cancer are diagnosed and treated in the community setting, only roughly 3% are enrolled onto clinical trials. Research contract and budget negotiations have been consistently identified as time consuming and a barrier to participation in clinical trials. ASCO's Community Research Forum conducted a survey about specific challenges of research contract and budget negotiation processes in community-based research settings. The goal was to ultimately identify potential solutions to these barriers. A survey was distributed to 780 community-based physician investigators and research staff. The survey included questions to provide insight into contract and budget negotiation processes and perceptions about related barriers. A total of 77% of the 150 respondents acknowledged barriers in the process. Respondents most frequently identified budget-related issues (n = 133), inefficiencies in the process (n = 80), or legal review and negotiation issues (n = 70). Of the respondents, 44.1% indicated that contract research organizations made the contract negotiations process harder for their research program, and only 5% believed contract research organizations made the process easier. The contract negotiations process is perceived to be impeded by sponsors through underestimation of costs, lack of flexibility with the contract language, and excessive delays. Improving clinical trial activation processes and reducing inefficiencies would be beneficial to all interested stakeholders, including patients who may ultimately stand to benefit from participation in clinical trials. The following key recommendations were made: standardization of contracts and negotiation processes to promulgate transparency and efficiencies, improve sponsor processes to minimize burden on sites, create and promote use of contract templates and best practices, and provide education

  9. Awareness and Knowledge of Glaucoma Among Adult Patients at the Eye Clinic of a Teaching Hospital.

    Science.gov (United States)

    Nkum, G; Lartey, S; Frimpong, C; Micah, F; Nkum, B

    2015-09-01

    Primary open angle glaucoma (POAG) is an irreversible blinding disease that often presents late because it is symptomless in the early stages. Prognosis depends on early diagnosis and treatment and patient understanding of their condition. Many patients present late because of poor awareness and knowledge. This study was conducted to assess patient's awareness and knowledge of glaucoma in a referral Teaching Hospital. Descriptive cross-sectional study conducted among glaucoma patients aged 40 years and above attending the Komfo Anokye Teaching Hospital (KATH). Patients were selected by simple random sampling. They were recruited after informed consent had been given. A questionnaire on demographics, socio-economics and awareness of glaucoma was administered. There were a total of 117 participants, 61 males and 56 females. The median and modal age group was 50 and 59 years. Amongst the participants, 74% were aware of glaucoma. There were no significant statistical difference in the various age groups, sex, ethnic group or religion and their awareness of glaucoma (P > 0.05).There were statistically significant differences between those who had higher education and their awareness of glaucoma (P < 0.001). Yet only 27% of these had accurate knowledge of glaucoma. Glaucoma awareness in patients attending Komfo Anokye Teaching Hospital is high. Higher education was associated with higher awareness yet this was not translated into accurate knowledge as there were significant misconceptions. There is the need to review the contents of health education with the aim of reducing dangerous misconception of glaucoma and targeting the lower socioeconomic population.

  10. 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.

  11. [Approaches, knowledge and capabilities of nurses and physicians regarding evidence-based clinical practice in the Imbadura province (Ecuador)].

    Science.gov (United States)

    Molina Mula, Jesús; Muñoz Navarro, Paulina; Vaca Auz, Janeth; Cabascango Cabascango, Carmita; Cabascango Cabascango, Katty

    2015-01-01

    The research raises the need to increase understanding of organizational and personal factors that influence the attitude and aptitude of each professional, with respect to evidence-based clinical practice. The aim of this study is to describe the transfer of knowledge into clinical practice in hospital units in Imbabura (Ecuador) identifying the obstacles to implementing evidence-based clinical practice validated questionnaire EBPQ-19. A cross-sectional observational study was conducted in hospitals of the Ministry of Public Health of Imbabura of Ecuador took place, including a total of 281 nurses and physicians. Nurses and physicians showed positive attitudes toward evidence-based clinical practice (EBCP) and their use to support clinical decision-making. This research evidences perceptions of professionals on strategies for knowledge transfer and obstacles to carry it out. Significant differences between the perception of the use of EBCP strategies between nurses and physicians are observed. Physicians consider they use them frequently, while nurses acknowledge using them less (chi-square: 105.254, P=.018). In conclusion, we can say that these factors should be considered as necessary to improve the quality of care that is provided to users based on the best available evidence. It is necessary to start developing change interventions in this regard to remedy the current situation of clinical practice based not on evidence, but rather on experience only. Experimental studies demonstrating the effectiveness of strategies to eliminate barriers to scientific evidence-based clinical practice should be conducted. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  12. 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…

  13. Compensated takings and negotiated solutions

    International Nuclear Information System (INIS)

    Thompson, R.P.

    1993-01-01

    More than 30 year ago, the USA began protecting its environment with regulatory laws. However, this approach has progressed to the point where our economic health may have needlessly incurred long-term damage. The article explores the implications of a resurgent demand for legal guarantees for compensation when environmental regulations take individual property. What will happen when a price tag is attached to new or existing environmental laws? Some predict dire results; however, a more balanced and efficient policy may lie ahead. The discussion explores the implications of recent rulings, describes possible outcomes, and offers several alternatives to the traditional lobby-and-appeal tactics used in setting environmental policy. The authors conclude that as the concept of a regulatory taking is restored, more innovative negotiated solutions will take place between competing interests as they are given more equal legal footing

  14. Meaning Negotiations of Collaborative Governance

    DEFF Research Database (Denmark)

    Plotnikof, Mie; Zandee, Danielle P.

    2016-01-01

    This chapter explores the potential for developing organizational discourse approaches through ethnographic fieldwork in the context of collaborative governance: a procedure to involve stakeholders in public problem solving of, for example, policy and service innovation. In doing so, the researcher...... engages with recent debates about the complexity of such new governance forms, as well as discussions on the relationship between discourse and materiality and the calls made to develop multi-method approaches to study complex organizational phenomena. In effect, the chapter develops empirical...... and analytical approaches to unfold discourse-material aspects of the negotiations of meanings and matters of such new governance form in practice. The chapter provides examples based on ethnographic fieldwork in collaborations across actors from the welfare area of education. In conclusion, the author reflects...

