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Sample records for partially supported practical

  1. Treatment planning: implant-supported partial overdentures.

    Science.gov (United States)

    Chee, Winston W L

    2005-04-01

    When multiple anterior teeth are missing, many options of replacement are available. Traditionally, the choice was between a fixed or removable prostheses. Today, with the predictability of dental implants, the options of tooth replacement range from removable partial dentures to implant-supported fixed prostheses. The choice of which restoration that will best provide occlusion and esthetics depends on multiple factors including the number and location of missing teeth, the residual ridge form in relation to the replacement teeth, the relationship of the maxillary and mandibular anterior teeth, the condition of teeth adjacent to the edentulous span, the amount of bone available for implant placement, the patients "smile line" and display of teeth, lip support, and financial constraints. When there is minimal loss of the ridge contour, restorations that emerge from the ridge are the most functional and esthetic restorations, adhesive-type fixed partial dentures, conventional fixed partial dentures, and implant-supported restorations can be indicated with the choice of restoration dependent on a risk benefit and cost benefit analysis. When there is a loss of ridge contour due to residual ridge resorption or trauma, the decision becomes more complex as not only does the tooth structure need to be replaced, the ridge form also has to be replaced. (Figures 1 and 2). This can be assessed clinically as illustrated by Figures 1 and 2 where a dis crepancy in arch form and ridge form in relation to the adjacent teeth and/or opposing arch can be observed. Other considerations are lip support and display of the teeth when smiling. This article presents a case and rationale for implant-supported par tial overdentures. Many authors have written on the merits of com plete overdentures. The complete overdenture has proven to be an improvement over conventional complete prostheses with respect to chewing efficiency, patient comfort and satisfaction. In partial edentulism, the

  2. Implant support for removable partial overdentures: a case report.

    Science.gov (United States)

    Halterman, S M; Rivers, J A; Keith, J D; Nelson, D R

    1999-01-01

    Functional stability and the preservation of remaining alveolar bone are primary, and often elusive, goals when restoring the partially edentulous arch. The incorporation of dental implants for the partial support of removable prostheses offers a practical adjunct in the fulfillment of these objectives. Planning for complex courses of treatment that include dental implants requires close coordination between the surgeon and the restorative dentist. Decisions that deal with type, location, size, number of implant fixtures, and design of the prosthesis are critical. All of these areas must be discussed and established as acceptable to the patient and each clinician before the initiation of treatment. In this report, we present a course of patient treatment in which a removable partial denture is supported by natural remaining teeth in conjunction with osseointegrated implants.

  3. Recommended practice for process sampling for partial pressure analysis

    International Nuclear Information System (INIS)

    Blessing, James E.; Ellefson, Robert E.; Raby, Bruce A.; Brucker, Gerardo A.; Waits, Robert K.

    2007-01-01

    This Recommended Practice describes and recommends various procedures and types of apparatus for obtaining representative samples of process gases from >10 -2 Pa (10 -4 Torr) for partial pressure analysis using a mass spectrometer. The document was prepared by a subcommittee of the Recommended Practices Committee of the American Vacuum Society. The subcommittee was comprised of vacuum users and manufacturers of mass spectrometer partial pressure analyzers who have practical experience in the sampling of process gas atmospheres

  4. Implant-supported removable partial dentures in the mandible

    NARCIS (Netherlands)

    Louwerse, Charlotte

    2017-01-01

    Conventional removable partial dentures (RPD) in a free-ending situation in the lower jaw (i.e. only front teeth left) have a poor reputation. Several problems like discomfort and functional problems are frequently encountered, resulting in dissatisfied patients and desperate dentists. By supporting

  5. Mastication improvement after partial implant-supported prosthesis use.

    Science.gov (United States)

    Gonçalves, T M S V; Campos, C H; Gonçalves, G M; de Moraes, M; Rodrigues Garcia, R C M

    2013-12-01

    Partially edentulous patients may be rehabilitated by the placement of removable dental prostheses, implant-supported removable dental prostheses, or partial implant fixed dental prostheses. However, it is unclear the impact of each prosthesis type over the masticatory aspects, which represents the objective of this paired clinical trial. Twelve patients sequentially received and used each of these 3 prosthesis types for 2 months, after which maximum bite force was assessed by a strain sensor and food comminution index was determined with the sieving method. Masseter and temporal muscle thicknesses during rest and maximal clenching were also evaluated by ultrasonography. Each maxillary arch received a new complete denture that was used throughout the study. Data were analyzed by analysis of variance for repeated measures, followed by the Tukey test (p mastication, and the magnitude of this effect was related to prosthesis type.

  6. Treadmill training with partial body weight support after stroke.

    Science.gov (United States)

    Hesse, Stefan; Werner, Cordula; von Frankenberg, Sophie; Bardeleben, Anita

    2003-02-01

    Treadmill therapy with partial BWS is a promising new approach to improve gait ability after stroke. This task-specific approach enables nonambulatory patients the repetitive practice of complex gait cycles instead of single-limb gait-preparatory maneuvers. Patients walk more symmetrically with less spasticity and better cardiovascular efficiency on the treadmill than with floor walking. Several controlled, clinical studies have shown the potential of treadmill training as a therapeutic intervention for nonambulatory patients with chronic stroke-related hemiplegia. Furthermore, controlled trials in acute stroke survivors have shown that treadmill training is as effective as other physiotherapy approaches that stress the repetitive practice of gait. Controlled multicenter trials comparing locomotor training with conventional therapy will be forthcoming. An electromechanical gait trainer that relieves the strenuous effort of the therapists and provides control of the trunk in a phase-dependent manner is a new technical alternative for gait training in severely impaired stroke patients.

  7. Implant-assisted removable partial dentures: practical considerations.

    Science.gov (United States)

    Omura, Aaron J; Latthe, Vaibhav; Marin, Mark M; Cagna, David R

    2016-01-01

    At the heart of prosthodontic treatment planning must be a sound understanding of the quality and reliability of the prosthodontic foundation. Implant prosthodontics relies almost entirely on the biological and mechanical properties of an osseous foundation. Initiation of therapy in the absence of a healthy and stable prosthodontic foundation risks unintended and suboptimal treatment outcomes. For conventional removable partial denture (RPD) therapy, consideration must be given to interactions between the soft and hard tissues available to support and stabilize planned prostheses. The strategic addition of implants to the partially edentulous foundation can improve the support, comfort, and esthetics of an RPD, resulting in elevated patient satisfaction and greater therapeutic success. This article discusses aspects of diagnosis, treatment planning, clinical management, laboratory execution, and maintenance that must be considered in order to obtain optimal results with implant-assisted RPDs.

  8. Partial Body Weight-Supported Treadmill Training in Spinocerebellar Ataxia.

    Science.gov (United States)

    de Oliveira, Laura Alice Santos; Martins, Camilla Polonini; Horsczaruk, Carlos Henrique Ramos; da Silva, Débora Cristina Lima; Vasconcellos, Luiz Felipe; Lopes, Agnaldo José; Meira Mainenti, Míriam Raquel; Rodrigues, Erika de Carvalho

    2018-01-01

    The motor impairments related to gait and balance have a huge impact on the life of individuals with spinocerebellar ataxia (SCA). Here, the aim was to assess the possibility of retraining gait, improving cardiopulmonary capacity, and challenging balance during gait in SCA using a partial body weight support (BWS) and a treadmill. Also, the effects of this training over functionality and quality of life were investigated. Eight SCA patients were engaged in the first stage of the study that focused on gait training and cardiovascular conditioning. From those, five took part in a second stage of the study centered on dynamic balance training during gait. The first and second stages lasted 8 and 10 weeks, respectively, both comprising sessions of 50 min (2 times per week). The results showed that gait training using partial BWS significantly increased gait performance, treadmill inclination, duration of exercise, and cardiopulmonary capacity in individuals with SCA. After the second stage, balance improvements were also found. Combining gait training and challenging tasks to the postural control system in SCA individuals is viable, well tolerated by patients with SCA, and resulted in changes in capacity for walking and balance.

  9. Robot-assisted partial nephrectomy in contemporary practice

    Directory of Open Access Journals (Sweden)

    Youssef S. Tanagho

    2013-01-01

    Full Text Available Laparoscopic renal surgery is associated with reduced blood loss, shorter hospital stay, enhanced cosmesis, and more rapid convalescence relative to open renal surgery. Laparoscopic partial nephrectomy is a minimally invasive, nephron-sparing alternative to laparoscopic radical nephrectomy for the management of small renal masses. While offering similar oncological outcomes to laparoscopic radical nephrectomy, the technical challenges and prolonged learning curve associated with laparoscopic partial nephrectomy limit its wider dissemination. Robot-assisted partial nephrectomy, although still an evolving procedure with no long-term data, has emerged as a viable alternative to laparoscopic partial nephrectomy, with favorable preliminary outcomes. This article provides an overview of the role of robot-assisted partial nephrectomy in the management of renal cell carcinoma. The clinical indications and principles of surgical technique for this procedure are discussed. The oncological, renal functional, and perioperative outcomes of robot-assisted partial nephrectomy are also evaluated, as are complication rates.

  10. Teaching Practices, School Support and Bullying

    Science.gov (United States)

    Rodríguez, Ana Carolina Reyes; Noriega, José Angel Vera; Cuervo, Angel Alberto Valdés

    2017-01-01

    Research in recent years indicates that schools, and in particular teaching practices, play an essential role in preventing bullying. This study's aim is to investigate the direct and indirect relationships between permissive and direct intervention teacher practices, school support and bullying. In a non-probabilistic way, 386 (58.1%) boys and…

  11. Screencasting to Support Effective Teaching Practices

    Science.gov (United States)

    Thomas, Amanda

    2017-01-01

    Increasing availability of digital devices in elementary school classrooms presents exciting new opportunities for teachers to support the teaching and learning of mathematics. Although many of the math applications available for these devices focus on drill and practice of mathematical procedures, screencasting apps can help support effective…

  12. Impella ventricular support in clinical practice

    DEFF Research Database (Denmark)

    Burzotta, Francesco; Trani, Carlo; Doshi, Sagar N

    2015-01-01

    Mechanical circulatory support represents an evolving field of clinical research and practice. Currently, several cardiac assist devices have been developed but, among different institutions and countries, a large variation in indications for use and device selection exists. The Impella platform...... is an easy to use percutaneous circulatory support device which is increasingly used worldwide. During 2014, we established a working group of European physicians who have collected considerable experience with the Impella device in recent years. By critically comparing the individual experiences...

  13. Student perceptions of support in practice.

    Science.gov (United States)

    Gidman, Janice; McIntosh, Annette; Melling, Katherine; Smith, Debra

    2011-11-01

    This paper reports on a funded research project exploring perceptions and experiences of pre-registration nursing students of support in practice in one Higher Education Institution in England. The study used a mixed method approach with samples of new students (within the first six months) and finishing students (within the last three months). Students reported that the most important areas they needed support with were clinical skills, placement situations, documentation and personal issues. The mentor qualities that were valued were personal attributes, being facilitative and being knowledgeable; newly qualified mentors and experienced students were seen as being the most supportive. Students saw their own responsibilities as learning and gaining skills, being professional and caring for patients. The finishing students also felt that accountability and teaching were part of their role. Reported challenges encompassed personal issues, including work-life balance and finances, dealing with elements such as patient death and uncertainties in new situations. The best aspects of practice emerged as being involved in patient care, feeling part of a team and experiencing positive support from mentors. The findings explicated the multi-faceted nature of student support in practice that need to be taken into account when putting support frameworks in place. Copyright © 2011 Elsevier Ltd. All rights reserved.

  14. Robot-assisted partial nephrectomy in contemporary practice

    Energy Technology Data Exchange (ETDEWEB)

    Tanagho, Youssef S.; Bhayani, Sam B.; Figenshau, Robert S., E-mail: tanaghoy@wudosis.wustl.edu [Division of Urologic Surgery, Washington University School of Medicine, St. Louis, MO (United States)

    2013-01-11

    Laparoscopic renal surgery is associated with reduced blood loss, shorter hospital stay, enhanced cosmesis, and more rapid convalescence relative to open renal surgery. Laparoscopic partial nephrectomy (LPN) is a minimally invasive, nephron-sparing alternative to laparoscopic radical nephrectomy (RN) for the management of small renal masses. While offering similar oncological outcomes to laparoscopic RN, the technical challenges and prolonged learning curve associated with LPN limit its wider dissemination. Robot-assisted partial nephrectomy (RAPN), although still an evolving procedure with no long-term data, has emerged as a viable alternative to LPN, with favorable preliminary outcomes. This article provides an overview of the role of RAPN in the management of renal cell carcinoma. The clinical indications and principles of surgical technique for this procedure are discussed. The oncological, renal functional, and perioperative outcomes of RAPN are also evaluated, as are complication rates.

  15. Robot-assisted partial nephrectomy in contemporary practice

    International Nuclear Information System (INIS)

    Tanagho, Youssef S.; Bhayani, Sam B.; Figenshau, Robert S.

    2013-01-01

    Laparoscopic renal surgery is associated with reduced blood loss, shorter hospital stay, enhanced cosmesis, and more rapid convalescence relative to open renal surgery. Laparoscopic partial nephrectomy (LPN) is a minimally invasive, nephron-sparing alternative to laparoscopic radical nephrectomy (RN) for the management of small renal masses. While offering similar oncological outcomes to laparoscopic RN, the technical challenges and prolonged learning curve associated with LPN limit its wider dissemination. Robot-assisted partial nephrectomy (RAPN), although still an evolving procedure with no long-term data, has emerged as a viable alternative to LPN, with favorable preliminary outcomes. This article provides an overview of the role of RAPN in the management of renal cell carcinoma. The clinical indications and principles of surgical technique for this procedure are discussed. The oncological, renal functional, and perioperative outcomes of RAPN are also evaluated, as are complication rates.

  16. Treadmill training with partial body weight support after stroke: a review.

    Science.gov (United States)

    Hesse, Stefan

    2008-01-01

    Restoration and improvement of gait after stroke are major aspects of neurorehabilitation. Mobilization out of the bed into the wheelchair and verticalisation with the help of a standing frame are first steps. With the patient cardiovascular stable, gait restoration is put on the agenda. Instead of tone-inhibiting and gait preparatory maneuvers, patients should practice complex gait cycles repetitively. Treadmill training with partial body weight support enables the harness-secured patients to practice numerous steps assisted by two or three therapists. In controlled studies, it proved equally effective as walking on the floor. Gait machines, as the Lokomat or the Gait Trainer GTI, intend to relieve the strenuous effort for the therapists. For the GTI, several controlled trials showed a superior effect in acute stroke patients with respect to walking ability and velocity. For the ambulatory patient, aerobic treadmill training is effective to improve speed and endurance without worsening gait quality. Belt velocity and inclination are gradually increased so that the patients reach a predefined target heart rate. On the belt, patients walk more symmetrically, and higher velocities result in a facilitation of paretic muscles and render gait more efficient. In summary, gait rehabilitation has seen dramatic changes over the last years. More is to be expected.

  17. Removable Partial Denture Supported by Implants with Prefabricated Telescopic Abutments - A Case Report

    Science.gov (United States)

    Sehgal, Komal

    2014-01-01

    Implants have been designed to rehabilitate edentulous patients with fixed prosthesis or implant supported overdentures. Implant-supported single crowns and fixed partial dentures have become successful treatment alternatives to removable and fixed partial dentures. However, it is common to have clinical situations which make it impossible to use conventional as well as implant supported fixed partial dentures. The implant supported removable partial dentures can be a treatment modality that offers the multitude of benefits of implant-based therapy—biologic, biomechanical, social, and psychological to such patients. The aim of this article is to present a case report describing the fabrication and advantages of removable partial denture supported by teeth and implants for a patient with long edentulous span. The patient was satisfied with his dentures in terms of function and aesthetics. Regular follow-up visits over a period of three years revealed that the periodontal condition of remaining natural dentition and peri-implant conditions were stable. There was no evidence of excessive residual ridge resorption or mobility of the teeth, nor were any visible changes in the bone levels of the natural teeth or implants noted on radiographs. PMID:25121066

  18. Removable partial denture supported by implants with prefabricated telescopic abutments - a case report.

    Science.gov (United States)

    Kumar, Lalit; Sehgal, Komal

    2014-06-01

    Implants have been designed to rehabilitate edentulous patients with fixed prosthesis or implant supported overdentures. Implant-supported single crowns and fixed partial dentures have become successful treatment alternatives to removable and fixed partial dentures. However, it is common to have clinical situations which make it impossible to use conventional as well as implant supported fixed partial dentures. The implant supported removable partial dentures can be a treatment modality that offers the multitude of benefits of implant-based therapy-biologic, biomechanical, social, and psychological to such patients. The aim of this article is to present a case report describing the fabrication and advantages of removable partial denture supported by teeth and implants for a patient with long edentulous span. The patient was satisfied with his dentures in terms of function and aesthetics. Regular follow-up visits over a period of three years revealed that the periodontal condition of remaining natural dentition and peri-implant conditions were stable. There was no evidence of excessive residual ridge resorption or mobility of the teeth, nor were any visible changes in the bone levels of the natural teeth or implants noted on radiographs.

  19. Load transfer characteristics of unilateral distal extension removable partial dentures with polyacetal resin supporting components.

    Science.gov (United States)

    Jiao, T; Chang, T; Caputo, A A

    2009-03-01

    To photoelastically examine load transfer by unilateral distal extension removable partial dentures with supporting and retentive components made of the lower stiffness polyacetal resins. A mandibular photoelastic model, with edentulous space distal to the right second premolar and missing the left first molar, was constructed to determine the load transmission characteristics of a unilateral distal extension base removable partial denture. Individual simulants were used for tooth structure, periodontal ligament, and alveolar bone. Three designs were fabricated: a major connector and clasps made from polyacetal resin, a metal framework as the major connector with polyacetal resin clasp and denture base, and a traditional metal framework I-bar removable partial denture. Simulated posterior bilateral and unilateral occlusal loads were applied to the removable partial dentures. Under bilateral and left side unilateral loading, the highest stress was observed adjacent to the left side posterior teeth with the polyacetal removable partial denture. The lowest stress was seen with the traditional metal framework. Unilateral loads on the right edentulous region produced similar distributed stress under the denture base with all three designs but a somewhat higher intensity with the polyacetal framework. The polyacetal resin removable partial denture concentrated the highest stresses to the abutment and the bone. The traditional metal framework I-bar removable partial denture most equitably distributed force. The hybrid design that combined a metal framework and polyacetal clasp and denture base may be a viable alternative when aesthetics are of primary concern.

  20. Effect of implant support on mandibular distal extension removable partial dentures: relationship between denture supporting area and stress distribution.

    Science.gov (United States)

    Sato, Maki; Suzuki, Yasunori; Kurihara, Daisuke; Shimpo, Hidemasa; Ohkubo, Chikahiro

    2013-04-01

    This study explored the relationship between implant support and the denture-supporting area by comparing the stability of an implant-supported distal extension removable partial denture and a conventional distal extension removable partial denture. A model simulating a mandibular bilateral distal extension missing (#34-37 and #44-47) was fabricated using silicone impression material as soft tissue (2 mm thick) on an epoxy resin bone model. The denture base was reduced by 5 mm cutting part of both the retromolar pad and the lingual border. Loads of up to 5 kg were applied, and the pressure and displacement of the RPDs were simultaneously measured and analyzed using the Wilcoxon test (αremovable partial denture (ISRPD) was significantly less than on the conventional RPD (CRPD). As the supporting area of the denture base decreased, the pressure and the denture displacement of the CRPD were greater than for the ISRPD. This study indicated that implant placement at the distal edentulous ridge can prevent denture displacement of the distal extension bases, regardless of the supporting area of the denture base. Copyright © 2013 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  1. Numerical solution of the problems for plates on partial internal supports of complicated configurations

    International Nuclear Information System (INIS)

    Quang A, Dang; Hai, Truong Ha

    2014-01-01

    Very recently in the work S imple Iterative Method for Solving Problems for Plates with Partial Internal Supports, Journal of Engineering Mathematics, DOI: 10.1007/s10665-013-9652-7 (in press) , we proposed a numerical method for solving some problems of plates on one and two line partial internal supports (LPIS). In the essence they are problems with strongly mixed boundary conditions for biharmonic equation. Using this method we reduced the problems to a sequence of boundary value problems for the Poisson equation with weakly mixed boundary conditions, which are easily solved numerically. The advantages of the method over other ones were shown. In this paper we apply the method to plates on internal supports of more complicated configurations. Namely, we consider the case of three LPIS and the case of the cross support. The convergence of the method is established theoretically and its efficiency is confirmed on numerical experiments

  2. Implant-supported removable partial dentures in the mandible : A 3-16 year retrospective study

    NARCIS (Netherlands)

    Jensen, Charlotte; Meijer, Henny J A; Raghoebar, Gerry M; Kerdijk, Wouter; Cune, Marco S

    PURPOSE: The purpose of this retrospective study was to assess performance, together with biological and technical complications, of implant-supported removable partial dentures (ISRPD) in mandibular Kennedy class I situations with implants placed in the anterior or posterior position. METHODS: 23

  3. Clinical Evaluation of Implant-Supported Removable Partial Dentures With a Stress-Breaking Attachment.

    Science.gov (United States)

    Suzuki, Yasunori; Kono, Kentaro; Shimpo, Hidemasa; Sato, Yohei; Ohkubo, Chikahiro

    2017-08-01

    The stress-breaking ball (SBB) attachment can distribute the occlusal force equally between the alveolar ridge and the implants. The purpose of this study was to evaluate the implant-supported distal extension removable partial dentures (RPDs) with SBB attachment in 10 patients who were partially edentulous. This randomized crossover study was designed to compare the function of RPDs with and without healing abutments and SBB attachments to support the posterior aspects of the RPDs. Mandibular jaw movements during mastication and the occlusal force and contact area were measured with a commercially available tracking device and pressure-sensitive sheets. Using a visual analog scale, 4 criteria-chewing, retention, stability, and comfort-were evaluated. All of the data obtained were analyzed using a 1-way analysis of variance (α = 0.05). There were no significant differences in either the mean time or the coefficient of variation among the SBB attachments and healing abutments of implant-supported removable partial dentures (ISRPDs) and conventional removable partial dentures (CRPDs). SBB attachments and healing abutments of ISRPDs had greater forces and contact areas than those of CRPDs with significant differences. For all criteria, patients preferred SBB attachments to healing abutments and CRPDs. The implant-supported distal extension RPDs with SBB attachment improved denture stability and patients' satisfaction.

  4. Cost-effectiveness of implant-supported mandibular removable partial dentures

    NARCIS (Netherlands)

    Jensen, Charlotte; Ross, Jamila; Feenstra, Talitha L; Raghoebar, Gerry M; Speksnijder, Caroline; Meijer, Henny J A; Cune, Marco S

    ObjectivesThe aim of this study was to conduct a cost-effectiveness analysis comparing conventional removable partial dentures (RPDs) and implant-supported RPDs (ISRPDs) treatment in patients with an edentulous maxilla and a bilateral free-ending situation in the mandible. Material and methodsThirty

  5. Implant-supported removable partial dentures in the mandible : A 3-16 year retrospective study

    NARCIS (Netherlands)

    Jensen, Charlotte; Meijer, Henny J. A.; Raghoebar, Gerry M.; Kerdijk, Wouter; Cune, Marco S.

    Purpose: The purpose of this retrospective study was to assess performance, together with biological and technical complications, of implant-supported removable partial dentures (ISRPD) in mandibular Kennedy class I situations with implants placed in the anterior or posterior position. Methods: 23

  6. Highly Active, Carbon-supported, PdSn Nano-core, Partially ...

    African Journals Online (AJOL)

    Carbon-supported, Pt partially covered, PdSn alloy nanoparticles (Pt-PdSn/C) were synthesized via a metathetical reaction of PdSn alloy nanoparticles, and a platinum precursor. The electrochemical activity was evaluated by methanol oxidation. The Pt-PdSn/C catalysts were characterized by transmission electron ...

  7. Positive Adult Support and Depression Symptoms in Adolescent Females: The Partially Mediating Role of Eating Disturbances

    Science.gov (United States)

    Linville, Deanna; O'Neil, Maya; Huebner, Angela

    2011-01-01

    This study examined linkages between depression symptoms (DEP) and positive adult support (PAS) in female adolescents and the partially mediating influence of eating disturbances (ED). Structural equation modeling was used to establish measurement models for each of the latent constructs, determine the relationships among the latent constructs,…

  8. Treadmill Training with Partial Body-Weight Support in Children with Cerebral Palsy: A Systematic Review

    Science.gov (United States)

    Mutlu, Akmer; Krosschell, Kristin; Spira, Deborah Gaebler

    2009-01-01

    OKAim: The aim of this systematic review was to examine the literature on the effects of partial body-weight support treadmill training (PBWSTT) in children with cerebral palsy (CP) on functional outcomes and attainment of ambulation. Method: We searched the relevant literature from 1950 to July 2007. We found eight studies on the use of PWSBTT on…

  9. Comparison of Treatment Outcomes in Partially Edentulous Patients with Implant-Supported Fixed Prostheses and Removable Partial Dentures.

    Science.gov (United States)

    Nogawa, Toshifumi; Takayama, Yoshiyuki; Ishida, Keita; Yokoyama, Atsuro

    The aim of this study was to compare masticatory performance, occlusal force, and oral health-related quality of life (OHRQoL) in patients with mandibular distal-extension edentulism between those with implant-supported fixed prostheses (ISFPs) and those with removable partial dentures (RPDs), and to evaluate relationships among them. Subjects were recruited from patients using ISFPs or RPDs for mandibular distal-extension edentulism. Masticatory performance was evaluated based on the glucose extracted from chewed gummy jelly. Occlusal force was measured with a pressure-sensitive sheet, and data were subjected to computer analysis. The Japanese version of the Oral Health Impact Profile (OHIP-J) was used to evaluate OHRQoL. The masticatory performance, occlusal force, and OHIP-J scores of the ISFP and RPD groups were compared using the Wilcoxon rank-sum test. The relationships among the variables were analyzed using the Spearman rank correlation coefficient test. Multivariate logistic regression analysis was employed with the OHIP-J score as a dependent variable. Nineteen patients with ISFPs and 25 patients with RPDs participated in this study. No significant difference was observed between the two groups with regard to masticatory performance and occlusal force. The OHIP-J score was significantly lower in the ISFP group than in the RPD group. The OHIP-J score had no significant correlation with masticatory performance, but was significantly correlated with occlusal force and the prosthetic method. Multivariate logistic regression analysis showed that younger age, RPDs, and lower occlusal force were significantly associated with a higher OHIP-J summary score. The present results suggest that the difference in masticatory performance and occlusal force between ISFPs and RPDs is small, but ISFPs are superior to RPDs with regard to OHRQoL in patients with mandibular distal-extension edentulism. In addition, there appears to be a slight correlation between the OHIP

  10. [Influence of attachment type on stress distribution of implant-supported removable partial dentures].

    Science.gov (United States)

    Yang, Xue; Rong, Qi-guo; Yang, Ya-dong

    2015-02-18

    To compare influences of different retention attachments on stress among supporting structures. By 3-dimensional laser scanner and reverse engineering computer aided design (CAD) software, a basic partially edentulous digital model with mandibular premolar and molar missing was established. Implant attachment and removable partial dentures (RPD) were added into the basic model to build three kinds of models: RPD only, RPD + implant + Locator attachment, and RPD + implant + Magfit attachment. Vertical and inclined loads were put on artificial teeth unilaterally. By means of 3-dimensional finite element analysis, the stress distribution and displacement of the main supportive structures were compared. A complete 3-dimensional finite element model was established, which contained tooth structure, and periodontal structures. The displacement of the denture was smaller in Locator (9.38 μm vertically, 45.48 μm obliquely) and Magfit models (9.54 μm vertically, 39.45 μm obliquely) compared with non-implant RPD model (95.27 μm vertically, 155.70 μm obliquely). Compared with the two different attachments, cortical bone stress value was higher in Locator model (Locator model 10.850 MPa vertically, 43.760 MPa obliquely; Magfit model 7.100 MPa vertically, 19.260 MPa obliquely).The stress value of abutment periodontal ligamentin Magfit model (0.420 MPa vertically) was lower than that in Locator model (0.520 MPa vertically). The existence of implant could reduce maximum von Mises value of each supportive structure when Kennedy I partially edentulous mandible was restored. Comparing the structure of Magfit and Locator attachment, the contact of Magfit attachment was rigid, while Locator was resilient. Locator attachment could improve stability of the denture dramatically. Locator had stronger effect on defending horizontal movement of the denture.

  11. DOES PERCEIVED ORGANIZATIONAL SUPPORT MEDIATE THE RELATIONSHIP BETWEEN HUMAN RESOURCE MANAGEMENT PRACTICES AND ORGANIZATIONAL COMMITMENT?

    Directory of Open Access Journals (Sweden)

    Aizzat Mohd. Nasurdin

    2008-01-01

    Full Text Available This study examines a model involving Human Resource Management (HRM practices, perceived organizational support, and organizational commitment. It was hypothesized that HRM practices (performance appraisal, training and career development will be positively related to organizational commitment, and that perceived organizational support would serve as a mediator in the relationship between HRM practices and commitment. The statistical results on data gathered from a sample of 214 employees within the Malaysian manufacturing sector demonstrated that career development and performance appraisal have direct, positive and significant relationships with organizational commitment. In addition, perceived organizational support was found to partially mediate the relationships between two of the three HRM practices (career development and performance appraisal and commitment. Theoretical and managerial implications are suggested.

  12. Factors associated with blood oxygen partial pressure and carbon dioxide partial pressure regulation during respiratory extracorporeal membrane oxygenation support: data from a swine model.

    Science.gov (United States)

    Park, Marcelo; Mendes, Pedro Vitale; Costa, Eduardo Leite Vieira; Barbosa, Edzangela Vasconcelos Santos; Hirota, Adriana Sayuri; Azevedo, Luciano Cesar Pontes

    2016-01-01

    The aim of this study was to explore the factors associated with blood oxygen partial pressure and carbon dioxide partial pressure. The factors associated with oxygen - and carbon dioxide regulation were investigated in an apneic pig model under veno-venous extracorporeal membrane oxygenation support. A predefined sequence of blood and sweep flows was tested. Oxygenation was mainly associated with extracorporeal membrane oxygenation blood flow (beta coefficient = 0.036mmHg/mL/min), cardiac output (beta coefficient = -11.970mmHg/L/min) and pulmonary shunting (beta coefficient = -0.232mmHg/%). Furthermore, the initial oxygen partial pressure and carbon dioxide partial pressure measurements were also associated with oxygenation, with beta coefficients of 0.160 and 0.442mmHg/mmHg, respectively. Carbon dioxide partial pressure was associated with cardiac output (beta coefficient = 3.578mmHg/L/min), sweep gas flow (beta coefficient = -2.635mmHg/L/min), temperature (beta coefficient = 4.514mmHg/ºC), initial pH (beta coefficient = -66.065mmHg/0.01 unit) and hemoglobin (beta coefficient = 6.635mmHg/g/dL). In conclusion, elevations in blood and sweep gas flows in an apneic veno-venous extracorporeal membrane oxygenation model resulted in an increase in oxygen partial pressure and a reduction in carbon dioxide partial pressure 2, respectively. Furthermore, without the possibility of causal inference, oxygen partial pressure was negatively associated with pulmonary shunting and cardiac output, and carbon dioxide partial pressure was positively associated with cardiac output, core temperature and initial hemoglobin.

  13. The Homecoming: A Review of Support Practices for Repatriates

    Science.gov (United States)

    Pattie, Marshall; White, Marion M.; Tansky, Judy

    2010-01-01

    Purpose: The purpose of this paper is to examine the prevalence of repatriate support practices in organizations within the context of the current literature in this field of study. Design/methodology/approach: A total of 42 firms employing 3,234 expatriates were surveyed regarding human resource practices that support repatriation. Analysis…

  14. Human Resources practices and workplace environmental support

    OpenAIRE

    Noel Ngwenya

    2014-01-01

    The key to retaining employees lies on the organization’s capability of supporting employees by understanding and answering to their intrinsic motivators. It is important for employees to perceive a positive and valuing attitude of the organization toward them in order to have greater motivation for staying in the organization. Such condition for employee retention is based on the social exchange theory which holds that the exchange relationship between employer and employ...

  15. The effect of implant-supported removable partial dentures on oral health quality of life.

    Science.gov (United States)

    Gates, W Day; Cooper, Lyndon F; Sanders, Anne E; Reside, Glenn J; De Kok, Ingeborg J

    2014-02-01

    Removable partial dentures (RPDs) represent standard treatment for partial edentulism despite major shortcomings. To alleviate these shortcomings, endosseous implants provide support and stability as well as contribute to maintenance of alveolar bone. This prospective, within subject, time series study evaluated patient-based outcomes of RPDs compared to implant-supported removable partial dentures (ISRPDs). The study hypothesis was that the ISRPD would substantially improve oral health quality of life for patients. Seventeen patients requesting new mandibular Kennedy I or II RPDs received one 6-mm dental implant in one or both of the posterior edentulous areas. After healing, conventional RPDs were fabricated and delivered. Twelve weeks later, second-stage surgery was performed, and ball abutments with Clix attachments were inserted, thereby converting the prostheses to ISRPDs. Oral health quality of life was evaluated using the 49-item Oral Health Impact Profile (OHIP-49) questionnaire. The OHIP-49 was administered prior to treatment (baseline), at 6 and 12 weeks following RPD delivery and at 6 and 12 weeks following ISRPD conversion. Radiographic evaluation was performed at 6 and 12 weeks following ISRPD conversion. In statistical analysis, a fixed-slope random intercept variance components model took account of the multiple observations per person over time. In 17 subjects, 29 of 30 implants survived. The failed implant was replaced without complications. Abutment complications were limited to one abutment loosening and one attachment replacement. Minor prosthodontic complications were recorded. The OHIP-49 score reduced by 11.8 points, on average, at 12 weeks following ISRPD conversion (P = 0.011). Patients reported improved oral health following conversion to an ISRPD from RPD. The ISRPD involving short implants is one treatment option that should be considered when treatment planning Kennedy Class I and II patients. © 2012 John Wiley & Sons A/S.

  16. Environmental control and life support - Partially closed system will save big money

    Science.gov (United States)

    Guy, W. W.

    1983-01-01

    Although the NASA space station has not yet been completely defined, realistic estimates may be made of the environmental control and life support system requirements entailed by a crew of eight, a resupply interval of 90 days, an initial launch which includes expendables for the first resupply interval, 7.86 lb/day of water per person, etc. An appraisal of these requirements is presented which strongly suggests the utility of a partially closed life support system. Such a scheme would give the crew high quality water to drink, and recycle nonpotable water from hand washing, bathing, clothes and dish washing, and urinal flushing. The excess recovery process water is electrolyzed to provide metabolic and leakage oxygen. The crew would drink electrolysis water and atmospheric humidity control moisture-derived water.

  17. Fit Analysis of Different Framework Fabrication Techniques for Implant-Supported Partial Prostheses.

    Science.gov (United States)

    Spazzin, Aloísio Oro; Bacchi, Atais; Trevisani, Alexandre; Farina, Ana Paula; Dos Santos, Mateus Bertolini

    2016-01-01

    This study evaluated the vertical misfit of implant-supported frameworks made using different techniques to obtain passive fit. Thirty three-unit fixed partial dentures were fabricated in cobalt-chromium alloy (n = 10) using three fabrication methods: one-piece casting, framework cemented on prepared abutments, and laser welding. The vertical misfit between the frameworks and the abutments was evaluated with an optical microscope using the single-screw test. Data were analyzed using one-way analysis of variance and Tukey test (α = .05). The one-piece casted frameworks presented significantly higher vertical misfit values than those found for framework cemented on prepared abutments and laser welding techniques (P Laser welding and framework cemented on prepared abutments are effective techniques to improve the adaptation of three-unit implant-supported prostheses. These techniques presented similar fit.

  18. Human Resources practices and workplace environmental support

    Directory of Open Access Journals (Sweden)

    Noel Ngwenya

    2014-01-01

    Full Text Available The key to retaining employees lies on the organization’s capability of supporting employees by understanding and answering to their intrinsic motivators. It is important for employees to perceive a positive and valuing attitude of the organization toward them in order to have greater motivation for staying in the organization. Such condition for employee retention is based on the social exchange theory which holds that the exchange relationship between employer and employee goes beyond exchange of impersonal resources such as money, information, and service. One of the leading challenges in creating attractive and supporting working environment has be implementing effective human development strategies to enhance organizational performance and employee commitment. Therefore, managing human resources plays a crucial role in a process of increasing organization, starting from line managers who need to be aware of factors that motivate their subordinates to make them perform well, ending up with human resources professionals who have to understand motivation to effectively design and implement reward structure and systems. In employment situation, as in personal relationships, commitment is a tow-away street. If employers want committed employees, they need to be committed employers. Committed employees do better work than uncommitted ones and organizations with committed workers do better financially than organizations with uncommitted ones. Employers need to determine what is responsible for this disparity. Many employees perceive that employers do not value loyalty and are willing to sacrifice workers to maintain the financial bottom line. Employees points to decades of downsizing, rightsizing, and re-engineering as the evidence that employers treat them as expendable commodities when times get tough (Bragg, 2002.

  19. Partial and incremental PCMH practice transformation: implications for quality and costs.

    Science.gov (United States)

    Paustian, Michael L; Alexander, Jeffrey A; El Reda, Darline K; Wise, Chris G; Green, Lee A; Fetters, Michael D

    2014-02-01

    To examine the associations between partial and incremental implementation of the Patient Centered Medical Home (PCMH) model and measures of cost and quality of care. We combined validated, self-reported PCMH capabilities data with administrative claims data for a diverse statewide population of 2,432 primary care practices in Michigan. These data were supplemented with contextual data from the Area Resource File. We measured medical home capabilities in place as of June 2009 and change in medical home capabilities implemented between July 2009 and June 2010. Generalized estimating equations were used to estimate the mean effect of these PCMH measures on total medical costs and quality of care delivered in physician practices between July 2009 and June 2010, while controlling for potential practice, patient cohort, physician organization, and practice environment confounders. Based on the observed relationships for partial implementation, full implementation of the PCMH model is associated with a 3.5 percent higher quality composite score, a 5.1 percent higher preventive composite score, and $26.37 lower per member per month medical costs for adults. Full PCMH implementation is also associated with a 12.2 percent higher preventive composite score, but no reductions in costs for pediatric populations. Incremental improvements in PCMH model implementation yielded similar positive effects on quality of care for both adult and pediatric populations but were not associated with cost savings for either population. Estimated effects of the PCMH model on quality and cost of care appear to improve with the degree of PCMH implementation achieved and with incremental improvements in implementation. © Health Research and Educational Trust.

  20. Influence of Abutment Angle on Implant Strain When Supporting a Distal Extension Removable Partial Dental Prosthesis: An In Vitro Study.

    Science.gov (United States)

    Hirata, Kiyotaka; Takahashi, Toshihito; Tomita, Akiko; Gonda, Tomoya; Maeda, Yoshinobu

    This study evaluated the impact of angled abutments on strain in implants supporting a distal extension removable partial denture. An in vitro model of an implant supporting a distal extension removable partial denture was developed. The implant was positioned with a 17- or 30-degree mesial inclination, with either a healing abutment or a corrective multiunit abutment. Levels of strain under load were compared, and the results were compared using t test (P = .05). Correcting angulation with a multiunit angled abutment significantly decreased strain (P abutment. An angled abutment decreased the strain on an inclined implant significantly more than a healing abutment when loaded under a distal extension removable partial denture.

  1. Partial discharge signal denoising with spatially adaptive wavelet thresholding and support vector machines

    Energy Technology Data Exchange (ETDEWEB)

    Mota, Hilton de Oliveira; Rocha, Leonardo Chaves Dutra da [Department of Computer Science, Federal University of Sao Joao del-Rei, Visconde do Rio Branco Ave., Colonia do Bengo, Sao Joao del-Rei, MG, 36301-360 (Brazil); Salles, Thiago Cunha de Moura [Department of Computer Science, Federal University of Minas Gerais, 6627 Antonio Carlos Ave., Pampulha, Belo Horizonte, MG, 31270-901 (Brazil); Vasconcelos, Flavio Henrique [Department of Electrical Engineering, Federal University of Minas Gerais, 6627 Antonio Carlos Ave., Pampulha, Belo Horizonte, MG, 31270-901 (Brazil)

    2011-02-15

    In this paper an improved method to denoise partial discharge (PD) signals is presented. The method is based on the wavelet transform (WT) and support vector machines (SVM) and is distinct from other WT-based denoising strategies in the sense that it exploits the high spatial correlations presented by PD wavelet decompositions as a way to identify and select the relevant coefficients. PD spatial correlations are characterized by WT modulus maxima propagation along decomposition levels (scales), which are a strong indicative of the their time-of-occurrence. Denoising is performed by identification and separation of PD-related maxima lines by an SVM pattern classifier. The results obtained confirm that this method has superior denoising capabilities when compared to other WT-based methods found in the literature for the processing of Gaussian and discrete spectral interferences. Moreover, its greatest advantages become clear when the interference has a pulsating or localized shape, situation in which traditional methods usually fail. (author)

  2. Organisational support for evidence-based practice: occupational therapists perceptions.

    Science.gov (United States)

    Bennett, Sally; Allen, Shelley; Caldwell, Elizabeth; Whitehead, Mary; Turpin, Merrill; Fleming, Jennifer; Cox, Ruth

    2016-02-01

    Barriers to the use of evidence-based practice extend beyond the individual clinician and often include organisational barriers. Adoption of systematic organisational support for evidence-based practice in health care is integral to its use. This study aimed to explore the perceptions of occupational therapy staff regarding the influence of organisational initiatives to support evidence-based practice on workplace culture and clinical practice. This study used semi-structured interviews with 30 occupational therapists working in a major metropolitan hospital in Brisbane, Australia regarding their perceptions of organisational initiatives designed to support evidence-based practice. Four themes emerged from the data: (i) firmly embedding a culture valuing research and EBP, (ii) aligning professional identity with the Research and Evidence in Practice model, (iii) experiences of change: pride, confidence and pressure and (iv) making evidence-based changes to clinical practices. Organisational initiatives for evidence-based practice were perceived as influencing the culture of the workplace, therapists' sense of identity as clinicians, and as contributing to changes in clinical practice. It is therefore important to consider organisational factors when attempting to increase the use of evidence in practice. © 2016 Occupational Therapy Australia.

  3. Catalytic partial oxidation of methane over porous silica supported VO{sub x} catalysts

    Energy Technology Data Exchange (ETDEWEB)

    Pirovano, C.; Schoenborn, E.; Kalevaru, V.N.; Wohlrab, S.; Luecke, B.; Martin, A. [University Rostock e.V., Rostock (Germany). Leibniz Inst. for Catalysis

    2011-07-01

    High surface area mesoporous siliceous MCM-41 and SBA-15 materials have been used as supports to disperse vanadium oxide species using wet impregnation and incipient wetness impregnation methods. These materials were used as catalysts for the partial oxidation of methane (POM) to formaldehyde. The physico-chemical properties of the solids were studied by means of BET, DR-UV/Vis spectroscopy, Py-FTIR and TEM. The influence of support and the preparation method on the dispersion of VOx is also investigated. The catalytic properties of the catalysts were examined in a fixed bed stainless steel reactor at 923 K. So far a maximum production of formaldehyde can be detected on SBA-15 supported VOx-catalysts prepared by incipient wetness impregnation. On this V/SBA-15 material a covalent attachment of catalytic active molecular vanadium species dominates, which in turn leads to a lower activation temperature and thereby reduced over-oxidation. From the best case, the space time yield of HCHO could be reached close to 775 g{sub HCHO} Kg{sub cat}{sup -1} h{sup -1}. (orig.)

  4. Friends Drinking Together: Young Adults' Evolving Support Practices

    Science.gov (United States)

    Dresler, Emma; Anderson, Margaret

    2018-01-01

    Purpose: Young adult's drinking is about pleasure, a communal practice of socialising together in a friendship group. The purpose of this paper is to investigate the evolving support practices of drinking groups for better targeting of health communications messages. Design/methodology/approach: This qualitative descriptive study examined the…

  5. Pedagogical Practices to Support Classroom Cultures of Scientific Inquiry

    Science.gov (United States)

    Herrenkohl, Leslie Rupert; Tasker, Tammy; White, Barbara

    2011-01-01

    This article examines the pedagogical practices of two science inquiry teachers and their students using a Web-based system called Web of Inquiry (WOI). There is a need to build a collective repertoire of pedagogical practices that can assist elementary and middle school teachers as they support students to develop a complex model of inquiry based…

  6. Cost-effectiveness of implant-supported mandibular removable partial dentures.

    Science.gov (United States)

    Jensen, Charlotte; Ross, Jamila; Feenstra, Talitha L; Raghoebar, Gerry M; Speksnijder, Caroline; Meijer, Henny J A; Cune, Marco S

    2017-05-01

    The aim of this study was to conduct a cost-effectiveness analysis comparing conventional removable partial dentures (RPDs) and implant-supported RPDs (ISRPDs) treatment in patients with an edentulous maxilla and a bilateral free-ending situation in the mandible. Thirty subjects were included. A new RPD was made and implant support was provided 3 months later. Treatment costs (opportunity costs and costs based on tariffs) were calculated. Treatment effect was expressed by means of the Dutch Oral Health Impact Profile questionnaire (OHIP-NL49), a chewing ability test (Mixing Ability Index, MAI) and a short-form health survey measuring perceived general health (SF-36), which was subsequently converted into quality-adjusted-life-years (QALYs). The incremental cost-effectiveness ratio (ICER) was the primary outcome measure of cost-effectiveness, comparing both treatment strategies. The mean total opportunity costs were €981 (95% CI €971-€991) for the RPD treatment and €2.480 (95% CI €2.461-€2.500) for the ISRPD treatment. The total costs derived from the national tariff structure were €850 for the RPD treatment and €2.610 for the ISRPD treatment. The ICER for OHIP-NL49 and MAI using the opportunity costs was €80 and €786, respectively. When using the tariff structure, corresponding ICERs were €94 and €921. The effect of supporting an RPD with implants when expressed in QALYs was negligible; hence an ICER was not determined. It is concluded that depending on the choice of outcome measure and monetary threshold, supporting an RPD with implants is cost-effective when payers are willing to pay more than €80 per OHIP point gained. Per MAI point gained, an additional €786 has to be invested. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Resident and user support for urban natural areas restoration practices

    Science.gov (United States)

    Paul H. Gobster; Kristin Floress; Lynne M. Westphal; Cristy A. Watkins; Joanne Vining; Alaka Wali

    2016-01-01

    Public support is important to the success of natural areas restoration programs. Support can be especially critical in urban settings where stakeholders recreate in or reside near natural areas but may lack familiarity with practices for managing ecological processes. Surveys of on-site recreationists and nearby residents (N= 888) of 11 Chicago metropolitan natural...

  8. In vitro investigation of marginal accuracy of implant-supported screw-retained partial dentures.

    Science.gov (United States)

    Koke, U; Wolf, A; Lenz, P; Gilde, H

    2004-05-01

    Mismatch occurring during the fabrication of implant-supported dentures may induce stress to the peri-implant bone. The purpose of this study was to investigate the influence of two different alloys and the fabrication method on the marginal accuracy of cast partial dentures. Two laboratory implants were bonded into an aluminium block so that the distance between their longitudinal axes was 21 mm. Frameworks designed for screw-retained partial dentures were cast either with pure titanium (rematitan) or with a CoCr-alloy (remanium CD). Two groups of 10 frameworks were cast in a single piece. The first group was made of pure titanium, and the second group of a CoCr-alloy (remanium CD). A third group of 10 was cast in two pieces and then laser-welded onto a soldering model. This latter group was also made of the CoCr-alloy. All the frameworks were screwed to the original model with defined torque. Using light microscopy, marginal accuracy was determined by measuring vertical gaps at eight defined points around each implant. Titanium frameworks cast in a single piece demonstrated mean vertical gaps of 40 microm (s.d. = 11 microm) compared with 72 microm (s.d. = 40 microm) for CoCr-frameworks. These differences were not significant (U-test, P = 0.124) because of a considerable variation of the values for CoCr-frameworks (minimum: 8 microm and maximum: 216 microm). However, frameworks cast in two pieces and mated with a laser showed significantly better accuracy in comparison with the other experimental groups (mean: 17 microm +/- 6; P laser welding. Manufacturing the framework pieces separately and then welding them together provides the best marginal fit.

  9. Theoretical role of adjunctive implant positional support in stress distribution of distal-extension mandibular removable partial dentures.

    Science.gov (United States)

    Xiao, Wei; Li, Zhiyong; Shen, Shiqian; Chen, Shaowu; Wang, Yining; Wang, Jiawei

    2014-01-01

    This preliminary study evaluated the adjunctive supporting role of diverse implant positions on stress distribution in a Class I removable partial denture (RPD) design. Nine three-dimensional finite element models were prepared to simulate mandibular RPD designs with three different loading conditions applied. Implant supported designs demonstrated lower stress value concentrations and mucosal displacement.

  10. Surgeons' preferences and practice patterns regarding intraoperative frozen section during partial nephrectomy.

    Science.gov (United States)

    Sidana, Abhinav; Donovan, James F; Gaitonde, Krishnanath

    2014-08-01

    Intraoperative frozen section (FS) evaluation for tumor margin during partial nephrectomy (PN) is a matter of controversy in urologic oncology. We evaluated the preferences and practice patterns of urologists regarding intraoperative FS during PN. A 17-item questionnaire was designed to collect information on surgeons' preferences and practice patterns regarding FS during PN. The survey was sent to the members of the Society of Urologic Oncology and Endourological Society. A total of 197 responses were received. Overall, 69% and 58% of respondents chose to obtain FS (always or sometimes) during open PN (OPN) and laparoscopic PN (LPN), respectively. There was a strong correlation between the surgeons' preferences during OPN and LPN. Younger surgeons are less likely to obtain FS during OPN. For surgeons who did not routinely obtain FS, "confidence about complete resection" was the most common reason (79%), followed by "no change in management with positive margins" (35%). Most surgeons (75%) believed the margins to be negative, if surgical margin was free of tumor microscopically by a single cell layer. Older surgeons considered negative margins to be free of tumor microscopically by ≥5 mm. Overall, 54% and 42% of respondents would repeat FS for positive microscopic margins during OPN and LPN, respectively. Of the respondents, 95% would not recommend additional treatment for positive margins on final pathology. Despite recent literature pointing to low clinical utility of FS, most surgeons still obtain FS during PN. Older surgeons tend to obtain FS more often. Fellowship training and practice type do not appear to influence preferences and practice patterns in regard to FS. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Breastfeeding practices that support women with diabetes to breastfeed.

    Science.gov (United States)

    Fallon, Anne; Dunne, Fidelma

    2015-10-01

    The aim of this literature review was to identify breastfeeding practices that support women with diabetes to breastfeed. A search was undertaken of CINAHL and Medline databases to identify studies that inform breastfeeding practice for women with diabetes. This resulted in 14 studies (19 records). Most studies focused on women with GDM and T1D with some consideration of T2D. The review has been organised using Maslow's Hierarchy of Needs, to enable a clear focus on the needs of women while identifying supportive practices. The key findings of this review are that breastfeeding as the first feed and exclusive breastfeeding are beneficial to meeting physiological needs. Preparations such as having food nearby and having someone to call on can help meet the woman's safety and security needs. A sense of love and belonging is supported by the practice of an early first breastfeed, but antenatal breast milk expression is currently not recommended. The woman's self-esteem can be enhanced through informed multidisciplinary support. Finally, self-actualisation or success with breastfeeding has been achieved by women with diabetes. Common breastfeeding concerns rather than diabetes have been identified as reasons for cessation of breastfeeding. Practices that support women deal with these concerns are recommended. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. Implant-supported removable partial dentures in the mandible: A 3-16 year retrospective study.

    Science.gov (United States)

    Jensen, Charlotte; Meijer, Henny J A; Raghoebar, Gerry M; Kerdijk, Wouter; Cune, Marco S

    2017-04-01

    The purpose of this retrospective study was to assess performance, together with biological and technical complications, of implant-supported removable partial dentures (ISRPD) in mandibular Kennedy class I situations with implants placed in the anterior or posterior position. 23 subjects with two endosseous implants to support a bilateral-free-ending mandibular removable denture were examined. Eight subjects had implants in the premolar (anterior) region and 15 subjects implants in the molar (posterior) region. Biological and technical complications were recorded from the patients' medical record. Patients filled out a validated questionnaire regarding their appreciation of oral health related quality of life (OHIP-NL49) and a VAS score on overall satisfaction. Over a mean follow-up period of 8 years (median 8 years, range 3-16 years) the cumulative implant survival rate was 91.7% (SE 0.05). Mean peri-implant bone loss was 0.9mm (SD 1.0mm). Scores for bleeding on probing, plaque and mucosal health were generally low, but significantly worse for posteriorly placed implants. Significantly more biological complications occurred in the posterior group (X 2 (1)=3.9; p=0.048). In 65% of the cases no technical complications were registered. Mean overall OHIP score was 16.1 (SD 18.4) and patients were highly satisfied (VAS: 8.4; SD 2.1). Within the limitations of this retrospective study, in case of a Kennedy class I situation in the mandible, an ISRPD is a viable treatment option with a high implant survival rate and satisfied patients after a maximum of 16 years. Technical and biological complications should be anticipated. Anteriorly placed implants performed slightly better. Copyright © 2016 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  13. Prediction of CO concentrations based on a hybrid Partial Least Square and Support Vector Machine model

    Science.gov (United States)

    Yeganeh, B.; Motlagh, M. Shafie Pour; Rashidi, Y.; Kamalan, H.

    2012-08-01

    Due to the health impacts caused by exposures to air pollutants in urban areas, monitoring and forecasting of air quality parameters have become popular as an important topic in atmospheric and environmental research today. The knowledge on the dynamics and complexity of air pollutants behavior has made artificial intelligence models as a useful tool for a more accurate pollutant concentration prediction. This paper focuses on an innovative method of daily air pollution prediction using combination of Support Vector Machine (SVM) as predictor and Partial Least Square (PLS) as a data selection tool based on the measured values of CO concentrations. The CO concentrations of Rey monitoring station in the south of Tehran, from Jan. 2007 to Feb. 2011, have been used to test the effectiveness of this method. The hourly CO concentrations have been predicted using the SVM and the hybrid PLS-SVM models. Similarly, daily CO concentrations have been predicted based on the aforementioned four years measured data. Results demonstrated that both models have good prediction ability; however the hybrid PLS-SVM has better accuracy. In the analysis presented in this paper, statistic estimators including relative mean errors, root mean squared errors and the mean absolute relative error have been employed to compare performances of the models. It has been concluded that the errors decrease after size reduction and coefficients of determination increase from 56 to 81% for SVM model to 65-85% for hybrid PLS-SVM model respectively. Also it was found that the hybrid PLS-SVM model required lower computational time than SVM model as expected, hence supporting the more accurate and faster prediction ability of hybrid PLS-SVM model.

  14. Fatigue Fracture Strength of Implant-Supported Full Contour Zirconia and Metal Ceramic Fixed Partial Dentures

    Directory of Open Access Journals (Sweden)

    Fariborz Vafaee

    2017-10-01

    Full Text Available Objectives: Zirconia restorations have been suggested as a more durable and more appealing alternative to metal restorations. However, their mechanical properties may be negatively affected by fatigue due to superficial stresses or low temperature degradation. This study aimed to assess the fatigue fracture strength of three-unit implant-supported full contour zirconia and pre-sintered cobalt-chromium (Co-Cr alloy posterior fixed partial dentures (FPDs.Materials and Methods: In this in-vitro experimental study, 28 posterior three-unit implant-supported FPDs were fabricated of full contour zirconia and pre-sintered Co-Cr alloy, and were cemented on implant abutments. To simulate the oral environment, FPDs were subjected to 10,000 thermal cycles between 5-55°C for 30 seconds, and were then transferred to a chewing simulator (100,000 cycles, 50 N, 0.5 Hz. Afterwards, fatigue fracture strength was measured using a universal testing machine. Data were analyzed by Mann-Whitney U test.Results: The mean and standard deviation of fracture strength were 2108.6±440.1 N in full contour zirconia, and 3499.9±1106.5 N in pre-sintered Co-Cr alloy. According to Mann- Whitney U test, the difference in this respect was statistically significant between the two groups (P=0.007.Conclusions: Since the fracture strength values obtained in the two groups were significantly higher than the maximum mean masticatory load in the oral environment, both materials can be used for fabrication of posterior three-unit FPDs, depending on the esthetic demands of patients.

  15. A comparative finite elemental analysis of glass abutment supported and unsupported cantilever fixed partial denture.

    Science.gov (United States)

    Ramakrishaniah, Ravikumar; Al Kheraif, Abdulaziz A; Elsharawy, Mohamed A; Alsaleh, Ayman K; Ismail Mohamed, Karem M; Rehman, Ihtesham Ur

    2015-05-01

    The purpose of this study was to investigate and compare the load distribution and displacement of cantilever prostheses with and without glass abutment by three dimensional finite element analysis. Micro-computed tomography was used to study the relationship between the glass abutment and the ridge. The external surface of the maxilla was scanned, and a simplified finite element model was constructed. The ZX-27 glass abutment and the maxillary first and second premolars were created and modified. The solid model of the three-unit cantilever fixed partial denture was scanned, and the fitting surface was modified with reference to the created abutments using the 3D CAD system. The finite element analysis was completed in ANSYS. The fit and total gap volume between the glass abutment and dental model were determined by Skyscan 1173 high-energy spiral micro-CT scan. The results of the finite element analysis in this study showed that the cantilever prosthesis supported by the glass abutment demonstrated significantly less stress on the terminal abutment and overall deformation of the prosthesis under vertical and oblique load. Micro-computed tomography determined a gap volume of 6.74162 mm(3). By contacting the mucosa, glass abutments transfer some amount of masticatory load to the residual alveolar ridge, thereby preventing damage to the periodontal microstructures of the terminal abutment. The passive contact of the glass abutment with the mucosa not only preserves the health of the mucosa covering the ridge but also permits easy cleaning. It is possible to increase the success rate of cantilever FPDs by supporting the cantilevered pontic with glass abutments. Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  16. Laboratory-supported influenza surveillance in Victorian sentinel general practices.

    Science.gov (United States)

    Kelly, H; Murphy, A; Leong, W; Leydon, J; Tresise, P; Gerrard, M; Chibo, D; Birch, C; Andrews, R; Catton, M

    2000-12-01

    Laboratory-supported influenza surveillance is important as part of pandemic preparedness, for identifying and isolating candidate vaccine strains, for supporting trials of anti-influenza drugs and for refining the influenza surveillance case definition in practice. This study describes the implementation of laboratory-supported influenza surveillance in Victorian sentinel general practices and provides an estimate of the proportion of patients with an influenza-like illness proven to have influenza. During 1998 and 1999, 25 sentinel general practices contributed clinical surveillance data and 16 metropolitan practices participated in laboratory surveillance. Serological, virus-antigen detection, virus culture and multiplex polymerase chain reaction procedures were used to establish the diagnosis of influenza. Two laboratories at major teaching hospitals in Melbourne provided additional data on influenza virus identification. General practice sentinel surveillance and laboratory identification of influenza provided similar data on the pattern of influenza in the community between May and September. The clinical suspicion of influenza was confirmed in 49 to 54 per cent of cases seen in general practice.

  17. Getting to uptake: do communities of practice support the implementation of evidence-based practice?

    Science.gov (United States)

    Barwick, Melanie A; Peters, Julia; Boydell, Katherine

    2009-02-01

    Practitioners are increasingly encouraged to adopt evidence-based practices (EBP) leading to a need for new knowledge translation strategies to support implementation and practice change. This study examined the benefits of a community of practice in the context of Ontario's children's mental health sector where organizations are mandated to adopt a standardized outcome measure to monitor client response to treatment. Readiness for change, practice change, content knowledge, and satisfaction with and use of implementation supports were examined among practitioners newly trained on the measure who were randomly assigned to a community of practice (CoP) or a practice as usual (PaU) group. CoP practitioners attended 6 sessions over 12 months; PaU practitioners had access to usual implementation supports. Groups did not differ on readiness for change or reported practice change, although CoP participants demonstrated greater use of the tool in practice, better content knowledge and were more satisfied with implementation supports than PaU participants. CoPs present a promising model for translating EBP knowledge and promoting practice change in children's mental health that requires further study.

  18. [A phd completed 10. Implant-supported removable partial -dentures in a Kennedy Class I-situation in the mandible].

    Science.gov (United States)

    Jensen-Louwerse, C

    2017-06-01

    Implant-supported removable partial dentures in the mandible often cause problems, which means that patients wear their dentures seldom if at all. A solution is to place implants that the dentures can be snapped onto. There is, however, no consensus about the best position of the implants in the mandible yet. In addition, it is worthwhile to balance the cost of treatment with its effectiveness. In a randomised cross-over clinical trial involving 30 patients with a shortened dental arch, the implant-supported removable partial denture in the mandible was evaluated based on the experience of the patient, mean time of wearing, chewing ability and the clinical and radiographic parameters in relation to 2 different implant positions: 2 in the pre-molar region or 2 in the molar region. The cost-effectiveness of both treatments was also evaluated. From the patient's point of view, the implant-supported removable partial dentures are best supported by implants placed in the molar region. The research also revealed, however, that significantly more bleeding occurred around implants placed in the molar region and from a clinical perspective placement in the pre-molar region would have preference. The cost-effectiveness of the treatment with an implant-supported removable partial denture depends on the choice of outcome measurement and monetary threshold.

  19. Pressure distribution of implant-supported removable partial dentures with stress-breaking attachments.

    Science.gov (United States)

    Kono, Kentaro; Kurihara, Daisuke; Suzuki, Yasunori; Ohkubo, Chikahiro

    2014-04-01

    This in vitro study investigated the pressure distribution of the implant-supported removable partial dentures (RPDs) with the stress-breaking attachments under the occlusal force. The experimental model of bilateral missing premolars and molars was modified from a commercial simulation model. Five pressure sensors were embedded near the bilateral first molars, first premolars, and medio-lingual alveolar crest. Two implants were placed near the second molars, and they were connected to the denture base using the following conditions: complete separation between the denture base and implant with cover screws (CRPD), flexible connection with a stress-breaking ball (SBB) attachment, and rigid connection without stress breaking with healing caps (HC). The pressure at five different areas of the soft tissue and the displacement of the RPDs were simultaneously measured, loading up to 50 N. The coefficient of variation (CV) for each connection was calculated from all data of the pressure at five areas to evaluate the pressure distribution. The pressure on medio-lingual alveolar crest and molars of the HC was less than SBB and CRPD. In contrast, the pressure on premolars of SBB was greater than for the HC and CRPD. The CV of SBB was less than that of HC and CRPD. Denture displacement of HC and SBB was less than for CRPD. Within the in vitro limitations, precise denture settlements and pressure distribution under the denture base could be controlled using an SBB attachment. An SBB attachment might be able to protect the implant from harmful force. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

  20. An ontology-driven, case-based clinical decision support model for removable partial denture design

    Science.gov (United States)

    Chen, Qingxiao; Wu, Ji; Li, Shusen; Lyu, Peijun; Wang, Yong; Li, Miao

    2016-06-01

    We present the initial work toward developing a clinical decision support model for specific design of removable partial dentures (RPDs) in dentistry. We developed an ontological paradigm to represent knowledge of a patient’s oral conditions and denture component parts. During the case-based reasoning process, a cosine similarity algorithm was applied to calculate similarity values between input patients and standard ontology cases. A group of designs from the most similar cases were output as the final results. To evaluate this model, the output designs of RPDs for 104 randomly selected patients were compared with those selected by professionals. An area under the curve of the receiver operating characteristic (AUC-ROC) was created by plotting true-positive rates against the false-positive rate at various threshold settings. The precision at position 5 of the retrieved cases was 0.67 and at the top of the curve it was 0.96, both of which are very high. The mean average of precision (MAP) was 0.61 and the normalized discounted cumulative gain (NDCG) was 0.74 both of which confirmed the efficient performance of our model. All the metrics demonstrated the efficiency of our model. This methodology merits further research development to match clinical applications for designing RPDs. This paper is organized as follows. After the introduction and description of the basis for the paper, the evaluation and results are presented in Section 2. Section 3 provides a discussion of the methodology and results. Section 4 describes the details of the ontology, similarity algorithm, and application.

  1. IMPROVING WOMEN'S LIVES Practical support for women gives ...

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

    IMPROVING WOMEN'S LIVES Practical support for women gives communities a better future. October 26 ... Organized into small cooperatives, the women produce and market argan oil using a mix of traditional and modern methods. At the same time ... arts and craft. Technology helps Asian women balance family and work.

  2. Music Teachers' Attitudes toward Transgender Students and Supportive School Practices

    Science.gov (United States)

    Silveira, Jason M.; Goff, Sarah C.

    2016-01-01

    The purpose of this study was to measure music teachers' attitudes toward transgender individuals and toward school practices that support transgender students. Participants (N = 612) included men and women who teach a variety of music subjects in elementary, middle, and high schools, in urban, suburban, and rural areas. An online questionnaire…

  3. Multifactorial risk assessment for survival of abutments of removable partial dentures based on practice-based longitudinal study.

    Science.gov (United States)

    Tada, Sayaka; Ikebe, Kazunori; Matsuda, Ken-Ichi; Maeda, Yoshinobu

    2013-12-01

    Predicting the tooth survival is such a great challenge for evidence-based dentistry. To prevent further tooth loss of partially edentulous patients, estimation of individualized risk and benefit for each residual tooth is important to the clinical decision-making. While there are several reports indicating a risk of losing the abutment teeth of RPDs, there are no existing reports exploring the cause of abutment loss by multifactorial analysis. The aim of this practice-based longitudinal study was to determine the prognostic factors affecting the survival period of RPD abutments using a multifactorial risk assessment. One hundred and forty-seven patients had been previously provided with a total of 236 new RPDs at the Osaka University Dental Hospital; the 856 abutments for these RPDs were analyzed. Survival of abutment teeth was estimated using the Kaplan-Meier method. Multivariate analysis was conducted by Cox's proportional hazard modelling. The 5-year survival rates were 86.6% for direct abutments and 93.1% for indirect abutments, compared with 95.8% survival in non-abutment teeth. The multivariate analysis showed that abutment survival was significantly associated with crown-root ratio (hazard ratio (HR): 3.13), root canal treatment (HR: 2.93), pocket depth (HR: 2.51), type of abutments (HR: 2.19) and occlusal support (HR: 1.90). From this practice-based longitudinal study, we concluded that RPD abutment teeth are more likely to be lost than other residual teeth. From the multifactorial risk factor assessment, several prognostic factors, such as occlusal support, crown-root ratio, root canal treatment, and pocket depth were suggested. These results could be used to estimate the individualized risk for the residual teeth, to predict the prognosis of RPD abutments and to facilitate an evidence-based clinical decision making. Copyright © 2013 Elsevier Ltd. All rights reserved.

  4. CPD Aligned to Competency Standards to Support Quality Practice

    Directory of Open Access Journals (Sweden)

    Rose Nash

    2017-02-01

    Full Text Available As medication experts, pharmacists are key members of the patient’s healthcare team. Pharmacists must maintain their competence to practice to remain responsive to the increasingly complex healthcare sector. This paper seeks to determine how competence training for pharmacists may enhance quality in their professional development. Results of two separately administered surveys (2012 and 2013 were compared to examine the reported continued professional development (CPD practices of Australian pharmacists. Examination of results from both studies enabled a focus on how the competency standards inform CPD practice.In the survey administered in 2012, 91% (n = 253/278 pharmacists reported that they knew their current registration requirements. However, in the survey administered in 2013, only 43% (n = 46/107 reported utilization of the National Competency Standards Framework for Pharmacists in Australia (NCS to self-asses their practice as part of their annual re-registration requirements. Fewer, 23% (n = 25/107, used the NCS to plan their CPD. This may be symptomatic of poor familiarity with the NCS, uncertainty around undertaking self-directed learning as part of a structured learning plan and/or misunderstandings around what CPD should include. This is supported by thematic analysis of pharmacists’ social media comments. Initial and ongoing competence training to support meaningful CPD requires urgent attention in Australia. The competence (knowledge, skills and attributes required to engage in meaningful CPD practice should be introduced and developed prior to entry into practice; other countries may find they are in a similar position.

  5. Supporting Implementation of Evidence-Based Practices through Practice-Based Coaching

    Science.gov (United States)

    Snyder, Patricia A.; Hemmeter, Mary Louise; Fox, Lise

    2015-01-01

    In active implementation science frameworks, coaching has been described as an important competency "driver" to ensure evidence-based practices are implemented as intended. Empirical evidence also has identified coaching as a promising job-embedded professional development strategy to support implementation of quality teaching practices.…

  6. Supporting student nurses in practice with additional online communication tools.

    Science.gov (United States)

    Morley, Dawn A

    2014-01-01

    Student nurses' potential isolation and difficulties of learning on placement have been well documented and, despite attempts to make placement learning more effective, evidence indicates the continuing schism between formal learning at university and situated learning on placement. First year student nurses, entering placement for the first time, are particularly vulnerable to the vagaries of practice. During 2012 two first year student nurse seminar groups (52 students) were voluntarily recruited for a mixed method study to determine the usage of additional online communication support mechanisms (Facebook, wiki, an email group and traditional methods of support using individual email or phone) while undertaking their first five week clinical placement. The study explores the possibility of strengthening clinical learning and support by promoting the use of Web 2.0 support groups for student nurses. Results indicate a high level of interactivity in both peer and academic support in the use of Facebook and a high level of interactivity in one wiki group. Students' qualitative comments voice an appreciation of being able to access university and peer support whilst working individually on placement. Recommendations from the study challenge universities to use online communication tools already familiar to students to complement the support mechanisms that exist for practice learning. This is tempered by recognition of the responsibility of academics to ensure their students are aware of safe and effective online communication. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Promoting recovery through peer support: possibilities for social work practice.

    Science.gov (United States)

    Loumpa, Vasiliki

    2012-01-01

    The Recovery Approach has been adopted by mental health services worldwide and peer support constitutes one of the main elements of recovery-based services. This article discusses the relevancy of recovery and peer support to mental health social work practice through an exploration of social work ethics and values. Furthermore, it provides an exploration of how peer support can be maximized in groupwork to assist the social work clinician to promote recovery and well-being. More specifically, this article discusses how the narrative therapy concepts of "retelling" and "witnessing" can be used in the context of peer support to promote recovery, and also how social constructionist, dialogical, and systemic therapy approaches can assist the social work practitioner to enhance peer support in recovery oriented groupwork. Copyright © Taylor & Francis Group, LLC

  8. Implant-supported mandibular removable partial dentures; patient-based outcome measures in relation to implant position

    NARCIS (Netherlands)

    Jensen, Charlotte; Raghoebar, Gerry M.; Kerdijk, Wouter; Meijer, Henny J. A.; Cune, Marco S.

    2016-01-01

    Objectives: To assess the benefits of implant support to Removable Partial Dentures (RPD) in patients with a bilateral free-ending situation in the mandible and to determine the most favorable implant position: the premolar (PM) or the molar (M) region. Methods: Thirty subjects with a bilateral

  9. Implant-supported mandibular removable partial dentures : Functional, clinical and radiographical parameters in relation to implant position

    NARCIS (Netherlands)

    Jensen, Charlotte; Speksnijder, Caroline M.; Raghoebar, Gerry M.; Kerdijk, Wouter; Meijer, Henny J A; Cune, Marco S.

    Background: Patients with a Kennedy class I situation often encounter problems with their removable partial denture (RPD). Purpose: To assess the functional benefits of implant support to RPDs, the clinical performance of the implants and teeth and to determine the most favorable implant position:

  10. [Supportive care during chemotherapy for lung cancer in daily practice].

    Science.gov (United States)

    Müller, Veronika; Tamási, Lilla; Gálffy, Gabriella; Losonczy, György

    2012-09-01

    Active oncotherapy, combination chemotherapy of lung cancer is accompanied with many side effects which may impair patients' quality of life and compromise the effectiveness of chemotherapy. Most side effects of chemotherapy are preventable or treatable with optimal supportive care which enhances success in patient care and treatment. The aim of this review is to summarize the most important conditions that may be associated with combined chemotherapy of lung cancer from the practical point of view.

  11. Theorizing E-Commerce Business Models: On the Impact of Partially and Fully Supported Transaction Phases on Customer Satisfaction and Loyalty

    Directory of Open Access Journals (Sweden)

    Maria Madlberger

    2017-03-01

    Full Text Available Although considerable research has been conducted on the definition and classification of e-commerce business models, little research has integrated the support and impact of distinct transaction phases within e-commerce business models. Indeed, any channel design decisions depend on the arrangement of the three transaction phases, viz. information phase, agreement phase and fulfilment phase. Whereas in literature, a complete support of transaction phases is implicitly assumed, in practice, e-commerce firms exist that consciously do not support all three transaction phases through the online channel. In cases for which only certain phases are supported in one channel, the customer is required to switch to another channel to complete the transaction. To gain an initial understanding of the relevance of transaction phases, we examine the influence of transaction phase support in one channel on satisfaction and reuse intention of an e-commerce website under consideration of users’ prior experiences. We conduct a laboratory experiment involving two e-commerce business models that differ only in the number of supported transaction phases via the online channel. Empirical data was analysed using a Bayesian network approach. Our analysis indicates the types of users who value partial support compared to those users who prefer full support of transaction phases. The results will assist firms in meeting future challenges regarding user engagement and attraction to their online stores.

  12. Partial Support Ventilation and Mitochondrial-Targeted Antioxidants Protect against Ventilator-Induced Decreases in Diaphragm Muscle Protein Synthesis.

    Directory of Open Access Journals (Sweden)

    Matthew B Hudson

    Full Text Available Mechanical ventilation (MV is a life-saving intervention in patients in respiratory failure. Unfortunately, prolonged MV results in the rapid development of diaphragm atrophy and weakness. MV-induced diaphragmatic weakness is significant because inspiratory muscle dysfunction is a risk factor for problematic weaning from MV. Therefore, developing a clinical intervention to prevent MV-induced diaphragm atrophy is important. In this regard, MV-induced diaphragmatic atrophy occurs due to both increased proteolysis and decreased protein synthesis. While efforts to impede MV-induced increased proteolysis in the diaphragm are well-documented, only one study has investigated methods of preserving diaphragmatic protein synthesis during prolonged MV. Therefore, we evaluated the efficacy of two therapeutic interventions that, conceptually, have the potential to sustain protein synthesis in the rat diaphragm during prolonged MV. Specifically, these experiments were designed to: 1 determine if partial-support MV will protect against the decrease in diaphragmatic protein synthesis that occurs during prolonged full-support MV; and 2 establish if treatment with a mitochondrial-targeted antioxidant will maintain diaphragm protein synthesis during full-support MV. Compared to spontaneously breathing animals, full support MV resulted in a significant decline in diaphragmatic protein synthesis during 12 hours of MV. In contrast, diaphragm protein synthesis rates were maintained during partial support MV at levels comparable to spontaneous breathing animals. Further, treatment of animals with a mitochondrial-targeted antioxidant prevented oxidative stress during full support MV and maintained diaphragm protein synthesis at the level of spontaneous breathing animals. We conclude that treatment with mitochondrial-targeted antioxidants or the use of partial-support MV are potential strategies to preserve diaphragm protein synthesis during prolonged MV.

  13. Partial Support Ventilation and Mitochondrial-Targeted Antioxidants Protect against Ventilator-Induced Decreases in Diaphragm Muscle Protein Synthesis.

    Science.gov (United States)

    Hudson, Matthew B; Smuder, Ashley J; Nelson, W Bradley; Wiggs, Michael P; Shimkus, Kevin L; Fluckey, James D; Szeto, Hazel H; Powers, Scott K

    2015-01-01

    Mechanical ventilation (MV) is a life-saving intervention in patients in respiratory failure. Unfortunately, prolonged MV results in the rapid development of diaphragm atrophy and weakness. MV-induced diaphragmatic weakness is significant because inspiratory muscle dysfunction is a risk factor for problematic weaning from MV. Therefore, developing a clinical intervention to prevent MV-induced diaphragm atrophy is important. In this regard, MV-induced diaphragmatic atrophy occurs due to both increased proteolysis and decreased protein synthesis. While efforts to impede MV-induced increased proteolysis in the diaphragm are well-documented, only one study has investigated methods of preserving diaphragmatic protein synthesis during prolonged MV. Therefore, we evaluated the efficacy of two therapeutic interventions that, conceptually, have the potential to sustain protein synthesis in the rat diaphragm during prolonged MV. Specifically, these experiments were designed to: 1) determine if partial-support MV will protect against the decrease in diaphragmatic protein synthesis that occurs during prolonged full-support MV; and 2) establish if treatment with a mitochondrial-targeted antioxidant will maintain diaphragm protein synthesis during full-support MV. Compared to spontaneously breathing animals, full support MV resulted in a significant decline in diaphragmatic protein synthesis during 12 hours of MV. In contrast, diaphragm protein synthesis rates were maintained during partial support MV at levels comparable to spontaneous breathing animals. Further, treatment of animals with a mitochondrial-targeted antioxidant prevented oxidative stress during full support MV and maintained diaphragm protein synthesis at the level of spontaneous breathing animals. We conclude that treatment with mitochondrial-targeted antioxidants or the use of partial-support MV are potential strategies to preserve diaphragm protein synthesis during prolonged MV.

  14. [General practice research units in Denmark: multidisciplinary research in support of practical work].

    Science.gov (United States)

    Reventlow, Susanne; Broholm, Katalin Alexa Király; Mäkelä, Marjukka

    2014-01-01

    In Denmark the general practice research units operating in connection with universities provide a home base, training and methodology support for researchers in the field from medical students to general practitioners carrying out practical work. Research issues frequently require a multidisciplinary approach and use of different kinds of materials. Problems arising from the practical work of general practitioners take priority in the wide selection of topics. The units have networked efficiently with organizations of general practitioners and medical education. The combination of research environments has created synergy benefiting everybody and increased the scientific productivity and visibility of the field.

  15. Treadmill training with partial body-weight support after anterior cruciate ligament reconstruction: a randomized controlled trial.

    Science.gov (United States)

    Luo, Yuan; Shen, Weizhong; Jiang, Zhong; Sha, Jiao

    2016-12-01

    [Purpose] To compare the effects of treadmill training with partial body weight support (TTPBWS) and conventional physical therapy (PT) on subjects with anterior cruciate ligament reconstructions. [Subjects and Methods] A total of 40 subjects were randomly allocated to either a treatment group or a control group. Subjects received either treadmill training with partial body weight support (treatment group) or conventional physical therapy (control group). The circumferences of the lower extremities, Holden classifications, 10-meter walking times and the International Knee Documentation Committee (IKDC) scores were compared at 12 and 24 weeks post-operation. The knee joint stability was tested at 24 weeks post-operation using a KT-1000. [Results] Significant differences were found between the two groups at the 12 weeks post-operation. For most of the measures, there was no significant difference between the groups at 24 weeks post-operation. Interestingly, for most of the measures, there was no significant difference between their values in the treatment group at 12 weeks and their values in the control group at 24 weeks post-operation. [Conclusion] The function of a subject's lower extremities can be improved and the improvement was clearly accelerated by the intervention of treadmill training with partial body weight support, without compromising the stability of the knee joints in a given follow-up period.

  16. Oral health related quality-of-life outcomes of partially edentulous patients treated with implant-supported single crowns or fixed partial dentures.

    Science.gov (United States)

    AlZarea, Bader K

    2017-05-01

    Oral health-related quality of life (OHRQoL) is afflicted by different variables. Limited information is available regarding the impact of different phases of implant therapy on OHRQoL of edentulous patients. This study was carried out to assess the OHRQoL of patients treated with implant-supported single crowns or fixed partial dentures. A total of 79 healthy partially edentulous subjects needing implant therapy were incorporated in this study. Before placement of the implants, the subjects were instructed to fill the original version of OHIP questionnaire. Subsequently patients received titanium oral implants of the ITI® Dental Implant System. After 1st, 2nd and 3rd year of implant placement, patients filled the same OHIP-49 questionnaire. In this manner the impact of implant therapy on OHRQoL by putting in comparison pre- and post-treatment OHIP-49 scores was assessed. Statistical analyses were performed using Statistical Package for the Social Science software (SPSS, version 22, Chicago, IL, USA). Paired t test and Unpaired t test were performed and a statistical significance was set at 5% level of significance ( p disability, psychological disability, social disability were significantly decreased from baseline to 1st year ( p 0.05). All variables were also significantly decreased from baseline to 2nd year and 3rd year ( p 0.05). Patients aged less than 60 years and more than 60 years of age groups differed significantly with respect to OHIP scores measured at 1st year, 2nd year and at 3rd year of implant placement ( p Oral health-related quality-of-life.

  17. Implant-tooth-supported fixed partial prostheses: correlations between in vivo occlusal bite forces and marginal bone reactions.

    Science.gov (United States)

    Akça, Kivanç; Uysal, Serdar; Cehreli, Murat Cavit

    2006-06-01

    To evaluate maximal occlusal bite forces (MOF) and marginal bone level (MBL) changes in patients with implant-tooth-supported fixed partial prostheses (FPP). Twenty nine partially edentulous patients consecutively who received 34 three-occlusal unit FPP with terminal implant and tooth support were subjected to quantification of MOFs using a sub-miniature load cell connected to a data acquisition system and measurement of the MBL changes around implants in digitalized periapical radiographs obtained at prostheses delivery and 24-month follow-up. MOFs for implant support (mean: 353.61 N) significantly differed from tooth support (mean: 275.48 N) (P 0.05). MBL changes at mesial and distal sites of the implants at 24 months of functional loading were 0.28 and 0.097 mm respectively. Although MOFs under functional loading might indicate an increase in load participation for supporting implant, the rigid connection between implant and natural tooth via three-occlusal unit FPP does not jeopardize the time-dependent MBL stability of the implant under functional loads.

  18. Periodontal ligament influence on the stress distribution in a removable partial denture supported by implant: a finite element analysis

    Directory of Open Access Journals (Sweden)

    Carlos Marcelo Archangelo

    2012-06-01

    Full Text Available OBJECTIVES: The non-homogenous aspect of periodontal ligament (PDL has been examined using finite element analysis (FEA to better simulate PDL behavior. The aim of this study was to assess, by 2-D FEA, the influence of non-homogenous PDL on the stress distribution when the free-end saddle removable partial denture (RPD is partially supported by an osseointegrated implant. MATERIAL AND METHODS: Six finite element (FE models of a partially edentulous mandible were created to represent two types of PDL (non-homogenous and homogenous and two types of RPD (conventional RPD, supported by tooth and fibromucosa; and modified RPD, supported by tooth and implant [10.00x3.75 mm]. Two additional Fe models without RPD were used as control models. The non-homogenous PDL was modeled using beam elements to simulate the crest, horizontal, oblique and apical fibers. The load (50 N was applied in each cusp simultaneously. Regarding boundary conditions the border of alveolar ridge was fixed along the x axis. The FE software (Ansys 10.0 was used to compute the stress fields, and the von Mises stress criterion (svM was applied to analyze the results. RESULTS: The peak of svM in non-homogenous PDL was higher than that for the homogenous condition. The benefits of implants were enhanced for the non-homogenous PDL condition, with drastic svM reduction on the posterior half of the alveolar ridge. The implant did not reduce the stress on the support tooth for both PDL conditions. Conclusion: The PDL modeled in the non-homogeneous form increased the benefits of the osseointegrated implant in comparison with the homogeneous condition. Using the non-homogenous PDL, the presence of osseointegrated implant did not reduce the stress on the supporting tooth.

  19. Preceptor Support in Hospital Transition to Practice Programs.

    Science.gov (United States)

    Blegen, Mary A; Spector, Nancy; Ulrich, Beth T; Lynn, Mary R; Barnsteiner, Jane; Silvestre, Josephine

    2015-12-01

    The aim of this study was to describe newly licensed RN (NLRN) preceptorships and the effects on competency and retention. Preceptors are widely used, but little is known about the benefit from the perspective of the NLRN or about the models of the relationships. The National Council of State Boards of Nursing added questions about the preceptor experience in a study of transition-to-practice programs. Hospitals were coded as having high or low preceptor support in regard to scheduling NLRN on the same shifts as their preceptors, assignment sharing, and preceptor release time and a low number of preceptors per preceptee. Half of the 82 hospitals were classified as high, and half as low preceptor support. NLRNs and their preceptors in high-support hospitals evaluated the preceptor experience and NLRN competence higher. In addition, NLRN retention was higher in the high-support hospitals. To improve NLRN competence and retention, preceptors should have adequate time with each NLRN, share shift and patient assignments, and have few preceptees assigned to each preceptor concurrently.

  20. Retrospective comparative ten-year study of cumulative survival rates of remaining teeth in large edentulism treated with implant-supported fixed partial dentures or removable partial dentures.

    Science.gov (United States)

    Yamazaki, Seiya; Arakawa, Hikaru; Maekawa, Kenji; Hara, Emilio Satoshi; Noda, Kinji; Minakuchi, Hajime; Sonoyama, Wataru; Matsuka, Yoshizo; Kuboki, Takuo

    2013-07-01

    This study aimed to compare the survival rates of remaining teeth between implant-supported fixed dentures (IFDs) and removable partial dentures (RPDs) in patients with large edentulous cases. The second goal was to assess the risk factors for remaining tooth loss. The study subjects were selected among those who received prosthodontic treatment at Okayama University Dental Hospital for their edentulous space exceeding at least four continuous missing teeth. Twenty-one patients were included in the IFD group and 82 patients were included in the RPD group. Survival rates of remaining teeth were calculated in three subcategories: (1) whole remaining teeth, (2) adjacent teeth to intended edentulous space, and (3) opposing teeth to intended edentulous space. The ten-year cumulative survival rate of the whole remaining teeth was significantly higher in the IFD group (40.0%) than in the RPD group (24.4%). On the other hand, there was no significant difference between two groups in the survival rate of teeth adjacent or opposing to intended edentulous space. A Cox proportional hazard analysis revealed that RPD restoration and gender (male) were the significant risk factors for remaining tooth loss (whole remaining teeth). These results suggest that IFD treatment can reduce the incidence of remaining tooth loss in large edentulous cases. Copyright © 2013 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  1. Educational Changes to Support Advanced Practice Nursing Education.

    Science.gov (United States)

    LeFlore, Judy L; Thomas, Patricia E

    2016-01-01

    Educational factors limit the number of advanced practice registered nurse (APRN) graduates to meet the growing workforce demands. Healthcare dynamics are necessitating a shift in how nursing education envisions, creates, and implements clinical learning opportunities. The current clinical education model in APRN programs continues to be the same as it was 45 years ago when the student numbers were much smaller. New approaches in graduate nursing education are needed to address the shortage of APRNs in primary and acute care areas. Determining competency based on the number of clinical hours can be inefficient, ineffective, and costly and limits the ability to increase capacity. Little research exists in graduate nursing education to support the effectiveness and efficiency of current hours of clinical required for nurse practitioner students. Simulation and academic-practice partnership models can offer innovative approaches to nurse practitioner education for clinical training, with the goal of producing graduates who can provide safe, quality care within the complex practice-based environment of the nation's evolving healthcare system.

  2. Partial ventilatory support modalities in acute lung injury and acute respiratory distress syndrome-a systematic review.

    Directory of Open Access Journals (Sweden)

    Sarah M McMullen

    Full Text Available The efficacy of partial ventilatory support modes that allow spontaneous breathing in patients with acute lung injury (ALI and acute respiratory distress syndrome (ARDS is unclear. The objective of this scoping review was to assess the effects of partial ventilatory support on mortality, duration of mechanical ventilation, and both hospital and intensive care unit (ICU lengths of stay (LOS for patients with ALI and ARDS; the secondary objective was to describe physiologic effects on hemodynamics, respiratory system and other organ function.MEDLINE (1966-2009, Cochrane, and EmBase (1980-2009 databases were searched using common ventilator modes as keywords and reference lists from retrieved manuscripts hand searched for additional studies. Two researchers independently reviewed and graded the studies using a modified Oxford Centre for Evidence-Based Medicine grading system. Studies in adult ALI/ARDS patients were included for primary objectives and pre-clinical studies for supporting evidence.Two randomized controlled trials (RCTs were identified, in addition to six prospective cohort studies, one retrospective cohort study, one case control study, 41 clinical physiologic studies and 28 pre-clinical studies. No study was powered to assess mortality, one RCT showed shorter ICU length of stay, and the other demonstrated more ventilator free days. Beneficial effects of preserved spontaneous breathing were mainly physiological effects demonstrated as improvement of gas exchange, hemodynamics and non-pulmonary organ perfusion and function.The use of partial ventilatory support modalities is often feasible in patients with ALI/ARDS, and may be associated with short-term physiological benefits without appreciable impact on clinically important outcomes.

  3. Comprehensive smoke-free policies attract more support from smokers in Europe than partial policies.

    Science.gov (United States)

    Mons, Ute; Nagelhout, Gera E; Guignard, Romain; McNeill, Ann; van den Putte, Bas; Willemsen, Marc C; Brenner, Hermann; Pötschke-Langer, Martina; Breitling, Lutz P

    2012-02-01

    Support for smoke-free policies increases over time and particularly after implementation of the policy. In this study we examined whether the comprehensiveness of such policies moderates the effect on support among smokers. We analysed two waves (pre- and post-smoke-free legislation) of the International Tobacco Control (ITC) surveys in France, Germany, and the Netherlands, and two pre-legislation waves of the ITC surveys in UK as control. Of 6,903 baseline smokers, 4,945 (71.6%) could be followed up and were included in the analyses. Generalised Estimating Equations (GEE) were used to compare changes in support from pre- to post-legislation to the secular trend in the control country. Multiple logistic regression models were employed to identify predictors of individual change in support. In France, the comprehensive smoking ban was associated with sharp increases in support for a total smoking ban in drinking establishments and restaurants that were above secular trends. In Germany and the Netherlands, where smoke-free policies and compliance are especially deficient in drinking establishments, only support for a total smoking ban in restaurants increased above the secular trend. Notable prospective predictors of becoming supportive of smoking bans in these countries were higher awareness of cigarette smoke being dangerous to others and weekly visiting of restaurants. Our findings suggest that smoke-free policies have the potential to improve support once the policy is in place. This effect seems to be most pronounced with comprehensive smoking bans, which thus might be the most valid option for policy-makers despite their potential for creating controversy and resistance in the beginning.

  4. Implant-supported mandibular removable partial dentures; patient-based outcome measures in relation to implant position.

    Science.gov (United States)

    Jensen, Charlotte; Raghoebar, Gerry M; Kerdijk, Wouter; Meijer, Henny J A; Cune, Marco S

    2016-12-01

    To assess the benefits of implant support to Removable Partial Dentures (RPD) in patients with a bilateral free-ending situation in the mandible and to determine the most favorable implant position: the premolar (PM) or the molar (M) region. Thirty subjects with a bilateral unbounded posterior saddle received 2 PM and 2M implants. A new RPD was placed. Implant support was provided 3 months later. Two PM implants supported the RPD. After 3 months the 2M implants were used or vice versa. Outcome measures included oral health related quality of life (OHIP-NL49), general health status (SF-36), contentment assessed on a Visual Analogue Scale (VAS) and the number of hours that the RPD was worn. Data were collected prior to treatment, 3 months after having functioned with a new RPD and after 3 and 6 months with implant support. Finally, patients expressed their preferred implant position. The general health status (SF-36) was not influenced. OHIP-NL49 values and mean wearing-time were statistical significantly more favorable for ISRPD's, regardless of the implant position. Per day, the ISRPD's were worn 2-3h more than the unsupported new RPD. Patients' expectations were met as the VAS-scores of anticipated and realized contentment did not reach a statistical significant level (p>0.05). VAS scores for ISRPD's with M implant support were higher than for PM implant support. Finally, 56.7% of subjects preferred the M implant support, 13.3% expressed no preference and 30% opted for PM implant support. Mandibular implant support favorably influences oral health related patient-based outcome measures in patients with a bilateral free-ending situation. The majority of patients prefer the implant support to be in the molar region. Patients with a bilateral free-ending situation in the mandible opposed by a maxillary denture benefit from implant support to their mandibular removable partial denture. Most patients prefer this support to be in the molar region. Copyright © 2016

  5. Exploring Intrinsic and Extrinsic Motivations to Participate in a Crowdsourcing Project to Support Blind and Partially Sighted Students.

    Science.gov (United States)

    Layas, Fatma; Petrie, Helen

    2016-01-01

    There have been a number of crowdsourcing projects to support people with disabilities. However, there is little exploration of what motivates people to participate in such crowdsourcing projects. In this study we investigated how different motivational factors can affect the participation of people in a crowdsourcing project to support visually disabled students. We are developing "DescribeIT", a crowdsourcing project to support blind and partially students by having sighted people describe images in digital learning resources. We investigated participants' behavior of the DescribeIT project using three conditions: one intrinsic motivation condition and two extrinsic motivation conditions. The results showed that participants were significantly intrinsically motivated to participate in the DescribeIT project. In addition, participants' intrinsic motivation dominated the effect of the two extrinsic motivational factors in the extrinsic conditions.