  15. 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.

  16. 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.

  17. 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.

  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. Advanced Knowledge Work and Stress-related Symptoms : Epidemiology and Clinical Intervention Studies

    OpenAIRE

    Wiholm, Clairy

    2006-01-01

    Well educated knowledge workers are a growing group of the work force. Little research has been conducted on this group regarding possible work-related health symptoms, as well as interventions in order to reduce work-related stress. This thesis describes the current work-related symptoms and potential risk and salutogenic, i.e. protective factors, associated with these symptoms among software and system designers in a high tech company in Sweden. A stress management intervention program 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. Awareness and knowledge of Human Papillomavirus (HPV), HPV-related cancers, and HPV vaccines in an uninsured adult clinic population.

    Science.gov (United States)

    Radecki Breitkopf, Carmen; Finney Rutten, Lila J; Findley, Victoria; Jacobson, Debra J; Wilson, Patrick M; Albertie, Monica; Jacobson, Robert M; Colón-Otero, Gerardo

    2016-11-01

    Human papillomavirus (HPV) vaccines offer primary prevention of cervical cancer and protection against other HPV-associated cancers. HPV vaccine coverage in the United States (U.S.) remains low, particularly among older adolescents/young adults, and the uninsured. We assessed awareness and knowledge of HPV disease, HPV-related cancers, and HPV vaccines among working, uninsured adults. Data from the 2014 Health Information National Trends Survey (HINTS 4, Cycle 4) were used as a benchmark. Patients were surveyed in late 2014 at the Volunteers in Medicine free clinic in Duval County, Florida. Surveys contained validated measures of HPV disease and vaccine knowledge; HPV-related cancer knowledge was also assessed. Two-hundred and ninety-six surveys were analyzable with an 84% participation rate. Half (50.3%) of participants had heard of HPV, and 32.1% had heard of the HPV vaccine; in HINTS, these estimates were 63.6% and 62.7%, respectively (both P HPV disease knowledge was associated with white race and increased education; high vaccine knowledge was associated with white race, increased education, and female sex. Recognition of HPV as a causative agent was 43.9% for cervical, 9.1% for anal, and 11.1% for throat cancers. For all HPV-associated cancers, participants had lower knowledge/recognition relative to HINTS. The uninsured, socioeconomically disadvantaged adults we surveyed were unaware of a ubiquitous virus that can cause cancer and the existence of a vaccine to protect against it. These findings point to settings and populations in which initiatives to promote HPV vaccination as a cancer prevention tool remain critical. © 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  2. 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

  3. 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, presearch on other specific learning outcomes of TBL for nursing students is recommended. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. 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.

  5. International variation in performance by clinical discipline and task on the United States medical licensing examination step 2 clinical knowledge component.

    Science.gov (United States)

    Holtzman, Kathleen Z; Swanson, David B; Ouyang, Wenli; Dillon, Gerard F; Boulet, John R

    2014-11-01

    To investigate country-to-country variation in performance across clinical science disciplines and tasks for examinees taking the Step 2 Clinical Knowledge (CK) component of the United States Medical Licensing Examination. In 2012 the authors analyzed demographic characteristics, total scores, and percent-correct clinical science discipline and task scores for more than 88,500 examinees taking Step 2 CK for the first time during the 2008-2010 academic years. For each examinee and score, differences between the score and the mean performance of examinees at U.S. MD-granting medical schools were calculated, and mean differences by country of medical school were tabulated for analysis of country-to-country variation in performance by clinical discipline and task. Controlling for overall performance relative to U.S. examinees, results showed that international medical graduates (IMGs) performed best in Surgery and worst in Psychiatry for clinical discipline scores; for clinical tasks, IMGs performed best in Understanding Mechanisms of Disease and worst in Promoting Preventive Medicine and Health Maintenance. The pattern of results was strongest for IMGs attending schools in the Middle East and Australasia, present to a lesser degree for IMGs attending schools in Europe, and absent for IMGs attending Caribbean medical schools. Country-to-country differences in relative performance were present for both clinical discipline and task scores. Possible explanations include differences in learning outcomes, curriculum emphasis and clinical experience, standards of care, and culture, as well as the effects of English as a second language and relative emphasis on preparing students to take the Step 2 CK exam.

  6. 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

  7. 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.

  8. The business of negotiating for hospital librarians.

    Science.gov (United States)

    Orick, Jan T

    2004-01-01

    Although many hospital librarians may find it difficult, negotiating with vendors has become a basic skill of library acquisitions. This article reports the results of a non-scientific questionnaire administered to hospital librarians and vendors attending a chapter meeting of the Medical Library Association in 2003. The answers revealed that vendors regard libraries as businesses, and while admitting that the role is often uncomfortable for them, librarians acknowledged that negotiating skills have become an important aspect of their jobs. Questions to help guide librarians through the negotiation process are provided in the Appendix.

  9. 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.

  10. 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

  11. Liberating the Oppressed: Research Knowledge Differentials and Ethical Investigation in Special Operations Forces Clinical Science.

    Science.gov (United States)

    Kemplin, Kate Rocklein; Bowling, F Young

    Special Operations Forces (SOF) medics do not have preparation in research knowledge that enables them to independently initiate or generate their own studies. Thus, medics rely on evidence generated by others, who are removed from medics' practice environment. Here, salient literature on research self-efficacy and the genesis of institutional review boards (IRBs) are reviewed and interpreted for contextual applications to medics' practice and initiation of studies. More publications delving into research methods are warranted to promote medics' participation and initiation of selfdirected scientific investigation, in collaboration with research scientists. 2017.

  12. 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.

  13. 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.

  14. 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…

  15. 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…

  16. How does knowledge from translational research impact our clinical care of pediatric inflammatory bowel disease patients?