  6. Veterinarians' perceptions of behaviour support in small-animal practice.

    Science.gov (United States)

    Roshier, A L; McBride, E A

    2013-03-09

    Veterinarians are professionals considered to be at the forefront of animal welfare, including behaviour medicine. However, concerns raised, both within the profession and without, highlight that the support offered is not optimal, due to deficiencies in veterinary training, which focuses on physical aspects and overlooks psychological aspects. This preliminary study explored the experiences and perceptions of six veterinarians (three male, three female, age range: 23-55 years) in two UK small-animal practices. Seventeen annual booster consultations were videoed and conversations thematically analysed for welfare topics discussed. Both veterinarians and clients completed questionnaires to gather demographic information and perspectives. All veterinarians recognised behaviour as a component of their caseload, and acknowledged that clients expected them to provide behaviour support. Veterinarians varied in their experiences of and confidence in providing behaviour support. Five felt unable to meet client expectations; four did not feel their training had prepared them sufficiently. Only one provided dedicated behaviour consultations, the others referred cases. All provided suggestions for behaviour skills needed for new veterinary graduates. The study has afforded an insight into the experiences of a small opportunistic sample of veterinarians. The data indicated important limitations regarding time available in general consultations to discuss behaviour concerns, and practitioner knowledge and skill in detection, anamnesis, assessment and provision of appropriate behaviour information. Suggestions for veterinary training in behaviour are provided.

  7. Top Management Support Partially Optimized Reverse Logistics in The Manufacturing Sector of Pakistan

    Directory of Open Access Journals (Sweden)

    Ms. Sitara Shafiq

    2013-07-01

    Full Text Available Supply chain management urges reverse logistics to be an effective tool for organizational competitive advantage. Reverse chains demand astute resource deployments and strategic focus by the top management. In Pakistan manufacturing industries employing reverse logistics for cost effectiveness reported heavy reliance on top management support. However, literature is yet not benefited by such empirical facts. This study hypothesized that top management support is key for cost effective reverse logistics. Collecting and analyzing reliable data for various elements of its variables of interests, the study confirmed considerable multi linear regression between top management support and cost effectiveness. Substantiating the hypothesis, it contributes that a significant impact of strategic focus and resource commitment by top management leads reverse logistics based manufacturers to success.

  8. Three-Year Outcome of Fixed Partial Rehabilitations Supported by Implants Inserted with Flap or Flapless Surgical Techniques.

    Science.gov (United States)

    Maló, Paulo; de Araújo Nobre, Miguel; Lopes, Armando

    2016-07-01

    The aim of this prospective clinical study was to evaluate the 3-year outcome of fixed partial prostheses supported by implants with immediate provisionalization without occlusal contacts inserted in predominantly soft bone with flap and flapless protocols. Forty-one patients partially rehabilitated with 72 NobelSpeedy implants (51 maxillary; 21 mandibular) were consecutively included and treated with a flapless surgical protocol (n = 20 patients; 32 implants) and flapped surgical protocol (n = 21 patients; 40 implants). Primary outcome measure was implant survival; secondary outcome measures were marginal bone resorption (comparing the bone levels at 1 and 3 years with baseline) and the incidence of biological, mechanical, and esthetic complications. Survival was computed through life tables; descriptive statistics were applied to the remaining variables of interest. Eight patients with eight implants dropped out of the study. One implant failed in one patient (flapless group) giving an overall cumulative survival rate (CSR) of 98.6%. No failures were noted with the flapped protocol (CSR 100%), while for the implants placed with the flapless surgical technique, a 96.9% CSR was registered. The overall average marginal bone resorption at 3 years was 1.37 mm (SD = 0.94 mm), with 1.14 mm (SD = 0.49 mm) and 1.60 mm (SD = 1.22 mm) for the flap and flapless groups, respectively. Mechanical complications occurred in nine patients (n = 5 patients in the flapless group; n = 4 patients in the flap group). Implant infection was registered in three implants and three patients (flapless group), who exhibited inadequate oral hygiene levels. Partial edentulism rehabilitation through immediate provisionalization fixed prosthesis supported by dental implants inserted through flap or flapless surgical techniques in areas of predominantly soft bone was viable at 3 years of follow-up. The limitations and risks of the "free-hand" method in flapless surgery should be considered when

  9. Exploring incentives for RNs to return to practice: a partial solution to the nursing shortage.

    Science.gov (United States)

    Langan, Joanne C; Tadych, Rita A; Kao, Chia-Chan

    2007-01-01

    Although many have suggested strategies to resolve the nursing shortage, few have considered inactive RNs. This pilot study investigated reasons why nurses leave the practice, the type of work environment and resources necessary to entice RNs to return to practice, and the specific skills required to assist RNs in feeling confident and competent to return to practice. Herzberg's Two-Factor Theory was used to study motivation and hygiene factors enticing RNs to practice. A screening questionnaire was sent to 1,004 randomly selected RNs in Missouri to determine who were licensed but not practicing. Fifty-two full questionnaires were mailed and 33 (63%) were returned. Quantitative data were analyzed using SPSS, whereas qualitative data were coded and analyzed using manifest content analysis. The lack of motivators such as recognition of one's work and achievements was one reason why RNs left the practice. The hygiene factors of money, improved working conditions, refresher courses, and health insurance would motivate RNs to return to practice. Those wishing to entice inactive nurses to practice will need to offer sign-on bonuses or make the hourly wages and benefits package very competitive. This study indicates that nurses value flexible working hours, part-time opportunities, consideration of family lives, and positive relationships with administrators.

  10. Loading Variables on Implant-Supported Distal-Extension Removable Partial Dentures: An In Vitro Pilot Study.

    Science.gov (United States)

    Hirata, Kiyotaka; Takahashi, Toshihito; Tomita, Akiko; Gonda, Tomoya; Maeda, Yoshinobu

    2016-01-01

    The aim of this study was to investigate strain on implants used for adjunctive support of distal extension removable partial dentures. An implant with strain gauges was used for testing purposes in two positions, parallel and inclined. Three loading scenarios--loading apparatus (LA), artificial teeth via cotton roll (CR), and artificial teeth (UT)--were studied and strains compared via the Kruskal-Wallis test (P=.05). Strain under CR was significantly larger than UT in parallel (P<.05). However, the opposite was observed in inclined. Strain in parallel was smallest for UT, whereas in inclined it was largest for CR.

  11. A walker with a device of partial suspension for patients with gait disturbance: body weight supported walker.

    Science.gov (United States)

    Ochi, Mitsuhiro; Makino, Kenichiro; Wada, Futoshi; Saeki, Satoru; Hachisuka, Kenji

    2009-09-01

    We developed a walker, the Body Weight Supported (BWS) Walker, with a device of partial suspension for patients with gait disturbance. It consists of a light frame with casters, a harness, and a winch system. One therapist alone can perform gait training safely with the BWS Walker without any additional physical load, even if a patient has severe gait disturbance, and the therapist can concentrate on evaluating and improving the patient' s standing balance and gait pattern. Because the BWS Walker is less expensive, simpler, and easier to operate than other BWS systems, we believe the BWS Walker can be widely applicable in training for patients with severe and moderate gait disturbance.

  12. Ethics support in community care makes a difference for practice.

    Science.gov (United States)

    Magelssen, Morten; Gjerberg, Elisabeth; Lillemoen, Lillian; Førde, Reidun; Pedersen, Reidar

    2018-03-01

    Through the Norwegian ethics project, ethics activities have been implemented in the health and care sector in more than 200 municipalities. To study outcomes of the ethics activities and examine which factors promote and inhibit significance and sustainability of the activities. Two online questionnaires about the municipal ethics activities. Participants and research context: A total of 137 municipal contact persons for the ethics project answered the first survey (55% response rate), whereas 217 ethics facilitators responded to the second survey (33% response rate). Ethical considerations: Based on informed consent, the study was approved by the Data Protection Official of the Norwegian Social Science Data Services. Around half of the respondents found the ethics project to have been highly significant for daily professional practice. Outcomes include better handling of ethical challenges, better employee cooperation, better service quality, and better relations to patients and next of kin. Factors associated with sustainability and/or significance of the activities were sufficient support from stakeholders, sufficient available time, and ethics facilitators having sufficient knowledge and skills in ethics and access to supervision. This study shows that ethics initiatives can be both sustainable and significant for practice. There is a need to create regional or national structures for follow-up and develop more comprehensive ethics training for ethics facilitators. It is both possible and potentially important to implement clinical ethics support activities in community health and care services systematically on a large scale. Future ethics initiatives in the community sector should be designed in light of documented promoting and inhibiting factors.

  13. An online community of practice to support evidence-based physiotherapy practice in manual therapy.

    Science.gov (United States)

    Evans, Cathy; Yeung, Euson; Markoulakis, Roula; Guilcher, Sara

    2014-01-01

    The purpose of this study was to explore how a community of practice promoted the creation and sharing of new knowledge in evidence-based manual therapy using Wenger's constructs of mutual engagement, joint enterprise, and shared repertoire as a theoretical framework. We used a qualitative approach to analyze the discussion board contributions of the 19 physiotherapists who participated in the 10-week online continuing education course in evidence-based practice (EBP) in manual therapy. The course was founded on community of practice, constructivism, social, and situated learning principles. The 1436 postings on 9 active discussion boards revealed that the community of practice was a social learning environment that supported strong participation and mutual engagement. Design features such as consistent facilitation, weekly guiding questions, and collaborative assignments promoted the creation and sharing of knowledge. Participants applied research evidence to the contexts in which they worked through reflective comparison of what they were reading to its applicability in their everyday practice. Participants' shared goals contributed to the common ground established in developing collective knowledge about different study designs, how to answer research questions, and the difficulties of conducting sound research. An online longitudinal community of practice utilized as a continuing education approach to deliver an online course based on constructivist and social learning principles allowed geographically dispersed physiotherapists to be mutually engaged in a joint enterprise in evidence-based manual therapy. Advantages included opportunity for reflection, modeling, and collaboration. Future studies should examine the impact of participation on clinical practice. © 2014 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital

  14. Implant-supported mandibular removable partial dentures: Functional, clinical and radiographical parameters in relation to implant position.

    Science.gov (United States)

    Jensen, Charlotte; Speksnijder, Caroline M; Raghoebar, Gerry M; Kerdijk, Wouter; Meijer, Henny J A; Cune, Marco S

    2017-06-01

    Patients with a Kennedy class I situation often encounter problems with their removable partial denture (RPD). To assess the functional benefits of implant support to RPDs, the clinical performance of the implants and teeth and to determine the most favorable implant position: the premolar (PM) or molar (M) region. Thirty subjects received 2 PM and 2 M implants. A new RPD was made. Implant support was provided 3 months later. In a cross-over model, randomly, 2 implants (PM or M) supported the RPD during 3 months. Masticatory performance was assessed using the mixing ability index (MAI). Clinical and radiographic parameters were assessed. Non-parametric statistical analysis for related samples and post hoc comparisons were performed. Masticatory performance differed significantly between the stages of treatment (P < .001). MAI-scores improved with implant support although the implant position had no significant effect. No complications to the implants or RPD were observed and clinical and radiographical parameters for both implants and teeth were favorable. Higher scores for bleeding on probing were seen for molar implants. Implant support to a Kennedy class I RPD significantly improves masticatory function, regardless of implant position. No major clinical problems were observed. © 2017 Wiley Periodicals, Inc.

  15. Disadvantageous decision-making in borderline personality disorder: Partial support from a meta-analytic review.

    Science.gov (United States)

    Paret, Christian; Jennen-Steinmetz, Christine; Schmahl, Christian

    2017-01-01

    To achieve long-term goals, organisms evaluate outcomes and expected consequences of their behaviors. Unfavorable decisions maintain many symptoms of borderline personality disorder (BPD); therefore, a better understanding of the mechanisms underlying decision-making in BPD is needed. In this review, the current literature comparing decision-making in patients with BPD versus healthy controls is analyzed. Twenty-eight empirical studies were identified through a structured literature search. The effect sizes from studies applying comparable experimental tasks were analyzed. It was found that (1) BPD patients discounted delayed rewards more strongly; (2) reversal learning was not significantly altered in BPD; and (3) BPD patients achieved lower net gains in the Iowa Gambling Task (IGT). Current psychotropic medication, sex and differences in age between the patient and control group moderated the IGT outcome. Altered decision-making in a variety of other tasks was supported by a qualitative review. In summary, current evidence supports the altered valuation of outcomes in BPD. A multifaceted influence on decision-making and adaptive learning is reflected in this literature. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Whole- and partial-body cryostimulation/cryotherapy: Current technologies and practical applications.

    Science.gov (United States)

    Bouzigon, Romain; Grappe, Frederic; Ravier, Gilles; Dugue, Benoit

    2016-10-01

    Cold therapy is commonly used as a method to relieve pain and inflammation. This review focuses primarily on two methods of cold therapy that have received recent attention: whole-body cryotherapy and partial-body cryotherapy. These methods are used to induce physiological and psychological benefits in humans in the context of medicine, health and sports. The subjects experiencing cryotherapy are dressed in minimal clothing and are exposed to very cold air (at -110°C or less) for 1-4min. Despite the increasing scientific interest in these methods, there is a lack of information about the technologies used. Moreover, there is no existing reference concerning exposure protocols and the relationship between temperature, duration, number of repetitions and the treatments' desired effects. The aim of this review is to compare whole- and partial-body cryotherapy effects (especially on skin temperature) and to classify the protocols for exposure according to the desired effects. This review emphasises 1) the lack of information concerning the actual temperatures inside the cabin or chamber during exposure and 2) the heterogeneity among the exposure protocols that have been reported in the scientific literature. This review will be valuable and relevant to health professionals endeavouring to optimize the cold treatments offered to patients and producers of cryotherapy apparatus striving to create more efficient devices that meet market requirements. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. A 2-year report on maxillary and mandibular fixed partial dentures supported by Astra Tech dental implants. A comparison of 2 implants with different surface textures

    DEFF Research Database (Denmark)

    Karlsson, U; Gotfredsen, K; Olsson, C

    1998-01-01

    In 50 partially edentulous patients, 133 (48 maxillary; 85 mandibular) Astra Tech dental implants of 2 different surface textures (machined; TiO-blasted) were alternately installed, supporting 52 fixed partial dentures (FPDs). Before abutment connection 2 machined implants (1 mandibular; 1...

  18. The effectiveness of family-based treatment for full and partial adolescent anorexia nervosa in an independent private practice setting: Clinical outcomes.

    Science.gov (United States)

    Goldstein, Mandy; Murray, Stuart B; Griffiths, Scott; Rayner, Kathryn; Podkowka, Jessica; Bateman, Joel E; Wallis, Andrew; Thornton, Christopher E

    2016-11-01

    Anorexia nervosa (AN) is a severe psychiatric illness with little evidence supporting treatment in adults. Among adolescents with AN, family-based treatment (FBT) is considered first-line outpatient approach, with a growing evidence base. However, research on FBT has stemmed from specialist services in research/public health settings. This study investigated the effectiveness of FBT in a case series of adolescent AN treated in a private practice setting. Thirty-four adolescents with full or partial AN, diagnosed according to DSM-IV criteria, participated, and were assessed at pretreatment and post-treatment. Assessments included change in % expected body weight, mood, and eating pathology. Significant weight gain was observed from pretreatment to post-treatment. 45.9% of the sample demonstrated full weight restoration and a further 43.2% achieved partial weight-based remission. Missing data precluded an examination of change in mood and ED psychopathology. Effective dissemination across different service types is important to the wider availability of evidence-based treatments. These weight restoration data lend preliminary support to the implementation of FBT in real world treatment settings. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:1023-1026). © 2016 Wiley Periodicals, Inc.

  19. Decision-making in healthcare: a practical application of partial least square path modelling to coverage of newborn screening programmes.

    Science.gov (United States)

    Fischer, Katharina E

    2012-08-02

    Decision-making in healthcare is complex. Research on coverage decision-making has focused on comparative studies for several countries, statistical analyses for single decision-makers, the decision outcome and appraisal criteria. Accounting for decision processes extends the complexity, as they are multidimensional and process elements need to be regarded as latent constructs (composites) that are not observed directly. The objective of this study was to present a practical application of partial least square path modelling (PLS-PM) to evaluate how it offers a method for empirical analysis of decision-making in healthcare. Empirical approaches that applied PLS-PM to decision-making in healthcare were identified through a systematic literature search. PLS-PM was used as an estimation technique for a structural equation model that specified hypotheses between the components of decision processes and the reasonableness of decision-making in terms of medical, economic and other ethical criteria. The model was estimated for a sample of 55 coverage decisions on the extension of newborn screening programmes in Europe. Results were evaluated by standard reliability and validity measures for PLS-PM. After modification by dropping two indicators that showed poor measures in the measurement models' quality assessment and were not meaningful for newborn screening, the structural equation model estimation produced plausible results. The presence of three influences was supported: the links between both stakeholder participation or transparency and the reasonableness of decision-making; and the effect of transparency on the degree of scientific rigour of assessment. Reliable and valid measurement models were obtained to describe the composites of 'transparency', 'participation', 'scientific rigour' and 'reasonableness'. The structural equation model was among the first applications of PLS-PM to coverage decision-making. It allowed testing of hypotheses in situations where there

  20. Decision-making in healthcare: a practical application of partial least square path modelling to coverage of newborn screening programmes

    Directory of Open Access Journals (Sweden)

    Fischer Katharina E

    2012-08-01

    Full Text Available Abstract Background Decision-making in healthcare is complex. Research on coverage decision-making has focused on comparative studies for several countries, statistical analyses for single decision-makers, the decision outcome and appraisal criteria. Accounting for decision processes extends the complexity, as they are multidimensional and process elements need to be regarded as latent constructs (composites that are not observed directly. The objective of this study was to present a practical application of partial least square path modelling (PLS-PM to evaluate how it offers a method for empirical analysis of decision-making in healthcare. Methods Empirical approaches that applied PLS-PM to decision-making in healthcare were identified through a systematic literature search. PLS-PM was used as an estimation technique for a structural equation model that specified hypotheses between the components of decision processes and the reasonableness of decision-making in terms of medical, economic and other ethical criteria. The model was estimated for a sample of 55 coverage decisions on the extension of newborn screening programmes in Europe. Results were evaluated by standard reliability and validity measures for PLS-PM. Results After modification by dropping two indicators that showed poor measures in the measurement models’ quality assessment and were not meaningful for newborn screening, the structural equation model estimation produced plausible results. The presence of three influences was supported: the links between both stakeholder participation or transparency and the reasonableness of decision-making; and the effect of transparency on the degree of scientific rigour of assessment. Reliable and valid measurement models were obtained to describe the composites of ‘transparency’, ‘participation’, ‘scientific rigour’ and ‘reasonableness’. Conclusions The structural equation model was among the first applications of PLS-PM to

  1. Quantitative risk assessment of WSSV transmission through partial harvesting and transport practices for shrimp aquaculture in Mexico.

    Science.gov (United States)

    Sanchez-Zazueta, Edgar; Martínez-Cordero, Francisco Javier; Chávez-Sánchez, María Cristina; Montoya-Rodríguez, Leobardo

    2017-10-01

    spilled in the culture pond (VCWSCP, 4 or 20L). In the sensitivity analysis, for a SD of 30 PL/m 2 , it was shown that starting with a VL of 1×10 5 mL -1 and a VCWSCP of 12L, the P N was moderate (1.05×10 -3 ). This was the threshold for greater risks, given the increase in either the VCWSCP or VL. These findings supported recommendations to prevent WSSV spread through more controlled transportation and partial harvesting practices. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Pharmacists' Scope of Practice: Supports for Canadians with Diabetes.

    Science.gov (United States)

    Mansell, Kerry; Edmunds, Kirsten; Guirguis, Lisa

    2017-12-01

    The pharmacists' role in Canada has significantly advanced over the past decade, resulting in increasing access to primary care services. This study aimed to characterize pharmacists' expanded scope of practice as it relates to providing services to Canadians with diabetes. This environmental scan characterized services that could be useful to Canadians with diabetes in each of the provinces (excluding the territories): immunizations, medication prescribing, ordering and interpreting laboratory tests, and medication reviews. Researchers also collected information on pharmacists' access to health information. Data were collected from regulatory authorities in each province, from pharmacy stakeholders and through a web search. Pharmacists' scope of practice varies widely across the Canadian provinces. Three provinces have medication-review programs focused specifically on diabetes, and many people with diabetes can access publicly funded medication reviews. Other than in Quebec, pharmacists can provide influenza (publicly funded) and pneumococcal vaccinations (publicly funded in British Columbia, Alberta and Manitoba). All pharmacists in Canadian provinces can renew prescriptions to ensure continuity of therapy. Pharmacists have varying levels of other prescriptive authority. Pharmacists in all provinces (except Ontario) can access provincial prescription information; in 4 provinces, they can access laboratory results, and in 3 provinces, they can order and interpret laboratory results, such as glycated hemoglobin levels. Canadians with diabetes can expect to receive influenza vaccines and have medications renewed at their pharmacies. Many patients with diabetes qualify for a publicly funded medication review, and some provinces allow pharmacists to order and interpret laboratory results. This expanded scope provides greater opportunities for pharmacists to help support patients with diabetes in conjunction with other health-care team members. Copyright © 2017

  3. Pelvic Organ Support in Animals with Partial Loss of Fibulin-5 in the Vaginal Wall.

    Science.gov (United States)

    Chin, Kathleen; Wieslander, Cecilia; Shi, Haolin; Balgobin, Sunil; Montoya, T Ignacio; Yanagisawa, Hiromi; Word, R Ann

    2016-01-01

    Compromise of elastic fiber integrity in connective tissues of the pelvic floor is most likely acquired through aging, childbirth-associated injury, and genetic susceptibility. Mouse models of pelvic organ prolapse demonstrate systemic deficiencies in proteins that affect elastogenesis. Prolapse, however, does not occur until several months after birth and is thereby acquired with age or after parturition. To determine the impact of compromised levels of fibulin-5 (Fbln5) during adulthood on pelvic organ support after parturition and elastase-induced injury, tissue-specific conditional knockout (cKO) mice were generated in which doxycycline (dox) treatment results in deletion of Fbln5 in cells that utilize the smooth muscle α actin promoter-driven reverse tetracycline transactivator and tetracycline responsive element-Cre recombinase (i.e., Fbln5f/f/SMA++-rtTA/Cre+, cKO). Fbln5 was decreased significantly in the vagina of cKO mice compared with dox-treated wild type or controls (Fbln5f/f/SMA++-rtTA/Cre-/-). In controls, perineal body length (PBL) and bulge increased significantly after delivery but declined to baseline values within 6-8 weeks. Although overt prolapse did not occur in cKO animals, these transient increases in PBL postpartum were amplified and, unlike controls, parturition-induced increases in PBL (and bulge) did not recover to baseline but remained significantly increased for 12 wks. This lack of recovery from parturition was associated with increased MMP-9 and nondetectable levels of Fbln5 in the postpartum vagina. This predisposition to prolapse was accentuated by injection of elastase into the vaginal wall in which overt prolapse occurred in cKO animals, but rarely in controls. Taken together, our model system in which Fbln5 is conditionally knock-downed in stromal cells of the pelvic floor results in animals that undergo normal elastogenesis during development but lose Fbln5 as adults. The results indicate that vaginal fibulin-5 during

  4. Pelvic Organ Support in Animals with Partial Loss of Fibulin-5 in the Vaginal Wall.

    Directory of Open Access Journals (Sweden)

    Kathleen Chin

    Full Text Available Compromise of elastic fiber integrity in connective tissues of the pelvic floor is most likely acquired through aging, childbirth-associated injury, and genetic susceptibility. Mouse models of pelvic organ prolapse demonstrate systemic deficiencies in proteins that affect elastogenesis. Prolapse, however, does not occur until several months after birth and is thereby acquired with age or after parturition. To determine the impact of compromised levels of fibulin-5 (Fbln5 during adulthood on pelvic organ support after parturition and elastase-induced injury, tissue-specific conditional knockout (cKO mice were generated in which doxycycline (dox treatment results in deletion of Fbln5 in cells that utilize the smooth muscle α actin promoter-driven reverse tetracycline transactivator and tetracycline responsive element-Cre recombinase (i.e., Fbln5f/f/SMA++-rtTA/Cre+, cKO. Fbln5 was decreased significantly in the vagina of cKO mice compared with dox-treated wild type or controls (Fbln5f/f/SMA++-rtTA/Cre-/-. In controls, perineal body length (PBL and bulge increased significantly after delivery but declined to baseline values within 6-8 weeks. Although overt prolapse did not occur in cKO animals, these transient increases in PBL postpartum were amplified and, unlike controls, parturition-induced increases in PBL (and bulge did not recover to baseline but remained significantly increased for 12 wks. This lack of recovery from parturition was associated with increased MMP-9 and nondetectable levels of Fbln5 in the postpartum vagina. This predisposition to prolapse was accentuated by injection of elastase into the vaginal wall in which overt prolapse occurred in cKO animals, but rarely in controls. Taken together, our model system in which Fbln5 is conditionally knock-downed in stromal cells of the pelvic floor results in animals that undergo normal elastogenesis during development but lose Fbln5 as adults. The results indicate that vaginal fibulin-5

  5. Pelvic Organ Support in Animals with Partial Loss of Fibulin-5 in the Vaginal Wall

    Science.gov (United States)

    Shi, Haolin; Balgobin, Sunil; Montoya, T. Ignacio; Yanagisawa, Hiromi; Word, R. Ann

    2016-01-01

    Compromise of elastic fiber integrity in connective tissues of the pelvic floor is most likely acquired through aging, childbirth-associated injury, and genetic susceptibility. Mouse models of pelvic organ prolapse demonstrate systemic deficiencies in proteins that affect elastogenesis. Prolapse, however, does not occur until several months after birth and is thereby acquired with age or after parturition. To determine the impact of compromised levels of fibulin-5 (Fbln5) during adulthood on pelvic organ support after parturition and elastase-induced injury, tissue-specific conditional knockout (cKO) mice were generated in which doxycycline (dox) treatment results in deletion of Fbln5 in cells that utilize the smooth muscle α actin promoter-driven reverse tetracycline transactivator and tetracycline responsive element-Cre recombinase (i.e., Fbln5f/f/SMA++-rtTA/Cre+, cKO). Fbln5 was decreased significantly in the vagina of cKO mice compared with dox-treated wild type or controls (Fbln5f/f/SMA++-rtTA/Cre-/-). In controls, perineal body length (PBL) and bulge increased significantly after delivery but declined to baseline values within 6–8 weeks. Although overt prolapse did not occur in cKO animals, these transient increases in PBL postpartum were amplified and, unlike controls, parturition-induced increases in PBL (and bulge) did not recover to baseline but remained significantly increased for 12 wks. This lack of recovery from parturition was associated with increased MMP-9 and nondetectable levels of Fbln5 in the postpartum vagina. This predisposition to prolapse was accentuated by injection of elastase into the vaginal wall in which overt prolapse occurred in cKO animals, but rarely in controls. Taken together, our model system in which Fbln5 is conditionally knock-downed in stromal cells of the pelvic floor results in animals that undergo normal elastogenesis during development but lose Fbln5 as adults. The results indicate that vaginal fibulin-5 during

  6. Parenting Practices and Attention-Deficit/Hyperactivity Disorder: New Findings Suggest Partial Specificity of Effects

    Science.gov (United States)

    Ellis, Brandi; Nigg, Joel

    2009-01-01

    The relation between attention deficit hyperactivity disorder (ADHD) and parenting practices is examined by assessing 182 children for ADHD and non ADHD status through parent semistructured clinical interview. Results show that maternal inconsistent discipline and paternal low involvement is associated with the disorder.

  7. Perceptions of the role of general practice and practical support measures for carers of stroke survivors: a qualitative study

    Directory of Open Access Journals (Sweden)

    Harris Ruth

    2011-06-01

    Full Text Available Abstract Background Informal carers frequently suffer adverse consequences from caring. General practice teams are well positioned to support them. However, what carers of stroke survivors want and expect from general practice, and the practical support measures they might like, remain largely unexplored. The aims of this study are twofold. Firstly it explores both the support stroke carers would like from general practice and their reactions to the community based support proposed in the New Deal. Secondly, perceptions of a general practice team are investigated covering similar topics to carer interviews but from their perspective. Methods Semi-structured interviews were conducted with 13 stroke carers and 10 members of a general practice team. Carers' experiences and expectations of general practice and opinions of support measures from recent government policy were explored. General practice professionals were asked about their perceived role and their perceptions of carers' support needs. Interviews were content analysed. Results Carers' expectations of support from general practice were low and they neither received nor expected much support for themselves. General practice was seen as reactive primarily because of time constraints. Some carers would appreciate emotional support but others did not want additional services. Responses to recent policy initiatives were mixed with carers saying these might benefit other carers but not themselves. General practice professionals' opinions were broadly similar. They recognise carers' support needs but see their role as reactive, focussed on stroke survivors, rather than carers. Caring was recognised as challenging. Providing emotional support and referral were seen as important but identification of carers was considered difficult. Time constraints limit their support. Responses to recent policy initiatives were positive. Conclusions Carers' expectations of support from general practice for

  8. Probabilistic Requirements (Partial) Verification Methods Best Practices Improvement. Variables Acceptance Sampling Calculators: Empirical Testing. Volume 2

    Science.gov (United States)

    Johnson, Kenneth L.; White, K. Preston, Jr.

    2012-01-01

    The NASA Engineering and Safety Center was requested to improve on the Best Practices document produced for the NESC assessment, Verification of Probabilistic Requirements for the Constellation Program, by giving a recommended procedure for using acceptance sampling by variables techniques as an alternative to the potentially resource-intensive acceptance sampling by attributes method given in the document. In this paper, the results of empirical tests intended to assess the accuracy of acceptance sampling plan calculators implemented for six variable distributions are presented.

  9. Elucidating mechanisms for insect body size: partial support for the oxygen-dependent induction of moulting hypothesis.

    Science.gov (United States)

    Kivelä, Sami M; Viinamäki, Sonja; Keret, Netta; Gotthard, Karl; Hohtola, Esa; Välimäki, Panu

    2018-01-25

    Body size is a key life history trait, and knowledge of its mechanistic basis is crucial in life history biology. Such knowledge is accumulating for holometabolous insects, whose growth is characterised and body size affected by moulting. According to the oxygen-dependent induction of moulting (ODIM) hypothesis, moult is induced at a critical mass at which oxygen demand of growing tissues overrides the supply from the tracheal respiratory system, which principally grows only at moults. Support for the ODIM hypothesis is controversial, partly because of a lack of proper data to explicitly test the hypothesis. The ODIM hypothesis predicts that the critical mass is positively correlated with oxygen partial pressure ( P O 2 ) and negatively with temperature. To resolve the controversy that surrounds the ODIM hypothesis, we rigorously test these predictions by exposing penultimate-instar Orthosia gothica (Lepidoptera: Noctuidae) larvae to temperature and moderate P O 2  manipulations in a factorial experiment. The relative mass increment in the focal instar increased along with increasing P O 2 , as predicted, but there was only weak suggestive evidence of the temperature effect. Probably owing to a high measurement error in the trait, the effect of P O 2  on the critical mass was sex specific; high P O 2  had a positive effect only in females, whereas low P O 2  had a negative effect only in males. Critical mass was independent of temperature. Support for the ODIM hypothesis is partial because of only suggestive evidence of a temperature effect on moulting, but the role of oxygen in moult induction seems unambiguous. The ODIM mechanism thus seems worth considering in body size analyses. © 2018. Published by The Company of Biologists Ltd.

  10. Practical purification scheme for decohered coherent-state superpositions via partial homodyne detection

    International Nuclear Information System (INIS)

    Suzuki, Shigenari; Takeoka, Masahiro; Sasaki, Masahide; Andersen, Ulrik L.; Kannari, Fumihiko

    2006-01-01

    We present a simple protocol to purify a coherent-state superposition that has undergone a linear lossy channel. The scheme constitutes only a single beam splitter and a homodyne detector, and thus is experimentally feasible. In practice, a superposition of coherent states is transformed into a classical mixture of coherent states by linear loss, which is usually the dominant decoherence mechanism in optical systems. We also address the possibility of producing a larger amplitude superposition state from decohered states, and show that in most cases the decoherence of the states are amplified along with the amplitude

  11. Impact of practice leadership management style on staff experience in services for people with intellectual disability and challenging behaviour: A further examination and partial replication.

    Science.gov (United States)

    Deveau, Roy; McGill, Peter

    2016-09-01

    Practice leadership (PL) style of frontline management has been shown to be associated with better experiences for staff working with people who may exhibit challenging behaviours (Deveau & McGill, 2014). This study aimed to examine additional staff experience factors with a different, larger sample and to partially replicate the findings of (Deveau & McGill, 2014). This study was a survey of staff self-reported data collected as part of a larger study. Information was collected on PL and staff experiences of: stress, turnover, job satisfaction and positive work experiences. The results broadly supported Deveau and McGill (2014) and demonstrated an association between PL and greater job satisfaction and positive experiences for staff. Results on staff turnover were inconsistent. The positive impact of PL on staff experience was further supported by this study. Suggestions are made for further research. These findings suggest further research is needed to examine the potential of interventions in frontline management/leadership practice to improve staff experience of working in challenging environments. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Examining the premises supporting the empirically supported intervention approach to social work practice.

    Science.gov (United States)

    McBeath, Bowen; Briggs, Harold E; Aisenberg, Eugene

    2010-10-01

    Federal, state, and local policymakers and funders have increasingly organized human service delivery functions around the selection and implementation of empirically supported interventions (ESIs), under the expectation that service delivery through such intervention frameworks results in improvements in cost-effectiveness and system performance. This article examines the validity of four premises undergirding the ESI approach: ESIs are effective, relevant to common client problems and needs, culturally appropriate, and replicable and sustainable in community-based settings. In reviewing available literature, the authors found insufficient support for the uniform application of an ESI approach to social work practice in the human service sector, particularly as applied within agency contexts serving ethnic minority clients. The authors recommend that greater attention be devoted to the development and dissemination of social work interventions that respond to needs that are broadly understood and shared across diverse cultural groups, have proven clinical efficacy, and can be translated successfully for use across different agency and cultural environments. Such attention to the research and development function of the social work profession is increasingly necessary as policymakers and human service system architects require reduced costs and improved performance for programs serving historically oppressed client populations.

  13. Fracture Strength of Three-Unit Implant Supported Fixed Partial Dentures with Excessive Crown Height Fabricated from Different Materials

    Directory of Open Access Journals (Sweden)

    Vahideh Nazari

    2017-01-01

    Full Text Available Objectives: Fracture strength is an important factor influencing the clinical long-term success of implant-supported prostheses especially in high stress situations like excessive crown height space (CHS. The purpose of this study was to compare the fracture strength of implant-supported fixed partial dentures (FPDs with excessive crown height, fabricated from three different materials.Materials and Methods: Two implants with corresponding abutments were mounted in a metal model that simulated mandibular second premolar and second molar. Thirty 3-unit frameworks with supportive anatomical design were fabricated using zirconia, nickel-chromium alloy (Ni-Cr, and polyetheretherketone (PEEK (n=10. After veneering, the CHS was equal to 15mm. Then; samples were axially loaded on the center of pontics until fracture in a universal testing machine at a crosshead speed of 0.5 mm/minute. The failure load data were analyzed by one-way ANOVA and Games-Howell tests at significance level of 0.05.Results: The mean failure loads for zirconia, Ni-Cr and PEEK restorations were 2086±362N, 5591±1200N and 1430±262N, respectively. There were significant differences in the mean failure loads of the three groups (P<0.001. The fracture modes in zirconia, metal ceramic and PEEK restorations were cohesive, mixed and adhesive type, respectively.Conclusions: According to the findings of this study, all implant supported three-unit FPDs fabricated of zirconia, metal ceramic and PEEK materials are capable to withstand bite force (even para-functions in the molar region with excessive CHS.Keywords: Dental Implants; Polyetheretherketone; Zirconium oxide; Dental Restoration Failure; Dental Porcelain

  14. Need for intraoperative ultrasound and surgical recommendation for partial nephrectomy: correlation with tumor imaging features and urologist practice patterns.

    Science.gov (United States)

    Sun, Maryellen R M; Wagner, Andrew A; San Francisco, Ignacio F; Brook, Alexander; Kavoussi, Louis; Russo, Paul; Steele, Graeme; Viterbo, Rosalia; Pedrosa, Ivan

    2012-03-01

    This study aimed to evaluate the need for intraoperative ultrasound (IOUS) and recommendation for surgical approach in the resection of renal tumors through a survey of practicing urologists, with correlation to tumor imaging features and urologist practice pattern. An institutional review board-approved retrospective review, compliant with the Health Insurance Portability and Accountability Act, of 44 renal tumors that underwent laparoscopic partial nephrectomy at the study institution was performed. The numeric component of the RENAL nephrometry score (radius [diameter], % exophytic, nearness [to collecting system/renal sinus], location) was calculated for each case using preoperative computed tomography/magnetic resonance imaging. Five anonymized images of each tumor were presented to 4 academic urologists with varying practice patterns. Reviewers independently scored each case for its need for IOUS, for recommendation of a surgical technique, and for the difficulty of the proposed surgery. The RENAL scores were as follows: RENAL 1 (low complexity, score 4-6; n = 19); RENAL 2 (moderate complexity, score 7-9; n = 23); RENAL 3 (high complexity, score 10-12; n = 2). The only RENAL score component significantly influencing need for IOUS was percentage exophytic (P = 0.00002). There was an inverse relationship between normalized and averaged need for IOUS and percentage exophytic (P recommendation of surgical method was the reviewer him/herself, with each reviewer's recommendations closely matching his/her practice pattern. Size and percentage exophytic represented the only tumor features significantly (P = 0.03) influencing surgical recommendation. There was a significant difference in the perceived need for IOUS and surgical recommendation when 4 academic urologists reviewed a series of renal masses requiring resection. Percentage exophytic correlated inversely with need for IOUS. Urologist's practice pattern and tumor size and percentage exophytic were most

  15. Uses of Technology to Support Reflective Teaching Practices

    Science.gov (United States)

    Brent, Wayne

    2010-01-01

    This dissertation researched and reported on how technology was used to facilitate and inform reflective teaching practices. It also identified the characteristics of benefits and barriers in using technology for teaching and reflection. The study, descriptive in nature, was designed to determine the reflective practices of instructors and how…

  16. Learning New Practices in Small Business: Engagement and Localised Support

    Science.gov (United States)

    Ehrich, Lisa C.; Billett, Stephen

    2004-01-01

    Discusses the findings of a study that investigated how the learning of innovative practices might best proceed in small businesses. The recent implementation of the Goods and Service Tax (GST) in Australia presented an opportunity for understanding how small business operatives learned to implement a new practice. The procedures comprised…

  17. Using Mobile Technology to Support Literacy Coaching Practices

    Science.gov (United States)

    Bates, C. C.; Martin, Aqueasha

    2013-01-01

    This article examines literacy coaches' (n = 7) digital note-taking practices using mobile technology and their influence on reflective practice. The study, which employed a design-based approach, investigated the coaches' transition from note-taking by paper and pencil to the note-taking application Evernote. Data included interviews with the…

  18. Practical fire design of partially encased composite steel-concrete columns according to Eurocode 4

    Directory of Open Access Journals (Sweden)

    Sadaoui Arezki

    2014-04-01

    Full Text Available A practical method based on Campus-Massonet criteria which is developed initially to steel structures with combined compression and bending is adapted for the calculation of the buckling resistance of eccentrically loaded columns. The latter at room temperature or in fire situation is expressed by a simple formula as a function of an equivalent buckling coefficient taking into account the amount the eccentricity of the compressive applied load. The method proposed combines accuracy, efficiency and convenience obviating the need of M-N interaction diagrams and long iteration process. Otherwise, the estimation of the fire resistance for a given loading is made on the assumption based on the linearity with the level applied compressive load. It was found that the fire resistance of a column subjected to an eccentric load decreases gradually with the increase in the load level (ƞ , the slenderness ratio (λ or the amount of the eccentricity. For a fire resistance of one hour, time enough to evacuate the building of all its occupants, it recommended to use η≤ 0.5 and λ ≤45. The range of values of reinforcement cover (u suggested by Eurocode 4 leads to a better fire resistance except for u = 60 mm where there is a decline of the about 10%.

  19. Hydrogen or synthesis gas production via the partial oxidation of methane over supported nickel-cobalt catalysts

    Energy Technology Data Exchange (ETDEWEB)

    Koh, Alaric C.W. [Department of Chemistry, National University of Singapore, 3 Science Drive 3, Singapore 117543 (Singapore); Institute of Chemical and Engineering Sciences, 1 Pesek Road, Jurong Island, Singapore 627833 (Singapore); Chen, Luwei; Lin, Jianyi [Institute of Chemical and Engineering Sciences, 1 Pesek Road, Jurong Island, Singapore 627833 (Singapore); Kee Leong, Weng [Department of Chemistry, National University of Singapore, 3 Science Drive 3, Singapore 117543 (Singapore); Johnson, Brian F.G.; Khimyak, Tetyana [University Chemical Laboratory, University of Cambridge, Lensfield Road, Cambridge, UK CB2 1EW (United Kingdom)

    2007-05-15

    Activity, selectivity, and coking-resistance of a series of Ni{sub x}Co{sub y} (where x,y are the respective metal loadings of 0, 1, 2 or 3 wt.%; x+y=3) bimetallic catalysts supported on CaAl{sub 2}O{sub 4}/Al{sub 2}O{sub 3} have been studied for hydrogen/synthesis gas production via the catalytic partial oxidation (CPO) of methane. Catalysts were characterized by temperature programmed reduction (TPR), transmission electron microscopy (TEM) and X-ray fluorescence multi-element analysis (XRF). Their activity for the partial oxidation of methane to hydrogen and carbon monoxide (at 1 bar, gas hourly space velocity (GHSV) of 144,000cm{sup 3}g{sup -1}h{sup -1} and CH{sub 4}/O{sub 2} molar ratio of 2) was investigated, and coke deposited on the spent catalysts was studied by scanning electron microscopy (SEM), energy dispersive X-ray analysis (EDX) and thermogravimetric analysis (TGA). The activity was found to decrease in the order of Ni{sub 2}Co>Ni{sub 3}>NiCo{sub 2}>>Co{sub 3}, while CO and H{sub 2} selectivities were found to be in the order ofNi{sub 2}Co>Ni{sub 3}{approx}NiCo{sub 2}>Co{sub 3}. Ni{sub 2}Co is also shown to be more resistant to coking as compared to Ni{sub 3}, which is a current catalyst of choice. Results show that not only does Ni{sub 2}Co have the highest activity and selectivity among all the catalysts tested, it is also relatively resistant to coking. This finding would be helpful for catalyst design to achieve high coking resistivity catalysts for hydrogen production from CPO of methane. (author)

  20. Practical Considerations in Creating School-Wide Positive Behavior Support in Public Schools

    Science.gov (United States)

    Handler, Marcie W.; Rey, Jannette; Connell, James; Thier, Kimberly; Feinberg, Adam; Putnam, Robert

    2007-01-01

    School-wide positive behavior support (SWPBS) has been identified as an effective and efficient method to teach students prosocial skills. It requires both effective behavior support practices and systems that will support these changes, including data-based decision making among the school leadership team. There are many practical and systemic…

  1. Internal reforming characteristics of cermet supported solid oxide fuel cell using yttria stabilized zirconia fed with partially reformed methane

    Energy Technology Data Exchange (ETDEWEB)

    Momma, Akihiko; Takano, Kiyonami; Tanaka, Yohei; Negishi, Akira; Kato, Ken; Nozaki, Ken; Kato, Tohru [Energy Technology Research Institute, National Institute of Advanced Industrial Science and Technology, 1-1-1 Umezono Tsukuba Ibaraki, 305-8568 (Japan); Ichigi, Takenori; Matsuda, Kazuyuki; Ryu, Takashi [Application Development Project, Corporate R and D, NGK Insulators, Ltd., 2-56 Suda-cho Mizuho-ku Nagoya-shi Aichi, 467-8530 (Japan)

    2009-08-01

    In order to investigate the internal reforming characteristics in a cermet supported solid oxide fuel cell (SOFC) using YSZ as the electrolyte, the concentration profiles of the gaseous species along the gas flow direction in the anode were measured. Partially reformed methane using a pre-reformer kept at a constant temperature is supplied to the center of the cell which is operated with a seal-less structure at the gas outlet. The anode gas is sucked in via silica capillaries to the initially evacuated gas tanks. The process is simultaneously carried out using five sampling ports. The sampled gas is analyzed by a gas chromatograph. Most of the measurements are made at the cell temperature (T{sub cell}) of 750 C and at various temperatures of the pre-reformer (T{sub ref}) with various fuel utilizations (U{sub f}) of the cell. The composition of the fuel at the inlet of the anode was confirmed to be almost the same as that theoretically calculated assuming equilibrium at the temperature of the pre-reformer. The effect of internal reforming in the anode is clearly observed as a steady decrease in the methane concentration along the flow axis. The effect of the water-gas shift reaction is also observed as a decrease in the CO{sub 2} concentration and an increase of CO concentration around the gas inlet region, as the water-gas shift reaction inversely proceeds when T{sub cell} is higher than T{sub ref}. The diffusion of nitrogen from the seal-less outermost edge is observed, and the diffusion is confirmed to be more significant as U{sub f} decreases. The observations are compared with the results obtained by the SOFC supported by lanthanum gallate electrolyte. With respect to the internal reforming performance, the cell investigated here is found to be more effective when compared to the previously reported electrolyte supported cell. (author)

  2. Internal reforming characteristics of cermet supported solid oxide fuel cell using yttria stabilized zirconia fed with partially reformed methane

    Science.gov (United States)

    Momma, Akihiko; Takano, Kiyonami; Tanaka, Yohei; Negishi, Akira; Kato, Ken; Nozaki, Ken; Kato, Tohru; Ichigi, Takenori; Matsuda, Kazuyuki; Ryu, Takashi

    In order to investigate the internal reforming characteristics in a cermet supported solid oxide fuel cell (SOFC) using YSZ as the electrolyte, the concentration profiles of the gaseous species along the gas flow direction in the anode were measured. Partially reformed methane using a pre-reformer kept at a constant temperature is supplied to the center of the cell which is operated with a seal-less structure at the gas outlet. The anode gas is sucked in via silica capillaries to the initially evacuated gas tanks. The process is simultaneously carried out using five sampling ports. The sampled gas is analyzed by a gas chromatograph. Most of the measurements are made at the cell temperature (T cell) of 750 °C and at various temperatures of the pre-reformer (T ref) with various fuel utilizations (U f) of the cell. The composition of the fuel at the inlet of the anode was confirmed to be almost the same as that theoretically calculated assuming equilibrium at the temperature of the pre-reformer. The effect of internal reforming in the anode is clearly observed as a steady decrease in the methane concentration along the flow axis. The effect of the water-gas shift reaction is also observed as a decrease in the CO 2 concentration and an increase of CO concentration around the gas inlet region, as the water-gas shift reaction inversely proceeds when T cell is higher than T ref. The diffusion of nitrogen from the seal-less outermost edge is observed, and the diffusion is confirmed to be more significant as U f decreases. The observations are compared with the results obtained by the SOFC supported by lanthanum gallate electrolyte. With respect to the internal reforming performance, the cell investigated here is found to be more effective when compared to the previously reported electrolyte supported cell.