    Science.gov (United States)

    Denson, Lee A

    2012-06-01

    Recent translational studies have provided new insights into pathogenesis, disease behavior, and treatment responses in pediatric Inflammatory Bowel Disease (IBD). Registry studies have identified distinct clinical phenotypes with increasing age of onset; this has led to a revision of the clinical phenotyping system, now termed the Paris classification system. It is recognized that there are infantile (age <2 years), very early onset (VEO, age 2-10), and early onset (EO, age 10-17) forms of disease. Rare genetic mutations affecting anti-microbial and anti-inflammatory pathways have been discovered in infantile and VEO forms, while genetic pathways identified in EO disease have been similar to adult-onset IBD. Genetic and serologic patterns measured soon after diagnosis have been shown to be associated with more aggressive stricturing behavior; these patterns may now be used clinically to help predict disease course. More recently, clinical and genetic models have been developed that, if validated, could be used to predict treatment responses.

  17. 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

  18. 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

  19. 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.

  20. 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...

  1. 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... CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Source Selection 315.372 Preparation of negotiation memorandum. The Contracting Officer shall prepare a negotiation memorandum, or summary of...

  2. 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…

  3. 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

  4. Business Negotiations: Interdependence Between Discourse and the Business Relationship.

    Science.gov (United States)

    Charles, Mirjaliisa

    1996-01-01

    Investigates the organization and rhetoric of sales negotiations using a methodology that draws on discourse analysis and business studies of negotiation. Differences in the status-bound behavior of New Relationship Negotiations and the role enactment of the Old Relationship Negotiations are noted, and various strategies for saving professional…

  5. What do People Value when they Negotiate? Mapping the Domain of Subjective Value in Negotiation

    OpenAIRE

    Curhan, Jared R.; Elfenbein, Hillary Anger; Xu, Heng

    2005-01-01

    Four studies provide support for the development and validation of a framework for understanding the range of social psychological outcomes valued subjectively as consequences of negotiations. Study 1 inductively elicited and coded elements of subjective value among students, community members, and negotiation practitioners, revealing 20 categories that negotiation theorists in Study 2 sorted to reveal four underlying dimensions: Feelings about Instrumental Outcomes, the Self, Process, and Re...

  6. WTO — The knowledge deficit in trade negotiations | IDRC ...

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

    2011-07-22

    Jul 22, 2011 ... It gives expression to a deep and dangerous power imbalance that afflicts poor countries bargaining with the rich. ... They have not developed the aggregations of scholars, interest groups, nongovernmental organizations, and professional public servants that work to generate the hard facts and policy ...

  7. Interdepartmental negotiation behavior in manufacturing organizations

    NARCIS (Netherlands)

    Nauta, A; Sanders, K

    2000-01-01

    The goal of this study was to examine individual, relational, and organizational determinants of negotiation behavior (problem solving, contending, yielding, and avoiding) between planning and marketing departments in manufacturing organizations. Results from a study among 41 managers and 85

  8. Models for intercultural collaboration and negotiation

    CERN Document Server

    Sycara, Katia; Abbe, Allison

    2013-01-01

    This book bridges the gap in modelling collaboration and negotiation between computational sciences and social sciences. It opens up the field for cross fertilization of ideas and methods in both communities.

  9. The Negotiated Curriculum in Trade Union Training.

    Science.gov (United States)

    Doyle, Mel

    1993-01-01

    Examines how participants in trade union courses can effectively influence their learning experience through discussion, consultation, and negotiation with the instructor while the training activity is in progress. (JOW)

  10. 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...

  11. 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....

  12. NEGOTIATING IN A GLOBAL BUSINESS ENVIRONMENT

    OpenAIRE

    Dorel PARASCHIV; Mihaela BELU

    2009-01-01

    Negotiating in International Business become more complex due to the rapid development of the globalization process and to the evolution of communication tools. Companies are attracted by favorable key locations in view of lowering production costs and increasing profit margins. Such international communication process can often fail because the local counterparts have taken more time to learn how to overcome the obstacles normally associated with international/crosscultural negotiations. Fai...

  13. 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...

  14. Financial Effectiveness of Negotiation Support Systems

    Directory of Open Access Journals (Sweden)

    Christian NĂSULEA

    2015-06-01

    Full Text Available Implementing negotiation support systems requires the commitment of significant amounts of resources within the host organization. This paper looks at the effectiveness of investments in these systems, looking at some standard indicators for economic efficiency and the impact of these systems on an organization’s overall activities. This article is part of a research project spanning over a period of 3 years, aimed at developing a successful model for computer assisted negotiations.

  15. 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.

  16. 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

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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

  2. Issues Associated With the Use of Semantic Web Technology in Knowledge Acquisition for Clinical Decision Support Systems: Systematic Review of the Literature.

    Science.gov (United States)

    Zolhavarieh, Seyedjamal; Parry, David; Bai, Quan

    2017-07-05

    Knowledge-based clinical decision support system (KB-CDSS) can be used to help practitioners make diagnostic decisions. KB-CDSS may use clinical knowledge obtained from a wide variety of sources to make decisions. However, knowledge acquisition is one of the well-known bottlenecks in KB-CDSSs, partly because of the enormous growth in health-related knowledge available and the difficulty in assessing the quality of this knowledge as well as identifying the "best" knowledge to use. This bottleneck not only means that lower-quality knowledge is being used, but also that KB-CDSSs are difficult to develop for areas where expert knowledge may be limited or unavailable. Recent methods have been developed by utilizing Semantic Web (SW) technologies in order to automatically discover relevant knowledge from knowledge sources. The two main objectives of this study were to (1) identify and categorize knowledge acquisition issues that have been addressed through using SW technologies and (2) highlight the role of SW for acquiring knowledge used in the KB-CDSS. We conducted a systematic review of the recent work related to knowledge acquisition MeM for clinical decision support systems published in scientific journals. In this regard, we used the keyword search technique to extract relevant papers. The retrieved papers were categorized based on two main issues: (1) format and data heterogeneity and (2) lack of semantic analysis. Most existing approaches will be discussed under these categories. A total of 27 papers were reviewed in this study. The potential for using SW technology in KB-CDSS has only been considered to a minor extent so far despite its promise. This review identifies some questions and issues regarding use of SW technology for extracting relevant knowledge for a KB-CDSS. ©Seyedjamal Zolhavarieh, David Parry, Quan Bai. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 05.07.2017.