  3. Knowledge Glyphs: Visualization Theory Development to Support C2 Practice

    National Research Council Canada - National Science Library

    Whitaker, Randall; Thomas-Meyers, Gina

    2006-01-01

    Recent and ongoing research into the subject of knowledge glyphs illustrates how the state of the art in theory and practice interact and open up new requirements for innovation with respect to each...

  4. Cross-sectorial cooperation and supportive care in general practice

    DEFF Research Database (Denmark)

    Lundstrøm, Louise Hyldborg; Johnsen, Anna Thit; Ross, Lone

    2011-01-01

    Background. Cancer care usually involves several health professionals from different parts of the health care system. Often, the GP has an important role. Patients’ experiences of continuity and support may be related to characteristics of health care, disease or patients. Objectives. To investig......Background. Cancer care usually involves several health professionals from different parts of the health care system. Often, the GP has an important role. Patients’ experiences of continuity and support may be related to characteristics of health care, disease or patients. Objectives...... patients experienced suboptimal cross-sectorial cooperation and supportive care. Efforts to improve cancer care cooperation may focus on the possible supportive role of the...

  5. Fabrication of a Customized Ball Abutment to Correct a Nonparallel Implant Abutment for a Mandibular Implant-Supported Removable Partial Prosthesis: A Case Report

    OpenAIRE

    Hossein Dasht; Mohammadreza Nakhaei; Nafiseh teimouri

    2017-01-01

    Introduction: While using an implant-supported removable partial prosthesis, the implant abutments should be parallel to one another along the path of insertion. If the implants and their attachments are placed vertically on a similar occlusal plane, not only is the retention improved, the prosthesis will also be maintained for a longer period. Case Report: A 65-year-old male patient referred to the School of Dentistry in Mashhad, Iran with complaints of discomfort with the removable partial ...

  6. Evaluation of features to support safety and quality in general practice clinical software

    Science.gov (United States)

    2011-01-01

    Background Electronic prescribing is now the norm in many countries. We wished to find out if clinical software systems used by general practitioners in Australia include features (functional capabilities and other characteristics) that facilitate improved patient safety and care, with a focus on quality use of medicines. Methods Seven clinical software systems used in general practice were evaluated. Fifty software features that were previously rated as likely to have a high impact on safety and/or quality of care in general practice were tested and are reported here. Results The range of results for the implementation of 50 features across the 7 clinical software systems was as follows: 17-31 features (34-62%) were fully implemented, 9-13 (18-26%) partially implemented, and 9-20 (18-40%) not implemented. Key findings included: Access to evidence based drug and therapeutic information was limited. Decision support for prescribing was available but varied markedly between systems. During prescribing there was potential for medicine mis-selection in some systems, and linking a medicine with its indication was optional. The definition of 'current medicines' versus 'past medicines' was not always clear. There were limited resources for patients, and some medicines lists for patients were suboptimal. Results were provided to the software vendors, who were keen to improve their systems. Conclusions The clinical systems tested lack some of the features expected to support patient safety and quality of care. Standards and certification for clinical software would ensure that safety features are present and that there is a minimum level of clinical functionality that clinicians could expect to find in any system.

  7. Supporting Students with Asperger Syndrome on College Campuses: Current Practices

    Science.gov (United States)

    Barnhill, Gena P.

    2016-01-01

    With the increasing number of students with Asperger syndrome (AS) and high functioning autism (HFA) enrolling in college, it has become apparent that support services are greatly needed to assist these students in navigating college life, both academically and socially. Yet, there is a dearth of research describing the specific supports needed…

  8. Lean waste classification model to support the sustainable operational practice

    Science.gov (United States)

    Sutrisno, A.; Vanany, I.; Gunawan, I.; Asjad, M.

    2018-04-01

    Driven by growing pressure for a more sustainable operational practice, improvement on the classification of non-value added (waste) is one of the prerequisites to realize sustainability of a firm. While the use of the 7 (seven) types of the Ohno model now becoming a versatile tool to reveal the lean waste occurrence. In many recent investigations, the use of the Seven Waste model of Ohno is insufficient to cope with the types of waste occurred in industrial practices at various application levels. Intended to a narrowing down this limitation, this paper presented an improved waste classification model based on survey to recent studies discussing on waste at various operational stages. Implications on the waste classification model to the body of knowledge and industrial practices are provided.

  9. A Novel High-Performance Beam-Supported Membrane Structure with Enhanced Design Flexibility for Partial Discharge Detection

    Directory of Open Access Journals (Sweden)

    Chenzhao Fu

    2017-03-01

    Full Text Available A novel beam-supported membrane (BSM structure for the fiber optic extrinsic Fabry-Perot interferometer (EFPI sensors showing an enhanced performance and an improved resistance to the temperature change was proposed for detecting partial discharges (PDs. The fundamental frequency, sensitivity, linear range, and flatness of the BSM structure were investigated by employing the finite element simulations. Compared with the intact membrane (IM structure commonly used by EFPI sensors, BSM structure provides extra geometrical parameters to define the fundamental frequency when the diameter of the whole membrane and its thickness is determined, resulting in an enhanced design flexibility of the sensor structure. According to the simulation results, it is noted that BSM structure not only shows a much higher sensitivity (increased by almost four times for some cases, and a wider working range of fundamental frequency to choose, but also an improved linear range, making the system development much easier. In addition, BSM structure presents a better flatness than its IM counterpart, providing an increased signal-to-noise ratio (SNR. A further improvement of performance is thought to be possible with a step-forward structural optimization. The BSM structure shows a great potential to design the EFPI sensors, as well as others for detecting the acoustic signals.

  10. Partial Body Weight-Supported Treadmill Training in Patients With Parkinson Disease: Impact on Gait and Clinical Manifestation.

    Science.gov (United States)

    Ganesan, Mohan; Sathyaprabha, Talakad N; Pal, Pramod Kumar; Gupta, Anupam

    2015-09-01

    To evaluate the effect of conventional gait training (CGT) and partial weight-supported treadmill training (PWSTT) on gait and clinical manifestation. Prospective experimental research design. Hospital. Patients with idiopathic Parkinson disease (PD) (N=60; mean age, 58.15±8.7y) on stable dosage of dopaminomimetic drugs were randomly assigned into the 3 following groups (20 patients in each group): (1) nonexercising PD group, (2) CGT group, and (3) PWSTT group. The interventions included in the study were CGT and PWSTT. The sessions of the CGT and PWSTT groups were given in patient's self-reported best on status after regular medications. The interventions were given for 30min/d, 4d/wk, for 4 weeks (16 sessions). Clinical severity was measured by the Unified Parkinson Disease Rating Scale (UPDRS) and its subscores. Gait was measured by 2 minutes of treadmill walking and the 10-m walk test. Outcome measures were evaluated in their best on status at baseline and after the second and fourth weeks. Four weeks of CGT and PWSTT gait training showed significant improvements of UPDRS scores, its subscores, and gait performance measures. Moreover, the effects of PWSTT were significantly better than CGT on most measures. PWSTT is a promising intervention tool to improve the clinical and gait outcome measures in patients with PD. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  11. Incorporating a Static Versus Supportive Mobile Phone App Into a Partial Meal Replacement Program With Face-to-Face Support: Randomized Controlled Trial.

    Science.gov (United States)

    Brindal, Emily; Hendrie, Gilly A; Freyne, Jill; Noakes, Manny

    2018-04-18

    Mobile phone apps may be acceptable to users and could improve retention and adherence over more traditional methods, but there is mixed literature supporting their efficacy. In the weight management space, very little is known about how a mobile phone app integrating features beyond text messaging (short message service) can affect behavior, particularly when combined with face-to-face support. The objective of this study was to examine the effectiveness of a mobile phone app when combined with a partial meal replacement program including face-to-face support. This paper compares a static versus supportive app over a 6-month randomized trial for effects on weight loss, weight-related biomarkers, and psychological outcomes. Overweight and obese adults (71.2% female, 104/146; mean 48.11, SD 11.75 years) were recruited to participate in the weight loss study, and they were randomized on a 1:1 basis using a computer algorithm. The supportive app (n=75) provided information, food intake recording, rewards, prompts for regular interaction through reminders, and the opportunity to review personal compliance with the dietary program. The static app (n=71) included only recipes and weight loss information. Both groups recieved equal amounts of face-to-face support in addition to app. The overall reduction in app usage over 24 weeks was lower for the supportive app in comparison with the static app; approximately 39.0% (57/146) of the users were still using the app at week 24. Despite the promising results for app usage, there were no differences in weight loss between groups (F1,128.12=0.83, P=.36). However, it should be noted that almost 60% (49/84) of all participants lost 5% or more of body weight during the trial. No weight-related biomarkers were significantly different between groups. Both groups experienced an increase in positive mood, but this was significantly higher for those who received the static app (F1,118.12=4.93, P=.03). Although the supportive app was

  12. Oral health-related quality of life in patients treated by implant-supported fixed dentures and removable partial dentures.

    Science.gov (United States)

    Furuyama, Chisako; Takaba, Masayuki; Inukai, Mika; Mulligan, Roseann; Igarashi, Yoshimasa; Baba, Kazuyoshi

    2012-08-01

    This study investigated the association between denture status [implant-supported fixed dentures (IDs) and removable partial dentures (RPDs)] and oral health-related quality of life (OHRQoL). Consecutive patients with IDs and RPDs were recruited from the Prosthodontics Departments at Showa University and Tokyo Medical and Dental University. The Japanese version of the Oral Health Impact Profile (OHIP-J-49) was administered to each subject. For each OHIP-J-49 question, the subjects were asked to indicate the frequency with which they had experienced a dental problem during the last month. Responses were recorded on a 5 point Likert rating scale, with 0 being never and 4, very often. Summary scores were calculated and regression analyses conducted to investigate the association between denture status and OHIP-J-49 summary score. In total 79 ID subjects (mean age±SD of 51.7±12.4 years, 44.3% men) and 109 RPD subjects (mean age of 66.5±8.6 years, 30% men) participated after giving informed consent. The regression analysis between the type of treatment and the OHIP-J-49 summary score revealed a significant association with a coefficient of 17.0 (Confidence interval, CI: 10.9-23.1). When age and duration of denture usage, which had significant associations with OHIP-J-49, were included in this model, the regression coefficient remained virtually unchanged at 17.4 (CI: 9.75-25.0), thus indicating little potential confounding by them. OHRQoL in patients with implant-supported fixed dentures is generally less impaired than it is in those patients with RPDs. © 2011 John Wiley & Sons A/S.

  13. Biomechanical comparison of two different collar structured implants supporting 3-unit fixed partial denture: a 3-D FEM study.

    Science.gov (United States)

    Meriç, Gökçe; Erkmen, Erkan; Kurt, Ahmet; Eser, Atilim; Ozden, Ahmet Utku

    2012-01-01

    The purpose of the study was to compare the effects of two distinct collar geometries of implants on stress distribution in the bone as well as in the fixture-abutment complex, in the framework and in the veneering material of 3-unit fixed partial denture (FPD). The 3-dimensional finite element analysis method was selected to evaluate the stress distribution in the system composed of 3-unit FPD supported by two different dental implant systems with two distinct collar geometries; microthread collar structure (MCS) and non-microthread collar structure (NMCS). In separate load cases, 300 N vertical, 150 N oblique and 60 N horizontal, forces were utilized to simulate the multidirectional chewing forces. Tensile and compressive stress values in the cortical and cancellous bone and von Mises stresses in the fixture-abutment complex, in the framework and veneering material, were simulated as a body and investigated separately. In the cortical bone lower stress values were found in the MCS model, when compared with NMCS. In the cancellous bone, lower stress values were observed in the NMCS model when compared with MCS. In the implant-abutment complex, highest von Mises stress values were noted in the NMCS model; however, in the framework and veneering material, highest stress values were calculated in MCS model. MCS implants when compared with NMCS implants supporting 3-unit FPDs decrease the stress values in the cortical bone and implant-abutment complex. The results of the present study will be evaluated as a base for our ongoing FEA studies focused on stress distribution around the microthread and non-microthread collar geometries with various prosthesis design.

  14. Unsplinted implants and teeth supporting maxillary removable partial dentures retained by telescopic crowns: a retrospective study with >6 years of follow-up.

    Science.gov (United States)

    Frisch, Eberhard; Ratka-Krüger, Petra; Wenz, Hans-Jürgen

    2015-09-01

    Data regarding tooth- and implant-supported maxillary removable partial dentures (TIRPDs) are scarce. The objective of this research was to perform a retrospective evaluation of the clinical long-term outcome of maxillary TIRPDs rigidly retained via telescopic crowns in patients undergoing supportive post-implant therapy (SIT). The inclusion criteria were met by 26 patients restored with maxillary TIRPDs between 1997 and 2011 in a private practice. Primary crowns (Marburg double crowns, MDCs) on teeth were cemented, whereas those on implants were screw-retained. Using patient records and data from a cross-sectional clinical examination in 2013, the survival rates of the teeth, implants and prostheses, together with the biological and technical complications, were analyzed. After 6.12 ± 3.80 (range: 2-16) years of loading, 23 non-smoking patients with 23 dentures supported by 60 implants and 66 teeth were available for assessment. Nine teeth (survival rate: 86.36%) were lost, whereas 1 implant (survival rate: 98.36%) failed because of peri-implantitis. Although 30 implants (50%) in 16 patients (69.57%) showed bleeding on probing (BOP+), no further peri-implantitis was observed. The mean peri-implant probing depth (PPD) was 3.68 ± 0.71 mm. All dentures were functional and required technical maintenance efforts amounting to 0.128 treatments per patient per year (T/P/Y). Within the limitations of this study, we conclude that TIRPDs retained via MDCs may represent a viable treatment option for patients with residual maxillary teeth. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Design directions for media-supported collocated remembering practices

    NARCIS (Netherlands)

    Broekhuijsen, M.; van den Hoven, E.; Markopoulos, P.

    2017-01-01

    Since the widespread adoption of digital photography, people create many digital photos, often with the intention to use them for shared remembering. Practices around digital photography have changed along with advances in media sharing technologies such as smartphones, social media, and mobile

  16. Case studies can support definitions of workplace innovation in practice

    NARCIS (Netherlands)

    Vaas, F.; Žiauberytė-Jakštienė, R.; Oeij, P.R.

    2017-01-01

    Many practitioners find it problematic to understand and describe workplace innovation (WPI). Whereas there are well-known definitions of WPI, these remain highly abstract. We argue that, for practitioners, case examples of WPI best practices can be a valuable addition to these definitions. In this

  17. Supporting Clinical Practice Candidates in Learning Community Development

    Science.gov (United States)

    DeJarnette, Nancy K.; Sudeck, Maria

    2015-01-01

    The purpose of this qualitative research study was to monitor pre-service teacher candidates' progression and implementation of the learning community philosophy along with classroom management strategies. The study took place during their final semester of clinical practice. Data were collected from self-reports, surveys, university supervisor…

  18. Practices that support coexistence: A survey of Alfalfa growers

    Science.gov (United States)

    The alfalfa industry has worked hard to foster the coexistence of genetically-engineered (GE) and conventional alfalfa production by developing a set of best management practices that aim to limit adventitious-presence (AP) of GE traits in conventional seed. The general goal is to minimize transgene...

  19. The Use of Digital Impressions to Fabricate Tooth-Supported Partial Removable Dental Prostheses: A Clinical Report.

    Science.gov (United States)

    Mansour, Mohamed; Sanchez, Eliana; Machado, Camilo

    2016-08-01

    Impression making is a critical step in the fabrication of a partial removable dental prosthesis (RDP). A technique is described for making final impressions to fabricate partial RDPs for Kennedy class III patients using a computer-aided design and computer-assisted manufacturing digital impression system. © 2015 by the American College of Prosthodontists.

  20. Dyslexia in general practice education: considerations for recognition and support.

    Science.gov (United States)

    Shrewsbury, Duncan

    2016-07-01

    Dyslexia is a common developmental learning difficulty, which persists throughout life. It is highly likely that those working in primary care will know, or even work with someone who has dyslexia. Dyslexia can impact on performance in postgraduate training and exams. The stereotypical characteristics of dyslexia, such as literacy difficulties, are often not obvious in adult learners. Instead, recognition requires a holistic approach to evaluating personal strengths and difficulties, in the context of a supportive relationship. Strategies to support dyslexic learners should consider recommendations made in formal diagnostic reports, and aim to address self-awareness and coping skills.

  1. Case-based discussion supporting learning and practice in optometry.

    Science.gov (United States)

    Bullock, Alison; Barnes, Emma; Ryan, Barbara; Sheen, Nik

    2014-09-01

    To enhance continuing professional development and address the risk that professional isolation poses, the UK General Optical Council introduced a requirement for all optometrists to engage in at least one case-based discussion per 3 year cycle of continuing education. In this paper, we explore participants' impression of the acceptability, effectiveness and long-term impact-on-practice of case-based discussion as a mode of continuing education. Case-based discussion participants attended an evening session comprising a lecture and a group discussion. They completed three questionnaires: prior to the session, immediately post-session and 3-4 months post-session. We coded the questionnaires to allow matching. Seventy-five case-based discussion groups were held with 379 participants; 377 completed both pre- and post-questionnaires and 331 (88%) returned a follow-up questionnaire. Case-based discussions were an acceptable method of learning, with many preferring it to distance-learning. Prior to the event, women, employees and part-time workers were more likely to have concerns about participating. In terms of learning, gaps in knowledge were more likely to be revealed in those who work in isolation. The respondents highlighted social aspects, reassurance of practice as well as new learning. Participants significantly improved self-confidence ratings in all key learning areas. At three months post-session, the majority (75%) self-reported that they had implemented their intended changes to practice. The evaluation showed that participants felt that case-based discussion developed their knowledge, notably for sole practitioners, and influenced later workplace practice. The peer interaction of this mode of continuing education can combat professional isolation. © 2014 The Authors Ophthalmic & Physiological Optics © 2014 The College of Optometrists.

  2. Effectiveness of multimedia-supported education in practical sports courses.

    Science.gov (United States)

    Leser, Roland; Baca, Arnold; Uhlig, Johannes

    2011-01-01

    Multimedia-assisted teaching and learning have become standard forms of education. In sports, multimedia material has been used to teach practical aspects of courses, such as motor skills. The main goal of this study is to examine if multimedia technology impacts learning in the field of sport motor skill acquisition. This question was investigated during a practical sports education course involving 35 students who participated in a university soccer class. The whole course was split into two groups: Group A was taught traditionally with no assistance of multimedia and Group B was prepared with multimedia-assisted instructional units. To quantify selected skills of soccer technique and tactic, the test subjects performed a specific passing test and a tactical assessment. Furthermore, a ques-tionnaire was used to assess the subjective impressions of the test subjects. All testing instruments were applied before and after a six-week-long teaching period. A comparison of the gathered data between the two groups resulted in no significant differences, neither concerning the results of the technique test nor concerning the tactic test. However, the results of the ques-tionnaire showed a positive agreement among the participants in the usability and assistance of multimedia for the sports practical course. Considering the reviewed conditions, it can be concluded that the use of multimedia content doesn't affect the learning effects. Key pointsMultimedia-assisted learning showed no positive learning effects on technical skills in soccer.Multimedia-assisted learning showed no positive learning effects on tactical skills in soccer.Students participating in practical sports courses have very good attitudes towards the use of multi-media learning material. This may be considered for motivational effects.

  3. Effectiveness of Multimedia-Supported Education in Practical Sports Courses

    Science.gov (United States)

    Leser, Roland; Baca, Arnold; Uhlig, Johannes

    2011-01-01

    Multimedia-assisted teaching and learning have become standard forms of education. In sports, multimedia material has been used to teach practical aspects of courses, such as motor skills. The main goal of this study is to examine if multimedia technology impacts learning in the field of sport motor skill acquisition. This question was investigated during a practical sports education course involving 35 students who participated in a university soccer class. The whole course was split into two groups: Group A was taught traditionally with no assistance of multimedia and Group B was prepared with multimedia-assisted instructional units. To quantify selected skills of soccer technique and tactic, the test subjects performed a specific passing test and a tactical assessment. Furthermore, a ques-tionnaire was used to assess the subjective impressions of the test subjects. All testing instruments were applied before and after a six-week-long teaching period. A comparison of the gathered data between the two groups resulted in no significant differences, neither concerning the results of the technique test nor concerning the tactic test. However, the results of the ques-tionnaire showed a positive agreement among the participants in the usability and assistance of multimedia for the sports practical course. Considering the reviewed conditions, it can be concluded that the use of multimedia content doesn’t affect the learning effects. Key points Multimedia-assisted learning showed no positive learning effects on technical skills in soccer. Multimedia-assisted learning showed no positive learning effects on tactical skills in soccer. Students participating in practical sports courses have very good attitudes towards the use of multi-media learning material. This may be considered for motivational effects. PMID:24149313

  4. EFFECTIVENESS OF MULTIMEDIA-SUPPORTED EDUCATION IN PRACTICAL SPORTS COURSES

    Directory of Open Access Journals (Sweden)

    Roland Leser

    2011-03-01

    Full Text Available Multimedia-assisted teaching and learning have become standard forms of education. In sports, multimedia material has been used to teach practical aspects of courses, such as motor skills. The main goal of this study is to examine if multimedia technology impacts learning in the field of sport motor skill acquisition. This question was investigated during a practical sports education course involving 35 students who participated in a university soccer class. The whole course was split into two groups: Group A was taught traditionally with no assistance of multimedia and Group B was prepared with multimedia-assisted instructional units. To quantify selected skills of soccer technique and tactic, the test subjects performed a specific passing test and a tactical assessment. Furthermore, a ques-tionnaire was used to assess the subjective impressions of the test subjects. All testing instruments were applied before and after a six-week-long teaching period. A comparison of the gathered data between the two groups resulted in no significant differences, neither concerning the results of the technique test nor concerning the tactic test. However, the results of the ques-tionnaire showed a positive agreement among the participants in the usability and assistance of multimedia for the sports practical course. Considering the reviewed conditions, it can be concluded that the use of multimedia content doesn't affect the learning effects.

  5. Supporting smoking cessation in the medical specialist practice

    NARCIS (Netherlands)

    Schippers, G. M.

    2004-01-01

    Although smoking cessation reduces the cardiovascular risk of smoking, why this is so is still uncertain. Nevertheless, because they are strongly and authoritatively involved in much of the serious health damage caused by smoking, medical specialists should do all they can to support their patients

  6. IMPROVING WOMEN'S LIVES Practical support for women gives ...

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

    IDRC Communications. LASTING IMPACTS. IDRC has supported poor women in developing countries in their efforts to learn, to earn, and to take part in local decision-making. University degrees and decent jobs make it easier ... Two Palestinian women sit in classroom. Scholarships bring hope to poor Palestinian women ...

  7. Understanding and Supporting Visual Communication within Costume Design Practice

    Science.gov (United States)

    Bradley, Rachael Leigh

    2009-01-01

    Theatres provide artistic value to many people and generate revenue for communities, yet little research has been conducted to understand or support theatrical designers. Over 1,800 non-profit theatres and 3,522 theatre companies and dinner theatres operate in the United States. In 2008, 11 million people attended 1,587 Broadway shows for a total…

  8. Parenting Support: Policy and Practice in the Irish Context

    Science.gov (United States)

    Connolly, Nuala; Devaney, Carmel

    2018-01-01

    Increasing government interest in parenting support has emerged in response to the increasingly diverse form of families, a growing emphasis on children's rights and a policy shift towards prevention and early intervention. This has contributed to a range of stakeholder activity in the area, with the notion that parenting is a set of skills that…

  9. Adapting research instruction to support the scholarship of practice: practice-scholar partnerships.

    Science.gov (United States)

    Crist, Patricia A

    2010-01-01

    ABSTRACT Evidence-based practice (EBP) is crucial to the success of delivering quality occupational therapy services. The skill to engage in the scholarship of practice is central to being able to create evidence specific to one's everyday practice and leads to an emerging role within occupational therapy called the practice-scholar. The purpose of this retrospective study was to investigate the effectiveness of an instructional approach that engaged the scholarship of practice and the functions of a practice-scholar. Occupational therapy graduate students and practitioners collaborated to develop a practice-based study proposal during a traditional experimental research class. The objective was to apply research concepts contextualized within the natural practice context while developing the role of the practice-scholar in designing outcomes studies. As part of an entry-level research course, students (n == 39) and practitioners (n == 14) were grouped into learning teams and discussed two self-assessments to reflect on their self-efficacy perceptions of practice-scholarship research at the beginning and the end of a series of guided sessions to design a research proposal. Postcourse results show that students' perceptions of self-efficacy improved regarding their abilities to participate in practice-scholarship as a result of the learning partnerships. Anecdotal similarities were found for practitioners. As an instructional method, the learning partnership facilitated the development of foundational knowledge and skills related to becoming practice-scholars through increased self-efficacy in using proposal design. This educational approach proactively used the scholarship of practice research to bridge practice and education using a meaningful, partnership-based model for entry-level graduate students and occupational therapy practitioners.

  10. Analysis of load distribution in tooth-implant supported fixed partial dentures by the use of resilient abutment.

    Science.gov (United States)

    Glisić, Mirko; Stamenković, Dragoslav; Grbović, Aleksandar; Todorović, Aleksandar; Marković, Aleksa; Trifković, Branka

    2016-01-01

    Differences between the tooth and implant response to load can lead to many biological and technical implications in the conditions of occlusal forces. The objective of this study was to analyze load distribution in tooth/implant-supported fixed partial dentures with the use of resilient TSA (Titan Shock Absorber, BoneCare GmbH, Augsburg, Germany) abutment and conventional non-resilient abutment using finite element method. This study presents two basic 3D models. For one model a standard non-resilient abutment is used, and on the implant of the second model a resilient TSA abutment is applied. The virtual model contains drawn contours of tooth, mucous membranes, implant, cortical bones and spongiosa, abutment and suprastructure. The experiment used 500 N of vertical force, applied in three different cases of axial load. Calculations of von Mises equivalent stresses of the tooth root and periodontium, implants and peri-implant tissue were made. For the model to which a non-resilient abutment is applied, maximum stress values in all three cases are observed in the cortical part of the bone (maximum stress value of 49.7 MPa). Measurements of stress and deformation in the bone tissue in the model with application of the resilientTSA abutment demonstrated similar distribution; however, these values are many times lower than in the model with non-resilient TSA abutment (maximum stress value of 28.9 MPa). Application of the resilient TSA abutment results in more equal distribution of stress and deformations in the bone tissue under vertical forces. These values are many times lower than in the model with the non-resilient abutment.

  11. Supporting the use of user generated content in journalistic practice

    OpenAIRE

    Tolmie, Peter; Procter, Rob; Rouncefield, Mark; Randall, Dave; Burger, Christian; Wong Sak Hoi, Geraldine; Zubiaga, Arkaitz; Liakata, Maria

    2017-01-01

    Social media and user-generated content (UGC) are increasingly important features of journalistic work in a number of different ways. However, their use presents major challenges, not least because information posted on social media is not always reliable and therefore its veracity needs to be checked before it can be considered as fit for use in the reporting of news. We report on the results of a series of in-depth ethnographic studies of journalist work practices undertaken as part of the ...

  12. Teacher coaching supported by formative assessment for improving classroom practices.

    Science.gov (United States)

    Fabiano, Gregory A; Reddy, Linda A; Dudek, Christopher M

    2018-06-01

    The present study is a wait-list controlled, randomized study investigating a teacher coaching approach that emphasizes formative assessment and visual performance feedback to enhance elementary school teachers' classroom practices. The coaching model targeted instructional and behavioral management practices as measured by the Classroom Strategies Assessment System (CSAS) Observer and Teacher Forms. The sample included 89 general education teachers, stratified by grade level, and randomly assigned to 1 of 2 conditions: (a) immediate coaching, or (b) waitlist control. Results indicated that, relative to the waitlist control, teachers in immediate coaching demonstrated significantly greater improvements in observations of behavior management strategy use but not for observations of instructional strategy use. Observer- and teacher-completed ratings of behavioral management strategy use at postassessment were significantly improved by both raters; ratings of instructional strategy use were significantly improved for teacher but not observer ratings. A brief coaching intervention improved teachers' use of observed behavior management strategies and self-reported use of behavior management and instructional strategies. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  13. Influence of connection type on the biomechanical behavior of distal extension mandibular removable partial dentures supported by implants and natural teeth.

    Science.gov (United States)

    Xiao, Wei; Li, Zhiyong; Shen, Shiqian; Chen, Shaowu; Chen, Sulin; Wang, Jiawei

    2016-02-01

    Few studies are performed to evaluate the influence of connection type on the stress distribution of distal extension mandibular removable partial dentures (RPDs) supported by both implants and natural teeth. In this study, five three-dimensional finite element models were prepared to simulate mandibular bilateral partially edentulous arches. Four were RPDs supported by both implants and natural teeth, and the other one was RPDs supported only by natural teeth. The maximum equivalent (EQV) stress values of bone around implants, the abutments, and the mucosa displacements of the related supporting structures were measured. It was found that a non-rigid telescopic coping was more favorable to protect the implant than a rigid telescopic coping. Compared with other connection types, the easy resilient attachment (ERA) system seemed to be effective to associate implant without complications. However, the results obtained in the present study should be cautiously interpreted in the clinic.

  14. Supporting primary care nurses to work at an advanced level through changing practices.

    Science.gov (United States)

    Forsdike, Kirsty; Murphy, Tracy Ann; Hegarty, Kelsey

    2018-04-06

    General practice nurses wishing to develop their careers in general practice are often unsupported, relying on the culture of individual practices. Given the structural diversity of Australian general practice, we qualitatively explored staff experiences of organisational governance, what supports are in place and can be used to assist nurses to advance. Semi-structured interviews with 28 staff (including nurses, GPs, receptions and practice managers) were undertaken across three practices, as part of a case-study approach. It was found that general practice staff know little of organisational governance and how it may be harnessed. Practical and flexible organisational governance were the most important factors in supporting general practice nurses to develop and utilise nursing skills, but advocacy from medical colleagues was necessary to support advancement. Barriers include funding structures, non-supportive cultures and inflexible organisational governance structures. Organisation governance has the potential to assist nurses to work at an advanced level, but significant financial, structural and cultural barriers may be too difficult for organisational governance resources alone to overcome. In addition to utilising resources, it may be useful for general practices to undertake a review of how they function as a team and reflect upon their practice culture.

  15. Clinical experiences of implant-supported prostheses with laser-welded titanium frameworks in the partially edentulous jaw: a 5-year follow-up study.

    Science.gov (United States)

    Ortorp, A; Jemt, T

    1999-01-01

    Titanium frameworks have been used in the endentulous implant patient for the last 10 years. However, knowledge of titanium frameworks for the partially dentate patient is limited. To report the 5-year clinical performance of implant-supported prostheses with laser-welded titanium frameworks in the partially edentulous jaw. A consecutive group of 383 partially edentulous patients were, on a routine basis, provided with fixed partial prostheses supported by Brånemark implants in the mandible or maxilla. Besides conventional frameworks in cast gold alloy, 58 patients were provided with titanium frameworks with three different veneering techniques, and clinical and radiographic 5-year data were collected for this group. The overall cumulative survival rate was 95.6% for titanium-framework prostheses and 93.6% for implants. Average bone loss during the follow-up period was 0.4 mm. The most common complications were minor veneering fractures. Loose and fractured implant screw components were fewer than 2%. An observation was that patients on medications for cardiovascular problems may lose more implants than others (p laser-welded titanium frameworks was similar to that reported for conventional cast frames in partially edentulous jaws. Low-fusing porcelain veneers also showed clinical performance comparable to that reported for conventional porcelain-fused-to-metal techniques.

  16. Assessment of patient support surfaces: principle, practice and limitations.

    Science.gov (United States)

    Rithalia, S

    2005-01-01

    Pressure ulcers cause great pain and suffering to patients as well as unnecessary strain on nursing staff. Their treatment is both costly and time consuming. Every effort therefore should be directed towards their prevention. Understanding of the aetiology of pressure ulcers is still incomplete and assessment of devices aimed at prevention is difficult. Over the years, numerous parameters, including interface pressure and transcutaneous blood gas measurements, have been used to evaluate mattresses and cushions. However, the quality of the data gathered is variable and its clinical interpretation remains unsatisfactory. It could be said that the science of evaluation of support surfaces is still at a formative stage, as clinical validation of many of the approaches has yet to be carried out.

  17. Practical considerations from construction of the FFTF pipe support system

    International Nuclear Information System (INIS)

    Hartsell, J.O.

    1979-04-01

    Late this year the FFTF is scheduled to initiate criticality and power operation, an event signifying complete resolution of construction problems and compliance with applicable requirements. One of the tasks accomplished to achieve this position was the conduct of cell completion walkthroughs, problem identification, and resolution. Heavily oriented toward the final verification of pipe supports, the cell completion process identified and resolved a series of problems not readily apparent during the detailed design phases of plant construction. It is the objective of this presentation to establish a degree of awareness of these types of problems and of the FFTF techniques employed in resolution. All of the problems depicted herein have been solved and the installations corrected

  18. The Five Attributes of a Supportive Midwifery Practice Climate: A Review of the Literature.

    Science.gov (United States)

    Thumm, E Brie; Flynn, Linda

    2018-01-01

    A supportive work climate is associated with decreased burnout and attrition, and increased job satisfaction and employee health. A review of the literature was conducted in order to determine the unique attributes of a supportive practice climate for midwives. The midwifery literature was reviewed and synthesized using concept analysis technique guided by literature from related professions. The search was conducted primarily in PubMed, CINAHL, Web of Science, and Google Scholar. Articles were included if they were conducted between 2006 and 2016 and addressed perceptions of the midwifery practice climate as it related to patient, provider, and organizational outcomes. The literature identified 5 attributes consistent with a supportive midwifery practice climate: effective leadership, adequate resources, collaboration, control of one's work, and support of the midwifery model of care. Effective leadership styles include situational and transformational, and 9 traits of effective leaders are specified. Resources consist of time, personnel, supplies, and equipment. Collaboration encompasses relationships with all members of the health care team, including midwives inside and outside of one's practice. Additionally, the patients are considered collaborating members of the team. Characteristics of effective collaboration include a shared vision, role clarity, and respectful communication. Support for the midwifery model of care includes value congruence, developing relationships with women, and providing high-quality care. The attributes of a supportive midwifery practice climate are generally consistent with theoretical models of supportive practice climates of advanced practice nurses and physicians, with the exception of a more inclusive definition of collaboration and support of the midwifery model of care. The proposed Midwifery Practice Climate Model can guide instrument development, determining relationships between the attributes of the practice climate and

  19. Fabrication of a Customized Ball Abutment to Correct a Nonparallel Implant Abutment for a Mandibular Implant-Supported Removable Partial Prosthesis: A Case Report

    Directory of Open Access Journals (Sweden)

    Hossein Dasht

    2017-12-01

    Full Text Available Introduction: While using an implant-supported removable partial prosthesis, the implant abutments should be parallel to one another along the path of insertion. If the implants and their attachments are placed vertically on a similar occlusal plane, not only is the retention improved, the prosthesis will also be maintained for a longer period. Case Report: A 65-year-old male patient referred to the School of Dentistry in Mashhad, Iran with complaints of discomfort with the removable partial dentures for his lower mandible. Due to the lack of parallelism in the supporting implants, prefabricated ball abutment could not be used. As a result, a customized ball abutment was fabricated in order to correct the non-parallelism of the implants. Conclusion: Using UCLA abutments could be a cost-efficient approach for the correction of misaligned implant abutments in implant-supported overdentures.

  20. Green shoots of recovery: a realist evaluation of a team to support change in general practice.

    Science.gov (United States)

    Bartlett, Maggie; Basten, Ruth; McKinley, Robert K

    2017-02-08

    A multidisciplinary support team for general practice was established in April 2014 by a local National Health Service (NHS) England management team. This work evaluates the team's effectiveness in supporting and promoting change in its first 2 years, using realist methodology. Primary care in one area of England. Semistructured interviews were conducted with staff from 14 practices, 3 key senior NHS England personnel and 5 members of the support team. Sampling of practice staff was purposive to include representatives from relevant professional groups. The team worked with practices to identify areas for change, construct action plans and implement them. While there was no specified timescale for the team's work with practices, it was tailored to each. In realist evaluations, outcomes are contingent on mechanisms acting in contexts, and both an understanding of how an intervention leads to change in a socially constructed system and the resultant changes are outcomes. The principal positive mechanisms leading to change were the support team's expertise and its relationships with practice staff. The 'external view' provided by the team via its corroborative and normalising effects was an important mechanism for increasing morale in some practice contexts. A powerful negative mechanism was related to perceptions of 'being seen as a failing practice' which included expressions of 'shame'. Outcomes for practices as perceived by their staff were better communication, improvements in patients' access to appointments resulting from better clinical and managerial skill mix, and improvements in workload management. The support team promoted change within practices leading to signs of the 'green shoots of recovery' within the time frame of the evaluation. Such interventions need to be tailored and responsive to practices' needs. The team's expertise and relationships between team members and practice staff are central to success. Published by the BMJ Publishing Group

  1. Practice leadership and active support in residential services for people with intellectual disabilities: an exploratory study.

    Science.gov (United States)

    Beadle-Brown, J; Mansell, J; Ashman, B; Ockenden, J; Iles, R; Whelton, B

    2014-09-01

    We hypothesised that a key factor determining the quality of active support was 'practice leadership' - provided by the first-line manager to focus staff attention and develop staff skills in providing direct support to enable people with intellectual disabilities to have a good quality of life. This exploratory study focused on what levels of practice leadership were found and its role in explaining variation in active support. Relevant aspects of management, including practice leadership, were assessed by questionnaires administered to staff in residential settings alongside observational measures of active support and resident engagement in meaningful activity. Relationships between these variables were explored using regression and post hoc group comparisons. There was wide variation, with average levels of practice leadership being low, though improving over the period studied. Practice leadership had a significant impact on active support, but was fully mediated by the effect of quality of management. When the quality of management was higher better practice leadership did produce a significant difference in active support. However, higher quality of management on its own did not produce better active support. A number of limitations are acknowledged and further research is required. Practice leadership appears to be an important factor in enabling staff to provide active support but as part of generally good management. Given the rather low levels found, attention needs to be given to the training, career development and support of practice leaders and also to how to protect their time from their many other responsibilities. © 2013 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

  2. Treadmill training with partial body weight support and an electromechanical gait trainer for restoration of gait in subacute stroke patients: a randomized crossover study.

    Science.gov (United States)

    Werner, C; Von Frankenberg, S; Treig, T; Konrad, M; Hesse, S

    2002-12-01

    The purpose of this study was to compare treadmill and electromechanical gait trainer therapy in subacute, nonambulatory stroke survivors. The gait trainer was designed to provide nonambulatory subjects the repetitive practice of a gait-like movement without overexerting therapists. This was a randomized, controlled study with a crossover design following an A-B-A versus a B-A-B pattern. A consisted of 2 weeks of gait trainer therapy, and B consisted of 2 weeks of treadmill therapy. Thirty nonambulatory hemiparetic patients, 4 to 12 weeks after stroke, were randomly assigned to 1 of the 2 groups receiving locomotor therapy every workday for 15 to 20 minutes for 6 weeks. Weekly gait ability (functional ambulation category [FAC]), gait velocity, and the required physical assistance during both kinds of locomotor therapy were the primary outcome measures, and other motor functions (Rivermead motor assessment score) and ankle spasticity (modified Ashworth score) were the secondary outcome measures. Follow-up occurred 6 months later. The groups did not differ at study onset with respect to the clinical characteristics and effector variables. During treatment, the FAC, gait velocity, and Rivermead scores improved in both groups, and ankle spasticity did not change. Median FAC level was 4 (3 to 4) in group A compared with 3 (2 to 3) in group B at the end of treatment (P=0.018), but the difference at 6-month follow up was not significant. The therapeutic effort was less on the gait trainer, with 1 instead of 2 therapists assisting the patient at study onset. All but seven patients preferred the gait trainer. The newly developed gait trainer was at least as effective as treadmill therapy with partial body weight support while requiring less input from the therapist. Further studies are warranted.

  3. Developing strategic systems supporting communities of practice in the Georgia Department of Transportation.

    Science.gov (United States)

    2011-12-01

    This study is designed to explore strategies through which the Georgia Department of : Transportation (GDOT) can develop communities of practice to help employees facilitate critical : exchanges of knowledge, support organizational learning, and ulti...

  4. How Social Software Supports Cooperative Practices in a Globally Distributed Software Project

    DEFF Research Database (Denmark)

    Giuffrida, Rosalba; Dittrich, Yvonne

    2014-01-01

    In Global Software Development (GSD), the lack of face- to-face communication is a major challenge and effective computer-mediated practices are necessary. This paper analyzes cooperative practices supported by Social Software (SoSo) in a GSD student project. The empirical results show...... that the role of SoSo is to support informal communication, enabling social talks and metawork, both necessary for establishing and for maintaining effective coordination mechanisms, thus successful cooperation....

  5. A Study on the Enrichment Practice Accompanied by Supportive Counselling for a Gifted Student

    OpenAIRE

    Cagla Gur

    2012-01-01

    The objective of this research is to examine whether or not the enrichment practice accompanied by supportive counselling in education has a positive effect on a gifted student’s problematic behaviours, current state and attitudes towards setting and reaching a target. This research is based on single subject research model, and the ABAB model has been chosen as a method among all single subject research designs. The research has revealed that the enrichment practice accompanied by supportive...

  6. A Systematic Scoping Literature Review of Publications Supporting Treatment Guidelines for Pediatric Atopic Dermatitis in Contrast to Clinical Practice Patterns.

    Science.gov (United States)

    Siegfried, Elaine C; Jaworski, Jennifer C; Mina-Osorio, Paola

    2018-06-01

    Treatment guidelines endorse a variety of strategies for atopic dermatitis (AD) which may vary from published data and clinical practice patterns. The objective of this review was to quantify the volume of available medical literature supporting pediatric AD treatments and compare these patterns to those recommended by published guidelines and/or clinical practice patterns. Searches of Embase (2005-2016) and abstracts from selected meetings (2014-2016) related to AD treatment in patients younger than 17 years of age yielded references that were assessed by study design, primary treatment, age groups, and AD severity. Published literature partially supports clinical guidelines, with emollients and topical medications being the most investigated. There were disproportionately more publications for topical calcineurin inhibitors (TCI) compared with topical corticosteroids (TCS); however, the search interval may have biased the results toward treatments approved near the beginning of the time frame. In contrast, publications documenting clinical practice patterns reflect greater use of emollients and TCS (over TCI), as well as systemic corticosteroids. Data is relatively limited for long-term and combination treatment, treatment of severe AD, and patients younger than 2 years of age, and completely lacking for systemic corticosteroids. This scoping review demonstrates that available medical literature largely supports published guidelines for topical therapy; however, clinical practice patterns are less aligned. There is a lack of data for older, more frequently used generic treatments, including oral antihistamines, oral antibiotics, and systemic corticosteroids. Overall, literature is lacking for long-term treatment, treatment for patients younger than 2 years of age, and for systemic treatment for severe disease. Regeneron Pharmaceuticals Inc.

  7. Supporting Students with Severe Disabilities in Inclusive Schools: A Descriptive Account From Schools Implementing Inclusive Practices

    Science.gov (United States)

    Kurth, Jennifer A.; Lyon, Kristin J.; Shogren, Karrie A.

    2015-01-01

    The purpose of the present study was to investigate practices that support the inclusion of students with severe disabilities in the learning and social activities of inclusive K-8 schools to inform inclusive school reform research and practice. Eighteen K-8 students with severe disabilities in six schools recognized for their implementation of…

  8. A RESEARCH AIMED AT DETERMINATION BETWEEN HUMAN RESOURCES PRACTICES AND PERCEIVED ORGANIZATIONAL SUPPORT RELATIONSHIP IN ORGANIZATIONS

    Directory of Open Access Journals (Sweden)

    EBRU AYKAN

    2013-06-01

    Full Text Available Perceived Organizational Support (POS which was popularized in the early 1990s, is conception that may have both positive and negative effect on the staff and organization. In many ways perceived organizational support can determine the continuity of an organization over the long term. This study look at relationship between human resources practices which is taken on five dimensions and perceived organizational support. An investigation has been conduct over bed and supplier industry in Kayseri. The research that was performed with 227 worker is concluded that there are positive relations between training and human resources politics practices and perceived organizational support as of dimensions and between human resource management practices and perceived organizational support as of general.

  9. A prospective 5-year study of fixed partial prostheses supported by implants with machined and TiO2-blasted surface

    DEFF Research Database (Denmark)

    Gotfredsen, K; Karlsson, U

    2001-01-01

    PURPOSE: The aim of the present study was to evaluate whether there was a difference between machined and TiO(2)-blasted implants regarding survival rate and marginal bone loss during a 5-year observation period. MATERIALS AND METHODS: A total of 133 implants (Astra Tech Dental Implants; Astra Tech...... AB, Mölndal, Sweden) were placed in 50 patients at 6 centers in 4 Scandinavian countries. Forty-eight implants were installed in the maxilla and 85 implants in the mandible. A randomization and a stratification were done, so that each fixed partial prosthesis was supported by at least 1 machined...... and 1 TiO(2)-blasted implant. The implant-supported fixed partial prostheses (ISFPP) were fabricated within 2 months after postoperative healing. A total of 52 ISFPP (17 maxillary, 35 mandibular) were inserted. The patients were clinically examined once a year for 5 years. At the annual follow...

  10. Effects of conventional overground gait training and a gait trainer with partial body weight support on spatiotemporal gait parameters of patients after stroke

    OpenAIRE

    Park, Byoung-Sun; Kim, Mee-Young; Lee, Lim-Kyu; Yang, Seung-Min; Lee, Won-Deok; Noh, Ji-Woong; Shin, Yong-Sub; Kim, Ju-Hyun; Lee, Jeong-Uk; Kwak, Taek-Yong; Lee, Tae-Hyun; Kim, Ju-Young; Kim, Junghwan

    2015-01-01

    [Purpose] The purpose of this study was to confirm the effects of both conventional overground gait training (CGT) and a gait trainer with partial body weight support (GTBWS) on spatiotemporal gait parameters of patients with hemiparesis following chronic stroke. [Subjects and Methods] Thirty stroke patients were alternately assigned to one of two treatment groups, and both groups underwent CGT and GTBWS. [Results] The functional ambulation classification on the affected side improved signifi...

  11. Supportive Housing for Homeless Families: Foster Care Outcomes and Best Practices. Summary

    Science.gov (United States)

    Lenz-Rashid, Sonja

    2013-01-01

    The "Supportive Housing for Homeless Families: Foster Care Outcomes and Best Practices" report describes the outcome evaluation of Cottage Housing Incorporated's Serna Village program in Sacramento, California. Serna Village is a supportive housing program serving homeless families. Outcomes from the program illustrate that it is…

  12. Practical support for Lean Six Sigma software process definition using IEEE software engineering standards

    CERN Document Server

    Land, Susan K; Walz, John W

    2012-01-01

    Practical Support for Lean Six Sigma Software Process Definition: Using IEEE Software Engineering Standards addresses the task of meeting the specific documentation requirements in support of Lean Six Sigma. This book provides a set of templates supporting the documentation required for basic software project control and management and covers the integration of these templates for their entire product development life cycle. Find detailed documentation guidance in the form of organizational policy descriptions, integrated set of deployable document templates, artifacts required in suppo

  13. Supporting chronic disease self-management: translating policies and principles into clinical practice.

    Science.gov (United States)

    Higgins, Rosemary; Murphy, Barbara; Worcester, Marian; Daffey, Angela

    2012-01-01

    To support self-management, health professionals need to adopt a client-centred approach and learn to deliver evidence-based behaviour change interventions. This paper reports on the evaluation of 1- and 2-day training programs developed to improve health professionals' capacity to support chronic disease self-management (CDSM). The 321 participants attended one of eighteen supporting CDSM courses held in urban and rural settings. Participants included nurses, allied health professionals, Aboriginal health workers and general practitioners. Data were collected at three time points: before participation; immediately after the training; and, for a sub-sample of 37 participants, 2 months after the training. Results revealed a significant and sustained increase in CDSM self-efficacy following training regardless of participants' gender, age or qualifications. A thematic analysis of the responses concerning intended practice revealed four main areas of intended practice change, namely: use behavioural strategies; improve communication with clients; adopt a client-centred approach; and improve goal setting. The number of practice changes at 2 months reported by a sub-sample of participants ranged from 1 to 20 with a mean of 14 (s.d.=4). The three most common areas of practice change point to the adoption by health professionals of a collaborative approach with chronic disease patients. Lack of staff trained in CDSM was seen as a major barrier to practice change, with lack of support and finance also named as barriers to practice change. Participants identified that increased training, support and awareness of the principles of supporting CDSM would help to overcome barriers to practice change. These results indicate a readiness among health professionals to adopt a more collaborative approach given the skills and the tools to put this approach into practice.

  14. Supported Decision-Making from Theory to Practice: Implementing the Right to Enjoy Legal Capacity

    Directory of Open Access Journals (Sweden)

    Rosie Harding

    2018-04-01

    Full Text Available The right to equal recognition before the law, protected by Article 12 of the United Nations (UN Convention on the Rights of Persons with Disabilities (CRPD, mandates the use of supported decision-making practices to enable disabled people, particularly those with intellectual and/or psychosocial disabilities, to enjoy their legal capacity. Finding ways to translate this theoretical mandate into practice poses a number of particularly challenging socio-legal issues, which this research seeks to address. The English Mental Capacity Act 2005 (MCA sets out a right to support with decision-making (s.1(3, underpinned by a presumption of capacity (s.1(2. Qualitative interviews with intellectually disabled people, their supporters, and care and support professionals were undertaken to explore how disabled people make decisions in their everyday lives, the kinds of support they need, and the strategies for supported decision-making used in practice. Analysis of these interviews suggests that a range of supported decision-making techniques have been developed in practice and are effective in supporting everyday preferences and some life choices. Paradoxically, it appears that as decisions become more complex, the support available to disabled people reduces. Specifically, much less support is available for more difficult decisions around finances, healthcare and legal matters. We argue that the reasons for this are due to a web of regulatory, social and policy issues. We conclude that implementing the right to enjoy legal capacity through supported decision-making will require a combination of regulatory reform, social change and policy amendment.

  15. School Practices to Foster LGBT-Supportive Climate: Associations with Adolescent Bullying Involvement.

    Science.gov (United States)

    Gower, Amy L; Forster, Myriam; Gloppen, Kari; Johnson, Abigail Z; Eisenberg, Marla E; Connett, John E; Borowsky, Iris W

    2017-10-14

    Lesbian, gay, bisexual, and transgender (LGBT) youth experience disproportionate rates of bullying compared to their heterosexual peers. Schools are well-positioned to address these disparities by creating supportive school climates for LGBT youth, but more research is needed to examine the variety of practices and professional development opportunities put in place to this end. The current study examines how school practices to create supportive LGBT student climate relate to student reports of bullying. Student-level data come from the 2013 Minnesota Student Survey, a state-wide survey of risk and protective factors. Ninth and eleventh grade students (N = 31,183) reported on frequency of physical and relational bullying victimization and perpetration and sexual orientation-based harassment. School administrators reported on six practices related to creating supportive LGBT school climate (N = 103 schools): having a point person for LGBT student issues, displaying sexual orientation-specific content, having a gay-straight alliance, discussing bullying based on sexual orientation, and providing professional development around LGBT inclusion and LGBT student issues. An index was created to indicate how many practices each school used (M = 2.45; SD = 1.76). Multilevel logistic regressions indicated that students attending schools with more supportive LGBT climates reported lower odds of relational bullying victimization, physical bullying perpetration, and sexual orientation-based harassment compared to students in schools with less supportive LGBT climates. Sexual orientation did not moderate these relations, indicating that LGBT-supportive practices may be protective for all students, regardless of their sexual orientation. Findings support school-wide efforts to create supportive climates for LGBQ youth as part of a larger bullying prevention strategy.

  16. Theory and practice of clinical ethics support services: narrative and hermeneutical perspectives.

    Science.gov (United States)

    Porz, Rouven; Landeweer, Elleke; Widdershoven, Guy

    2011-09-01

    In this paper we introduce narrative and hermeneutical perspectives to clinical ethics support services (CESS). We propose a threefold consideration of 'theory' and show how it is interwoven with 'practice' as we go along. First, we look at theory in its foundational role: in our case 'narrative ethics' and 'philosophical hermeneutics' provide a theoretical base for clinical ethics by focusing on human identities entangled in stories and on moral understanding as a dialogical process. Second, we consider the role of theoretical notions in helping practitioners to understand their situation in clinical ethics practice, by using notions like 'story', 'responsibility', or 'vulnerability' to make explicit and explain their practical experience. Such theoretical notions help us to interpret clinical situations from an ethical perspective and to foster moral awareness of practitioners. And, thirdly, we examine how new theoretical concepts are developed by interpreting practice, using practice to form and improve our ethical theory. In this paper, we discuss this threefold use of theory in clinical ethics support services by reflecting on our own theoretical assumptions, methodological steps and practical experiences as ethicists, and by providing examples from our daily work. In doing so, we illustrate that theory and practice are interwoven, as theoretical understanding is dependent upon practical experience, and vice-versa. © 2011 Blackwell Publishing Ltd.

  17. Perception of adult men on their preventive practices and health support networks

    Directory of Open Access Journals (Sweden)

    Guilherme Oliveira de Arruda

    2015-07-01

    Full Text Available Objectives: to know the preventive practices adopted by adult men in daily life and to identify health support networks. Methods: a descriptive qualitative study, made during the months of November and December 2012, at two emergency units, along with 32 men aged between 20 and 59 years. Data were collected through semi-structured interviews and subjected to content analysis with thematic modality. Results: men highlighted different preventive practices such as sanitizing hands, eating properly, having screening tests, avoiding psychoactive substance abuse, using personal protective equipment at work and condoms during sex. Most of the participants had nuclear family and its members were their primary support network regarding the health-disease process. Conclusion: it is for health team members to try to leverage the adoption of preventive practices by adult men from the support networks they consider significant.

  18. Quit in General Practice: a cluster randomised trial of enhanced in-practice support for smoking cessation

    Directory of Open Access Journals (Sweden)

    Zwar Nicholas

    2010-08-01

    Full Text Available Abstract Background This study will test the uptake and effectiveness of a flexible package of smoking cessation support provided primarily by the practice nurse (PN and tailored to meet the needs of a diversity of patients. Methods/Design This study is a cluster randomised trial, with practices allocated to one of three groups 1 Quit with Practice Nurse 2 Quitline referral 3 GP usual care. PNs from practices randomised to the intervention group will receive a training course in smoking cessation followed by access to mentoring. GPs from practices randomised to the Quitline referral group will receive information about the study and the process of written referral and GPs in the usual care group will receive information about the study. Eligible patients are those aged 18 and over presenting to their GP who are daily or weekly smokers and who are able to give informed consent. Patients on low incomes in all three groups will be able to access free nicotine patches. Primary outcomes are sustained abstinence and point prevalence abstinence at the three month and 12 month follow-up points; and incremental cost effectiveness ratios at 12 months. Process evaluation on the reach and acceptability of the intervention approached will be collected through Computer Assisted Telephone Interviews (CATI with patients and semi-structured interviews with PNs and GPs. The primary analysis will be by intention to treat. Cessation outcomes will be compared between the three arms at three months and 12 month follow-up using multiple logistic regression. The incremental cost effectiveness ratios will be estimated for the 12 month quit rate for the intervention groups compared to usual care and to each other. Analysis of qualitative data on process outcomes will be based on thematic analysis. Discussion High quality evidence on effectiveness of practice nurse interventions is needed to inform health policy on development of practice nurse roles. If effective

  19. Transition to independent practice: a national enquiry into the educational support for newly qualified GPs.

    Science.gov (United States)

    Griffin, Ann; Abouharb, Tareq; Etherington, Clare; Bandura, Induja

    2010-09-01

    The nature of the work that NQGPs are undertaking in their transition to independent practice is changing; current training may not fully prepare them for this new peripatetic role, as indicated by rising numbers of reports of poor performance in this group. Educational support at the time of transition from general practitioner (GP) training to independent practice had previously demonstrated benefits, but many formal schemes have finished. This study aimed to map out the current provision of educational support provided by the UK deaneries for NQGPs and to explore NQGPs' perceptions of the present transition from registrar to independent practitioner. Questionnaire surveys of deanery provision and semi-structured telephone interviews of a purposeful sample of newly qualified GPs across the UK. Interviews were thematically analysed. Deanery provision of educational support to NQGPs varies across the UK. Telephone interviews highlighted the transformation as problematic; NQGPs perceived that independent practice was substantially different from being in a training post - locum work, isolation and accessing educational opportunities were concerns. NQGPs frequently expressed a desire for more formalised relationships with mentors, senior colleagues or peer groups, to support their shift. As NQGPs increasingly find themselves working as locums, lacking the opportunity for stable work-based relationships, and with an increase in medical errors being reported in this group of doctors, it is suggested that there is a need to reconsider the educational support required to facilitate the transition in the early years of independent general practice.

  20. The all-ceramic, inlay supported fixed partial denture. Part 1. Ceramic inlay preparation design: a literature review.

    Science.gov (United States)

    Thompson, M C; Thompson, K M; Swain, M

    2010-06-01

    The effect of cavity design is a controversial and underrated factor in the clinical success of ceramic inlays and inlay supported prosthesis. Many articles and studies have been conducted into the advantages and disadvantages of isolated aspects of preparation design, but lacking is a review of the most relevant papers which bring together a consensus on all the critical features. Hence, a review and analysis of cavity depth, width, preparation taper and internal line angles is warranted in our attempts to formulate preparation guidelines that will lead to clinically successful, all-ceramic inlay restorations and ceramic inlay supported prosthesis.

  1. Expatriate training and support: How effective are multinational companies’ practices in Cyprus?

    OpenAIRE

    Hadjiyianni, Chara

    2009-01-01

    Most of the literature demonstrates that multinational companies do not adequately train and support expatriates prior to and during overseas assignments. If expatriates do not sufficiently adjust to host-country conditions, this can have detrimental effects on expatriate managers themselves, the assignment and the sending organisation. This study examines the effectiveness of expatriate training and support practices of multinational companies in Cyprus. The dissertation builds on three them...

  2. Exploring Nurse Manager Support of Evidence-Based Practice: Clinical Nurse Perceptions.

    Science.gov (United States)

    Caramanica, Laura; Spiva, LeeAnna

    2018-05-01

    The study identifies what constitutes nurse manager (NM) support and other resources that enable clinical nurses (CNs) to engage in evidence-based practice (EBP). Clinical nurses report that NM support enables them to use EBP but what constitutes NM support is still unclear. Nurse managers, CNs, and EBP mentors received specialized education and use a team approach for EBP. Data were collected preintervention, mid-intervention, and postintervention from observations, interviews, journaling, and surveys. Results demonstrate how NMs can perform their role responsibilities and still engage CNs to develop a spirit of inquiry, seek answers to their clinical questions using EBP, and advance their clinical performance to improve patient outcomes. Four NM supportive behaviors emerged: cultivating a shared EBP vision, ensuring use of EBP, communicating the value of EBP, and providing resources for EBP. Through education and support, NMs describe supportive behaviors necessary for the successful conduction of EBP by CNs.

  3. Maxillary implant-supported overdentures opposed by (partial) natural dentitions : A 5-year prospective case series study

    NARCIS (Netherlands)

    Boven, G. C.; Slot, J. W. A.; Raghoebar, G. M.; Vissink, A.; Meijer, H. J. A.

    2017-01-01

    The aim of this study was to assess the 5-year treatment outcome of maxillary implant-retained overdentures opposed by natural antagonistic teeth. Fifty consecutive patients received maxillary overdentures supported by six dental implants. Implants were placed in the anterior region, if enough bone

  4. Patient education and emotional support practices in abortion care facilities in the United States.

    Science.gov (United States)

    Gould, Heather; Perrucci, Alissa; Barar, Rana; Sinkford, Danielle; Foster, Diana Greene

    2012-01-01

    Little is known about how patient education and emotional support is provided at abortion facilities. This pilot study documents 27 facilities' practices in this aspect of abortion care. We conducted confidential telephone interviews with staff from 27 abortion facilities about their practices. The majority of facilities reported they rely primarily on trained nonclinician staff to educate patients and provide emotional support. As part of their informed consent and counseling processes, facilities reported that staff always provide patients with information about the procedure (96%), assess the certainty of their abortion decisions (92%), assess their feelings and provide emotional support (74%), and provide contraceptive health education (92%). Time spent providing these components of care varied across facilities and patients. When describing their facility's care philosophy, many respondents expressed support for "patient-centered," "supportive," "nonjudgmental" care. Eighty-two percent agreed that it is the facility's role to provide counseling for emotional issues related to abortion. All facilities valued informed consent, patient education, and emotional support. Although the majority of facilities considered counseling for emotional issues to be a part of their role, some did not. Future research should examine patients' preferences regarding abortion care and counseling and how different approaches to care affect women's emotional well-being after having an abortion. This information is important in light of current, widespread legislative efforts that aim to regulate abortion counseling, which are being proposed without an understanding of patient needs or facility practices. Copyright © 2012 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  5. Nurses' clinical reasoning practices that support safe medication administration: An integrative review of the literature.

    Science.gov (United States)

    Rohde, Emily; Domm, Elizabeth

    2018-02-01

    To review the current literature about nurses' clinical reasoning practices that support safe medication administration. The literature about medication administration frequently focuses on avoiding medication errors. Nurses' clinical reasoning used during medication administration to maintain medication safety receives less attention in the literature. As healthcare professionals, nurses work closely with patients, assessing and intervening to promote mediation safety prior to, during and after medication administration. They also provide discharge teaching about using medication safely. Nurses' clinical reasoning and practices that support medication safety are often invisible when the focus is medication errors avoidance. An integrative literature review was guided by Whittemore and Knafl's (Journal of Advanced Nursing, 5, 2005 and 546) five-stage review of the 11 articles that met review criteria. This review is modelled after Gaffney et al.'s (Journal of Clinical Nursing, 25, 2016 and 906) integrative review on medical error recovery. Health databases were accessed and systematically searched for research reporting nurses' clinical reasoning practices that supported safe medication administration. The level and quality of evidence of the included research articles were assessed using The Johns Hopkins Nursing Evidence-Based Practice Rating Scale©. Nurses have a central role in safe medication administration, including but not limited to risk awareness about the potential for medication errors. Nurses assess patients and their medication and use knowledge and clinical reasoning to administer medication safely. Results indicated nurses' use of clinical reasoning to maintain safe medication administration was inadequately articulated in 10 of 11 studies reviewed. Nurses are primarily responsible for safe medication administration. Nurses draw from their foundational knowledge of patient conditions and organisational processes and use clinical reasoning that

  6. A comparison of laser-welded titanium and conventional cast frameworks supported by implants in the partially edentulous jaw: a 3-year prospective multicenter study.

    Science.gov (United States)

    Jemt, T; Henry, P; Lindén, B; Naert, I; Weber, H; Bergström, C

    2000-01-01

    The purpose of this prospective multicenter study was to evaluate and compare the clinical performance of laser-welded titanium fixed partial implant-supported prostheses with conventional cast frameworks. Forty-two partially edentulous patients were provided with Brånemark system implants and arranged into 2 groups. Group A was provided with a conventional cast framework with porcelain veneers in one side of the jaw and a laser-welded titanium framework with low-fusing porcelain on the other side. The patients in group B had an old implant prosthesis replaced by a titanium framework prosthesis. The patients were followed for 3 years after prosthesis placement. Clinical and radiographic data were collected and analyzed. Only one implant was lost, and all prostheses were still in function after 3 years. The 2 framework designs showed similar clinical performance with few clinical complications. Only one abutment screw (1%) and 9 porcelain tooth units (5%) fractured. Four prostheses experienced loose gold screws (6%). In group A, marginal bone loss was similar for both designs of prostheses, with a mean of 1.0 mm and 0.3 mm in the maxilla and mandible, respectively. No bone loss was observed on average in group B. No significant relationship (P > 0.05) was observed between marginal bone loss and placement of prosthesis margin or prosthesis design. The use of laser-welded titanium frameworks seems to present similar clinical performance to conventional cast frameworks in partial implant situations after 3 years.

  7. Supporting students with disabilities--promoting understanding amongst mentors in practice.

    Science.gov (United States)

    Tee, Stephen; Cowen, Michelle

    2012-01-01

    Good practice demands a clinical practice culture positively disposed to students with disabilities. Equality legislation seeks to protect those with a disability from either direct or indirect discrimination. The balance between providing "reasonable adjustments" for the student, whilst ensuring "Fitness to Practice", and ultimate employability, requires a close partnership between higher education and practice mentors. This paper reports on the development and evaluation of a range of interactive resources, used in the preparation of mentors to help them address the specific learning needs of disabled students. The evaluation revealed the benefit of student 'stories' in helping mentors to understand the support needs of disabled students and ensure reasonable adjustments are implemented in compliance with disability legislation. The interactive resources have been helpful in promoting positive action towards disabled students' learning, empathic understanding of mental health issues and knowledge and skills acquisition in support of dyslexic students. Implementing reasonable adjustments in practice requires a close working partnership between HEI's and mentors who appreciate support in understanding the development and application of coping strategies to overcome disabilities. Effective preparation of mentors is essential to ensure that opportunities for disabled students to succeed are maximised. Copyright © 2011. Published by Elsevier Ltd.

  8. Staff views on supporting evidence based practice for children with ASD.

    Science.gov (United States)

    Trembath, David; Sulek, Rhylee; Paynter, Jessica; Simpson, Kate; Keen, Deb

    2017-11-22

    A variety of empirically supported interventions are available for children with autism spectrum disorder (ASD), but previous research suggests that their selection and use within an evidence-based practice (EBP) framework in clinical settings is challenging. To date, research has primarily focused on identifying individual, organisational, and contextual barriers to EBP rather than identifying collaborative solutions to these barriers through consultation with staff. The aim of our study was to explore staff views on supporting EBP in their work with children with ASD. We conducted five focus groups involving 29 professional (e.g., speech pathologists, teachers), paraprofessional (e.g., childcare workers), and managerial staff to explore their views. Audio recordings were transcribed verbatim and analysed using thematic analysis. Two central themes, comprising six categories, emerged to account for the participants' views. Initiative and Effort accounted for the range of creative strategies staff had developed to support their engagement in EBP. They also expressed the need for A Better Way involving organisational-wide support such as this engagement, including peer-to-peer mentoring. The findings suggest that an organisational-wide model to support engagement in EBP, with peer-to-peer mentoring at its foundation, may provide a desirable, ecologically valid, and acceptable model. Implications for Rehabilitation Clinicians and educators recognise the importance of evidence-based practice. Efforts to support evidence-based practice have focused mostly on access to research evidence. Clinicians and educators in this study were developing their own strategies based on intuition. They identified a need for organisation-wide approaches to supporting evidence-based practice. Peer-to-peer mentoring appears to be an acceptable and viable strategy.

  9. Knowledge in communicative planning practice : a different perspective for planning support systems

    NARCIS (Netherlands)

    Pelzer, Peter; Geertman, Stan; van der Heijden, Rob

    2015-01-01

    Although planning support systems (PSS) have now undergone more than two decades of research and development, this is not reflected in their practical application. In this paper we argue that one of the reasons for this is that too much emphasis is put on the instrument rather than the usage and

  10. Expanding Opportunities to Learn to Support Inclusive Education through Drama-Enhanced Literacy Practices

    Science.gov (United States)

    Kilinc, Sultan; Farrand, Kathleen; Chapman, Kathryn; Kelley, Michael; Millinger, Jenny; Adams, Korbi

    2017-01-01

    This study examines how the Early Years Educators at Play (EYEPlay) professional development (PD) programme supported inclusive learning settings for all children, including English language learners and students with disabilities. The EYEPlay PD model is a year-long programme that integrates drama strategies into literacy practices within…

  11. Pedagogical Practices of NetNZ Teachers for Supporting Online Distance Learners

    Science.gov (United States)

    Lai, Kwok-Wing

    2017-01-01

    A supportive online learning environment entails teachers using effective pedagogical practices to meet the needs of their students and developing a positive teacher-student relationship to foster learner motivation and engagement. This paper reports a study investigating how 32 secondary teachers in New Zealand taught their online distance…

  12. Practical Recommendations to Improve the Quality of Training and Methodical Support of Professional Teacher Education

    Science.gov (United States)

    Grebennikov, Valery V.; Grudtsina, Ludmila Yu.; Marchuk, Nikolay N.; Sangadgiev, Badma V.; Kudyashev, Nail K.

    2016-01-01

    The research urgency is caused by the transition to the knowledge society and new demands for training and methodical provision of professional pedagogical education. The purpose of this paper is to develop practical recommendations to improve the quality of training and methodical support of professional pedagogical education. The leading…

  13. A Guide to Providing Social Support for Apprentices. Good Practice Guide

    Science.gov (United States)

    National Centre for Vocational Education Research (NCVER), 2016

    2016-01-01

    The main purpose of this guide is to provide some ideas for employers of apprentices to provide an environment in which strong informal bases of support can succeed. Formal mentoring is an important aspect of apprenticeships; however, it is also informal mentoring--practices that are difficult to formally nurture--that plays a significant and…

  14. Parenting with Positive Behavior Support: A Practical Guide to Resolving Your Child's Difficult Behavior

    Science.gov (United States)

    Hieneman, Meme; Childs, Karen; Sergay, Jane

    2006-01-01

    Now the theory and research behind the positive behavior support (PBS) process--an approach already proven effective in schools and community programs--has been transformed into a practical, easy-to-use guide that's perfect for sharing with parents. Developed by educators and families, this user-friendly handbook offers parents easy-to-follow…

  15. School System (Re)design: Developing Educational Infrastructures to Support School Leadership and Teaching Practice

    Science.gov (United States)

    Hopkins, Megan; Woulfin, Sarah L.

    2015-01-01

    A central challenge for local education agencies (i.e., school districts in the United States) undergoing reform is to design systems that facilitate instructional improvement. At the core of these systems are educational infrastructures that bolster capacity building efforts and support teaching and leadership practices. Our goal for this special…

  16. Examining Instructional Practices, Intellectual Challenge, and Supports for African American Student Writers

    Science.gov (United States)

    Alston, Chandra L.

    2012-01-01

    The debate surrounding how best to support African American student writers continues today as the gap between achievement scores persists. This qualitative analysis documents the classroom structures and instructional practices of two English Language Arts teachers working in a predominately African American public middle school, whose students…

  17. Developing a Community of Practice through Learning Climate, Leader Support, and Leader Interaction

    Science.gov (United States)

    Baker-Eveleth, Lori J.; Chung, Yunhyung; Eveleth, Daniel M.; O'Neill, Michele

    2011-01-01

    The Communities of Practice (CoP) concept and the knowledge management literature both provide useful frameworks for conceptualizing how an individual's performance in the classroom (e.g., earning a grade) or in an organization (e.g., solving a client's problem) can be supported by a collection of other individuals performing similar tasks and…

  18. The design of patient decision support interventions: addressing the theory-practice gap

    NARCIS (Netherlands)

    Elwyn, G.; Stiel, M.; Durand, M.A.; Boivin, J.

    2011-01-01

    BACKGROUND: Although an increasing number of decision support interventions for patients (including decision aids) are produced, few make explicit use of theory. We argue the importance of using theory to guide design. The aim of this work was to address this theory-practice gap and to examine how a

  19. Theory and practice of clinical ethics support services: narrative and hermeneutical perspectives

    NARCIS (Netherlands)

    Porz, R.; Landeweer, E.G.M.; Widdershoven, G.A.M.

    2011-01-01

    In this paper we introduce narrative and hermeneutical perspectives to clinical ethics support services (CESS). We propose a threefold consideration of 'theory' and show how it is interwoven with 'practice' as we go along. First, we look at theory in its foundational role: in our case 'narrative

  20. Supporting First-Generation College Students through Classroom-Based Practices. Issue Brief

    Science.gov (United States)

    Institute for Higher Education Policy, 2012

    2012-01-01

    This report, which was commissioned as part of the Institute for Higher Education Policy's Walmart Minority Student Success Initiative, seeks to highlight how specific institutional policies and faculty-driven, classroom-based practices at Minority-Serving Institutions (MSIs) can change in an effort to better support the academic and social…

  1. Supporting near-peer teaching in general practice: a national survey.

    Science.gov (United States)

    van de Mortel, Thea F; Silberberg, Peter L; Ahern, Christine M; Pit, Sabrina W

    2016-05-12

    Training bodies see teaching by junior doctors and vocational trainees in general practice (family medicine) as integral to a doctor's role. While there is a body of literature on teacher training programs, and on peer and near-peer teaching in hospitals and universities, there has been little examination of near-peer teaching in general practice. Near-peer teaching is teaching to those close to oneself but not at the same level in the training continuum. This study investigated the perceptions of key stakeholders on near-peer teaching in general practice, their current near-peer teaching activities, and methods of recruitment and support. A national anonymous online survey was used to obtain data on Australian stakeholders' perceptions of, and processes related to, near-peer teaching in general practice. Recruitment occurred via electronic invitations sent by training providers and stakeholder associations. Separate questionnaires, which were validated via several cycles of review and piloting, were developed for supervisors and learners. The survey included both fixed response and open response questions. Responses (n = 1,122) were obtained from 269 general practitioner supervisors, 221 general practice registrars, 319 prevocational trainees, and 313 medical students. All stakeholder groups agreed that registrars should teach learners in general practice, and 72% of registrars, 68% of prevocational trainees, and 33% of medical students reported having done some teaching in this setting. Three-quarters of supervisors allowed learners to teach. Having another learner observe their consultations was the most common form of teaching for registrars and prevocational trainees. Eight percent of registrars received some remuneration for teaching. The approach used to determine teaching readiness and quality varied greatly between supervisors. Near-peer teaching was supported by the majority of stakeholders, but is underutilised and has poor structural support

  2. The partial mediation effect of satisfaction with social support and coping effectiveness on health-related quality of life and perceived stress long-term after heart transplantation

    Directory of Open Access Journals (Sweden)

    White-Williams C

    2014-12-01

    Full Text Available Connie White-Williams,1 Kathleen L Grady,2 Pariya Fazeli,1 Susan Myers,1 Linda Moneyham,3 Karen Meneses,3 Bruce Rybarczyk4 1University of Alabama Medical Center, Birmingham, AL, USA; 2Division of Cardiac Surgery, Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; 3School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA; 4Department of Psychology, Clinical Psychology Program, Virginia Commonwealth University, Richmond, VA, USA Abstract: The purpose of this research was to examine whether satisfaction with social support and coping effectiveness mediate the relationship between stress and health-related quality of life (HRQOL 5 years after heart transplantation. Data were collected from 212 heart transplant patients (80% male, 92% white, mean age 59.9 years at four United States sites using the Heart Transplant Stressor Scale, Social Support Index, Jalowiec Coping Scale, and Quality of Life Index. Using Baron and Kenny's approach, a series of regression equations for mediation revealed that both satisfaction with social support and coping partially mediated the relationship between perceived stress and HRQOL. Understanding the relationships of social support, stress, and coping on patients' HRQOL is important for the development of interventions to provide optimal patient care. Keywords: heart transplantation, social support, coping, stress, mediation

  3. Online mentoring and peer support: using learning technologies to facilitate entry into a community of practice

    Directory of Open Access Journals (Sweden)

    Lori Lockyer

    2002-12-01

    Full Text Available A vital aspect of any professional education is the opportunity for students to engage in meaningful practical experiences. In pre-service teacher education in Australia, this vital teaching practice component has undergone challenges in recent years due to increasing student numbers (linked to the increasing demand for new teachers and limited resources in university and school sectors. As such, initiatives to enhance the practical component of this professional degree have been sought. This paper details the methodology and outcomes associated with a pilot project that utilized asynchronous Web-based communication tools to facilitate mentoring and peer support through the teaching practice experience. Analysis of the online discussions and interviews with participants provides an indication of the nature of the interactions and the perceived value of the intervention, and informs the potential for larger-scale implementation.

  4. Effect of implant number and distribution on load transfer in implant-supported partial fixed dental prostheses for the anterior maxilla: A photoelastic stress analysis study.

    Science.gov (United States)

    Lee, Jae-In; Lee, Yoon; Kim, Yu-Lee; Cho, Hye-Won

    2016-02-01

    The 4-, 3- or even 2-implant-supported partial fixed dental prosthesis (PFDP) designs have been used to rehabilitate the anterior edentulous maxilla. The purpose of this in vitro study was to compare the stress distribution in the supporting tissues surrounding implants placed in the anterior maxilla with 5 PFDP designs. A photoelastic model of the human maxilla with an anterior edentulous region was made with photoelastic resin (PL-2; Vishay Micro-Measurements), and 6 straight implants (OsseoSpeed; Astra Tech AB) were placed in the 6 anterior tooth positions. The 5 design concepts based on implant location were as follows: model 6I: 6 implants; model 2C2CI: 4 implants (2 canines and 2 central incisors); model 2C2LI: 4 implants (2 canines and 2 lateral incisors); model 2C1CI: 3 implants (2 canines and 1 central incisor); and model 2C: 2 canines. A load of 127.4 N was applied on the cingulum of 3 teeth at a 30-degree angle to the long axis of the implant. Stresses that developed in the supporting structure were recorded photographically. The 6-implant-supported PFDP exhibited the most even and lowest distribution of stresses in all loading conditions. When the canine was loaded, the 2- or 3-implant-supported PFDP showed higher stresses around the implant at the canine position than did the 4- or 6-implant-supported PFDP. When the central incisor or lateral incisor was loaded, the two 4-implant-supported PFDPs exhibited similar levels of stresses around the implants and showed lower stresses than did the 2- or 3-implant-supported PFDP. Implant number and distribution influenced stress distribution around the implants in the anterior maxilla. With a decrease in implant number, the stresses around the implants increased. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  5. Friendliness, functionality and freedom: Design characteristics that support midwifery practice in the hospital setting.

    Science.gov (United States)

    Hammond, Athena; Homer, Caroline S E; Foureur, Maralyn

    2017-07-01

    to identify and describe the design characteristics of hospital birth rooms that support midwives and their practice. this study used a qualitative exploratory descriptive methodology underpinned by the theoretical approach of critical realism. Data was collected through 21 in-depth, face-to-face photo-elicitation interviews and a thematic analysis guided by study objectives and the aims of exploratory research was undertaken. the study was set at a recently renovated tertiary hospital in a large Australian city. participants were 16 registered midwives working in a tertiary hospital; seven in delivery suite and nine in birth centre settings. Experience as a midwife ranged from three to 39 years and the sample included midwives in diverse roles such as educator, student support and unit manager. three design characteristics were identified that supported midwifery practice. They were friendliness, functionality and freedom. Friendly rooms reduced stress and increased midwives' feelings of safety. Functional rooms enabled choice and provided options to better meet the needs of labouring women. And freedom allowed for flexible, spontaneous and responsive midwifery practice. hospital birth rooms that possess the characteristics of friendliness, functionality and freedom offer enhanced support for midwives and may therefore increase effective care provision. new and existing birth rooms can be designed or adapted to better support the wellbeing and effectiveness of midwives and may thereby enhance the quality of midwifery care delivered in the hospital. Quality midwifery care is associated with positive outcomes and experiences for labouring women. Further research is required to investigate the benefit that may be transmitted to women by implementing design intended to support and enhance midwifery practice. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. The utility of an online diagnostic decision support system (Isabel) in general practice: a process evaluation.

    Science.gov (United States)

    Henderson, Emily J; Rubin, Greg P

    2013-05-01

    To evaluate the utility of Isabel, an online diagnostic decision support system developed by Isabel Healthcare primarily for secondary medical care, in the general practice setting. Focus groups were conducted with clinicians to understand why and how they used the system. A modified online post-use survey asked practitioners about its impact on their decision-making. Normalization process theory (NPT) was used as a theoretical framework to determine whether the system could be incorporated into routine clinical practice. The system was introduced by NHS County Durham and Darlington in the UK in selected general practices as a three-month pilot. General practitioners and nurse practitioners who had access to Isabel as part of the Primary Care Trust's pilot. General practitioners' views, experiences and usage of the system. Seven general practices agreed to pilot Isabel. Two practices did not subsequently use it. The remaining five practices conducted searches on 16 patients. Post-use surveys (n = 10) indicated that Isabel had little impact on diagnostic decision-making. Focus group participants stated that, although the diagnoses produced by Isabel in general did not have an impact on their decision-making, they would find the tool useful if it were better tailored to the primary care setting. Our analysis concluded that normalization was not likely to occur in its current form. Isabel was of limited utility in this short pilot study and may need further modification for use in general practice.

  7. In Vivo Tooth-Supported Implant Surgical Guides Fabricated With Desktop Stereolithographic Printers: Fully Guided Surgery Is More Accurate Than Partially Guided Surgery.

    Science.gov (United States)

    Bencharit, Sompop; Staffen, Adam; Yeung, Matthew; Whitley, Daniel; Laskin, Daniel M; Deeb, George R

    2018-02-21

    Desktop stereolithographic printers combined with intraoral scanning and implant planning software promise precise and cost-effective guided implant surgery. The purpose of the present study was to determine the overall range of accuracy of tooth-supported guided implant surgery using desktop printed stereolithographic guides. A cross-sectional study comparing fully and partially guided implant surgery was conducted. Preoperative cone beam computed tomography (CBCT) and intraoral scans were used to plan the implant sites. Surgical guides were then fabricated using a desktop stereolithographic 3-dimensional printer. Postoperative CBCT was used to evaluate the accuracy of placement. Deviations from the planned positions were used as the primary outcome variables. The planning software used, implant systems, and anterior/posterior positions were the secondary outcome variables. The differences between the planned and actual implant positions in the mesial, distal, buccal, and lingual dimensions and buccolingual angulations were determined, and the accuracy was compared statistically using the 1-tail F-test (P = .01), box plots, and 95% confidence intervals for the mean. Sixteen partially edentulous patients requiring placement of 31 implants were included in the present study. The implant deviations from the planned positions for mesial, distal, buccal, and lingual dimensions and buccolingual angulations with the fully guided protocol (n = 20) were 0.17 ± 0.78 mm, 0.44 ± 0.78 mm, 0.23 ± 1.08 mm, -0.22 ± 1.44 mm, and -0.32° ± 2.36°, respectively. The corresponding implant deviations for the partially guided protocol (n = 11) were 0.33 ± 1.38 mm, -0.03 ± 1.59 mm, 0.62 ± 1.15 mm, -0.27 ± 1.61 mm, and 0.59° ± 6.83°. The difference between the variances for fully and partially guided surgery for the distal and angulation dimensions was statistically significant (P = .006 and P guided implant surgery is more accurate than

  8. Addressing Prediabetes in Childhood Obesity Treatment Programs: Support from Research and Current Practice

    Science.gov (United States)

    Grow, H. Mollie; Fernandez, Cristina; Lukasiewicz, Gloria J.; Rhodes, Erinn T.; Shaffer, Laura A.; Sweeney, Brooke; Woolford, Susan J.; Estrada, Elizabeth

    2014-01-01

    Abstract Background: Type 2 diabetes mellitus (T2DM) and prediabetes have increased in prevalence among overweight and obese children, with significant implications for long-term health. There is little published evidence on the best approaches to care of prediabetes among overweight youth or the current practices used across pediatric weight management programs. Methods: This article reviews the literature and summarizes current practices for screening, diagnosis, and treatment of prediabetes at childhood obesity treatment centers. Findings regarding current practice were based on responses to an online survey from 28 pediatric weight management programs at 25 children's hospitals in 2012. Based on the literature reviewed, and empiric data, consensus support statements on prediabetes care and T2DM prevention were developed among representatives of these 25 children's hospitals' obesity clinics. Results: The evidence reviewed demonstrates that current T2DM and prediabetes diagnostic parameters are derived from adult-based studies with little understanding of clinical outcomes among youth. Very limited evidence exists on preventing progression of prediabetes. Some evidence suggests that a significant proportion of obese youth with prediabetes will revert to normoglycemia without pharmacological management. Evidence supports lifestyle modification for children with prediabetes, but further study of specific lifestyle changes and pharmacological treatments is needed. Conclusion: Evidence to guide management of prediabetes in children is limited. Current practice patterns of pediatric weight management programs show areas of variability in practice, reflecting the limited evidence base. More research is needed to guide clinical care for overweight youth with prediabetes. PMID:25055134

  9. Proposal of a Holistic Model to Support Local-Level Evidence-Based Practice

    Directory of Open Access Journals (Sweden)

    Said Shahtahmasebi

    2010-01-01

    Full Text Available In response to a central drive for evidence-based practice, there have been many research support schemes, setups, and other practices concentrating on facilitating access to external research, such as the Centre for Evidence Based Healthcare Aotearoa, the Cochrane Collaboration, and the York Centre for Reviews and Dissemination. Very little attention has been paid to supporting internal research in terms of local evidence and internal research capabilities. The whole evidence-based practice movement has alienated internal decision makers and, thus, very little progress has been made in the context of evidence informing local policy formation. Health and social policies are made centrally based on dubious claims and often evidence is sought after implementation. For example, on record, most health care practitioners appear to agree with the causal link between depression and mental illness (sometimes qualified with other social factors with suicide; off the record, even some psychiatrists doubt that such a link is applicable to the population as a whole. Therefore, be it through misplaced loyalty or a lack of support for internal researchers/decision makers, local evidence informing local decision making may have been ignored in favour of external evidence. In this paper, we present a practical holistic model to support local evidence-based decision making. This approach is more relevant in light of a new approach to primary health care of “local knowledge” complementing external evidence. One possible outcome would be to network with other regional programmes around the world to share information and identify “best” practices, such as the “Stop Youth Suicide Campaign”(www.stopyouthsuicide.com.

  10. The IAEA activities supporting implementation of best practice in uranium production cycle

    International Nuclear Information System (INIS)

    Slezak, J.

    2010-01-01

    'Full text:' Since the International Atomic Energy Agency's foundation in 1957, the Agency has had an increasing interest in uranium production cycle (UPC) developments. Recent activities cover tasks on uranium geology & deposits, exploration, mining & processing including environmental issues. The two projects titles are (1) Updating uranium resources, supply and demand and nuclear fuel cycle databases and (2) Supporting good practices in the UPC in particular for new countries. Based o the recent experience, one of the new activities is focused at human resources development to improve application of best practice called Uranium Production Cycle Network (UPNet). (author)

  11. Maxillary implant-supported overdentures opposed by (partial) natural dentitions: a 5-year prospective case series study.

    Science.gov (United States)

    Boven, G C; Slot, J W A; Raghoebar, G M; Vissink, A; Meijer, H J A

    2017-12-01

    The aim of this study was to assess the 5-year treatment outcome of maxillary implant-retained overdentures opposed by natural antagonistic teeth. Fifty consecutive patients received maxillary overdentures supported by six dental implants. Implants were placed in the anterior region, if enough bone was present (n = 25 patients) Implant were placed in the posterior region if implant placement in the anterior region was not possible (n = 25 patients). Variables assessed included survival of implants, condition of hard and soft peri-implant tissues and patients' satisfaction. The five-year implant survival rate was 97·0% and 99·3%, and mean radiographic bone loss was 0·23 and 0·69 mm in the anterior and posterior group, respectively. Median scores for plaque, calculus, gingiva, bleeding and mean scores for pocket probing depth were low and stayed low. Patients' satisfaction after treatment was high in both groups. Within the limits of this 5-year study, it is concluded that six dental implants (placed in the anterior or posterior region) connected with a bar and opposed to natural antagonistic teeth result in acceptable results for clinical parameters and good outcomes for marginal bone level changes and patient satisfaction. © 2017 John Wiley & Sons Ltd.

  12. Comparative analysis of speed's impact on muscle demands during partial body weight support motor-assisted elliptical training.

    Science.gov (United States)

    Burnfield, Judith M; Irons, Sonya L; Buster, Thad W; Taylor, Adam P; Hildner, Gretchen A; Shu, Yu

    2014-01-01

    Individuals with walking limitations often experience challenges engaging in functionally relevant exercise. An adapted elliptical trainer (motor to assist pedal movement, integrated body weight harness, ramps/stairs, and grab rails) has been developed to help individuals with physical disabilities and chronic conditions regain/retain walking capacity and fitness. However, limited published studies are available to guide therapeutic interventions. This repeated measures study examined the influence of motor-assisted elliptical training speed on lower extremity muscle demands at four body weight support (BWS) levels commonly used therapeutically for walking. Electromyography (EMG) and pedal trajectory data were recorded as ten individuals without known disability used the motor-assisted elliptical trainer at three speeds [20,40, 60 revolutions per minute (RPM)] during each BWS level (0%, 20%, 40%, 60%). Overall, the EMG activity (peak, mean, duration) in key stabilizer muscles (i.e., gluteus medius, gluteus maximus, vastus lateralis, medial gastrocnemius and soleus) recorded at 60 RPM exceeded those at 40 RPM, which were higher than values at 20 RPM in all but three situations (gluteus medius mean at 0% BWS, vastus lateralis mean at 20% BWS, soleus duration at 40% BWS); however, these differences did not always achieve statistical significance. Slower motor-assisted speeds can be used to accommodate weakness of gluteus medius, gluteus maximus, vastus lateralis, medial gastrocnemius and soleus. As strength improves, training at faster motor-assisted speeds may provide a means to progressively challenge key lower extremity stabilizers. Copyright © 2013 Elsevier B.V. All rights reserved.

  13. Quality of communication and master impressions for the fabrication of cobalt chromium removable partial dentures in general dental practice in England, Ireland and Wales in 2009.

    Science.gov (United States)

    Kilfeather, G P; Lynch, C D; Sloan, A J; Youngson, C C

    2010-04-01

    The aim of this study was to investigate the quality of communication and master impressions for the fabrication of cobalt chromium removable partial dentures (RPDs) in general dental practice in England, Ireland and Wales in 2009. Two hundred and ten questionnaires were distributed to 21 laboratories throughout England, Ireland and Wales. Information was collected regarding the quality of written communication and selection of master impression techniques for cobalt chromium partial dentures in general dental practice. One hundred and forty-four questionnaires were returned (response rate = 68%). Alginate was the most popular impression material being used in 58% of cases (n = 84), while plastic stock trays were the most popular impression tray, being used in 31% of cases (n = 44). Twenty-four per cent (n = 35) of impressions were not adequately disinfected. Opposing casts were provided in 81% of cases (n = 116). Written instructions were described as being 'clear' in 31% of cases (n = 44). In 54% of cases (n = 76), the technician was asked to design the RPD. Based on the findings of this study, written communication for cobalt chromium RPDs by general dental practitioners is inadequate. This finding is in breach of relevant contemporary legal and ethical guidance. There are also concerns in relation to the fabrication process for this form of prosthesis, particularly, in relation to consideration of occlusal schemes.

  14. Probabilistic Requirements (Partial) Verification Methods Best Practices Improvement. Variables Acceptance Sampling Calculators: Derivations and Verification of Plans. Volume 1

    Science.gov (United States)

    Johnson, Kenneth L.; White, K, Preston, Jr.

    2012-01-01

    The NASA Engineering and Safety Center was requested to improve on the Best Practices document produced for the NESC assessment, Verification of Probabilistic Requirements for the Constellation Program, by giving a recommended procedure for using acceptance sampling by variables techniques. This recommended procedure would be used as an alternative to the potentially resource-intensive acceptance sampling by attributes method given in the document. This document contains the outcome of the assessment.