  3. 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

  4. Academic Productivity, Knowledge, and Education in Plastic Surgery: The Benefit of the Clinical Research Fellow.

    Science.gov (United States)

    Carney, Martin J; Weissler, Jason M; Koltz, Peter F; Fischer, John P; Wu, Liza C; Serletti, Joseph M

    2017-10-01

    Academic research productivity is limited by strenuous resident and faculty schedules but nevertheless is imperative to the growth and success of our discipline. The authors report institutional experience with their clinical research fellowship model, providing two positions per year. A critical analysis of research productivity was performed for all trainees, faculty, and research fellows from 2000 to 2015. Academic productivity was determined by the number of peer-reviewed publications, podium presentations, and h-index. Academic fate of previous research fellows was also noted. During the 16-year timeframe, 484 articles were published in print. Notably, 92 articles were published from 2000 to 2007 and 392 articles were published from 2008 to 2015 (p = 0.0066), demonstrating linear growth after instituting the research fellowship. In addition, 33 articles were published from 2002 to 2004 before leadership change, 47 from 2005 to 2007 after leadership change but before fellowship, and 58 from 2008 to 2010 in the first few years of the fellowship (p = 0.0204). Overall, 39.9 percent of publications appeared in Plastic and Reconstructive Surgery, with a total of 77 different peer-reviewed journal inclusions. American Association of Plastic Surgeons, American Society of Plastic Surgeons, and Northeastern Society of Plastic Surgeons podium presentations totaled 143 between 2005 and 2015. Of the eight previous fellows who applied into integrated and independent programs, 100 percent have matched. Incorporation of a formalized research fellowship into a plastic surgery program can drastically increase clinical research contribution in a reproducible fashion.

  5. 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.

  6. Negotiation of risk in sexual relationships and reproductive decision-making amongst HIV sero-different couples.

    Science.gov (United States)

    Kelly, Carmel; Lohan, Maria; Alderdice, Fiona; Spence, Dale

    2011-08-01

    The paper focuses on the ways in which medical discourses of HIV transmission risk, personal bodily meanings and reproductive decision-making are re-negotiated within the context of sero-different relationships, in which one partner is known to be HIV-positive. Eighteen in-depth interviews were conducted with 10 individuals in Northern Ireland during 2008-2009. Drawing on an embodied sociological approach, the findings show that physical pleasure, love, commitment, a desire to conceive without medical interventions and a dislike of condoms within regular ongoing relationships, shaped individuals' sense of biological risk. In addition, the subjective logic that a partner had not previously become infected through unprotected sex prior to knowledge of HIV status and the added security of an undetectable viral load significantly impacted upon women's and, especially, men's decisions to have unprotected sex in order to conceive. The findings speak to the importance of reframing public health campaigns and clinical counselling discourses on HIV risk transmission to acknowledge how couples negotiate this risk, alongside pleasure and commitment within ongoing relationships.

  7. Knowledge, attitude, and practice regarding the risk of cardiovascular diseases in patients attending outpatient clinic in Kuantan, Malaysia

    Directory of Open Access Journals (Sweden)

    Nursyafiza B Mohammad

    2018-01-01

    Full Text Available Background: 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. Materials and Methods: 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. Results: 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. Conclusion: 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.

  8. 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

  9. 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

  10. Ageism and its clinical impact in oncogeriatry: state of knowledge and therapeutic leads

    Science.gov (United States)

    Schroyen, Sarah; Adam, Stéphane; Jerusalem, Guy; Missotten, Pierre

    2015-01-01

    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. PMID:25678781

  11. Ageism and its clinical impact in oncogeriatry: state of knowledge and therapeutic leads.

    Science.gov (United States)

    Schroyen, Sarah; Adam, Stéphane; Jerusalem, Guy; Missotten, Pierre

    2015-01-01

    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.

  12. Survey of the Attitude to, the Knowledge and the Practice of Contraception and Medical Abortion in Women Who Attended a Family Planning Clinic

    OpenAIRE

    K.M., Umashankar; M.N., Dharmavijaya; Kumar D.E., Jayanta; K., Kala; Nagure, Abed Gulab; Ramadevi,

    2013-01-01

    Objective: To assess the attitude to, the knowledge and practice of contraception and medical abortion in women attending the family planning clinic at the mvj medical college , hosakote , Bangalore, India.

  13. 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.

  14. 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

  15. Preparing for successful gas negotiations

    International Nuclear Information System (INIS)

    Burrell, D.

    1998-01-01

    The task of understanding and managing all the variables required to optimize the reliability and cost of gas purchases is not an easy one. The following list of recommended steps may help. Study your gas requirements and bills thoroughly. Evaluate all of your options and risks in detail. Set specific goals for your gas needs and management. Negotiate each contract on both a short-term and long-term basis. With increased competition, suppliers have even more incentive to make their clients happy. Make sure that you understand all the details of your new contract including expiration dates, automatic rollover dates, notice requirements for changes and force majeure limitations. Monitor the results of the pricing index that you select to assure that it will provide you the results that you have in mind. Cautiously shop around for the best prices, but keep in mind that it is a small world and price shoppers may find it increasingly hard to get a quote if you change suppliers too often. Don't forget to compare your local LDC with other suppliers. They may have become more competitive and ready to offer more services at less cost than before. Keep in touch with the market changes on a regular basis. Assign the daily management responsibility to a staff person, or outside firm, that has demonstrated a complete understanding of the gas industry and your specific needs. The bottom line is clear when one compares the cost of industrial gas 10 years ago to the current price today. The average burner tip price to industrials/mcf was in a range from $4.50 to $7.00 in the mid-1980's. The mid-1990's average price is in a range from $2.60 to $3.60. This proves that the additional management that is required is well worth the additional effort

  16. 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

  17. 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.

  18. 78 FR 57571 - Negotiated Rulemaking Committee, Negotiator Nominations and Schedule of Committee Meetings-Title...

    Science.gov (United States)

    2013-09-19

    ...: Intention to establish negotiated rulemaking committee. SUMMARY: We announce our intention to establish a... Act made by the VAWA (Pub. L. 113-4), and the definition of ``adverse credit'' for borrowers in the... process regarding other proposed rulemaking topics, we announced our intention to establish a negotiated...