  15. Mental health and psychosocial support in humanitarian settings: linking practice and research.

    Science.gov (United States)

    Tol, Wietse A; Barbui, Corrado; Galappatti, Ananda; Silove, Derrick; Betancourt, Theresa S; Souza, Renato; Golaz, Anne; van Ommeren, Mark

    2011-10-29

    This review links practice, funding, and evidence for interventions for mental health and psychosocial wellbeing in humanitarian settings. We studied practice by reviewing reports of mental health and psychosocial support activities (2007-10); funding by analysis of the financial tracking service and the creditor reporting system (2007-09); and interventions by systematic review and meta-analysis. In 160 reports, the five most commonly reported activities were basic counselling for individuals (39%); facilitation of community support of vulnerable individuals (23%); provision of child-friendly spaces (21%); support of community-initiated social support (21%); and basic counselling for groups and families (20%). Most interventions took place and were funded outside national mental health and protection systems. 32 controlled studies of interventions were identified, 13 of which were randomised controlled trials (RCTs) that met the criteria for meta-analysis. Two studies showed promising effects for strengthening community and family supports. Psychosocial wellbeing was not included as an outcome in the meta-analysis, because its definition varied across studies. In adults with symptoms of post-traumatic stress disorder (PTSD), meta-analysis of seven RCTs showed beneficial effects for several interventions (psychotherapy and psychosocial supports) compared with usual care or waiting list (standardised mean difference [SMD] -0·38, 95% CI -0·55 to -0·20). In children, meta-analysis of four RCTs failed to show an effect for symptoms of PTSD (-0·36, -0·83 to 0·10), but showed a beneficial effect of interventions (group psychotherapy, school-based support, and other psychosocial support) for internalising symptoms (six RCTs; SMD -0·24, -0·40 to -0·09). Overall, research and evidence focuses on interventions that are infrequently implemented, whereas the most commonly used interventions have had little rigorous scrutiny. Copyright © 2011 Elsevier Ltd. All

  16. Mental health and psychosocial support in humanitarian settings: linking practice and research

    Science.gov (United States)

    Tol, Wietse A; Barbui, Corrado; Galappatti, Ananda; Silove, Derrick; Betancourt, Theresa S; Souza, Renato; Golaz, Anne; van Ommeren, Mark

    2014-01-01

    This review links practice, funding, and evidence for interventions for mental health and psychosocial wellbeing in humanitarian settings. We studied practice by reviewing reports of mental health and psychosocial support activities (2007–10); funding by analysis of the financial tracking service and the creditor reporting system (2007–09); and interventions by systematic review and meta-analysis. In 160 reports, the five most commonly reported activities were basic counselling for individuals (39%); facilitation of community support of vulnerable individuals (23%); provision of child-friendly spaces (21%); support of community-initiated social support (21%); and basic counselling for groups and families (20%). Most interventions took place and were funded outside national mental health and protection systems. 32 controlled studies of interventions were identified, 13 of which were randomised controlled trials (RCTs) that met the criteria for meta-analysis. Two studies showed promising effects for strengthening community and family supports. Psychosocial wellbeing was not included as an outcome in the meta-analysis, because its definition varied across studies. In adults with symptoms of post-traumatic stress disorder (PTSD), meta-analysis of seven RCTs showed beneficial effects for several interventions (psychotherapy and psychosocial supports) compared with usual care or waiting list (standardised mean difference [SMD] −0.38, 95% CI −0.55 to −0.20). In children, meta-analysis of four RCTs failed to show an effect for symptoms of PTSD (−0.36, −0.83 to 0.10), but showed a beneficial effect of interventions (group psychotherapy, school-based support, and other psychosocial support) for internalising symptoms (six RCTs; SMD −0.24, −0.40 to −0.09). Overall, research and evidence focuses on interventions that are infrequently implemented, whereas the most commonly used interventions have had little rigorous scrutiny. PMID:22008428

  17. Education and information for practicing school nurses: which technology-supported resources meet their needs?

    Science.gov (United States)

    Anderson, Lori S; Enge, Karmin J

    2012-10-01

    School nurses care for children with a variety of health-related conditions and they need information about managing these conditions, which is accessible, current, and useful. The goal of this literature review was to gather and synthesize information on technology-supported resources and to determine which met the educational needs of school nurses. Successful online educational programs were interactive and self-directed. The most common barriers were lack of time to find educational information, lack of knowledge about computers, technology, the Internet and specific programs, and lack of administrative support from school officials to use technology to access information and evidence for practice. Recommendations for successful use of technology to meet practicing school nurse's educational needs are offered.

  18. The importance of good time management in supporting succesful dental practice

    OpenAIRE

    Mita Juliawati

    2016-01-01

    n the globalization and Asean Economic Community (MEA) era, especially in the era of  competition and modern dentistry, dentists need increasing services in order to maintain and increase patient visits. Especially in patient’s complain about dental services that caused by unmanaged time, such as late dentist, long queue of patients and time inefficiency in dental practice. The objective of this review is to discuss the importance of good time management ’in supporting successful dental prati...

  19. Management accounting in support of strategy - a strategy as practice perspective

    OpenAIRE

    Pitcher, GS

    2014-01-01

    The term Strategic Management Accounting (SMA) was coined in the 1980's to both describe and encourage the development of accounting techniques that addressed strategic decision-making. This prompted the production of books and research papers into SMA techniques. However, there is very little research into how management accounting supports strategy making. Adopting the lens of strategy-as-practice and utilising a narrative research \\ud approach this developmental paper addresses the questio...

  20. Mothers who formula feed: their practices, support needs and factors influencing their Infant feeding decision

    LENUS (Irish Health Repository)

    Tarrant, R C

    2013-01-01

    The majority of mothers in Ireland provide formula milk to their infants during the initial weeks postpartum; however, data are lacking on their formula feeding practices and support needs. This prospective Dublin-based observational study, which included 450 eligible mother-term infant pairs recruited and followed up to 6 months postpartum, aimed to advance our understanding of maternal formula feeding practices, their reasons for deciding to formula feed, sources of feeding information and perceived support needs; insights into infant formula milk consumption patterns in relation to current feeding guidelines are also provided. In summary, the vast majority of infants at 6 weeks were provided with formula milk (n = 368; 81.8%). Positive maternal perceptions of formula feeding were among the most frequently reported reasons underlying mothers’ decision to formula feed (e.g. convenience, 17.3%). Potential public health concerns over the large formula milk volumes consumed by infants (mean 205ml\\/kilogram\\/day) relative to infant feeding guidelines (150ml\\/kilogram\\/day) were raised from this study. Some mothers continue to add solid foods to infant bottle feeds at 6 weeks (3.8%) and 6 months (6%), a non-recommended feeding practice posing a choking risk for infants. Crucially, this study highlights the need to provide greater support and information to mothers who decide to formula feed postpartum including practical information on sterilisation and formula reconstitution. While breastfeeding promotion and research continues to be a public health priority in Ireland, addressing the support and information needs of mothers who formula feed, an underrepresented and understudied population in the literature, also needs to be considered to ensure optimal health and safety for their infants.

  1. The importance of good time management in supporting succesful dental practice

    Directory of Open Access Journals (Sweden)

    Mita Juliawati

    2016-06-01

    Full Text Available n the globalization and Asean Economic Community (MEA era, especially in the era of  competition and modern dentistry, dentists need increasing services in order to maintain and increase patient visits. Especially in patient’s complain about dental services that caused by unmanaged time, such as late dentist, long queue of patients and time inefficiency in dental practice. The objective of this review is to discuss the importance of good time management ’in supporting successful dental pratice. Time management is the act or process of planning and exercising conscious control over the amount of time spent on specific activities, especially to increase  effectiveness, efficiency or productivity. Implementation in dental practice are as follow: planning, scheduling and time organizing to avoid wasted time. Proper time management resulted in greater efficiency and productivity, professional reputation,reduces stress and improves the image of dental practices. Routine evaluation is needed to increase time management quality. Efficient time management in dental practice requires organizing  individual tasks, analizing daily task, scheduling main projects, establishing deadlines and organizing workflow. The implementation in dental practice like organizing patients, medical and non medical employee daily schedule, managing the patient’s queue to get the minimum waiting time and avoiding doctors being late in giving services to patient. Setting good time management will make the dentist's work 'smarter not harder' to get more results with limited time. In principle all medical and non-medical personnel should support the implementation of service excellence in the health care services especially dental practice. The final objective in realizing good time management in dental clinic is concerning in quality service and aims to achieve patient satisfaction (customer satisfaction that the end goal is a loyal patient, customer loyalty and

  2. Supporting nurse mentor development: An exploration of developmental constellations in nursing mentorship practice.

    Science.gov (United States)

    MacLaren, Julie-Ann

    2018-01-01

    Supervised practice as a mentor is currently an integral component of nurse mentor education. However, workplace education literature tends to focus on dyadic mentor-student relationships rather than developmental relationships between colleagues. This paper explores the supportive relationships of nurses undertaking a mentorship qualification, using the novel technique of constellation development to determine the nature of workplace support for this group. Semi-structured interviews were conducted with three recently qualified nurse mentors. All participants developed a mentorship constellation identifying colleagues significant to their own learning in practice. These significant others were also interviewed alongside practice education, and nurse education leads. Constellations were analysed in relation to network size, breadth, strength of relationships, and attributes of individuals. Findings suggest that dyadic forms of supervisory mentorship may not offer the range of skills and attributes that developing mentors require. Redundancy of mentorship attributes within the constellation (overlapping attributes between members) may counteract problems caused when one mentor attempts to fulfil all mentorship roles. Wider nursing teams are well placed to provide the support and supervision required by mentors in training. Where wider and stronger networks were not available to mentorship students, mentorship learning was at risk. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  3. Action to Support Practices Implement Research Evidence (ASPIRE): protocol for a cluster-randomised evaluation of adaptable implementation packages targeting 'high impact' clinical practice recommendations in general practice.

    Science.gov (United States)

    Willis, Thomas A; Hartley, Suzanne; Glidewell, Liz; Farrin, Amanda J; Lawton, Rebecca; McEachan, Rosemary R C; Ingleson, Emma; Heudtlass, Peter; Collinson, Michelle; Clamp, Susan; Hunter, Cheryl; Ward, Vicky; Hulme, Claire; Meads, David; Bregantini, Daniele; Carder, Paul; Foy, Robbie

    2016-02-29

    There are recognised gaps between evidence and practice in general practice, a setting which provides particular challenges for implementation. We earlier screened clinical guideline recommendations to derive a set of 'high impact' indicators based upon criteria including potential for significant patient benefit, scope for improved practice and amenability to measurement using routinely collected data. We aim to evaluate the effectiveness and cost-effectiveness of a multifaceted, adaptable intervention package to implement four targeted, high impact recommendations in general practice. The research programme Action to Support Practice Implement Research Evidence (ASPIRE) includes a pair of pragmatic cluster-randomised trials which use a balanced incomplete block design. Clusters are general practices in West Yorkshire, United Kingdom (UK), recruited using an 'opt-out' recruitment process. The intervention package adapted to each recommendation includes combinations of audit and feedback, educational outreach visits and computerised prompts with embedded behaviour change techniques selected on the basis of identified needs and barriers to change. In trial 1, practices are randomised to adapted interventions targeting either diabetes control or risky prescribing and those in trial 2 to adapted interventions targeting either blood pressure control in patients at risk of cardiovascular events or anticoagulation in atrial fibrillation. The respective primary endpoints comprise achievement of all recommended target levels of haemoglobin A1c (HbA1c), blood pressure and cholesterol in patients with type 2 diabetes, a composite indicator of risky prescribing, achievement of recommended blood pressure targets for specific patient groups and anticoagulation prescribing in patients with atrial fibrillation. We are also randomising practices to a fifth, non-intervention control group to further assess Hawthorne effects. Outcomes will be assessed using routinely collected data

  4. Effects of conventional overground gait training and a gait trainer with partial body weight support on spatiotemporal gait parameters of patients after stroke.

    Science.gov (United States)

    Park, Byoung-Sun; Kim, Mee-Young; Lee, Lim-Kyu; Yang, Seung-Min; Lee, Won-Deok; Noh, Ji-Woong; Shin, Yong-Sub; Kim, Ju-Hyun; Lee, Jeong-Uk; Kwak, Taek-Yong; Lee, Tae-Hyun; Kim, Ju-Young; Kim, Junghwan

    2015-05-01

    [Purpose] The purpose of this study was to confirm the effects of both conventional overground gait training (CGT) and a gait trainer with partial body weight support (GTBWS) on spatiotemporal gait parameters of patients with hemiparesis following chronic stroke. [Subjects and Methods] Thirty stroke patients were alternately assigned to one of two treatment groups, and both groups underwent CGT and GTBWS. [Results] The functional ambulation classification on the affected side improved significantly in the CGT and GTBWS groups. Walking speed also improved significantly in both groups. [Conclusion] These results suggest that the GTBWS in company with CGT may be, in part, an effective method of gait training for restoring gait ability in patients after a stroke.

  5. A model for the electronic support of practice-based research networks.

    Science.gov (United States)

    Peterson, Kevin A; Delaney, Brendan C; Arvanitis, Theodoros N; Taweel, Adel; Sandberg, Elisabeth A; Speedie, Stuart; Richard Hobbs, F D

    2012-01-01

    The principal goal of the electronic Primary Care Research Network (ePCRN) is to enable the development of an electronic infrastructure to support clinical research activities in primary care practice-based research networks (PBRNs). We describe the model that the ePCRN developed to enhance the growth and to expand the reach of PBRN research. Use cases and activity diagrams were developed from interviews with key informants from 11 PBRNs from the United States and United Kingdom. Discrete functions were identified and aggregated into logical components. Interaction diagrams were created, and an overall composite diagram was constructed describing the proposed software behavior. Software for each component was written and aggregated, and the resulting prototype application was pilot tested for feasibility. A practical model was then created by separating application activities into distinct software packages based on existing PBRN business rules, hardware requirements, network requirements, and security concerns. We present an information architecture that provides for essential interactions, activities, data flows, and structural elements necessary for providing support for PBRN translational research activities. The model describes research information exchange between investigators and clusters of independent data sites supported by a contracted research director. The model was designed to support recruitment for clinical trials, collection of aggregated anonymous data, and retrieval of identifiable data from previously consented patients across hundreds of practices. The proposed model advances our understanding of the fundamental roles and activities of PBRNs and defines the information exchange commonly used by PBRNs to successfully engage community health care clinicians in translational research activities. By describing the network architecture in a language familiar to that used by software developers, the model provides an important foundation for the

  6. Transition from failing dentition to full-arch fixed implant-supported prosthesis with a staged approach using removable partial dentures: a case series.

    Science.gov (United States)

    Cortes, Arthur Rodriguez Gonzalez; Cortes, Djalma Nogueira; No-Cortes, Juliana; Arita, Emiko Saito

    2014-06-01

    The present retrospective case series is aimed at evaluating a staged approach using a removable partial denture (RPD) as an interim prosthesis in treatment to correct a failing dentition until such time as a full-arch fixed implant-supported prosthesis may be inserted. Eight patients, who had undergone maxillary full-arch rehabilitation with dental implants due to poor prognosis of their dentitions, were analyzed. All treatment included initial periodontal therapy and a strategic order of extraction of hopeless teeth. An RPD supported by selected teeth rehabilitated the compromised arch during implant osseointegration. These remaining teeth were extracted prior to definitive prosthesis delivery. Advantages and drawbacks of this technique were also recorded for the cases presented. Among the advantages provided by the staged approach are simplicity of fabrication, low cost, and ease of insertion. Additionally, RPD tooth support prevented contact between the interim prosthesis and healing abutments, promoting implant osseointegration. The main drawbacks were interference with speech and limited esthetic results. Implant survival rate was 100% within a follow-up of at least 1 year. The use of RPDs as interim prostheses allowed for the accomplishment of the analyzed rehabilitation treatments. It is a simple treatment alternative for patients with a low smile line. © 2013 by the American College of Prosthodontists.

  7. Controlling the hydrogenolysis of silica-supported tungsten pentamethyl leads to a class of highly electron deficient partially alkylated metal hydrides

    KAUST Repository

    Maity, Niladri; Barman, Samir; Callens, Emmanuel; Samantaray, Manoja K.; Abou-Hamad, Edy; Minenkov, Yury; D'Elia, Valerio; Hoffman, Adam S.; Widdifield, Cory M.; Cavallo, Luigi; Gates, Bruce C.; Basset, Jean-Marie

    2015-01-01

    The well-defined single-site silica-supported tungsten complex [([triple bond, length as m-dash]Si–O–)W(Me)5], 1, is an excellent precatalyst for alkane metathesis. The unique structure of 1 allows the synthesis of unprecedented tungsten hydrido methyl surface complexes via a controlled hydrogenolysis. Specifically, in the presence of molecular hydrogen, 1 is quickly transformed at −78 °C into a partially alkylated tungsten hydride, 4, as characterized by 1H solid-state NMR and IR spectroscopies. Species 4, upon warming to 150 °C, displays the highest catalytic activity for propane metathesis yet reported. DFT calculations using model systems support the formation of [([triple bond, length as m-dash]Si–O–)WH3(Me)2], as the predominant species at −78 °C following several elementary steps of hydrogen addition (by σ-bond metathesis or α-hydrogen transfer). Rearrangement of 4 occuring between −78 °C and room temperature leads to the formation of an unique methylidene tungsten hydride [([triple bond, length as m-dash]Si–O–)WH3([double bond, length as m-dash]CH2)], as determined by solid-state 1H and 13C NMR spectroscopies and supported by DFT. Thus for the first time, a coordination sphere that incorporates both carbene and hydride functionalities has been observed.

  8. Controlling the hydrogenolysis of silica-supported tungsten pentamethyl leads to a class of highly electron deficient partially alkylated metal hydrides

    KAUST Repository

    Maity, Niladri

    2015-11-30

    The well-defined single-site silica-supported tungsten complex [([triple bond, length as m-dash]Si–O–)W(Me)5], 1, is an excellent precatalyst for alkane metathesis. The unique structure of 1 allows the synthesis of unprecedented tungsten hydrido methyl surface complexes via a controlled hydrogenolysis. Specifically, in the presence of molecular hydrogen, 1 is quickly transformed at −78 °C into a partially alkylated tungsten hydride, 4, as characterized by 1H solid-state NMR and IR spectroscopies. Species 4, upon warming to 150 °C, displays the highest catalytic activity for propane metathesis yet reported. DFT calculations using model systems support the formation of [([triple bond, length as m-dash]Si–O–)WH3(Me)2], as the predominant species at −78 °C following several elementary steps of hydrogen addition (by σ-bond metathesis or α-hydrogen transfer). Rearrangement of 4 occuring between −78 °C and room temperature leads to the formation of an unique methylidene tungsten hydride [([triple bond, length as m-dash]Si–O–)WH3([double bond, length as m-dash]CH2)], as determined by solid-state 1H and 13C NMR spectroscopies and supported by DFT. Thus for the first time, a coordination sphere that incorporates both carbene and hydride functionalities has been observed.

  9. Partial body weight support treadmill training speed influences paretic and non-paretic leg muscle activation, stride characteristics, and ratings of perceived exertion during acute stroke rehabilitation.

    Science.gov (United States)

    Burnfield, Judith M; Buster, Thad W; Goldman, Amy J; Corbridge, Laura M; Harper-Hanigan, Kellee

    2016-06-01

    Intensive task-specific training is promoted as one approach for facilitating neural plastic brain changes and associated motor behavior gains following neurologic injury. Partial body weight support treadmill training (PBWSTT), is one task-specific approach frequently used to improve walking during the acute period of stroke recovery (training parameters and physiologic demands during this early recovery phase. To examine the impact of four walking speeds on stride characteristics, lower extremity muscle demands (both paretic and non-paretic), Borg ratings of perceived exertion (RPE), and blood pressure. A prospective, repeated measures design was used. Ten inpatients post unilateral stroke participated. Following three familiarization sessions, participants engaged in PBWSTT at four predetermined speeds (0.5, 1.0, 1.5 and 2.0mph) while bilateral electromyographic and stride characteristic data were recorded. RPE was evaluated immediately following each trial. Stride length, cadence, and paretic single limb support increased with faster walking speeds (p⩽0.001), while non-paretic single limb support remained nearly constant. Faster walking resulted in greater peak and mean muscle activation in the paretic medial hamstrings, vastus lateralis and medial gastrocnemius, and non-paretic medial gastrocnemius (p⩽0.001). RPE also was greatest at the fastest compared to two slowest speeds (ptraining at the slowest speeds. Copyright © 2016 Elsevier B.V. All rights reserved.

  10. Significant Published Articles for Pharmacy Nutrition Support Practice in 2014 and 2015.

    Science.gov (United States)

    Dickerson, Roland N; Kumpf, Vanessa J; Blackmer, Allison B; Bingham, Angela L; Tucker, Anne M; Ybarra, Joseph V; Kraft, Michael D; Canada, Todd W

    2016-07-01

    To assist the pharmacy clinician engaged in nutrition support in staying current with the most pertinent literature. Several experienced board-certified clinical pharmacists engaged in nutrition support therapy compiled a list of articles published in 2014 and 2015 that they considered to be important to their practice. Only those articles available in print format were considered for potential inclusion. Articles available only in preprint electronic format were not evaluated. The citation list was compiled into a single spreadsheet where the author participants were asked to ascertain whether they considered the paper important to nutrition support pharmacy practice. A culled list of publications was then identified whereby the majority of author participants (at least 5 out of 8) considered the paper to be important. A total of 108 articles were identified; 36 of which were considered to be of high importance. An important guideline article published in early 2016, but not ranked, was also included. The top-ranked articles from the primary literature were reviewed. It is recommended that the informed pharmacist, who is engaged in nutrition support therapy, be familiar with the majority of these articles.

  11. Supporting transvisibility and gender diversity in nursing practice and education: embracing cultural safety.

    Science.gov (United States)

    Kellett, Peter; Fitton, Chantelle

    2017-01-01

    Many nursing education programs deserve a failing grade with respect to supporting gender diversity in their interactions with their students and in terms of the curricular content directed toward engaging in the safe and supportive nursing care of transgender clients. This situation contributes to transinvisibility in the nursing profession and lays a foundation for nursing practice that does not recognize the role that gender identity plays in the health and well-being of trans-clients and trans-nurses. This article seeks to raise readers' awareness about the problems inherent to transinvisibility and to propose several curricular and structural-level interventions that may serve to gradually increase the recognition of gender diversity in the planning and delivery of nursing education and practice. Contextualized in gender and intersectionality theory, cultural safety is presented as a viable and appropriate framework for engaging in these upstream approaches to addressing gender diversity in nursing education and practice. Among the structural interventions proposed are as follows: inclusive information systems, creation of gender neutral and safe spaces, lobbying for inclusion of competencies that address care of trans-persons in accreditation standards and licensure examinations and engaging in nursing research in this area. © 2016 John Wiley & Sons Ltd.

  12. Using Open Educational Practices to Support Institutional Strategic Excellence in Teaching, Learning & Scholarship

    Directory of Open Access Journals (Sweden)

    Thomas Carey

    2015-04-01

    Full Text Available This paper explores the integration of Open Educational Practices (OEP into an institutional strategy to develop distinctive excellence in teaching, learning and scholarship. The institution in the case study is a public polytechnic university serving a metropolitan area in Canada. If emerging Open Educational Practices are to flourish at our university, support for OEP must integrate with and contribute to our broader efforts to clarify and enhance our strategic position. We have identified three focal points where our institution can focus attention in order to ensure that our use of emerging Open Educational Practices will best align with, contribute to, and benefit from our institutional strategy for distinctive excellence in teaching and learning: - Opening up the pedagogy underlying exemplary OER, to enable a deeper faculty engagement in integrating and mobilizing diverse sources of knowledge in teaching;- Opening up that process by which individual faculty improve teaching and learning, as a model for our students’ own engagements with knowledge;- Opening up our collective faculty work in innovation networks, as a model for students and as a signature institutional strength and outcome. We summarize the rationale and planned next steps for each of these focal points, which are intended to cumulatively build on each other as a value chain to support the development of distinctive graduate capabilities as signature outcomes of our teaching and learning. http://dx.doi.org/10.5944/openpraxis.7.2.201

  13. Prediction of retention indices for frequently reported compounds of plant essential oils using multiple linear regression, partial least squares, and support vector machine.

    Science.gov (United States)

    Yan, Jun; Huang, Jian-Hua; He, Min; Lu, Hong-Bing; Yang, Rui; Kong, Bo; Xu, Qing-Song; Liang, Yi-Zeng

    2013-08-01

    Retention indices for frequently reported compounds of plant essential oils on three different stationary phases were investigated. Multivariate linear regression, partial least squares, and support vector machine combined with a new variable selection approach called random-frog recently proposed by our group, were employed to model quantitative structure-retention relationships. Internal and external validations were performed to ensure the stability and predictive ability. All the three methods could obtain an acceptable model, and the optimal results by support vector machine based on a small number of informative descriptors with the square of correlation coefficient for cross validation, values of 0.9726, 0.9759, and 0.9331 on the dimethylsilicone stationary phase, the dimethylsilicone phase with 5% phenyl groups, and the PEG stationary phase, respectively. The performances of two variable selection approaches, random-frog and genetic algorithm, are compared. The importance of the variables was found to be consistent when estimated from correlation coefficients in multivariate linear regression equations and selection probability in model spaces. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  14. Cyborg practices: call-handlers and computerised decision support systems in urgent and emergency care.

    Science.gov (United States)

    Pope, Catherine; Halford, Susan; Turnbull, Joanne; Prichard, Jane

    2014-06-01

    This article draws on data collected during a 2-year project examining the deployment of a computerised decision support system. This computerised decision support system was designed to be used by non-clinical staff for dealing with calls to emergency (999) and urgent care (out-of-hours) services. One of the promises of computerised decisions support technologies is that they can 'hold' vast amounts of sophisticated clinical knowledge and combine it with decision algorithms to enable standardised decision-making by non-clinical (clerical) staff. This article draws on our ethnographic study of this computerised decision support system in use, and we use our analysis to question the 'automated' vision of decision-making in healthcare call-handling. We show that embodied and experiential (human) expertise remains central and highly salient in this work, and we propose that the deployment of the computerised decision support system creates something new, that this conjunction of computer and human creates a cyborg practice.

  15. Practical, economical, and eco-friendly starch-supported palladium catalyst for Suzuki coupling reactions.

    Science.gov (United States)

    Baran, Talat

    2017-06-15

    In catalytic systems, the support materials need to be both eco friendly and low cost as well as having high thermal and chemical stability. In this paper, a novel starch supported palladium catalyst, which had these outstanding properties, was designed and its catalytic activity was evaluated in a Suzuki coupling reaction under microwave heating with solvent-free and mild reaction conditions. The starch supported catalyst gave remarkable reaction yields after only 5min as a result of the coupling reaction of the phenyl boronic acid with 23 different substrates, which are bearing aril bromide, iodide, and chloride. The longevity of the catalyst was also investigated, and the catalyst could be reused for 10 runs. The starch supported Pd(II) catalyst yielded remarkable TON (up to 25,000) and TOF (up to 312,500) values by using a simple, fast and eco-friendly method. In addition, the catalytic performance of the catalyst was tested against different commercial palladium catalysts, and the green starch supported catalyst had excellent selectivity. The catalytic tests showed that the novel starch based palladium catalyst proved to be an economical and practical catalyst for the synthesis of biaryl compounds. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Assessing experience in the deliberate practice of running using a fuzzy decision-support system

    Science.gov (United States)

    Roveri, Maria Isabel; Manoel, Edison de Jesus; Onodera, Andrea Naomi; Ortega, Neli R. S.; Tessutti, Vitor Daniel; Vilela, Emerson; Evêncio, Nelson

    2017-01-01

    The judgement of skill experience and its levels is ambiguous though it is crucial for decision-making in sport sciences studies. We developed a fuzzy decision support system to classify experience of non-elite distance runners. Two Mamdani subsystems were developed based on expert running coaches’ knowledge. In the first subsystem, the linguistic variables of training frequency and volume were combined and the output defined the quality of running practice. The second subsystem yielded the level of running experience from the combination of the first subsystem output with the number of competitions and practice time. The model results were highly consistent with the judgment of three expert running coaches (r>0.88, p0.86, p<0.001). From the expert’s knowledge and the fuzzy model, running experience is beyond the so-called "10-year rule" and depends not only on practice time, but on the quality of practice (training volume and frequency) and participation in competitions. The fuzzy rule-based model was very reliable, valid, deals with the marked ambiguities inherent in the judgment of experience and has potential applications in research, sports training, and clinical settings. PMID:28817655

  17. Ethnographic study of ICT-supported collaborative work routines in general practice

    Science.gov (United States)

    2010-01-01

    Background Health informatics research has traditionally been dominated by experimental and quasi-experimental designs. An emerging area of study in organisational sociology is routinisation (how collaborative work practices become business-as-usual). There is growing interest in the use of ethnography and other in-depth qualitative approaches to explore how collaborative work routines are enacted and develop over time, and how electronic patient records (EPRs) are used to support collaborative work practices within organisations. Methods/design Following Feldman and Pentland, we will use 'the organisational routine' as our unit of analysis. In a sample of four UK general practices, we will collect narratives, ethnographic observations, multi-modal (video and screen capture) data, documents and other artefacts, and analyse these to map and compare the different understandings and enactments of three common routines (repeat prescribing, coding and summarising, and chronic disease surveillance) which span clinical and administrative spaces and which, though 'mundane', have an important bearing on quality and safety of care. In a detailed qualitative analysis informed by sociological theory, we aim to generate insights about how complex collaborative work is achieved through the process of routinisation in healthcare organisations. Discussion Our study offers the potential not only to identify potential quality failures (poor performance, errors, failures of coordination) in collaborative work routines but also to reveal the hidden work and workarounds by front-line staff which bridge the model-reality gap in EPR technologies and via which "automated" safety features have an impact in practice. PMID:21190583

  18. Assessing experience in the deliberate practice of running using a fuzzy decision-support system.

    Directory of Open Access Journals (Sweden)

    Maria Isabel Roveri

    Full Text Available The judgement of skill experience and its levels is ambiguous though it is crucial for decision-making in sport sciences studies. We developed a fuzzy decision support system to classify experience of non-elite distance runners. Two Mamdani subsystems were developed based on expert running coaches' knowledge. In the first subsystem, the linguistic variables of training frequency and volume were combined and the output defined the quality of running practice. The second subsystem yielded the level of running experience from the combination of the first subsystem output with the number of competitions and practice time. The model results were highly consistent with the judgment of three expert running coaches (r>0.88, p0.86, p<0.001. From the expert's knowledge and the fuzzy model, running experience is beyond the so-called "10-year rule" and depends not only on practice time, but on the quality of practice (training volume and frequency and participation in competitions. The fuzzy rule-based model was very reliable, valid, deals with the marked ambiguities inherent in the judgment of experience and has potential applications in research, sports training, and clinical settings.

  19. Ethnographic study of ICT-supported collaborative work routines in general practice.

    Science.gov (United States)

    Swinglehurst, Deborah; Greenhalgh, Trisha; Myall, Michelle; Russell, Jill

    2010-12-29

    Health informatics research has traditionally been dominated by experimental and quasi-experimental designs. An emerging area of study in organisational sociology is routinisation (how collaborative work practices become business-as-usual). There is growing interest in the use of ethnography and other in-depth qualitative approaches to explore how collaborative work routines are enacted and develop over time, and how electronic patient records (EPRs) are used to support collaborative work practices within organisations. Following Feldman and Pentland, we will use 'the organisational routine' as our unit of analysis. In a sample of four UK general practices, we will collect narratives, ethnographic observations, multi-modal (video and screen capture) data, documents and other artefacts, and analyse these to map and compare the different understandings and enactments of three common routines (repeat prescribing, coding and summarising, and chronic disease surveillance) which span clinical and administrative spaces and which, though 'mundane', have an important bearing on quality and safety of care. In a detailed qualitative analysis informed by sociological theory, we aim to generate insights about how complex collaborative work is achieved through the process of routinisation in healthcare organisations. Our study offers the potential not only to identify potential quality failures (poor performance, errors, failures of coordination) in collaborative work routines but also to reveal the hidden work and workarounds by front-line staff which bridge the model-reality gap in EPR technologies and via which "automated" safety features have an impact in practice.

  20. Type-Directed Partial Evaluation

    DEFF Research Database (Denmark)

    Danvy, Olivier

    1998-01-01

    Type-directed partial evaluation uses a normalization function to achieve partial evaluation. These lecture notes review its background, foundations, practice, and applications. Of specific interest is the modular technique of offline and online type-directed partial evaluation in Standard ML...

  1. Type-Directed Partial Evaluation

    DEFF Research Database (Denmark)

    Danvy, Olivier

    1998-01-01

    Type-directed partial evaluation uses a normalization function to achieve partial evaluation. These lecture notes review its background, foundations, practice, and applications. Of specific interest is the modular technique of offline and online type-directed partial evaluation in Standard ML of ...

  2. A guideline for interpersonal capabilities enhancement to support sustainable facility management practice

    Science.gov (United States)

    Sarpin, Norliana; Kasim, Narimah; Zainal, Rozlin; Noh, Hamidun Mohd

    2018-04-01

    Facility management is the key phase in the development cycle of an assets and spans over a considerable length of time. Therefore, facility managers are in a commanding position to maximise the potential of sustainability through the development phases from construction, operation, maintenance and upgrade leading to decommission and deconstruction. Sustainability endeavours in facility management practices will contribute to reducing energy consumption, waste and running costs. Furthermore, it can also help in improving organisational productivity, financial return and community standing of the organisation. Facility manager should be empowered with the necessary knowledge and capabilities at the forefront facing sustainability challenge. However, literature studies show a gap between the level of awareness, specific knowledge and the necessary skills required to pursue sustainability in the facility management professional. People capability is considered as the key enabler in managing the sustainability agenda as well as being central to the improvement of competency and innovation in an organisation. This paper aims to develop a guidelines for interpersonal capabilities to support sustainability in facility management practice. Starting with a total of 7 critical interpersonal capabilities factors identified from previous questionnaire survey, the authors conducted an interview with 3 experts in facility management to assess the perceived importance of these factors. The findings reveal a set of guidelines for the enhancement of interpersonal capabilities among facility managers by providing what can be done to acquire these factors and how it can support the application of sustainability in their practice. The findings of this paper are expected to form the basis of a mechanism framework developed to equip facility managers with the right knowledge, to continue education and training and to develop new mind-sets to enhance the implementation of sustainability

  3. How supportive supervision influences immunization session site practices: a quasi-experimental study in Odisha, India

    Directory of Open Access Journals (Sweden)

    Bhuputra Panda

    2015-01-01

    Full Text Available Background: Routine immunization (RI is a key child survival intervention. Ensuring acceptable standards of RI service delivery is critical for optimal outcomes. Accumulated evidences suggest that ‘supportive supervision’ improves the quality of health care services in general. During 2009–2010, the Government of Odisha and UNICEF jointly piloted this strategy in four districts to improve RI program outcomes. The present study aims to assess the effect of this strategy on improvement of skills and practices at immunization session sites. Design: A quasi-experimental ‘post-test only’ study design was adopted to compare the opinion and practices of frontline health workers and their supervisors in four intervention districts (IDs with two control districts (CDs. Altogether, we interviewed 111 supervisor–supervisee (health worker pairs using semi-structured interview schedules and case vignettes. We also directly observed health workers’ practices during immunization sessions at 111 sites. Data were analyzed with SPSS version 16.0. Results: The mean knowledge score of supervisors in CDs was significantly higher than in intervention groups. Variegated responses were obtained on case vignettes. The control group performed better in solving certain hypothetically asked problems, whereas the intervention group scored better in others. Health workers in IDs gave a lower rating to their respective supervisors’ knowledge, skill, and frequency of supervision. Logistics and vaccine availability were better in CDs. Conclusion: Notwithstanding other limitations, supportive supervision may not have independent effects on improving the quality of immunization services. Addressing systemic issues, such as the availability of essential logistics, supply chain management, timely indenting, and financial resources, could complement the supportive supervision strategy in improving immunization service delivery.

  4. Sustained Large-Scale Collective Climate Action Supported by Effective Climate Change Education Practice

    Science.gov (United States)

    Niepold, F., III; Crim, H.; Fiorile, G.; Eldadah, S.

    2017-12-01

    Since 2012, the Climate and Energy Literacy community have realized that as cities, nations and the international community seek solutions to global climate change over the coming decades, a more comprehensive, interdisciplinary approach to climate literacy—one that includes economic and social considerations—will play a vital role in knowledgeable planning, decision-making, and governance. City, county and state leaders are now leading the American response to a changing climate by incubating social innovation to prevail in the face of unprecedented change. Cities are beginning to realize the importance of critical investments to support the policies and strategies that will foster the climate literacy necessary for citizens to understand the urgency of climate actions and to succeed in a resilient post-carbon economy and develop the related workforce. Over decade of federal and non-profit Climate Change Education effective methods have been developed that can support municipality's significant educational capabilities for the purpose of strengthening and scaling city, state, business, and education actions designed to sustain and effectively address this significant social change. Looking to foster the effective and innovative strategies that will enable their communities several networks have collaborated to identify recommendations for effective education and communication practices when working with different types of audiences. U.S. National Science Foundation funded Climate Change Education Partnership (CCEP) Alliance, the National Wildlife Federation, NOAA Climate Program Office, Tri-Agency Climate Change Education Collaborative and the Climate Literacy and Energy Awareness Network (CLEAN) are working to develop a new web portal that will highlight "effective" practices that includes the acquisition and use of climate change knowledge to inform decision-making. The purpose of the web portal is to transfer effective practice to support communities to be

  5. How supportive supervision influences immunization session site practices: a quasi-experimental study in Odisha, India.

    Science.gov (United States)

    Panda, Bhuputra; Pati, Sanghamitra; Nallala, Srinivas; Chauhan, Abhimanyu S; Anasuya, Anita; Som, Meena; Zodpey, Sanjay

    2015-01-01

    Routine immunization (RI) is a key child survival intervention. Ensuring acceptable standards of RI service delivery is critical for optimal outcomes. Accumulated evidences suggest that 'supportive supervision' improves the quality of health care services in general. During 2009-2010, the Government of Odisha and UNICEF jointly piloted this strategy in four districts to improve RI program outcomes. The present study aims to assess the effect of this strategy on improvement of skills and practices at immunization session sites. A quasi-experimental 'post-test only' study design was adopted to compare the opinion and practices of frontline health workers and their supervisors in four intervention districts (IDs) with two control districts (CDs). Altogether, we interviewed 111 supervisor-supervisee (health worker) pairs using semi-structured interview schedules and case vignettes. We also directly observed health workers' practices during immunization sessions at 111 sites. Data were analyzed with SPSS version 16.0. The mean knowledge score of supervisors in CDs was significantly higher than in intervention groups. Variegated responses were obtained on case vignettes. The control group performed better in solving certain hypothetically asked problems, whereas the intervention group scored better in others. Health workers in IDs gave a lower rating to their respective supervisors' knowledge, skill, and frequency of supervision. Logistics and vaccine availability were better in CDs. Notwithstanding other limitations, supportive supervision may not have independent effects on improving the quality of immunization services. Addressing systemic issues, such as the availability of essential logistics, supply chain management, timely indenting, and financial resources, could complement the supportive supervision strategy in improving immunization service delivery.

  6. How different are ICT-supported pedagogical practices from extensive and non-extensive ICT-using science teachers?

    OpenAIRE

    Voogt, Joke

    2009-01-01

    This paper aims to understand the differences between characteristics of ICT-supported pedagogical practices of grade 8 science teachers of extensive and non-extensive ICT-using science teachers. The differences of the pedagogical practices are described in terms of innovative and traditionally important practice orientations. The innovative practice orientation reflects a demand for education in an information society (e.g. communication skills; ability to learn at own pace), while the tradi...

  7. SOMWeb: a semantic web-based system for supporting collaboration of distributed medical communities of practice.

    Science.gov (United States)

    Falkman, Göran; Gustafsson, Marie; Jontell, Mats; Torgersson, Olof

    2008-08-26

    Information technology (IT) support for remote collaboration of geographically distributed communities of practice (CoP) in health care must deal with a number of sociotechnical aspects of communication within the community. In the mid-1990s, participants of the Swedish Oral Medicine Network (SOMNet) began discussing patient cases in telephone conferences. The cases were distributed prior to the conferences using PowerPoint and email. For the technical support of online CoP, Semantic Web technologies can potentially fulfill needs of knowledge reuse, data exchange, and reasoning based on ontologies. However, more research is needed on the use of Semantic Web technologies in practice. The objectives of this research were to (1) study the communication of distributed health care professionals in oral medicine; (2) apply Semantic Web technologies to describe community data and oral medicine knowledge; (3) develop an online CoP, Swedish Oral Medicine Web (SOMWeb), centered on user-contributed case descriptions and meetings; and (4) evaluate SOMWeb and study how work practices change with IT support. Based on Java, and using the Web Ontology Language and Resource Description Framework for handling community data and oral medicine knowledge, SOMWeb was developed using a user-centered and iterative approach. For studying the work practices and evaluating the system, a mixed-method approach of interviews, observations, and a questionnaire was used. By May 2008, there were 90 registered users of SOMWeb, 93 cases had been added, and 18 meetings had utilized the system. The introduction of SOMWeb has improved the structure of meetings and their discussions, and a tenfold increase in the number of participants has been observed. Users submit cases to seek advice on diagnosis or treatment, to show an unusual case, or to create discussion. Identified barriers to submitting cases are lack of time, concern about whether the case is interesting enough, and showing gaps in one's own

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

    Science.gov (United States)

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

    2017-06-01

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

  9. The Family Health Support Core (NASF And Health Practices: Are There Many Challenges To Be Overcome?

    Directory of Open Access Journals (Sweden)

    Djavan Gomes Leite

    2017-04-01

    Full Text Available Objective: Describe and characterize NASF health practices. Method: It is a review of current literature carried out by consulting the database Lilacs and Virtual Library of SciELO in the period from December 2016 to January 2017. Conclusion: It is concluded that, although the NASF is recognized as a support to the Family Health Strategy (FHS, still does not act in an articulated way, being fundamental that changes take place in the organization of the services and in the conduct of the health professionals who contemplate it. Descriptors: Primary Health Care. Family Health; Public Health Policies. Nursing.

  10. Study on practical of eddy current testing of core and core support graphite components in HTTR

    International Nuclear Information System (INIS)

    Ishihara, Masahiro; Iyoku, Tatsuo; Ooka, Norikazu; Shindo, Yoshihisa; Kawae, Hidetoshi; Hayashi, Motomitsu; Kambe, Mamoru; Takahashi, Masaaki; Ide, Akira.

    1994-01-01

    Core and core support graphite components in the HTTR (High Temperature Engineering Test Reactor) are mainly made of nuclear-grade IG-110 and PGX graphites. Nondestructive inspection with Eddy Current Testing (ECT) is planned to be applied to these components. The method of ECT has been already established for metallic components, however, cannot be applied directly to the graphite ones, because the characteristics of graphite are quite different in micro-structure from those of metals. Therefore, ECT method and condition were studied for the application of the ECT to the graphite components. This paper describes the study on practical method and conditions of ECT for above mentioned graphite structures. (author)

  11. Influence of artificial aging on the load-bearing capability of straight or angulated zirconia abutments in implant/tooth-supported fixed partial dentures.

    Science.gov (United States)

    Nothdurft, Frank P; Doppler, Klaus E; Erdelt, Kurt J; Knauber, Andreas W; Pospiech, Peter R

    2010-01-01

    The aim of the study was to evaluate the influence of artificial aging on the fracture behavior of straight and angulated zirconia implant abutments used in ZirDesign (Astra Tech) implant/tooth-supported fixed partial dentures (FPDs) in the maxilla. Four different test groups (n = 8) representing anterior implant/tooth-supported FPDs were prepared. Groups 1 and 2 simulated a clinical situation with an ideal implant position (maxillary left central incisor) from a prosthetic point of view, which allowed for the use of a straight, prefabricated zirconia abutment. Groups 3 and 4 simulated a situation with a compromised implant position that required an angulated (20-degree) abutment. OsseoSpeed implants (4.5 3 13 mm, Astra Tech) as well as metal tooth analogs (maxillary right lateral incisor) with simulated periodontal mobility were mounted in polymethyl methacrylate. The FPDs (chromium-cobalt alloy) were cemented with glass ionomer. Groups 2 and 4 were thermomechanically loaded and subjected to static loading until failure. Statistical analysis of force data at the fracture site was performed using nonparametric tests. All samples survived thermomechanical loading. Artificial aging did not lead to a significant decrease in load-bearing capacity in either the straight abutments or the angulated abutments. The restorations that used angulated abutments exhibited higher fracture loads than the restorations with straight abutments (group 1: 209.13 ± 39.11 N; group 2: 233.63 ± 30.68 N; group 3: 324.62 ± 108.07 N; group 4: 361.75 ± 73.82 N). This difference in load-bearing performance was statistically significant, both with and without artificial aging. All abutment fractures occurred below the implant shoulder. Compensation for angulated implant positions with an angulated zirconia abutment is possible without reducing the load-bearing capacity of implant/tooth-supported anterior FPDs.

  12. Bridging the gap between research-supported interventions and everyday social work practice: a new approach.

    Science.gov (United States)

    Rubin, Allen

    2014-07-01

    This article describes a rationale for a focus on case studies that would provide a database of single-group pre-post mean effect sizes that could be analyzed to identify which service provision characteristics are associated with more desirable outcomes when interventions supported by randomized clinical trials are adapted in everyday practice settings. In addition, meta-analyses are proposed that would provide benchmarks that agency practitioners could compare with their mean effect size to inform their decisions about whether to continue, modify, or replace existing efforts to adopt or adapt a specific research-supported treatment. Social workers should be at the forefront of the recommended studies in light of the profession's emphasis on applied research in real-world settings and the prominence of social work practitioners in such settings.

  13. Access to and value of information to support good practice for staff in Kenyan hospitals

    Directory of Open Access Journals (Sweden)

    Naomi Muinga

    2015-05-01

    Full Text Available Background: Studies have sought to define information needs of health workers within very specific settings or projects. Lacking in the literature is how hospitals in low-income settings are able to meet the information needs of their staff and the use of information communication technologies (ICT in day-to-day information searching. Objective: The study aimed to explore where professionals in Kenyan hospitals turn to for work-related information in their day-to-day work. Additionally, it examined what existing solutions are provided by hospitals with regard to provision of best practice care. Lastly, the study explored the use of ICT in information searching. Design: Data for this study were collected in July 2012. Self-administered questionnaires (SAQs were distributed across 22 study hospitals with an aim to get a response from 34 health workers per hospital. Results: SAQs were collected from 657 health workers. The most popular sources of information to guide work were fellow health workers and printed guidelines while the least popular were scientific journals. Of value to health workers were: national treatment policies, new research findings, regular reports from surveillance data, information on costs of services and information on their performance of routine clinical tasks; however, hospitals only partially met these needs. Barriers to accessing information sources included: ‘not available/difficult to get’ and ‘difficult to understand’. ICT use for information seeking was reported and with demographic specific differences noted from the multivariate logistic regression model; nurses compared to medical doctors and older workers were less likely to use ICT for health information searching. Barriers to accessing Internet were identified as: high costs and the lack of the service at home or at work. Conclusions: Hospitals need to provide appropriate information by improving information dissemination efforts and providing an

  14. The design of patient decision support interventions: addressing the theory-practice gap.

    Science.gov (United States)

    Elwyn, Glyn; Stiel, Mareike; Durand, Marie-Anne; Boivin, Jacky

    2011-08-01

    Although an increasing number of decision support interventions for patients (including decision aids) are produced, few make explicit use of theory. We argue the importance of using theory to guide design. The aim of this work was to address this theory-practice gap and to examine how a range of selected decision-making theories could inform the design and evaluation of decision support interventions. We reviewed the decision-making literature and selected relevant theories. We assessed their key principles, theoretical pathways and predictions in order to determine how they could inform the design of two core components of decision support interventions, namely, information and deliberation components and to specify theory-based outcome measures. Eight theories were selected: (1) the expected utility theory; (2) the conflict model of decision making; (3) prospect theory; (4) fuzzy-trace theory; (5) the differentiation and consolidation theory; (6) the ecological rationality theory; (7) the rational-emotional model of decision avoidance; and finally, (8) the Attend, React, Explain, Adapt model of affective forecasting. Some theories have strong relevance to the information design (e.g. prospect theory); some are more relevant to deliberation processes (conflict theory, differentiation theory and ecological validity). None of the theories in isolation was sufficient to inform the design of all the necessary components of decision support interventions. It was also clear that most work in theory-building has focused on explaining or describing how humans think rather than on how tools could be designed to help humans make good decisions. It is not surprising therefore that a large theory-practice gap exists as we consider decision support for patients. There was no relevant theory that integrated all the necessary contributions to the task of making good decisions in collaborative interactions. Initiatives such as the International Patient Decision Aids Standards

  15. Exploring the perspectives of clinical professionals and support staff on implementing supported self-management for asthma in UK general practice: an IMP2ART qualitative study.