  19. 78 FR 69612 - Negotiated Rulemaking Committee, Negotiator Nominations and Schedule of Committee Meetings-Title...

    Science.gov (United States)

    2013-11-20

    .... ACTION: Notice of intention to establish. SUMMARY: We announce our intention to establish a negotiated... Policy and Campus Crime Statistics Act (Clery Act); and the definition of ``adverse credit'' for... announced our intention to establish a negotiated rulemaking committee to prepare proposed regulations to...

  20. Virtual versus face-to-face clinical simulation in relation to student knowledge, anxiety, and self-confidence in maternal-newborn nursing: A randomized controlled trial.

    Science.gov (United States)

    Cobbett, Shelley; Snelgrove-Clarke, Erna

    2016-10-01

    Clinical simulations can provide students with realistic clinical learning environments to increase their knowledge, self-confidence, and decrease their anxiety prior to entering clinical practice settings. To compare the effectiveness of two maternal newborn clinical simulation scenarios; virtual clinical simulation and face-to-face high fidelity manikin simulation. Randomized pretest-posttest design. A public research university in Canada. Fifty-six third year Bachelor of Science in Nursing students. Participants were randomized to either face-to-face or virtual clinical simulation and then to dyads for completion of two clinical simulations. Measures included: (1) Nursing Anxiety and Self-Confidence with Clinical Decision Making Scale (NASC-CDM) (White, 2011), (2) knowledge pretest and post-test related to preeclampsia and group B strep, and (3) Simulation Completion Questionnaire. Before and after each simulation students completed a knowledge test and the NASC-CDM and the Simulation Completion Questionnaire at study completion. There were no statistically significant differences in student knowledge and self-confidence between face-to-face and virtual clinical simulations. Anxiety scores were higher for students in the virtual clinical simulation than for those in the face-to-face simulation. Students' self-reported preference was face-to-face citing the similarities to practicing in a 'real' situation and the immediate debrief. Students not liking the virtual clinical simulation most often cited technological issues as their rationale. Given the equivalency of knowledge and self-confidence when undergraduate nursing students participate in either maternal newborn clinical scenarios of face-to-face or virtual clinical simulation identified in this trial, it is important to take into the consideration costs and benefits/risks of simulation implementation. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. 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.

  2. Simplifying the negotiating process with physicians: critical elements in negotiating from private practice to employed physician.

    Science.gov (United States)

    Gallucci, Armen; Deutsch, Thomas; Youngquist, Jaymie

    2013-01-01

    The authors attempt to simplify the key elements to the process of negotiating successfully with private physicians. From their experience, the business elements that have resulted in the most discussion center on the compensation including the incentive plan. Secondarily, how the issue of malpractice is handled will also consume a fair amount of time. What the authors have also learned is that the intangible issues can often be the reason for an unexpectedly large amount of discussion and therefore add time to the negotiation process. To assist with this process, they have derived a negotiation checklist, which seeks to help hospital leaders and administrators set the proper framework to ensure successful negotiation conversations. More importantly, being organized and recognizing these broad issues upfront and remaining transparent throughout the process will help to ensure a successful negotiation.

  3. Validity evidence for Surgical Improvement of Clinical Knowledge Ops: a novel gaming platform to assess surgical decision making.

    Science.gov (United States)

    Lin, Dana T; Park, Julia; Liebert, Cara A; Lau, James N

    2015-01-01

    Current surgical education curricula focus mainly on the acquisition of technical skill rather than clinical and operative judgment. SICKO (Surgical Improvement of Clinical Knowledge Ops) is a novel gaming platform developed to address this critical need. A pilot study was performed to collect validity evidence for SICKO as an assessment for surgical decision making. Forty-nine subjects stratified into 4 levels of expertise were recruited to play SICKO. Later, players were surveyed regarding the realism of the gaming platform as well as the clinical competencies required of them while playing SICKO. Each group of increasing expertise outperformed the less experienced groups. Mean total game scores for the novice, junior resident, senior resident, and expert groups were 5,461, 8,519, 11,404, and 13,913, respectively (P = .001). Survey results revealed high scores for realism and content. SICKO holds the potential to be not only an engaging and immersive educational tool, but also a valid assessment in the armamentarium of surgical educators. Published by Elsevier Inc.

  4. 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.

  5. 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...

  6. 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

  7. T-cell exhaustion in chronic hepatitis B infection: current knowledge and clinical significance

    Science.gov (United States)

    Ye, B; Liu, X; Li, X; Kong, H; Tian, L; Chen, Y

    2015-01-01

    Hepatitis B virus (HBV) infection is the major cause of inflammatory liver disease, of which the clinical recovery and effective anti-viral therapy is associated with the sustained viral control of effector T cells. In humans, chronic HBV infection often shows weak or absent virus-specific T-cell reactivity, which is described as the ‘exhaustion' state characterized by poor effector cytotoxic activity, impaired cytokine production and sustained expression of multiple inhibitory receptors, such as programmed cell death-1 (PD-1), lymphocyte activation gene-3, cytotoxic T lymphocyte-associated antigen-4 and CD244. As both CD4+ and CD8+ T cells participate in the immune responses against chronic hepatitis virus through distinct manners, compelling evidences have been proposed, which restore the anti-viral function of these exhausted T cells by blocking those inhibitory receptors with its ligand and will pave the way for the development of more effective immunotherapeutic and prophylactic strategies for the treatment of chronic infectious diseases. A large number of studies have stated the essentiality of T-cell exhaustion in virus-infected diseases, such as LCMV, hepatitis C virus (HCV), human immunodeficiency virus infections and cancers. Besides, the functional restoration of HCV- and HIV-specific CD8+ T cells by PD-1 blockade has already been repeatedly verified, and also for the immunological control of tumors in humans, blocking the PD-1 pathway could be a major immunotherapeutic strategy. Although the specific molecular pathways of T-cell exhaustion remain ambiguous, several transcriptional pathways have been implicated in T-cell exhaustion recently; among them Blimp-1, T-bet and NFAT2 were able to regulate exhausted T cells during chronic viral infection, suggesting a distinct lineage fate for this sub-population of T cells. This paper summarizes the current literature relevant to T-cell exhaustion in patients with HBV-related chronic hepatitis, the options

  8. 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.