    Science.gov (United States)

    Morrow, Susan; Daines, Luke; Wiener-Ogilvie, Sharon; Steed, Liz; McKee, Lorna; Caress, Ann-Louise; Taylor, Stephanie J C; Pinnock, Hilary

    2017-07-18

    Despite an overwhelming evidence base, supported self-management of asthma is poorly implemented into routine practice. Strategies for implementation must address organisational routines, as well as provide resources for patients and training to improve professionals' skills. We aimed to explore the priority that primary care practices attach to asthma self-management, to describe their existing asthma management routines, and to generate innovative implementation strategies. We recruited 33 participants (23 general practitioners; seven nurses; three administrative staff) from 14 general practices. The 12 interviews and three focus groups were transcribed, coded and analysed thematically. Supported self-management was largely a nurse-led task within clinic-based annual reviews. Barriers included poor attendance at asthma clinics, lack of time, demarcation of roles, limited access to a range of tailored resources, and competing agendas in consultation, often due to multimorbidity. Suggestions for initiatives to improve the provision of supported self-management included emphasising the evidence for benefit (to influence prioritisation), improving teamwork (including team-based education), organisational strategies (including remote consulting) which need to fit within existing practice routines. Technology offers some potential solutions (e.g., improved templates, 'app'-based plans), but must be integrated with the practice information technology systems. Building on these insights, we will now develop a theoretically-based implementation strategy that will address patient, professional, and organisational buy-in, provide team-based education and offer a range of practical options and tools, which can be adapted and integrated within existing routines of individual practices.OVERCOMING THE ORGANISATIONAL BARRIERS TO IMPLEMENTING ASTHMA SELF-MANAGEMENT: Understanding the routines of primary care practices can suggest strategies to implement supported self

  16. Online Platform as a Tool to Support Postgraduate Training in General Practice – A Case Report

    Science.gov (United States)

    Dini, Lorena; Galanski, Claire; Döpfmer, Susanne; Gehrke-Beck, Sabine; Bayer, Gudrun; Boeckle, Martin; Micheel, Isabel; Novak, Jasminko; Heintze, Christoph

    2017-01-01

    Objective: Physicians in postgraduate training (PPT) in General Practice (GP) typically have very little interaction with their peers, as there is usually only one resident physician working in their respective department or GP office at a given time. Therefore, the online platform KOLEGEA, presented here, aims to support postgraduate training in general practice (PT in GP) in Germany through virtual interaction. Methodology: In 2012, the interdisciplinary research project KOLEGEA set up an online platform that any physicians in PT in GP can use for free after registration with their unitary continuous education number (Einheitliche Fortbildungsnummer, EFN). It offers problem-based learning and allows to discuss self-published anonymized patient cases with the community that can be classified and discussed with experienced mentors (specialists in general practice - GPs) in small virtual groups. Results: An anonymous online survey carried out as part of the 2014 project evaluation showed a good acceptance of the platform, even though shortage of time was mentioned as a limiting factor for its use. Data analysis showed that KOLEGEA was used by PPT in GP in all federal states. Patterns of passive use were predominant (90%). This report also describes the further development of the platform (in 2015 and 2016) that integrates an activity monitor as part of a gamification concept. Conclusions: Due to a low response rate of the 2014 online survey and the preliminary evaluations of usage patterns we could identify only initial trends regarding the role of KOLEGEA in supporting PPT. The platform was perceived as a helpful supplement to better structure PT in GP. PMID:29226227

  17. Core measures for developmentally supportive care in neonatal intensive care units: theory, precedence and practice.

    Science.gov (United States)

    Coughlin, Mary; Gibbins, Sharyn; Hoath, Steven

    2009-10-01

    This paper is a discussion of evidence-based core measures for developmental care in neonatal intensive care units. Inconsistent definition, application and evaluation of developmental care have resulted in criticism of its scientific merit. The key concept guiding data organization in this paper is the United States of America's Joint Commission's concept of 'core measures' for evaluating and accrediting healthcare organizations. This concept is applied to five disease- and procedure-independent measures based on the Universe of Developmental Care model. Electronically accessible, peer reviewed studies on developmental care published in English were culled for data supporting the selected objective core measures between 1978 and 2008. The quality of evidence was based on a structured predetermined format that included three independent reviewers. Systematic reviews and randomized control trials were considered the strongest level of evidence. When unavailable, cohort, case control, consensus statements and qualitative methods were considered the strongest level of evidence for a particular clinical issue. Five core measure sets for evidence-based developmental care were evaluated: (1) protected sleep, (2) pain and stress assessment and management, (3) developmental activities of daily living, (4) family-centred care, and (5) the healing environment. These five categories reflect recurring themes that emerged from the literature review regarding developmentally supportive care and quality caring practices in neonatal populations. This practice model provides clear metrics for nursing actions having an impact on the hospital experience of infant-family dyads. Standardized disease-independent core measures for developmental care establish minimum evidence-based practice expectations and offer an objective basis for cross-institutional comparison of developmental care programmes.

  18. Measuring Clinical Decision Support Influence on Evidence-Based Nursing Practice.

    Science.gov (United States)

    Cortez, Susan; Dietrich, Mary S; Wells, Nancy

    2016-07-01

    To measure the effect of clinical decision support (CDS) on oncology nurse evidence-based practice (EBP).
. Longitudinal cluster-randomized design.
. Four distinctly separate oncology clinics associated with an academic medical center.
. The study sample was comprised of randomly selected data elements from the nursing documentation software. The data elements were patient-reported symptoms and the associated nurse interventions. The total sample observations were 600, derived from a baseline, posteducation, and postintervention sample of 200 each (100 in the intervention group and 100 in the control group for each sample).
. The cluster design was used to support randomization of the study intervention at the clinic level rather than the individual participant level to reduce possible diffusion of the study intervention. An elongated data collection cycle (11 weeks) controlled for temporary increases in nurse EBP related to the education or CDS intervention.
. The dependent variable was the nurse evidence-based documentation rate, calculated from the nurse-documented interventions. The independent variable was the CDS added to the nursing documentation software.
. The average EBP rate at baseline for the control and intervention groups was 27%. After education, the average EBP rate increased to 37%, and then decreased to 26% in the postintervention sample. Mixed-model linear statistical analysis revealed no significant interaction of group by sample. The CDS intervention did not result in an increase in nurse EBP.
. EBP education increased nurse EBP documentation rates significantly but only temporarily. Nurses may have used evidence in practice but may not have documented their interventions.
. More research is needed to understand the complex relationship between CDS, nursing practice, and nursing EBP intervention documentation. CDS may have a different effect on nurse EBP, physician EBP, and other medical professional EBP.

  19. Influence of visual and auditory biofeedback on partial body weight support treadmill training of individuals with chronic hemiparesis: a randomized controlled clinical trial.

    Science.gov (United States)

    Brasileiro, A; Gama, G; Trigueiro, L; Ribeiro, T; Silva, E; Galvão, É; Lindquist, A

    2015-02-01

    Stroke is an important causal factor of deficiency and functional dependence worldwide. To determine the immediate effects of visual and auditory biofeedback, combined with partial body weight supported (PBWS) treadmill training on the gait of individuals with chronic hemiparesis. Randomized controlled trial. Outpatient rehabilitation hospital. Thirty subjects with chronic hemiparesis and ability to walk with some help. Participants were randomized to a control group that underwent only PBWS treadmill training; or experimental I group with visual biofeedback from the display monitor, in the form of symbolic feet as the subject took a step; or experimental group II with auditory biofeedback associated display, using a metronome at 115% of the individual's preferred cadence. They trained for 20 minutes and were evaluated before and after training. Spatio-temporal and angular gait variables were obtained by kinematics from the Qualisys Motion Analysis system. Increases in speed and stride length were observed for all groups over time (speed: F=25.63; Phemiparesis, in short term. Additional studies are needed to determine whether, in long term, the biofeedback will promote additional benefit to the PBWS treadmill training. The findings of this study indicate that visual and auditory biofeedback does not bring immediate benefits on PBWS treadmill training of individuals with chronic hemiparesis. This suggest that, for additional benefits are achieved with biofeedback, effects should be investigated after long-term training, which may determine if some kind of biofeedback is superior to another to improve the hemiparetic gait.

  20. Senior management leadership, social support, job design and stressor-to-strain relationships in hospital practice.

    Science.gov (United States)

    Buttigieg, Sandra C; West, Michael A

    2013-01-01

    The purpose of this paper is to examine the effect of the quality of senior management leadership on social support and job design, whose main effects on strains, and moderating effects on work stressors-to-strains relationships were assessed. A survey involving distribution of questionnaires was carried out on a random sample of health care employees in acute hospital practice in the UK. The sample comprised 65,142 respondents. The work stressors tested were quantitative overload and hostile environment, whereas strains were measured through job satisfaction and turnover intentions. Structural equation modelling and moderated regression analyses were used in the analysis. Quality of senior management leadership explained 75 per cent and 94 per cent of the variance of social support and job design respectively, whereas work stressors explained 51 per cent of the variance of strains. Social support and job design predicted job satisfaction and turnover intentions, as well as moderated significantly the relationships between quantitative workload/hostility and job satisfaction/turnover intentions. The findings are useful to management and to health employees working in acute/specialist hospitals. Further research could be done in other counties to take into account cultural differences and variations in health systems. The limitations included self-reported data and percept-percept bias due to same source data collection. The quality of senior management leaders in hospitals has an impact on the social environment, the support given to health employees, their job design, as well as work stressors and strains perceived. The study argues in favour of effective senior management leadership of hospitals, as well as ensuring adequate support structures and job design. The findings may be useful to health policy makers and human resources managers.

  1. Moving empirically supported practices to addiction treatment programs: recruiting supervisors to help in technology transfer.

    Science.gov (United States)

    Amodeo, Maryann; Storti, Susan A; Larson, Mary Jo

    2010-05-01

    Federal and state funding agencies are encouraging or mandating the use of empirically supported treatments in addiction programs, yet many programs have not moved in this direction (Forman, Bovasso, and Woody, 2001 ; Roman and Johnson, 2002 ; Willenbring et al., 2004 ). To improve the skills of counselors in community addiction programs, the authors developed an innovative Web-based course on Cognitive Behavioral Therapy (CBT), a widely accepted empirically-supported practice (ESP) for addiction. Federal funding supports this Web course and a randomized controlled trial to evaluate its effectiveness. Since supervisors often play a pivotal role in helping clinicians transfer learned skills from training courses to the workplace, the authors recruited supervisor-counselor teams, engaging 54 supervisors and 120 counselors. Lessons learned focus on supervisor recruitment and involvement, supervisors' perceptions of CBT, their own CBT skills and their roles in the study, and implications for technology transfer for the addiction field as a whole. Recruiting supervisors proved difficult because programs lacked clinical supervisors. Recruiting counselors was also difficult because programs were concerned about loss of third-party reimbursement. Across the addiction field, technology transfer will be severely hampered unless such infrastructure problems can be solved. Areas for further investigation are identified.

  2. Tensile-Creep Test Specimen Preparation Practices of Surface Support Liners

    Science.gov (United States)

    Guner, Dogukan; Ozturk, Hasan

    2017-12-01

    Ground support has always been considered as a challenging issue in all underground operations. Many forms of support systems and supporting techniques are available in the mining/tunnelling industry. In the last two decades, a new polymer based material, Thin Spray-on Liner (TSL), has attained a place in the market as an alternative to the current areal ground support systems. Although TSL provides numerous merits and has different application purposes, the knowledge on mechanical properties and performance of this material is still limited. In laboratory studies, since tensile rupture is the most commonly observed failure mechanism in field applications, researchers have generally studied the tensile testing of TSLs with modification of American Society for Testing and Materials (ASTM) D-638 standards. For tensile creep testing, specimen preparation process also follows the ASTM standards. Two different specimen dimension types (Type I, Type IV) are widely preferred in TSL tensile testing that conform to the related standards. Moreover, molding and die cutting are commonly used specimen preparation techniques. In literature, there is a great variability of test results due to the difference in specimen preparation techniques and practices. In this study, a ductile TSL product was tested in order to investigate the effect of both specimen preparation techniques and specimen dimensions under 7-day curing time. As a result, ultimate tensile strength, tensile yield strength, tensile modulus, and elongation at break values were obtained for 4 different test series. It is concluded that Type IV specimens have higher strength values compared to Type I specimens and moulded specimens have lower results than that of prepared by using die cutter. Moreover, specimens prepared by molding techniques have scattered test results. Type IV specimens prepared by die cutter technique are suggested for preparation of tensile test and Type I specimens prepared by die cutter technique

  3. Young people who are being bullied - do they want general practice support?

    Science.gov (United States)

    Scott, Emma; Dale, Jeremy; Russell, Rachel; Wolke, Dieter

    2016-08-22

    Childhood bullying is a major risk factor for health, education and social relationships, with effects persisting into adulthood. It affects half of all children at some point, with 10-14 % experiencing bullying that lasts for years. With the advent of cyberbullying, it can happen at all times and places. There have been calls for GPs to take a more active role in identifying and supporting young people who are being bullied. This paper explores young people's and parents' opinions about whether general practice should be involved in identifying and supporting young people who are being bullied. Two hundred six young people (85.9 % female, mean ± sd age 16.2 ± 3.2 years) and 44 parents were recruited through established bullying charity websites and their social media channels to complete an online questionnaire comprising multiple-choice questions and unlimited narrative responses. Questionnaire responses were analysed by age and gender using descriptive statistics. A descriptive analysis of the narrative responses was undertaken and key themes identified. Young people (90.8 %) and parents (88.7 %) thought it was important for GPs to be better able to recognise and help young people who are being bullied. Most recognised the link between bullying and health. The doctor's independence was seen as advantageous. Young people preferred completing a screening questionnaire to disclose experience of being bullied than being asked directly. They expressed concerns about how questions would be asked and whether information would be shared with parents/guardians. Parents were supportive of the use of a screening questionnaire, and most expected their child's disclosure to be shared with them. Young people and parents recruited through anti-bullying websites and social media would welcome greater GP involvement in identifying and supporting young people who are being bullied and their families, provided it is offered in a caring, compassionate and

  4. Facilitating the implementation of evidence- based practice through contextual support and nursing leadership.

    Science.gov (United States)

    Kueny, Angela; Shever, Leah L; Lehan Mackin, Melissa; Titler, Marita G

    2015-01-01

    Nurse managers (NMs) play an important role promoting evidence-based practice (EBP) on clinical units within hospitals. However, there is a dearth of research focused on NM perspectives about institutional contextual factors to support the goal of EBP on the clinical unit. The purpose of this article is to identify contextual factors described by NMs to drive change and facilitate EBP at the unit level, comparing and contrasting these perspectives across nursing units. This study employed a qualitative descriptive design using interviews with nine NMs who were participating in a large effectiveness study. To stratify the sample, NMs were selected from nursing units designated as high or low performing based on implementation of EBP interventions, scores on the Meyer and Goes research use scale, and fall rates. Descriptive content analysis was used to identify themes that reflect the complex nature of infrastructure described by NMs and contextual influences that supported or hindered their promotion of EBP on the clinical unit. NMs perceived workplace culture, structure, and resources as facilitators or barriers to empowering nurses under their supervision to use EBP and drive change. A workplace culture that provides clear communication of EBP goals or regulatory changes, direct contact with CEOs, and clear expectations supported NMs in their promotion of EBP on their units. High-performing unit NMs described a structure that included nursing-specific committees, allowing nurses to drive change and EBP from within the unit. NMs from high-performing units were more likely to articulate internal resources, such as quality-monitoring departments, as critical to the implementation of EBP on their units. This study contributes to a deeper understanding of institutional contextual factors that can be used to support NMs in their efforts to drive EBP changes at the unit level.

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

    Science.gov (United States)

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

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

  6. How different are ICT-supported pedagogical practices from extensive and non-extensive ICT-using science teachers?

    NARCIS (Netherlands)

    Voogt, Joke

    2009-01-01

    This paper aims to understand the differences between characteristics of ICT-supported pedagogical practices of grade 8 science teachers of extensive and non-extensive ICT-using science teachers. The differences of the pedagogical practices are described in terms of innovative and traditionally

  7. Facilitating the implementation of evidence-based practice through contextual support and nursing leadership

    Directory of Open Access Journals (Sweden)

    Kueny A

    2015-06-01

    Full Text Available Angela Kueny,1 Leah L Shever,2 Melissa Lehan Mackin,3 Marita G Titler4 1Luther College, Decorah, IA, 2The University of Michigan Hospital and Health Center, Ann Arbor, MI, 3University of Iowa College of Nursing, Iowa City, IA, 4University of Michigan School of Nursing, Ann Arbor, MI, USA Background/purpose: Nurse managers (NMs play an important role promoting evidence-based practice (EBP on clinical units within hospitals. However, there is a dearth of research focused on NM perspectives about institutional contextual factors to support the goal of EBP on the clinical unit. The purpose of this article is to identify contextual factors described by NMs to drive change and facilitate EBP at the unit level, comparing and contrasting these perspectives across nursing units. Methods: This study employed a qualitative descriptive design using interviews with nine NMs who were participating in a large effectiveness study. To stratify the sample, NMs were selected from nursing units designated as high or low performing based on implementation of EBP interventions, scores on the Meyer and Goes research use scale, and fall rates. Descriptive content analysis was used to identify themes that reflect the complex nature of infrastructure described by NMs and contextual influences that supported or hindered their promotion of EBP on the clinical unit. Results: NMs perceived workplace culture, structure, and resources as facilitators or barriers to empowering nurses under their supervision to use EBP and drive change. A workplace culture that provides clear communication of EBP goals or regulatory changes, direct contact with CEOs, and clear expectations supported NMs in their promotion of EBP on their units. High-performing unit NMs described a structure that included nursing-specific committees, allowing nurses to drive change and EBP from within the unit. NMs from high-performing units were more likely to articulate internal resources, such as quality

  8. Assessing fidelity of delivery of smoking cessation behavioural support in practice.

    Science.gov (United States)

    Lorencatto, Fabiana; West, Robert; Christopherson, Charlotte; Michie, Susan

    2013-04-04

    Effectiveness of evidence-based behaviour change interventions is likely to be undermined by failure to deliver interventions as planned. Behavioural support for smoking cessation can be a highly cost-effective, life-saving intervention. However, in practice, outcomes are highly variable. Part of this may be due to variability in fidelity of intervention implementation. To date, there have been no published studies on this. The present study aimed to: evaluate a method for assessing fidelity of behavioural support; assess fidelity of delivery in two English Stop-Smoking Services; and compare the extent of fidelity according to session types, duration, individual practitioners, and component behaviour change techniques (BCTs). Treatment manuals and transcripts of 34 audio-recorded behavioural support sessions were obtained from two Stop-Smoking Services and coded into component BCTs using a taxonomy of 43 BCTs. Inter-rater reliability was assessed using percentage agreement. Fidelity was assessed by examining the proportion of BCTs specified in the manuals that were delivered in individual sessions. This was assessed by session type (i.e., pre-quit, quit, post-quit), duration, individual practitioner, and BCT. Inter-coder reliability was high (87.1%). On average, 66% of manual-specified BCTs were delivered per session (SD 15.3, range: 35% to 90%). In Service 1, average fidelity was highest for post-quit sessions (69%) and lowest for pre-quit (58%). In Service 2, fidelity was highest for quit-day (81%) and lowest for post-quit sessions (56%). Session duration was not significantly correlated with fidelity. Individual practitioner fidelity ranged from 55% to 78%. Individual manual-specified BCTs were delivered on average 63% of the time (SD 28.5, range: 0 to 100%). The extent to which smoking cessation behavioural support is delivered as specified in treatment manuals can be reliably assessed using transcripts of audiotaped sessions. This allows the investigation of

  9. RURAL AREA OF MARAMUREŞ SUPPORT FOR THE DEVELOPMENT AND PRACTICE OF VARIOUS FORMS OF TOURISM

    Directory of Open Access Journals (Sweden)

    ALINA SIMONA SIMION

    2014-11-01

    Full Text Available Rural Area of Maramureş Support for the Development and Practice of Various Forms of Tourism. In Maramureș the tourist can find a comprehensive tourist offer based on the diversity of tourism potential, natural and anthropogenic, which can be exploited throughout the year regardless of the season for all age groups. Here are all types of tourism (recreational, cultural, curative and mixed, conducted under various forms, the importance of this is variable spatial and temporal through the volume of tourists and socio-economic effects induced. The predominant types of tourism are cultural and recreeativ tourism, this are associated with most forms of tourism (rural tourism, sports tourism, religious tourism, school, etc..

  10. Collaborative ethnography for information systems research Studying knowledge work practices and designing supportive information systems

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    Ronald Maier

    2012-04-01

    Full Text Available Understanding knowledge work and supporting it with information systems (ISs are challenging tasks. Knowledge work has changed substantially recently and studies on how knowledge work is currently performed are scarce. Ethnography is the most suitable qualitative research method for studying knowledge work, yet too time-consuming, costly and unfocused for the fast changing IS domain. Moreover, results from qualitative studies need to be transformed into artefacts useful for IS requirements engineering and design. This paper proposes a procedure for collaborative ethnography to study knowledge work practices and inform IS requirements gathering and design illustrated with the case of a collaborative ethnographic study of seven organisations in four European countries performed in a large-scale international IS research and development project. The paper also critically discusses the procedure’s applicability and limitations.

  11. Integration of evidence-based practice in bedside teaching paediatrics supported by e-learning.

    Science.gov (United States)

    Potomkova, Jarmila; Mihal, Vladimir; Zapletalova, Jirina; Subova, Dana

    2010-03-01

    Bedside teaching with evidence-based practice elements, supported by e-learning activities, can play an important role in modern medical education. Teachers have to incorporate evidence from the medical literature to increase student motivation and interactivity. An integral part of the medical curricula at Palacky University Olomouc (Czech Republic) are real paediatric scenarios supplemented with a review of current literature to enhance evidence-based bedside teaching & learning. Searching for evidence is taught through librarian-guided interactive hands-on sessions and/or web-based tutorials followed by clinical case presentations and feedback. Innovated EBM paediatric clerkship demonstrated students' preferences towards web-based interactive bedside teaching & learning. In two academic years (2007/2008, 2008/2009), learning-focused feedback from 106 and 131 students, resp. was obtained about their attitudes towards evidence-based bedside teaching. The assessment included among others the overall level of instruction, quality of practical evidence-based training, teacher willingness and impact of instruction on increased interest in the specialty. There was some criticism about excessive workload. A parallel survey was carried out on the perceived values of different forms of information skills training (i.e. demonstration, online tutorials, and librarian-guided interactive search sessions) and post-training self-reported level of search skills. The new teaching/learning paediatric portfolio is a challenge for further activities, including effective knowledge translation, continuing medical & professional development of teachers, and didactic, clinically integrated teaching approaches.

  12. Supporting graduate nurse transition to practice through a quality assurance feedback loop.

    Science.gov (United States)

    Phillips, Craig; Kenny, Amanda; Esterman, Adrian

    2017-11-01

    This mixed-method study focused on new graduate nurses and their transition to practice. Transition to practice can be a time of heightened stress and anxiety, leaving many new graduates disillusioned and dissatisfied with their work. The study explored how satisfaction levels with transition may improve during their first year, using a unique approach of a continuous quality assurance feedback loop. This assurance framework is utilised in hospitality, automotive and supply chain logistics and in health, primarily to monitor patient outcomes. However, an association with graduate nurse satisfaction has not been previously reported. Graduate nurses from two health services completed a short survey questionnaire every four weeks for 12 months. De-identified aggregated data was sent to health service management, giving them an opportunity to integrate the findings with the objective of potentially increasing graduate satisfaction ratings. Quantitative findings showed no statistical significance of graduate nurse satisfaction scores between health services, however, one health service consistently outperformed the other. Qualitative findings drawn from a seminar and interviews confirmed that one health service took a more proactive stance with the monthly reports, communicating the results to ward managers. Outcomes reflected a greater commitment of support and an overall increase of satisfaction scores. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Social support, acculturation, and optimism: understanding positive health practices in Asian American college students.

    Science.gov (United States)

    Ayres, Cynthia G; Mahat, Ganga

    2012-07-01

    This study developed and tested a theory to better understand positive health practices (PHP) among Asian Americans aged 18 to 21 years. It tested theoretical relationships postulated between PHP and (a) social support (SS), (b) optimism, and (c) acculturation, and between SS and optimism and acculturation. Optimism and acculturation were also tested as possible mediators in the relationship between SS and PHP. A correlational study design was used. A convenience sample of 163 Asian college students in an urban setting completed four questionnaires assessing SS, PHP, optimism, and acculturation and one demographic questionnaire. There were statistically significant positive relationships between SS and optimism with PHP, between acculturation and PHP, and between optimism and SS. Optimism mediated the relationship between SS and PHP, whereas acculturation did not. Findings extend knowledge regarding these relationships to a defined population of Asian Americans aged 18 to 21 years. Findings contribute to a more comprehensive knowledge base regarding health practices among Asian Americans. The theoretical and empirical findings of this study provide the direction for future research as well. Further studies need to be conducted to identify and test other mediators in order to better understand the relationship between these two variables.

  14. Broadening participation in community problem solving: a multidisciplinary model to support collaborative practice and research.

    Science.gov (United States)

    Lasker, Roz D; Weiss, Elisa S

    2003-03-01

    Over the last 40 years, thousands of communities-in the United States and internationally-have been working to broaden the involvement of people and organizations in addressing community-level problems related to health and other areas. Yet, in spite of this experience, many communities are having substantial difficulty achieving their collaborative objective, and many funders of community partnerships and participation initiatives are looking for ways to get more out of their investment. One of the reasons we are in this predicament is that the practitioners and researchers who are interested in community collaboration come from a variety of contexts, initiatives, and academic disciplines, and few of them have integrated their work with experiences or literatures beyond their own domain. In this article, we seek to overcome some of this fragmentation of effort by presenting a multidisciplinary model that lays out the pathways by which broadly participatory processes lead to more effective community problem solving and to improvements in community health. The model, which builds on a broad array of practical experience as well as conceptual and empirical work in multiple fields, is an outgrowth of a joint-learning work group that was organized to support nine communities in the Turning Point initiative. Following a detailed explication of the model, the article focuses on the implications of the model for research, practice, and policy. It describes how the model can help researchers answer the fundamental effectiveness and "how-to" questions related to community collaboration. In addition, the article explores differences between the model and current practice, suggesting strategies that can help the participants in, and funders of, community collaborations strengthen their efforts.

  15. Linear support vector regression and partial least squares chemometric models for determination of Hydrochlorothiazide and Benazepril hydrochloride in presence of related impurities: A comparative study

    Science.gov (United States)

    Naguib, Ibrahim A.; Abdelaleem, Eglal A.; Draz, Mohammed E.; Zaazaa, Hala E.

    2014-09-01

    Partial least squares regression (PLSR) and support vector regression (SVR) are two popular chemometric models that are being subjected to a comparative study in the presented work. The comparison shows their characteristics via applying them to analyze Hydrochlorothiazide (HCZ) and Benazepril hydrochloride (BZ) in presence of HCZ impurities; Chlorothiazide (CT) and Salamide (DSA) as a case study. The analysis results prove to be valid for analysis of the two active ingredients in raw materials and pharmaceutical dosage form through handling UV spectral data in range (220-350 nm). For proper analysis a 4 factor 4 level experimental design was established resulting in a training set consisting of 16 mixtures containing different ratios of interfering species. An independent test set consisting of 8 mixtures was used to validate the prediction ability of the suggested models. The results presented indicate the ability of mentioned multivariate calibration models to analyze HCZ and BZ in presence of HCZ impurities CT and DSA with high selectivity and accuracy of mean percentage recoveries of (101.01 ± 0.80) and (100.01 ± 0.87) for HCZ and BZ respectively using PLSR model and of (99.78 ± 0.80) and (99.85 ± 1.08) for HCZ and BZ respectively using SVR model. The analysis results of the dosage form were statistically compared to the reference HPLC method with no significant differences regarding accuracy and precision. SVR model gives more accurate results compared to PLSR model and show high generalization ability, however, PLSR still keeps the advantage of being fast to optimize and implement.

  16. Social Support Strategies for Immigrants: The Context of Social Work Practice in Lithuania

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    Aistė Bartkevičienė

    2013-06-01

    Full Text Available Intensification of migration flows makes Lithuania one of the immigrants host countries which, like other European Union countries, faces the challenge of integration of immigrants and in this process an important role has a social worker. The aim of research was to reveal the social support strategies used by social workers in solving social problems of immigrants during the process of their integration. The qualitative research using semi-structured interview method and content analysis method was done. The survey results suggest that immigrants during the process of integration face these social problems: the search for housing, employment, legal, financial, lack of access to relevant information. The results revealed that social workers, solving the social problems of immigrants, evaluate their nature and level and then apply the appropriate level of intervention. Social workers apply these micro level interventions: information and consultancy of immigrants, mediation and emotional support, which include individual social assistance. Social workers, solving the social problems of immigrants, apply these mezzo level interventions: development of social network of immigrants, organization of socio-cultural events, organization and coordination of volunteer activities. Social workers providing social assistance to immigrants' integration process, use the following macro level interventions: dissemination of information onimmigrantissues, conduction and dissemination of researches based on immigrant integration issues, dissemination of best practice of social workers.

  17. The Theoretical and Practical Aspects of Forming the Financial Support for the Health Care System

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    Goncharuk Svitlana M.

    2017-04-01

    Full Text Available The objectives of the article are: defining the theoretical and methodological foundations for financial support for health care institutions; disclosure of the concept and substance of the targeted budget programs in the health care system; a critical analysis of the current practice in the use of performance indicators for the targeted budget programs; improving the methods for managerial decision-making in the course of implementation of the targeted budget programs; determining ways to improve the effectiveness and efficiency of the targeted budget programs in the health care system. In order to develop the health care sector, there’s a necessity to define the order and mechanisms for the priority financing, as well as the personnel and material-technical provision of health care institutions. There is also a need for the State support and regulation of an adequate financing for health care programs to achieve equal access in different regions of Ukraine. It is important further to define the specifics of the health sector’s targeted programs that will facilitate management of them.

  18. Incidence of Parental Support and Pressure on Their Children's Motivational Processes towards Sport Practice Regarding Gender.

    Science.gov (United States)

    Amado, Diana; Sánchez-Oliva, David; González-Ponce, Inmaculada; Pulido-González, Juan José; Sánchez-Miguel, Pedro Antonio

    2015-01-01

    Grounded in Self-Determination Theory, structural equation modeling (SEM) with the aim of examining how parental support/pressure could influence their children´s motivational processes in sport was conducted, as well as the models´ differences in operability regarding gender. The sample size was 321 children ranging in age from 10 to 16 years old who were athletes from Extremadura, and 321 parents (included only the father or mother more involved with the sport of his or her child). 175 participants were male and 146 were female from individual (n = 130), and team sports (n=191). A questionnaire was conducted to assess parental perception of support/pressure and another questionnaire was conducted to measure satisfaction of basic psychological needs, type of motivation and enjoyment/boredom showed by their children towards sport practice. Results revealed that parental pressure negatively predicted satisfaction of the basic psychological needs. It also emerged as a strong positive predictor of intrinsic motivation and negative predictor of amotivation. Moreover, intrinsic motivation emerged as positive predictor of enjoyment and a negative predictor of boredom, whereas amotivation positively predicted boredom and negatively predicted enjoyment. Furthermore, results showed there were mean differences by gender: male athletes perceived greater parental pressure. Hence, it is necessary to decrease parental pressure towards their children in sport, with the aim of making them more motivated and enjoy, promoting positive consequences.

  19. Incidence of Parental Support and Pressure on Their Children's Motivational Processes towards Sport Practice Regarding Gender.

    Directory of Open Access Journals (Sweden)

    Diana Amado

    Full Text Available Grounded in Self-Determination Theory, structural equation modeling (SEM with the aim of examining how parental support/pressure could influence their children´s motivational processes in sport was conducted, as well as the models´ differences in operability regarding gender. The sample size was 321 children ranging in age from 10 to 16 years old who were athletes from Extremadura, and 321 parents (included only the father or mother more involved with the sport of his or her child. 175 participants were male and 146 were female from individual (n = 130, and team sports (n=191. A questionnaire was conducted to assess parental perception of support/pressure and another questionnaire was conducted to measure satisfaction of basic psychological needs, type of motivation and enjoyment/boredom showed by their children towards sport practice. Results revealed that parental pressure negatively predicted satisfaction of the basic psychological needs. It also emerged as a strong positive predictor of intrinsic motivation and negative predictor of amotivation. Moreover, intrinsic motivation emerged as positive predictor of enjoyment and a negative predictor of boredom, whereas amotivation positively predicted boredom and negatively predicted enjoyment. Furthermore, results showed there were mean differences by gender: male athletes perceived greater parental pressure. Hence, it is necessary to decrease parental pressure towards their children in sport, with the aim of making them more motivated and enjoy, promoting positive consequences.

  20. Development of clinical practice guidelines for supportive care in childhood cancer-prioritization of topics using a Delphi approach

    NARCIS (Netherlands)

    Loeffen, E. A. H.; Mulder, R. L.; Kremer, L. C. M.; Michiels, E. M. C.; Abbink, F. C. H.; Ball, L. M.; Segers, H.; Mavinkurve-Groothuis, A. M. C.; Smit, F. J.; Vonk, I. J. M.; vd Wetering, M. D.; Tissing, W. J. E.

    Currently, very few guidelines for supportive care for children with cancer exist. In the Netherlands, nationwide guidelines are over 10 years old and mostly based on expert opinion. Consequently, there is growing support and need for clinical practice guidelines (CPGs), which ought to be developed

  1. Development of clinical practice guidelines for supportive care in childhood cancer--prioritization of topics using a Delphi approach

    NARCIS (Netherlands)

    Loeffen, E. A. H.; Mulder, R. L.; Kremer, L. C. M.; Michiels, E. M. C.; Abbink, F. C. H.; Ball, L. M.; Segers, H.; Mavinkurve-Groothuis, A. M. C.; Smit, F. J.; Vonk, I. J. M.; Vd Wetering, M. D.; Tissing, W. J. E.

    2015-01-01

    Currently, very few guidelines for supportive care for children with cancer exist. In the Netherlands, nationwide guidelines are over 10 years old and mostly based on expert opinion. Consequently, there is growing support and need for clinical practice guidelines (CPGs), which ought to be developed

  2. Sustainable Telemedicine: Designing and Building Infrastructure to Support a Comprehensive Telemedicine Practice.

    Science.gov (United States)

    Kreofsky, Beth L H; Blegen, R Nicole; Lokken, Troy G; Kapraun, Susan M; Bushman, Matthew S; Demaerschalk, Bart M

    2018-04-16

    Telemedicine services in medical institutions are often developed in isolation of one another and not as part of a comprehensive telemedicine program. The Center for Connected Care is the administrative home for a broad range of telehealth services at Mayo Clinic. This article speaks of real-time video services, referenced as telemedicine throughout. This article discusses how a large healthcare system designed and built the infrastructure to support a comprehensive telemedicine practice. Based on analysis of existing services, Mayo Clinic developed a multifaceted operational plan that addressed high-priority areas and outlined clear roles and responsibilities of the Center for Connected Care and that of the clinical departments. The plan set priorities and a direction that would lead to long-term success. The plan articulated the governing and operational infrastructure necessary to support telemedicine by defining the role of the Center for Connected Care as the owner of core administrative operations and the role of the clinical departments as the owners of clinical telemedicine services. Additional opportunities were identified to develop product selection processes, implementation services, and staffing models that would be applied to ensure successful telemedicine deployment. The telemedicine team within the Center for Connected Care completed 45 business cases resulting in 54 implementations. The standardization of core products along with key operational offerings around implementation services, and the establishment of a 24/7 support model resulted in improved provider satisfaction and fewer reported technical issues. The foundation for long-term scalability and growth was developed by centralizing operations of telemedicine services, implementing sustainable processes, employing dedicated qualified personnel, and deploying robust products.

  3. Understanding the psychology of seeking support to increase Health Science student engagement in academic support services. A Practice Report

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    Gerard Francis Hoyne

    2013-04-01

    Full Text Available Increasing student engagement within higher education academic support services is a constant challenge. Whilst engagement with support is positively associated with successful retention, and non-engagement connected to attrition, the most vulnerable students are often the least likely to engage. Our data has shown that Health Science students are reluctant to engage with academic support services despite being made aware of their academic deficiencies. The “psychology of seeking support” was used as a lens to identify some of the multifaceted issues around student engagement. The School of Health Sciences made attendance at support courses compulsory for those students who were below the benchmark score in a post entrance literacy test. Since the policy change was implemented, there has been a 50% reduction in the fail rate of “at risk” students in a core literacy unit. These findings are encouraging and will help reduce student attrition in the long term.

  4. Supporting work practices through telehealth: impact on nurses in peripheral regions

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    Courcy François

    2011-02-01

    Full Text Available Abstract Background In Canada, workforce shortages in the health care sector constrain the ability of the health care system to meet the needs of its population and of its health care professionals. This issue is of particular importance in peripheral regions of Quebec, where significant inequalities in workforce distribution between regions has lead to acute nursing shortages and increased workloads. Information and communication technologies (ICTs are innovative solutions that can be used to develop strategies to optimise the use of available resources and to design new nursing work practices. However, current knowledge is still limited about the real impact of ICTs on nursing recruitment and retention. Our aim is to better understand how work practice reorganization, supported by ICTs, and particularly by telehealth, may influence professional, educational, and organizational factors relating to Quebec nurses, notably those working in peripheral regions. Methods/Design First, we will conduct a descriptive study on the issue of nursing recruitment. Stratified sampling will be used to select approximately twenty innovative projects relating to the reorganization of work practices based upon ICTs. Semi-structured interviews with key informants will determine professional, educational, and organizational recruitment factors. The results will be used to create a questionnaire which, using a convenience sampling method, will be mailed to 600 third year students and recent graduates of two Quebec university nursing faculties. Descriptive, correlation, and hierarchical regression analyses will be performed to identify factors influencing nursing graduates' intentions to practice in peripheral regions. Secondly, we will conduct five case studies pertaining to the issue of nursing retention. Five ICT projects in semi-urban, rural, and isolated regions have been identified. Qualitative data will be collected through field observation and approximately

  5. Innovative physical therapy practice: a qualitative verification of factors that support diffusion of innovation in outpatient physical therapy practice.

    Science.gov (United States)

    Sabus, Carla; Spake, Ellen

    2016-01-01

    New ideas, methods, and technologies spread through cultures through typical patterns described by diffusion of innovation (DOI) theory. Professional cultures, including the physical therapy profession, have distinctive features and traditions that determine the adoption of practice innovation. The Consolidated Framework for Implementation Research (CFIR) proposes a framework of innovation implementation specific to health care services. While the CFIR has been applied to medical and nursing practice, it has not been extended to rehabilitation professions. The purpose of this qualitative study was to verify the CFIR factors in outpatient physical therapy practice. Through a nomination process of area rehabilitation managers and area directors of clinical education, 2 exemplar, outpatient, privately owned physical therapy clinics were identified as innovation practices. A total of 18 physical therapists (PTs), including 3 owners and a manager, participated in the study. The 2 clinics served as case studies within a qualitative approach of directed content analysis. Data were collected through observation, spontaneous, unstructured questioning, workflow analysis, structured focus group sessions, and artifact analysis including clinical documents. Focus group data were transcribed. All the data were analyzed and coded among 4 investigators. Through data analysis and alignment with literature in DOI theory in health care practice, the factors that determine innovation adoption were verified. The phenomena of implementation in PT practice are largely consistent with models of implementation in health care service. Within the outpatient practices studied, patient-centered care and collaborative learning were foundational elements to diffusion of an innovation. Innovation in outpatient physical therapy practice can be understood as a social process situated within the culture of the physical therapy professional that follows predictable patterns that strongly align with

  6. Treadmill training with partial body weight support compared with conventional gait training for low-functioning children and adolescents with nonspastic cerebral palsy: a two-period crossover study.

    Science.gov (United States)

    Su, Ivan Y W; Chung, Kenny K Y; Chow, Daniel H K

    2013-12-01

    Partial body weight-supported treadmill training has been shown to be effective in gait training for patients with neurological disorders such as spinal cord injuries and stroke. Recent applications on children with cerebral palsy were reported, mostly on spastic cerebral palsy with single subject design. There is lack of evidence on the effectiveness of such training for nonspastic cerebral palsy, particularly those who are low functioning with limited intellectual capacity. This study evaluated the effectiveness of partial body weight-supported treadmill training for improving gross motor skills among these clients. A two-period randomized crossover design with repeated measures. A crossover design following an A-B versus a B-A pattern was adopted. The two training periods consisted of 12-week partial body weight-supported treadmill training (Training A) and 12-week conventional gait training (Training B) with a 10-week washout in between. Ten school-age participants with nonspastic cerebral palsy and severe mental retardation were recruited. The Gross Motor Function Measure-66 was administered immediately before and after each training period. Significant improvements in dimensions D and E of the Gross Motor Function Measure-66 and the Gross Motor Ability Estimator were obtained. Our findings revealed that the partial body weight-supported treadmill training was effective in improving gross motor skills for low-functioning children and adolescents with nonspastic cerebral palsy. .

  7. Supporting communities of practice: A reflection on the benefits and challenges facing communities of practice for research and engagement in nursing

    Directory of Open Access Journals (Sweden)

    Maretha De Waal

    2016-09-01

    Full Text Available Because of its potential self-sustainability, communities of practice may serve as useful practice-based knowledge sharing platforms for collaborative research and training, and thereby enhance development of human resources in the health sector. However, communities of practice are complex structures and need support from their host organisations and commitment from their members.  This article examines the diverse ways in which communities of nurse educators and practitioners who were part of a funded program in Tshwane District, South Africa evolved over a period of seven years. Adopting an ethnographic approach of reflexivity and learning, we compared and analysed the ways in which the communities of practice became sustainable over time. Our recommendations for institutional support of communities of practice in the health sector are based on the lessons we learned during the program that contributed to the configuration and reconfiguration of some of our communities of practice and the disengagement of others. We believe that our findings may have implications for replicability and sustainability of other communities of practice. Keywords: collaborative learning, collective knowledge, self-sustainability

  8. Partial Cancellation

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Partial Cancellation. Full Cancellation is desirable. But complexity requirements are enormous. 4000 tones, 100 Users billions of flops !!! Main Idea: Challenge: To determine which cross-talker to cancel on what “tone” for a given victim. Constraint: Total complexity is ...

  9. SUPPORTING TEACHERS IN IMPLEMENTING FORMATIVE ASSESSMENT PRACTICES IN EARTH SYSTEMS SCIENCE

    Science.gov (United States)

    Harris, C. J.; Penuel, W. R.; Haydel Debarger, A.; Blank, J. G.

    2009-12-01

    An important purpose of formative assessment is to elicit student thinking to use in instruction to help all students learn and inform next steps in teaching. However, formative assessment practices are difficult to implement and thus present a formidable challenge for many science teachers. A critical need in geoscience education is a framework for providing teachers with real-time assessment tools as well as professional development to learn how to use formative assessment to improve instruction. Here, we describe a comprehensive support system, developed for our NSF-funded Contingent Pedagogies project, for addressing the challenge of helping teachers to use formative assessment to enhance student learning in middle school Earth Systems science. Our support system is designed to improve student understanding about the geosphere by integrating classroom network technology, interactive formative assessments, and contingent curricular activities to guide teachers from formative assessment to instructional decision-making and improved student learning. To accomplish this, we are using a new classroom network technology, Group Scribbles, in the context of an innovative middle-grades Earth Science curriculum called Investigating Earth Systems (IES). Group Scribbles, developed at SRI International, is a collaborative software tool that allows individual students to compose “scribbles” (i.e., drawings and notes), on “post-it” notes in a private workspace (a notebook computer) in response to a public task. They can post these notes anonymously to a shared, public workspace (a teacher-controlled large screen monitor) that becomes the centerpiece of group and class discussion. To help teachers implement formative assessment practices, we have introduced a key resource, called a teaching routine, to help teachers take advantage of Group Scribbles for more interactive assessments. Routine refers to a sequence of repeatable interactions that, over time, become

  10. Innovative physical therapy practice: a qualitative verification of factors that support diffusion of innovation in outpatient physical therapy practice

    Directory of Open Access Journals (Sweden)

    Sabus C

    2016-12-01

    Full Text Available Carla Sabus,1 Ellen Spake2 1Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, 2Rockhurst University, Kansas City, MO, USA Background and purpose: New ideas, methods, and technologies spread through cultures through typical patterns described by diffusion of innovation (DOI theory. Professional cultures, including the physical therapy profession, have distinctive features and traditions that determine the adoption of practice innovation. The Consolidated Framework for Implementation Research (CFIR proposes a framework of innovation implementation specific to health care services. While the CFIR has been applied to medical and nursing practice, it has not been extended to rehabilitation professions. The purpose of this qualitative study was to verify the CFIR factors in outpatient physical therapy practice.Design: Through a nomination process of area rehabilitation managers and area directors of clinical education, 2 exemplar, outpatient, privately owned physical therapy clinics were identified as innovation practices. A total of 18 physical therapists (PTs, including 3 owners and a manager, participated in the study.Methods: The 2 clinics served as case studies within a qualitative approach of directed content analysis. Data were collected through observation, spontaneous, unstructured questioning, ­workflow analysis, structured focus group sessions, and artifact analysis including clinical documents. Focus group data were transcribed. All the data were analyzed and coded among 4 investigators.Results: Through data analysis and alignment with literature in DOI theory in health care practice, the factors that determine innovation adoption were verified. The phenomena of implementation in PT practice are largely consistent with models of implementation in health care service. Within the outpatient practices studied, patient-centered care and collaborative learning were foundational

  11. Supporting Aboriginal Women to Quit Smoking: Antenatal and Postnatal Care Providers' Confidence, Attitudes, and Practices.