  9. 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

  10. 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)

  11. Interns' knowledge of clinical pharmacology and therapeutics after undergraduate and on-going internship training in Nigeria: a pilot study

    Science.gov (United States)

    Oshikoya, Kazeem A; Senbanjo, Idowu O; Amole, Olufemi O

    2009-01-01

    Background A sound knowledge of pathophysiology of a disease and clinical pharmacology and therapeutics (CPT) of a drug is required for safe and rational prescribing. The aim of this study was therefore to assess how adequately the undergraduate CPT teaching had prepared interns in Nigeria for safe and rational prescribing and retrospectively, to know how they wanted the undergraduate curriculum to be modified so as to improve appropriate prescribing. The effect of internship training on the prescribing ability of the interns was also sought. Methods A total of 100 interns were randomly selected from the Lagos State University Teaching Hospital (LASUTH), Ikeja; Lagos University Teaching Hospital (LUTH), Idiaraba; General Hospital Lagos (GHL); the EKO Hospital, Ikeja; and Havana Specialist Hospital, Surulere. A structured questionnaire was the instrument of study. The questionnaire sought information about the demographics of the interns, their undergraduate CPT teaching, experience of adverse drug reactions (ADRs) and drug interactions since starting work, confidence in drug usage and, in retrospect; any perceived deficiencies in their undergraduate CPT teaching. Results The response rate was 81%. All the respondents graduated from universities in Nigeria. The ability of the interns to prescribe rationally (66, 81.4%) and safely (47, 58%) was provided by undergraduate CPT teaching. Forty two (51.8%) respondents had problems with prescription writing. The interns would likely prescribe antibiotics (71, 87.6%), nonsteroidal analgesics (66, 81.4%), diuretics (55, 67.9%), sedatives (52, 62.9%), and insulin and oral hypoglycaemics (43, 53%) with confidence and unsupervised. The higher the numbers of clinical rotations done, the more confident were the respondents to prescribe unsupervised (χ2 = 19.98, P < 0.001). Similarly, respondents who had rotated through the four major clinical rotations and at least a special posting (χ2 = 11.57, P < 0.001) or four major

  12. Can Clinical Scenario Videos Improve Dental Students' Perceptions of the Basic Sciences and Ability to Apply Content Knowledge?

    Science.gov (United States)

    Miller, Cynthia Jayne; Metz, Michael James

    2015-12-01

    Dental students often have difficulty understanding the importance of basic science classes, such as physiology, for their future careers. To help alleviate this problem, the aim of this study was to create and evaluate a series of video modules using simulated patients and custom-designed animations that showcase medical emergencies in the dental practice. First-year students in a dental physiology course formatively assessed their knowledge using embedded questions in each of the three videos; 108 to 114 of the total 120 first-year students answered the questions, for a 90-95% response rate. These responses indicated that while the students could initially recognize the cause of the medical emergency, they had difficulty in applying their knowledge of physiology to the scenario. In two of the three videos, students drastically improved their ability to answer high-level clinical questions at the conclusion of the video. Additionally, when compared to the previous year of the course, there was a significant improvement in unit exam scores on clinically related questions (6.2% increase). Surveys were administered to the first-year students who participated in the video modules and fourth-year students who had completed the course prior to implementation of any clinical material. The response rate for the first-year students was 96% (115/120) and for the fourth-year students was 57% (68/120). The first-year students indicated a more positive perception of the physiology course and its importance for success on board examinations and their dental career than the fourth-year students. The students perceived that the most positive aspects of the modules were the clear applications of physiology to real-life dental situations, the interactive nature of the videos, and the improved student comprehension of course concepts. These results suggest that online modules may be used successfully to improve students' perceptions of the basic sciences and enhance their ability to

  13. 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

  14. 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.

  15. 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 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.

  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. THE EQUIPMENT ACQUISITION PROCESS: ANALYSIS FOR NEGOTIATION

    Directory of Open Access Journals (Sweden)

    Irena Peharda

    2011-02-01

    Full Text Available The analysis for negotiation results in a prescriptive negotiation procedure that improves the decision making process by increasing the understanding of the decision situation and by the explaining rationale for decision. This prescriptive procedure is used for the evaluation of stakeholders who negotiate, for guidance when there are tensions between various stakeholders, and for the change in the stakeholders` perceptions when considering the creation of additional value and possible agreement(s. The procedure is divided into five specific steps, based on the standard acquisition procedure. The procedure is applied to the case of acquiring Armored Wheeled Vehicles 8x8 (AWV for the Croatian Armed Forces (CAF, according to the Croatian procurement regulations.

  19. Contract Negotiations Supported Through Risk Analysis

    Science.gov (United States)

    Rodrigues, Sérgio A.; Vaz, Marco A.; Souza, Jano M.

    Many clients often view software as a commodity; then, it is critical that IT sellers know how to create value into their offering to differentiate their service from all the others. Clients sometimes refuse to contract software development due to lack of technical understanding or simply because they are afraid of IT contractual commitments. The IT negotiators who recognize the importance of this issue and the reason why it is a problem will be able to work to reach the commercial terms they want. Therefore, this chapter aims to stimulate IT professionals to improve their negotiation skills and presents a computational tool to support managers to get the best out of software negotiations through the identification of contract risks.

  20. 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, 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.

  1. 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.

  2. Desire to Bargain and Negotiation Success: Lessons About the Need to Negotiate from Six Hydropower Disputes.

    Science.gov (United States)

    BURKARDT; LAMB; TAYLOR

    1998-11-01

    / We investigated the notion that successful 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.KEY WORDS: Alternative dispute resolution; Federal licenses; Federal Energy Regulatory Commission; Instream flow; Environmental planning

  3. 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

  4. 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.

  5. 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.

  6. 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.

  7. Effectiveness of a clinical knowledge support system for reducing diagnostic errors in outpatient care in Japan: A retrospective study.

    Science.gov (United States)

    Shimizu, Taro; Nemoto, Takaaki; Tokuda, Yasuharu

    2018-01-01

    Clinical evidence has indicated the effectiveness of computer-based systems for preventing and reducing diagnostic errors. Our study aimed to evaluate the effectiveness of UpToDate, a computer-based clinical knowledge management system, for reducing diagnostic errors. We retrospectively identified 100 patients who visited an outpatient department in a community-based hospital from July 2014 to June 2015. Fifty patients (exposure group) were seen by UpToDate-equipped physicians and another 50 (control group) were seen by UpToDate-unequipped physicians. We extracted data on patient sex, age, primary diagnosis, and case difficulty that could potentially affect diagnostic outcomes. We compared the two groups regarding diagnostic error rate and performed logistic regression analysis to analyze the concurrent effects of various factors affecting diagnostic error. The diagnostic error rate was 2% in the exposure group, while the error rate was 24% in the control group. Multivariate logistic regression analysis showed that error rate reduction was significantly associated with exposure to UpToDate with an odds ratio of 15.21 (95% CI 1.86-124.36). Our results demonstrated the effectiveness of UpToDate for the prevention and reduction of diagnostic error. Copyright © 2017. Published by Elsevier B.V.

  8. 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.

  9. 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.

  10. 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

  11. 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.

  12. 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…

  13. 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...

  14. 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...

  15. 76 FR 12887 - Wholesale Pork Reporting Negotiated Rulemaking Committee

    Science.gov (United States)

    2011-03-09

    ...; ] DEPARTMENT OF AGRICULTURE Agricultural Marketing Service 7 CFR Part 59 Wholesale Pork Reporting Negotiated Rulemaking Committee AGENCY: Agricultural Marketing Service, USDA. ACTION: Notice of negotiated rulemaking... at the Radisson Hotel Reagan National Airport, 2020 Jefferson Davis Highway, Arlington VA 22202...

  16. Business Negotiation Strategies: the Concept, Definitions and Process

    Directory of Open Access Journals (Sweden)

    Kęstutis Peleckis

    2013-04-01

    Full Text Available The modern business is developing in the context of rapid social and political changes, which contributes to the changes in economic and cultural priorities as well as mindset and behaviour of people. This puts new requirements on development and implementation of business negotiation strategies, aiming to ensure that during bargaining, everything is done to understand the other party and related contexts, to achieve mutual understanding, to reach common agreement and eventually find the optimal negotiating decision. The author of this article researched and analysed negotiation process concepts in the global scientific literature and practice. The article examines negotiation and bargaining concepts. Also, the global analysis of the scientific literature revealed that there is no single negotiation planning concept. The author defines the basic conceptual negotiation planning concepts. The paper deals with negotiation strategy conceptions used by scientists around the world. Conclusions present the proposals for further business negotiation research.Article in Lithuanian

  17. 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...

  18. 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.

  19. International business: Raising cultural awareness in global negotiating

    OpenAIRE

    Jovana Gardašević; Jelena Vapa-Tankosić

    2015-01-01

    The global marketplace is a fast-growing and rapidly changing field. Global negotiation is a process where each party from two or more different countries involved in negotiating tries to gain an advantage for itself by the end of the process. The process of global negotiating differs from culture to culture in terms of language, different types of communication (verbal and nonverbal), negotiating style, approaches to problem – solving, etc. The aspects of culture that are of vital importance...

  20. Order and Mystery in Negotiation Groups.

    Science.gov (United States)

    Putnam, Linda L.; Bullis, Connie

    A preliminary study investigating the perceptions of intergroup relations in the bargaining process supports Kenneth Burke's concepts of order and mystery. Questionnaires, interviews, and direct observations of teachers' and school boards' teams involved in contract negotiations show that people closest to the bargaining saw more order in the…

  1. The Negotiation of Meaning in Epistemic Situations

    Science.gov (United States)

    Baker, Michael J.

    2016-01-01

    This article is a commentary on a model for negotiation in teaching-learning dialogues (Baker 1994) that traces its origins and developments over the past 20 years. The first main section of the paper describes the research background out of which the model arose, within the "credo" of individualised tutoring of the 1980s. This is…

  2. Negotiating Rights : Building Coalitions for Improving Maternal ...

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

    Negotiating Rights : Building Coalitions for Improving Maternal Health Services. While India is rapidly gaining popularity as a destination for world-class health care, the state of maternal health in the country reflects poorly on public health priorities. Uttar Pradesh has the highest rate of maternal mortality in the country, ...

  3. M&A Negotiations and Lawyer Expertise

    NARCIS (Netherlands)

    Karsten, C.; Malmendier, U.; Sautner, Z.

    2013-01-01

    We use proprietary data to look into the "black box" of M&A negotiations and to shed light on the effects of lawyer expertise on M&A contract design, the bargaining process, and acquisition pricing. Measuring the effects of buyer relative to seller lawyer expertise, we document that more expertise

  4. Validity of a virtual negotiation training

    NARCIS (Netherlands)

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

    2011-01-01

    In this paper we present a rigorously setup VR negotiation training, including an intelligent virtual agent able to express emotion and to give explanations of its behavior. We discuss the measures we took to ensure the validity of the VR training. We also present a small scale experiment showing

  5. 78 FR 51757 - Negotiated Service Agreement

    Science.gov (United States)

    2013-08-21

    ... Services (GEPS) 3 negotiated service agreement (Agreement).\\1\\ The Postal Service seeks inclusion of the... statement, and supporting financial workpapers. Id., Attachment 4 at 3. The Postal Service filed redacted versions of the financial workpapers publically. In the Notice, the Postal Service asserts that the...

  6. Modeling Cultural Factors in Collaboration and Negotiation

    Science.gov (United States)

    2014-04-25

    users of individualistic cultures (e.g. the US) would not be influenced as much by their friends in their twitting behavior as users of collectivist ...advanced experiment (Georgila and Traum, 2011c) we learn policies for three cultural norms ( individualists , collectivists , and altruists... individualists , collectivists , and altruists). Third, unlike (Heeman, 2009) who built hand-crafted SUs for learning negotiation dialogue policies

  7. Pre-Contract Negotiation of Technical Matters

    Science.gov (United States)

    1984-12-01

    launching and sea trials exceeds three months, the underwater hull surfaces and propeller could become fouled by barnacles, slime , etc. Dry-docking...consider what subjects require negotiations and from fear of overlooking something important. Obviously, check lists best serve ship- builder/owner

  8. Communicating for Peace: Diplomacy and Negotiation.

    Science.gov (United States)

    Korzenny, Felipe, Ed.; Ting-Toomey, Stella, Ed.

    1990-01-01

    Inspired by trends towards increasing attention to peace studies and an emphasis in international relations on placing communication at the center of diplomacy and negotiation, this book presents 13 papers divided into three main sections. The first section contains conceptual selections that address general theory. The second section more clearly…

  9. Shifting Selves: Constructing and Negotiating Academic Identities

    Science.gov (United States)

    Vandeyar, S.

    2010-01-01

    This study set out to explore how academics construct and negotiate their identities within the world of the academe. Identity construction involves different forms of community participation and identification. Utilising the research methodology of narrative inquiry, this article explores how academics came to see themselves across those…

  10. 77 FR 59343 - Contracting by Negotiation

    Science.gov (United States)

    2012-09-27

    ... DEPARTMENT OF DEFENSE Defense Acquisition Regulations System 48 CFR Part 3415 Contracting by Negotiation CFR Correction In Title 48 of the Code of Federal Regulations, Chapter 29 to End, revised as of... commitments were received from Departmental employees regarding acceptance of this proposal. Date...

  11. Licensing and negotiating: exploring unfamiliar ground

    NARCIS (Netherlands)

    Verhagen, N.; Stone, G.; Anderson, R.; Feinstein, J.

    2006-01-01

    Over the last decade the scene in which librarians have had to operate has completely changed. Librarians have migrated from book-buyers to licence-negotiators, from circulation experts to providers of digital services. This chapter tries to map some of the fields that they have entered and to

  12. Pair Negotiation When Developing English Speaking Tasks

    Science.gov (United States)

    Bohórquez Suárez, Ingrid Liliana; Gómez Sará, Mary Mily; Medina Mosquera, Sindy Lorena

    2011-01-01

    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'…

  13. Negotiating growth in turbulentscapes: Violence, secrecy and ...

    African Journals Online (AJOL)

    This essay therefore, examines how a partially demented child- protagonist negotiates her identity in the absence of her parents and the comfort zone of a nuclear family in ... subjects and the heavily patriarchal familial base where she struggles for self-assertion through a kind of voicing which is not associated with speech.

  14. How undergraduate students 'negotiate' academic performance ...

    African Journals Online (AJOL)

    This article examines the practices, norms and values that constrain or enable successful participation of undergraduate students at a South African university undergoing a radical change. We look at four constructs about the resources that Wits students draw on when they negotiate their integration into the Wits culture of ...

  15. Negotiating Your Syllabus: Building a Collaborative Contract

    Science.gov (United States)

    Kaplan, David M.; Renard, Monika K.

    2015-01-01

    We provide instruction for engaging students in negotiating their course syllabus. In contrast to the common conceptualization of the syllabus as an instructor-determined contract, we involve our students in developing the collaborative contract under which they will be evaluated. We discuss our successful facilitation of this activity and how to…

  16. 32 CFR 644.83 - Negotiations.

    Science.gov (United States)

    2010-07-01

    ... landowner his constitutional guarantee of “just compensation” as that term has been defined by Federal... negotiator's report, of course, will not be included. The Department of Justice will be requested to handle all further matters pertaining to settlement or trial of the case. The Department of Justice has...

  17. How to manage your negotiating team.

    Science.gov (United States)

    Brett, Jeanne M; Friedman, Ray; Behfar, Kristin

    2009-09-01

    You are leading a negotiating team for your company. When you sit down with the other party, someone on your side of the table blurts out: "Just tell us--what do we need to do to get more of your business?" And in that moment, you know you've lost the upper hand. Gaffes like this are more common than most businesspeople would care to admit, management professors Brett, Friedman, and Behfar have found in their research. Even though team members are all technically on the same side, they often have different priorities and imagine different ideal outcomes: Business development just wants to close the deal. Finance is most concerned about costs. Legal is focused on patents and intellectual property. The authors recommend taking four steps, either singly or in tandem, to align those goals: Map out each person's priorities, work out conflicts directly with departments, employ a mediator if that doesn't work, and use data to resolve differences. Once you are all on the same page, you can take steps to make sure everyone is coordinated during the negotiations themselves. Try simulating the negotiation beforehand, assigning roles to team members that take advantage of their strengths, and establishing the signals you will use to communicate with one another during the session. The payoff from working as a cohesive group is clear. With access to greater expertise and the ability to assign members to specialized roles, teams can implement more-complex strategies than a sole negotiator could ever pull off.

  18. HWONS: A Hyperwave Online Negotiation System.

    Science.gov (United States)

    Lennon, J.; Liu, H.; Maurer, H.

    The authors developed a Web-based negotiation system that is closely modeled on real-world transactions. This paper illustrates the generality of the system by discussing two disparate applications of the system: one taken from business and the other from collaborative e-learning. The application generates, in real time, transparency-controlled…

  19. 78 FR 17234 - Negotiated Service Agreement

    Science.gov (United States)

    2013-03-20

    ... statutory requirements of improving the net financial position of the Postal Service, while not causing any... Postal Service filing concerning an amendment to Discover Financial Services Negotiated Service Agreement... U.S.C. 3622 and 3642, as well as 39 CFR 3010 and 3020, et seq., to add a Discover Financial Services...

  20. Negotiated economic opportunity and power: perspectives and ...

    African Journals Online (AJOL)

    It is least acknowledged in daily discourses that street vending is a very important phenomenon. Little wonder that street vending involves negotiating for space in all its manifestations: physical space, economic opportunity and power. The vendors are coerced by both local urban and national authorities and sometimes the ...