    Science.gov (United States)

    Tzelepis, Flora; Daly, Justine; Dowe, Sarah; Bourke, Alex; Gillham, Karen; Freund, Megan

    2017-05-01

    Tobacco use during pregnancy is substantially higher among Aboriginal women compared to non-Aboriginal women in Australia. However, no studies have investigated the amount or type of smoking cessation care that staff from Aboriginal antenatal and postnatal services provide to clients who smoke or staff confidence to do so. This study examined Aboriginal antenatal and postnatal staff confidence, perceived role and delivery of smoking cessation care to Aboriginal women and characteristics associated with provision of such care. Staff from 11 Aboriginal Maternal and Infant Health Services and eight Aboriginal Child and Family Health services in the Hunter New England Local Health District in Australia completed a cross-sectional self-reported survey (n = 67, response rate = 97.1%). Most staff reported they assessed clients' smoking status most or all of the time (92.2%). However, only a minority reported they offered a quitline referral (42.2%), provided follow-up support (28.6%) or provided nicotine replacement therapy (4.7%) to most or all clients who smoked. Few staff felt confident in motivating clients to quit smoking (19.7%) and advising clients about using nicotine replacement therapy (15.6%). Staff confident with talking to clients about how smoking affected their health had significantly higher odds of offering a quitline referral [OR = 4.9 (1.7-14.5)] and quitting assistance [OR = 3.9 (1.3-11.6)] to clients who smoke. Antenatal and postnatal staff delivery of smoking cessation care to pregnant Aboriginal women or mothers with young Aboriginal children could be improved. Programs that support Aboriginal antenatal and postnatal providers to deliver smoking cessation care to clients are needed. Aboriginal antenatal and postnatal service staff have multiple opportunities to assist Aboriginal women to quit smoking during pregnancy and postpartum. However, staff confidence and practices of offering various forms of smoking cessation support to pregnant Aboriginal

  12. Utilizing Professional Vision in Supporting Preservice Teachers' Learning About Contextualized Scientific Practices. Collaborative Discourse Practices Between Teachers and Scientists

    Science.gov (United States)

    Sezen-Barrie, Asli

    2018-03-01

    Drawn from the cultural-historical theories of knowing and doing science, this article uses the concept of professional vision to explore what scientists and experienced teachers see and articulate as important aspects of climate science practices. The study takes an abductive reasoning approach to analyze scientists' videotaped lectures to recognize what scientists pay attention to in their explanations of climate science practices. It then analyzes how ideas scientists attended align with experienced teachers' sense-making of scientific practices to teach climate change. The findings show that experienced teachers' and scientists' explanations showed alignment in the focus on scientific practices, but indicated variations in the temporal and spatial reasoning of climate data. Furthermore, the interdisciplinarity of climate science was emphasized in climate scientists' lectures, but was not apparent once scientists and teachers shared the same culture in meetings to provide feedback to preservice teachers. Given the importance of teaching through scientific practices in classrooms, this study provides suggestions to capture the epistemic diversity of scientific disciplines.

  13. Organizational Dimensions of Innovative Practice: A Qualitative Investigation of the Processes Supporting Innovation Adoption in Outpatient Physical Therapy Practice.

    Science.gov (United States)

    Sabus, Carla; Spake, Ellen

    2018-01-01

    The ability to innovate and adapt practice is a requirement of the progressive healthcare provider. Innovative practice by rehabilitation providers has largely been approached as personal professional development; this study extends that perspective by examining innovation uptake from the organizational level. The varied professions can be expected to have distinct qualities of innovation adoption that reflect professional norms, values, and expectations. The purpose of this qualitative study was to describe the organizational processes of innovation uptake in outpatient physical therapy practice. Through nomination, two outpatient, privately owned physical therapy clinics were identified as innovation practices. Eighteen physical therapists, three owners, and a manager participated in the study. The two clinics served as case studies within a grounded theory approach. Data were collected through observation, unstructured questioning, work flow analysis, focus group sessions, and artifact analysis. Data were analyzed and coded among the investigators. A theoretical model of the innovation adoption process in outpatient physical therapy practice was developed. Elements of the model included (1) change grounded in relationship-centered care, (2) clinic readiness to accept change, and (3) clinic adaptability and resilience. A social paradigm of innovation adoption informed through this research complements the concentration on personal professional development.

  14. Utilizing Professional Vision in Supporting Preservice Teachers' Learning About Contextualized Scientific Practices - Collaborative Discourse Practices Between Teachers and Scientists

    Science.gov (United States)

    Sezen-Barrie, Asli

    2018-03-01

    Drawn from the cultural-historical theories of knowing and doing science, this article uses the concept of professional vision to explore what scientists and experienced teachers see and articulate as important aspects of climate science practices. The study takes an abductive reasoning approach to analyze scientists' videotaped lectures to recognize what scientists pay attention to in their explanations of climate science practices. It then analyzes how ideas scientists attended align with experienced teachers' sense-making of scientific practices to teach climate change. The findings show that experienced teachers' and scientists' explanations showed alignment in the focus on scientific practices, but indicated variations in the temporal and spatial reasoning of climate data. Furthermore, the interdisciplinarity of climate science was emphasized in climate scientists' lectures, but was not apparent once scientists and teachers shared the same culture in meetings to provide feedback to preservice teachers. Given the importance of teaching through scientific practices in classrooms, this study provides suggestions to capture the epistemic diversity of scientific disciplines.

  15. Honey for Wound Healing, Ulcers, and Burns; Data Supporting Its Use in Clinical Practice

    Directory of Open Access Journals (Sweden)

    Noori Al-Waili

    2011-01-01

    Full Text Available The widespread existence of unhealed wounds, ulcers, and burns has a great impact on public health and economy. Many interventions, including new medications and technologies, are being used to help achieve significant wound healing and to eliminate infections. Therefore, to find an intervention that has both therapeutic effect on the healing process and the ability to kill microbes is of great value. Honey is a natural product that has been recently introduced in modern medical practice. Honey's antibacterial properties and its effects on wound healing have been thoroughly investigated. Laboratory studies and clinical trials have shown that honey is an effective broad-spectrum antibacterial agent. This paper reviews data that support the effectiveness of natural honey in wound healing and its ability to sterilize infected wounds. Studies on the therapeutic effects of honey collected in different geographical areas on skin wounds, skin and gastric ulcers, and burns are reviewed and mechanisms of action are discussed. (Ulcers and burns are included as an example of challenging wounds. The data show that the wound healing properties of honey include stimulation of tissue growth, enhanced epithelialization, and minimized scar formation. These effects are ascribed to honey's acidity, hydrogen peroxide content, osmotic effect, nutritional and antioxidant contents, stimulation of immunity, and to unidentified compounds. Prostaglandins and nitric oxide play a major role in inflammation, microbial killing, and the healing process. Honey was found to lower prostaglandin levels and elevate nitric oxide end products. These properties might help to explain some biological and therapeutic properties of honey, particularly as an antibacterial agent or wound healer. The data presented here demonstrate that honeys from different geographical areas have considerable therapeutic effects on chronic wounds, ulcers, and burns. The results encourage the use of honey

  16. The Curriculum Customization Service: A Tool for Customizing Earth Science Instruction and Supporting Communities of Practice

    Science.gov (United States)

    Melhado, L. C.; Devaul, H.; Sumner, T.

    2010-12-01

    contributed by colleagues to create personalized, annotated collections of resources best suited to address the needs of the students in their classroom. Teachers can see the resources that their colleagues are using to customize their instruction, and share their ideas about the suitability of resources for different learners or learning styles through the use of tags and annotations thus creating a community of practice in support of differentiated instruction. A field trial involving 124 middle and high school Earth science teachers in a large urban school district was conducted in the 2009-2010 academic year, accompanied by a mixed-method research and evaluation study to investigate the impact of the use of this system on teacher beliefs and practice, and student learning. This presentation will include a demonstration of the system as well as discuss the results of the research thus far.

  17. Nursing in general practice: organizational possibilities for decision latitude, created skill, social support and identity derived from role.

    Science.gov (United States)

    Merrick, Eamon; Duffield, Christine; Baldwin, Richard; Fry, Margaret

    2012-03-01

    This article is a report of a study to describe the factors that support organizational opportunities for practice nurse decision-making and skill development for nurses employed in general practice in New South Wales, Australia. Corresponding to the availability of subsidies from the Australian universal health insurer (Medicare), there has been an increase in the number of nurses employed in general practice. Currently, there is no Australian evidence as to the organizational possibilities for these practice nurses to make decisions, develop their own skills and abilities, derive identity from their role or how their role is influenced by social support. Over a 8-month period in 2008 practice, nurses employed in general practice in the State of New South Wales were invited to complete a 26-item self-administered online questionnaire utilizing constructs from Karaseks (1998) Job Content Questionnaire (valid n = 160). Confirmatory Factor Analysis indicated that all scales demonstrated acceptable levels of internal consistency. Sequential regression models revealed that social support exerts a weak influence on decision latitude (R(2) = 0·07); the addition of self-identity through work significantly improved the predictive ability of the model (R(2) = 0·16). Social support and self-identity through work exerted a negative influence on created skill (R(2) = 0·347), whereas social support was effective in predicting self-identity through work (R(2) = 0·148).   Collegial and supervisory support in the work environment predicts organizational possibilities for practice nurse decision-making. © 2011 Blackwell Publishing Ltd.

  18. Current evidence does not support the use of Kinesio Taping in clinical practice: a systematic review

    Directory of Open Access Journals (Sweden)

    Patrícia do Carmo Silva Parreira

    2014-03-01

    Full Text Available Questions: Is Kinesio Taping more effective than a sham taping/placebo, no treatment or other interventions in people with musculoskeletal conditions? Is the addition of Kinesio Taping to other interventions more effective than other interventions alone in people with musculoskeletal conditions? Design: Systematic review of randomised trials. Participants: People with musculoskeletal conditions. Intervention: Kinesio Taping was compared with sham taping/placebo, no treatment, exercises, manual therapy and conventional physiotherapy. Outcome measures: Pain intensity, disability, quality of life, return to work, and global impression of recovery. Results: Twelve randomised trials involving 495 participants were included in the review. The effectiveness of the Kinesio Taping was tested in participants with: shoulder pain in two trials; knee pain in three trials; chronic low back pain in two trials; neck pain in three trials; plantar fasciitis in one trial; and multiple musculoskeletal conditions in one trial. The methodological quality of eligible trials was moderate, with a mean of 6.1 points on the 10-point PEDro Scale score. Overall, Kinesio Taping was no better than sham taping/placebo and active comparison groups. In all comparisons where Kinesio Taping was better than an active or a sham control group, the effect sizes were small and probably not clinically significant or the trials were of low quality. Conclusion: This review provides the most updated evidence on the effectiveness of the Kinesio Taping for musculoskeletal conditions. The current evidence does not support the use of this intervention in these clinical populations. PROSPERO registration: CRD42012003436. [Parreira PdCS, Costa LdCM, Hespanhol Junior LC, Lopes AD, Costa LOP (2014 Current evidence does not support the use of Kinesio Taping in clinical practice: a systematic review. Journal of Physiotherapy 60: 31–39

  19. How space design and technology can support the Pharmacy Practice Model Initiative through interprofessional collaboration

    Directory of Open Access Journals (Sweden)

    Lindsay Hahn

    2014-01-01

    Full Text Available Purpose: The Pharmacy Practice Model Initiative (PPMI calls pharmacists to more direct patient care and increased responsibility for medication-related outcomes, as a means of achieving greater safety, improving outcomes and reducing costs. This article acknowledges the value of interprofessional collaboration to the PPMI and identifies the implications of the Initiative for space design and technology, both of which stand to help the Initiative gather additional support. Summary: The profession of pharmacy has for some time now become increasingly vocal about its desire to take on greater responsibility for patient outcomes. With drug costs representing the largest portion of a hospital's pharmacy budget and reimbursements becoming more contingent on readmission avoidance, the pharmacy's influence on a hospital's bottom line is significant. More importantly, study after study is showing that with greater pharmacist intervention, patient outcomes improve. This article addresses the ways in which developments in the fields of technology and facility design can assist in the deployment of the PPMI. Conclusion: As the PPMI achieves a critical level of support from inside and outside the pharmacy, and more empirical research emerges regarding the improved outcomes and cost savings of increasing the roles of both clinical pharmacists and pharmacy technicians, the industry sectors of healthcare technology and healthcare design stand ready to assist in the execution of this new model. By encouraging pharmacists, doctors and nurses to work together - and all caregivers to work with facility designers, biomedical engineers and IT specialists, there is the increased likelihood of these fields turning to each other to problem-solve together, all for the ultimate benefit to patients and their families.   Type: Commentary

  20. A Comparison of Locomotor Therapy Interventions: Partial-Body Weight-Supported Treadmill, Lokomat, and G-EO Training in People With Traumatic Brain Injury.

    Science.gov (United States)

    Esquenazi, Alberto; Lee, Stella; Wikoff, Amanda; Packel, Andrew; Toczylowski, Theresa; Feeley, John

    2017-09-01

    Literature in the application of gait training techniques in persons with traumatic brain injury (TBI) is limited. Current techniques require multiple staff and are physically demanding. The use of a robotic locomotor training may provide improved training capacity for this population. To examine the impact of 3 different modes of locomotor therapy on gait velocity and spatiotemporal symmetry using an end effector robot (G-EO); a robotic exoskeleton (Lokomat), and manual assisted partial-body weight-supported treadmill training (PBWSTT) in participants with traumatic brain injury. Randomized, prospective study. Tertiary rehabilitation hospital. A total of 22 individuals with ≥12 months chronic TBI with hemiparetic pattern able to walk overground without assistance at velocities between 0.2 and 0.6 m/s. Eighteen sessions of 45 minutes of assigned locomotor training. Overground walking self-selected velocity (SSV), maximal velocity (MV), spatiotemporal asymmetry ratio, 6-Minute Walk Test (6MWT), and mobility domain of Stroke Impact Scale (MSIS). Severity in walking dysfunction was similar across groups as determined by walking velocity data. At baseline, participants in the Lokomat group had a baseline velocity that was slightly slower compared with the other groups. Training elicited a statistically significant median increase in SSV for all groups compared with pretraining (Lokomat, P = .04; G-EO, P = .03; and PBWSTT, P = .02) and MV excluding the G-EO group (Lokomat, P = .04; PBWSTT, P = .03 and G-EO, P = .15). There were no pre-post significant differences in swing time, stance time, and step length asymmetry ratios at SSV or MV for any of the interventions. Mean rank in the change of SSV and MV was not statistically significantly different between groups. Participants in the G-EO and PBWSTT groups significantly improved their 6MWT posttraining (P = .04 and .03, respectively). The MSIS significantly improved only for the Lokomat group (P = .04 and .03). The

  1. Partial processing

    International Nuclear Information System (INIS)

    1978-11-01

    This discussion paper considers the possibility of applying to the recycle of plutonium in thermal reactors a particular method of partial processing based on the PUREX process but named CIVEX to emphasise the differences. The CIVEX process is based primarily on the retention of short-lived fission products. The paper suggests: (1) the recycle of fission products with uranium and plutonium in thermal reactor fuel would be technically feasible; (2) it would, however, take ten years or more to develop the CIVEX process to the point where it could be launched on a commercial scale; (3) since the majority of spent fuel to be reprocessed this century will have been in storage for ten years or more, the recycling of short-lived fission products with the U-Pu would not provide an effective means of making refabrication fuel ''inaccessible'' because the radioactivity associated with the fission products would have decayed. There would therefore be no advantage in partial processing

  2. Partial gigantism

    Directory of Open Access Journals (Sweden)

    М.М. Karimova

    2017-05-01

    Full Text Available A girl with partial gigantism (the increased I and II fingers of the left foot is being examined. This condition is a rare and unresolved problem, as the definite reason of its development is not determined. Wait-and-see strategy is recommended, as well as correcting operations after closing of growth zones, and forming of data pool for generalization and development of schemes of drug and radial therapeutic methods.

  3. Why drivers use cell phones and support legislation to restrict this practice.

    Science.gov (United States)

    Sanbonmatsu, David M; Strayer, David L; Behrends, Arwen A; Ward, Nathan; Watson, Jason M

    2016-07-01

    The use of cell phones while driving is ubiquitous, particularly in countries where the practice is legal. However, surveys indicate that most drivers favor legislation to limit the use of mobile devices during the operation of a vehicle. A study was conducted to understand this inconsistency between what drivers do and what they advocate for others. Participants completed a survey about their driving attitudes, abilities, and behaviors. Following previous research, drivers reported using cell phones for benefits such as getting work done. The hypocrisy of using cell phones while advocating restrictions appears to stem from differences in the perceived safety risks of self vs. others' use of cell phones. Many if not most drivers believe they can drive safely while using mobile devices. However, they lack confidence in others' ability to drive safely while distracted and believe that others' use of cell phones is dangerous. The threat to public safety of others' usage of mobile devices was one of the strongest independent predictors of support for legislation to restrict cell phone use. Published by Elsevier Ltd.

  4. The views and experiences of female GPs on professional practice and career support.

    Science.gov (United States)

    Wedderburn, Clare; Scallan, Samantha; Whittle, Clare; Curtis, Anthony

    2013-09-01

    National GP demographic data demonstrate an increasing 'feminisation' of the workforce. With female GP specialty trainees continuing to outnumber males, this trend is set to continue. The changing composition of the workforce presents challenges in terms of how best to support the long-term career and educational development needs of this sector of the workforce in an evolving healthcare context. The aim of this work was to capture female GPs' experiences of working in general practice and their expectations concerning their career and educational development. Participants were surveyed and completed a semi-structured questionnaire, which generated qualitative and quantitative data. The sample comprised GP registrars, principals and sessionals. This study has generated an important dataset on working patterns, educational experiences and long-term career intentions of female GPs. Despite increased representation in the GP workforce, female GPs (particularly those with young children) appear less likely to be involved in education and training than their male counterparts, and even less likely to be involved in roles linked to primary care trusts, medico-political issues, hospital service delivery, special clinical interests or deanery education management. younger GPs reported significantly more difficulties in managing their childcare needs than older colleagues. Marital status, number of children and employment status did not moderate the effect of these difficulties. Female GPs reported working more hours with increasing age, but were not necessarily represented in a range of educational and/or training posts as a consequence.

  5. Introducing out-of-pocket payment for general practice in Denmark: feasibility and support.

    Science.gov (United States)

    Poulsen, Camilla Aavang

    2014-07-01

    The financing of General Practice (GP) is a much-debated topic. In spite of out-of-pocket (OOP) payment for other primary health care provided by self-employed professionals, there is no OOP payment for the use of GP in Denmark. This article aims to explore the arguments, the actors and the decision-making context. An analysis of the healthcare-policy debate in Parliament and the media from 1990 until September 2012. The materials are parliamentary hearings/discussions and newspaper articles. Kingdon's model on Policy Windows and the Advocacy Coalition framework by Sabatier and Jenkins are used to investigate explanations. The arguments from the proponents are: that OOP payment for GP will reduce pressure on the primary sector; that the current allocation of OOP payment in the sector is historically conditioned; and that resistance towards OOP payment is based on emotions. The main argument from the opponents is that OOP payment will increase social inequality in health. There is little connection between the attitudes and ideological backgrounds of the political parties. Despite factors such as perceived expert/scientific evidence for OOP payment, changes of government, financial crisis and a market-based reform wave, no government has introduced OOP payment for GP. This article suggests that governmental positions, public- and especially health-professional support are important factors in the decision-making context. Copyright © 2014. Published by Elsevier Ireland Ltd.

  6. Decision support systems in clinical practice: The case of venous thromboembolism prevention.

    Science.gov (United States)

    Nazarenko, G I; Kleymenova, E B; Payushik, S A; Otdelenov, V A; Sychev, D A; Yashina, L P

    2015-01-01

    Today medicine is facing a "knowledge crisis" in that explosively expanding medical knowledge encounters limited abilities to disseminate new practices [1]. Clinical practice guidelines (CPGs) are intended to promote high standards of care in specific areas of medicine by summarizing best clinical practice based on careful reviews of current research. However, doctors are often short of time to study these documents and check their updates, have little motivation for strict adherence to them. A systematic review of 11 studies reporting on 29 recommendations has found that median adherence to all recommendations was 34%, suggesting that potential benefits for patients from health research may be lost [2].Clinical decision support systems (CDSS) can serve as a knowledge translation tool, mediator between clinical guidelines and physicians by providing the right information to the right person at the right time. To evaluate the effectiveness of implementation of international and national CPGs for venous thromboembolism (VTE) prevention with the help of CDSS in a general hospital. A multifunctional CDSS based on national and international guidelines on the VTE prevention was developed and implemented in the Medical Center of the Bank of Russia (MC). The system has the following functionalities: 1) it supports the decision on the VTE prevention based on individual risk assessment of thrombosis (scales of Caprini, Rogers and Khorana, Padua Prediction Score, additional risk factors) and bleeding (IMPROVE scale for non-surgical patients, major bleeding scale for surgical patients and major orthopedic surgeries, hemorrhagic complications risk in cancer patients); 2) generates the summary containing the grade of recommendations and the level of evidence, personalized recommendations on regimen and duration of preventive antithrombotic therapy, dose correction according to creatinine clearance; 3) provides an audit form for and statistical analysis of VTE cases; 3

  7. Peer support for families of children with complex needs: Development and dissemination of a best practice toolkit.

    Science.gov (United States)

    Schippke, J; Provvidenza, C; Kingsnorth, S

    2017-11-01

    Benefits of peer support interventions for families of children with disabilities and complex medical needs have been described in the literature. An opportunity to create an evidence-informed resource to synthesize best practices in peer support for program providers was identified. The objective of this paper is to describe the key activities used to develop and disseminate the Peer Support Best Practice Toolkit. This project was led by a team of knowledge translation experts at a large pediatric rehabilitation hospital using a knowledge exchange framework. An integrated knowledge translation approach was used to engage stakeholders in the development process through focus groups and a working group. To capture best practices in peer support, a rapid evidence review and review of related resources were completed. Case studies were also included to showcase practice-based evidence. The toolkit is freely available online for download and is structured into four sections: (a) background and models of peer support, (b) case studies of programs, (c) resources, and (d) rapid evidence review. A communications plan was developed to disseminate the resource and generate awareness through presentations, social media, and champion engagement. Eight months postlaunch, the peer support website received more than 2,400 webpage hits. Early indicators suggest high relevance of this resource among stakeholders. The toolkit format was valuable to synthesize and share best practices in peer support. Strengths of the work include the integrated approach used to develop the toolkit and the inclusion of both the published research literature and experiential evidence. © 2017 John Wiley & Sons Ltd.

  8. Global transaction support for workflow management systems: from formal specification to practical implementation

    NARCIS (Netherlands)

    Grefen, P.W.P.J.; Vonk, J.; Apers, P.M.G.

    2001-01-01

    In this paper, we present an approach to global transaction management in workflow environments. The transaction mechanism is based on the well-known notion of compensation, but extended to deal with both arbitrary process structures to allow cycles in processes and safepoints to allow partial

  9. Practices in relation to nutritional care and support--report from the Council of Europe

    NARCIS (Netherlands)

    Beck, Anne Marie; Balknäs, Ulla Nilsson; Camilo, Maria Ermelinda; Fürst, Peter; Gentile, Maria Gabriella; Hasunen, Kaija; Jones, Liz; Jonkers-Schuitema, Cora; Keller, Ulrich; Melchior, Jean-Claude; Mikkelsen, Bent Egberg; Pavcic, Marusa; Schauder, Peter; Sivonen, Lauri; Zinck, Orla; Øien, Henriette; Ovesen, Lars

    2002-01-01

    Disease-related undernutrition is significant in European hospitals but is seldom treated. In 1999, the Council of Europe decided to collect information regarding Nutrition programmes in hospitals and for this purpose a network consisting of national experts from 12 of the Partial Agreement member

  10. Rapid learning in practice: A lung cancer survival decision support system in routine patient care data

    International Nuclear Information System (INIS)

    Dekker, Andre; Vinod, Shalini; Holloway, Lois; Oberije, Cary; George, Armia; Goozee, Gary; Delaney, Geoff P.; Lambin, Philippe; Thwaites, David

    2014-01-01

    Background and purpose: A rapid learning approach has been proposed to extract and apply knowledge from routine care data rather than solely relying on clinical trial evidence. To validate this in practice we deployed a previously developed decision support system (DSS) in a typical, busy clinic for non-small cell lung cancer (NSCLC) patients. Material and methods: Gender, age, performance status, lung function, lymph node status, tumor volume and survival were extracted without review from clinical data sources for lung cancer patients. With these data the DSS was tested to predict overall survival. Results: 3919 lung cancer patients were identified with 159 eligible for inclusion, due to ineligible histology or stage, non-radical dose, missing tumor volume or survival. The DSS successfully identified a good prognosis group and a medium/poor prognosis group (2 year OS 69% vs. 27/30%, p < 0.001). Stage was less discriminatory (2 year OS 47% for stage I–II vs. 36% for stage IIIA–IIIB, p = 0.12) with most good prognosis patients having higher stage disease. The DSS predicted a large absolute overall survival benefit (∼40%) for a radical dose compared to a non-radical dose in patients with a good prognosis, while no survival benefit of radical radiotherapy was predicted for patients with a poor prognosis. Conclusions: A rapid learning environment is possible with the quality of clinical data sufficient to validate a DSS. It uses patient and tumor features to identify prognostic groups in whom therapy can be individualized based on predicted outcomes. Especially the survival benefit of a radical versus non-radical dose predicted by the DSS for various prognostic groups has clinical relevance, but needs to be prospectively validated

  11. Structured clinical documentation in the electronic medical record to improve quality and to support practice-based research in epilepsy.

    Science.gov (United States)

    Narayanan, Jaishree; Dobrin, Sofia; Choi, Janet; Rubin, Susan; Pham, Anna; Patel, Vimal; Frigerio, Roberta; Maurer, Darryck; Gupta, Payal; Link, Lourdes; Walters, Shaun; Wang, Chi; Ji, Yuan; Maraganore, Demetrius M

    2017-01-01

    Using the electronic medical record (EMR) to capture structured clinical data at the point of care would be a practical way to support quality improvement and practice-based research in epilepsy. We describe our stepwise process for building structured clinical documentation support tools in the EMR that define best practices in epilepsy, and we describe how we incorporated these toolkits into our clinical workflow. These tools write notes and capture hundreds of fields of data including several score tests: Generalized Anxiety Disorder-7 items, Neurological Disorders Depression Inventory for Epilepsy, Epworth Sleepiness Scale, Quality of Life in Epilepsy-10 items, Montreal Cognitive Assessment/Short Test of Mental Status, and Medical Research Council Prognostic Index. The tools summarize brain imaging, blood laboratory, and electroencephalography results, and document neuromodulation treatments. The tools provide Best Practices Advisories and other clinical decision support when appropriate. The tools prompt enrollment in a DNA biobanking study. We have thus far enrolled 231 patients for initial visits and are starting our first annual follow-up visits and provide a brief description of our cohort. We are sharing these EMR tools and captured data with other epilepsy clinics as part of a Neurology Practice Based Research Network, and are using the tools to conduct pragmatic trials using subgroup-based adaptive designs. © 2016 The Authors. Epilepsia published by Wiley Periodicals, Inc. on behalf of International League Against Epilepsy.

  12. Motivation, Needs Support, and Language Arts Classroom Practices: Creation and Validation of a Measure of Young Adolescents' Perceptions

    Science.gov (United States)

    Pennington, Sarah E.

    2017-01-01

    Early adolescence is a critical time for examining academic motivation, specifically motivation to read. To support self-determined motivation to read, students' needs for competence, autonomy, and relatedness must be met within the classroom context. Because classroom instructional practices are a key component of adolescents' daily experiences…

  13. Influential Factors for Knowledge Creation Practices of CTE Teachers: Mutual Impact of Perceived School Support, Transformational Leadership, and Work Engagement

    Science.gov (United States)

    Song, Ji Hoon; Bae, Sang Hoon; Park, Sunyoung; Kim, Hye Kyoung

    2013-01-01

    This study examined the structural relationships among perceived school support, transformational leadership, teachers' work engagement, and teachers' knowledge creation practices. It also investigated the mediating effects of transformational leadership and work engagement in explaining the association between perceived school support…

  14. Professionals' Perspectives on Organizational Factors that Support or Hinder the Successful Implementation of Family-Centered Practice

    Science.gov (United States)

    Wright, Alexandra; Hiebert-Murphy, Diane; Trute, Barry

    2010-01-01

    This article presents findings from an exploratory, qualitative study whose objective was to identify professionals' perceptions of organizational factors that support or hinder the implementation of family-centered practice (FCP). Two disability services organizations in Manitoba, Canada, were selected as the research sites. In 2002, all staff…

  15. Modelling the effect of support practices (P-factor) on the reduction of soil erosion by water at European Scale

    NARCIS (Netherlands)

    Panagos, P.; Borrelli, P.; Meusburger, K.; van der Zanden, E.H.; Poesen, J.; Alewell, C.

    2015-01-01

    The USLE/RUSLE support practice factor (P-factor) is rarely taken into account in soil erosion risk modelling at sub-continental scale, as it is difficult to estimate for large areas. This study attempts to model the P-factor in the European Union. For this, it considers the latest policy

  16. Assembly and evaluation of an inventory of guidelines that are available to support clinical hematology laboratory practice.

    Science.gov (United States)

    Hayward, C P M; Moffat, K A; George, T I; Proytcheva, M

    2015-05-01

    Practice guidelines provide helpful support for clinical laboratories. Our goal was to assemble an inventory of publically listed guidelines on hematology laboratory topics, to create a resource for laboratories and for assessing gaps in practice-focused guidelines. PubMed and website searches were conducted to assemble an inventory of hematology laboratory-focused guidelines. Exclusions included annual, technical, or collaborative study reports, clinically focused guidelines, position papers, nomenclature, and calibration documents. Sixty-eight guidelines were identified on hematology laboratory practice topics from 12 organizations, some as joint guidelines. The median year of publication was 2010 and 15% were >10 years old. Coagulation topics had the largest numbers of guidelines, whereas some areas of practice had few guidelines. A minority of guidelines showed evidence of periodic updates, as some organizations did not remove or identify outdated guidelines. This inventory of current practice guidelines will encourage awareness and uptake of guideline recommendations by the worldwide hematology laboratory community, with the International Society for Laboratory Hematology facilitating ongoing updates. There is a need to encourage best guideline development practices, to ensure that hematology laboratory community has current, high-quality, and evidence-based practice guidelines that cover the full scope of hematology laboratory practice. © 2015 John Wiley & Sons Ltd.

  17. Supporting Transfer of Learning: Practice-based considerations on the applicability of transfer literature in online design

    DEFF Research Database (Denmark)

    Noesgaard, Signe Schack

    2014-01-01

    for school teachers. The PhD-project is inspired by design-based research and the research into learning transfer. It aims to evaluate if, how, and why an online facilitated, collaborative learning solution can improve the teaching practices of science teachers in Danish elementary schools. Based...... on the ethnographic study, this paper attempts to answer the following questions: what characterizes the work environment at the schools, specifically in regards to collegial support, organizational support, and manager support? How does the empirical research relate to the learning transfer literature? Do...... these characteristics give rise to reconsiderations of applying learning transfer research when designing for competence development?...

  18. Social Support and Motivation to Transfer as Predictors of Training Transfer: Testing Full and Partial Mediation Using Meta-Analytic Structural Equation Modelling

    Science.gov (United States)

    Reinhold, Sarah; Gegenfurtner, Andreas; Lewalter, Doris

    2018-01-01

    Social support and motivation to transfer are important components in conceptual models on transfer of training. Previous research indicates that both support and motivation influence transfer. To date, however, it is not yet clear if social support influences transfer of training directly, or if this influence is mediated by motivation to…

  19. Human factors evaluation of remote afterloading brachytherapy. Supporting analyses of human-system interfaces, procedures and practices, training and organizational practices and policies. Volume 3

    International Nuclear Information System (INIS)

    Callan, J.R.; Kelly, R.T.; Quinn, M.L.

    1995-07-01

    A human factors project on the use of nuclear by-product material to treat cancer using remotely operated afterloaders was undertaken by the Nuclear Regulatory Commission. The purpose of the project was to identify factors that contribute to human error in the system for remote afterloading brachytherapy (RAB). This report documents the findings from the second, third, fourth, and fifth phases of the project, which involved detailed analyses of four major aspects of the RAB system linked to human error: human-system interfaces; procedures and practices; training practices and policies; and organizational practices and policies, respectively. Findings based on these analyses provided factual and conceptual support for the final phase of this project, which identified factors leading to human error in RAB. The impact of those factors on RAB performance was then evaluated and prioritized in terms of safety significance, and alternative approaches for resolving safety significant problems were identified and evaluated

  20. Human factors evaluation of remote afterloading brachytherapy. Supporting analyses of human-system interfaces, procedures and practices, training and organizational practices and policies. Volume 3

    Energy Technology Data Exchange (ETDEWEB)

    Callan, J.R.; Kelly, R.T.; Quinn, M.L. [Pacific Science & Engineering Group, San Diego, CA (United States)] [and others

    1995-07-01

    A human factors project on the use of nuclear by-product material to treat cancer using remotely operated afterloaders was undertaken by the Nuclear Regulatory Commission. The purpose of the project was to identify factors that contribute to human error in the system for remote afterloading brachytherapy (RAB). This report documents the findings from the second, third, fourth, and fifth phases of the project, which involved detailed analyses of four major aspects of the RAB system linked to human error: human-system interfaces; procedures and practices; training practices and policies; and organizational practices and policies, respectively. Findings based on these analyses provided factual and conceptual support for the final phase of this project, which identified factors leading to human error in RAB. The impact of those factors on RAB performance was then evaluated and prioritized in terms of safety significance, and alternative approaches for resolving safety significant problems were identified and evaluated.

  1. Identification of a common language describing paediatric physiotherapy practice for children with additional support needs, to support communication with those outside the physiotherapy profession.

    Science.gov (United States)

    Hunter, Cathleen; Maciver, Donald; Howden, Stella; Forsyth, Kirsty; Adamson, Amanda; Bremner, Lynne

    2013-03-01

    Children with additional support needs (ASNs) often require physiotherapy intervention to help maximise their participation within the primary school setting. The aim of this research was to investigate paediatric physiotherapy practice in supporting primary school aged children with ASNs, in order to identify a language to describe this, which could be used to support communication with teachers, parents and others outside the profession. Using a qualitative research multiple methods design, 2 focus groups and 5 structured interviews were held to investigate physiotherapy practice for this group. Senior paediatric physiotherapists (n=13) from a range of specialities, with experience of supporting primary school aged children with ASNs. Focus groups and interviews were digitally recorded, transcribed verbatim and analysed to establish links and patterns: followed by a cyclical process of respondent validation, and expert review. Eight targets for physiotherapy intervention and twelve technique headings were synthesised from the data. The language used for labelling and description of these was aimed to be easily understood by colleagues outside the profession. The findings clearly identified the role of the paediatric physiotherapist as being to support primary school aged children with ASNs to acquire aspects of postural control, mobility and cardio-respiratory function. By grouping the data into eight areas of challenge as the focus of intervention, and twelve commonly used techniques, the researchers generated a language which can be used by paediatric physiotherapists to support communication with teachers, parents and others outside the profession, when describing their intent and interactions regarding these children. Copyright © 2012 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  2. NASA Supportability Engineering Implementation Utilizing DoD Practices and Processes

    Science.gov (United States)

    Smith, David A.; Smith, John V.

    2010-01-01

    The Ares I design and development program made the determination early in the System Design Review Phase to utilize DoD ILS and LSA approach for supportability engineering as an integral part of the system engineering process. This paper is to provide a review of the overall approach to design Ares-I with an emphasis on a more affordable, supportable, and sustainable launch vehicle. Discussions will include the requirements development, design influence, support concept alternatives, ILS and LSA planning, Logistics support analyses/trades performed, LSA tailoring for NASA Ares Program, support system infrastructure identification, ILS Design Review documentation, Working Group coordination, and overall ILS implementation. At the outset, the Ares I Project initiated the development of the Integrated Logistics Support Plan (ILSP) and a Logistics Support Analysis process to provide a path forward for the management of the Ares-I ILS program and supportability analysis activities. The ILSP provide the initial planning and coordination between the Ares-I Project Elements and Ground Operation Project. The LSA process provided a system engineering approach in the development of the Ares-I supportability requirements; influence the design for supportability and development of alternative support concepts that satisfies the program operability requirements. The LSA planning and analysis results are documented in the Logistics Support Analysis Report. This document was required during the Ares-I System Design Review (SDR) and Preliminary Design Review (PDR) review cycles. To help coordinate the LSA process across the Ares-I project and between programs, the LSA Report is updated and released quarterly. A System Requirement Analysis was performed to determine the supportability requirements and technical performance measurements (TPMs). Two working groups were established to provide support in the management and implement the Ares-I ILS program, the Integrated Logistics

  3. Technology-supported reflection : towards bridging the gap between theory and practice in teacher education

    NARCIS (Netherlands)

    Almodaires, Abdullah Abdulaziz

    2009-01-01

    The ability to convert theoretical knowledge into practical behavior is a common obstacle facing newly graduated employees in most professions. To overcome this obstacle, educational institutes are offering some kind of field training courses that allow their students to practice and gain experience

  4. Environmentally Sustainable Practices among College Outdoor Programs and Their Association with Organizational Support Structures

    Science.gov (United States)

    Frauman, Eric

    2017-01-01

    Sustainability has gained increasing importance amongst both academic research and organizational practice over the past two decades (Davis & Challenger, 2014). The primary purpose of this study was to examine environmentally sustainable practices among college outdoor programs, while also examining how college level policy and infrastructural…

  5. Supporting One Another as Beginning Teacher Educators: Forging an Online Community of Critical Inquiry into Practice

    Science.gov (United States)

    Ramirez, Laurie A.; Allison-Roan, Valerie A.; Peterson, Sandra; Elliott-Johns, Susan E.

    2012-01-01

    Four novice teacher educators working at different universities in the USA and Canada used online journaling and dialoguing combined with feedback from their students to explore their practice and new roles as teacher educators in new contexts. Their priorities included modeling critical reflection and enacting democratic practices. They chronicle…

  6. [Acrylic resin removable partial dentures

    NARCIS (Netherlands)

    Baat, C. de; Witter, D.J.; Creugers, N.H.J.

    2011-01-01

    An acrylic resin removable partial denture is distinguished from other types of removable partial dentures by an all-acrylic resin base which is, in principle, solely supported by the edentulous regions of the tooth arch and in the maxilla also by the hard palate. When compared to the other types of

  7. Research supporting the congruence between rehabilitation principles and home health nursing practice.

    Science.gov (United States)

    Neal, L J

    1999-01-01

    A grounded-theory study of 30 home health nurses conducted in the Washington, DC, metropolitan area used unstructured audiotaped interviews to elicit data as to how home health nurses define their practice. The purpose of the study was to develop a beginning substantive research-based theory of home health nursing practice. The model that emerged consists of three stages by which nurses attain autonomy in their practice. Adaptation was found to be the core category, in that nurses cannot function effectively or successfully in the home health arena unless they are or learn to be adaptable. Data also revealed that home health nurses either knowingly or unknowingly use rehabilitation nursing principles in their practice, thereby lending credence to the supposition that home health nursing practice is congruent with rehabilitation nursing principles.

  8. Empowerment and Social Support: Implications for Practice and Programming among Minority Women with Substance Abuse and Criminal Justice Histories

    Science.gov (United States)

    Barringer, Alexandra; Hunter, Bronwyn A.; Salina, Doreen; Jason, Leonard A.

    2016-01-01

    Programs for women with substance abuse and criminal justice histories often incorporate empowerment and social support into service delivery systems. Women’s empowerment research has focused on the relationship between women’s personal identities and the larger sociopolitical context, with an emphasis on how community based resources are critical for promoting well-being. Social support often protects against negative outcomes for individuals who live with chronic stress. However, few studies have evaluated community resource knowledge and empowerment among marginalized women or how social support might strengthen or weaken this relationship. This study investigated resource knowledge, social support and empowerment among 200 minority women in substance abuse recovery who had recent criminal justice involvement. Results indicated that resource knowledge was related to empowerment and belonging social support marginally moderated this relationship. In addition, education level increased and current involvement in the criminal justice system decreased empowerment. Implications for research, practice and policy are discussed. PMID:27084362

  9. Putting Flow–Ecology Relationships into Practice: A Decision-Support System to Assess Fish Community Response to Water-Management Scenarios

    Directory of Open Access Journals (Sweden)

    Jennifer Cartwright

    2017-03-01

    Full Text Available This paper presents a conceptual framework to operationalize flow–ecology relationships into decision-support systems of practical use to water-resource managers, who are commonly tasked with balancing multiple competing socioeconomic and environmental priorities. We illustrate this framework with a case study, whereby fish community responses to various water-management scenarios were predicted in a partially regulated river system at a local watershed scale. This case study simulates management scenarios based on interactive effects of dam operation protocols, withdrawals for municipal water supply, effluent discharges from wastewater treatment, and inter-basin water transfers. Modeled streamflow was integrated with flow–ecology relationships relating hydrologic departure from reference conditions to fish species richness, stratified by trophic, reproductive, and habitat characteristics. Adding a hypothetical new water-withdrawal site was predicted to increase the frequency of low-flow conditions with adverse effects for several fish groups. Imposition of new reservoir release requirements was predicted to enhance flow and fish species richness immediately downstream of the reservoir, but these effects were dissipated further downstream. The framework presented here can be used to translate flow–ecology relationships into evidence-based management by developing decision-support systems for conservation of riverine biodiversity while optimizing water availability for human use.

  10. Putting flow-ecology relationships into practice: A decision-support system to assess fish community response to water-management scenarios

    Science.gov (United States)

    Cartwright, Jennifer M.; Caldwell, Casey; Nebiker, Steven; Knight, Rodney

    2017-01-01

    This paper presents a conceptual framework to operationalize flow–ecology relationships into decision-support systems of practical use to water-resource managers, who are commonly tasked with balancing multiple competing socioeconomic and environmental priorities. We illustrate this framework with a case study, whereby fish community responses to various water-management scenarios were predicted in a partially regulated river system at a local watershed scale. This case study simulates management scenarios based on interactive effects of dam operation protocols, withdrawals for municipal water supply, effluent discharges from wastewater treatment, and inter-basin water transfers. Modeled streamflow was integrated with flow–ecology relationships relating hydrologic departure from reference conditions to fish species richness, stratified by trophic, reproductive, and habitat characteristics. Adding a hypothetical new water-withdrawal site was predicted to increase the frequency of low-flow conditions with adverse effects for several fish groups. Imposition of new reservoir release requirements was predicted to enhance flow and fish species richness immediately downstream of the reservoir, but these effects were dissipated further downstream. The framework presented here can be used to translate flow–ecology relationships into evidence-based management by developing decision-support systems for conservation of riverine biodiversity while optimizing water availability for human use.

  11. Beyond parenting practices: extended kinship support and the academic adjustment of African-American and European-American teens.

    Science.gov (United States)

    Pallock, Linda L; Lamborn, Susie D

    2006-10-01

    This study examined adolescents' perceptions of parenting practices and extended kinship support in relation to academic adjustment for 104 African American and 60 European American 9th and 10th graders (14 and 15 year olds). For African-American teens, parental acceptance was associated with school values, teacher bonding, and work orientation. Higher levels of behavioral control and lower levels of psychological control were associated with a stronger work orientation. After accounting for the demographic variables and the three parenting practices, higher levels of extended kinship support related to stronger school values, higher teacher bonding, and a stronger work orientation. For European-American teens, parental acceptance related to academic adjustment, including stronger school values, higher teacher bonding, and a stronger work orientation. European-American adolescents with stronger extended kinship networks reported higher teacher bonding and a stronger work orientation. Results indicate the importance of extended kinship support for both African-American and European-American adolescents.

  12. Role of Social Support in Improving Infant Feeding Practices in Western Kenya: A Quasi-Experimental Study.

    Science.gov (United States)

    Mukuria, Altrena G; Martin, Stephanie L; Egondi, Thaddeus; Bingham, Allison; Thuita, Faith M

    2016-03-01

    We designed and tested an intervention that used dialogue-based groups to engage infants' fathers and grandmothers to support optimal infant feeding practices. The study's aim was to test the effectiveness of increased social support by key household influencers on improving mothers' complementary feeding practices. Using a quasi-experimental design, we enrolled mothers, fathers, and grandmothers from households with infants 6-9 months old in 3 rural communities (1 intervention arm with fathers, 1 intervention arm with grandmothers, and 1 comparison arm) in western Kenya. We engaged 79 grandmothers and 85 fathers in separate dialogue groups for 6 months from January to July 2012. They received information on health and nutrition and were encouraged to provide social support to mothers (defined as specific physical actions in the past 2 weeks or material support actions in the past month). We conducted a baseline household survey in December 2011 in the 3 communities and returned to the same households in July 2012 for an endline survey. We used a difference-in-difference (DiD) approach and logistic regression to evaluate the intervention. We surveyed 554 people at baseline (258 mothers, 165 grandmothers, and 131 fathers) and 509 participants at endline. The percentage of mothers who reported receiving 5 or more social support actions (of a possible 12) ranged from 58% to 66% at baseline in the 3 groups. By endline, the percentage had increased by 25.8 percentage points (P=.002) and 32.7 percentage points (P=.001) more in the father and the grandmother intervention group, respectively, than in the comparison group. As the number of social support actions increased in the 3 groups, the likelihood of a mother reporting that she had fed her infant the minimum number of meals in the past 24 hours also increased between baseline and endline (odds ratio [OR], 1.14; confidence interval [CI], 1.00 to 1.30; P=.047). When taking into account the interaction effects of

  13. Health and safety matters! Associations between organizational practices and personal support workers' life and work stress in Ontario, Canada.

    Science.gov (United States)

    Zeytinoglu, Isik U; Denton, Margaret; Brookman, Catherine; Davies, Sharon; Sayin, Firat K

    2017-06-21

    The home and community care sector is one of the fastest growing sectors globally and most prominently in mature industrialized countries. Personal support workers (PSWs) are the largest occupational group in the sector. This paper focuses on the emotional health of PSWs working in the home and community care sector in Ontario, Canada. The purpose of this paper is to present evidence on the associations between PSWs' life and work stress and organizational practices of full-time and guaranteed hours, and PSWs' perceptions of support at work and preference for hours. Data come from our 2015 survey of 1543 PSWs. Dependent variables are life and work stress. Independent variables are: objective organizational practices of full-time and guaranteed hours, and subjective organizational practices of perceived support at work, and preferred hours of work. Descriptive statistics, correlations and ordinary least square regression analyses with collinearity tests are conducted. Organizational practices of employing PSWs in full-time or guaranteed hours are not associated with their life and work stress. However, those who perceive support from their organizations are also the ones reporting lower life and work stress. In addition, those PSWs perceiving support from their supervisor report lower work stress. PSWs would like to work in their preferred hours, and those who prefer to work more hours report lower life and work stress, and conversely, those who prefer to work less hours report life and work stress. For PSWs in home and community care, perceived support from their organizations and supervisors, and employment in preferred hours are important factors related to their life and work stress.

  14. Good practice in social care: the views of people with severe and complex needs and those who support them.

    Science.gov (United States)

    Gridley, Kate; Brooks, Jenni; Glendinning, Caroline

    2014-11-01

    This paper reports findings drawn from a study of good practice in English social care for adults with disability and older people with severe and complex needs. People with severe and complex needs are a relatively small proportion of adult social care service users, but they are growing in numbers and have resource-intensive needs. The study involved qualitative research with adults with disability and older people with severe and complex needs, family carers and members of specialist organisations (n = 67), focusing on the features of social care services they considered to be good practice. Data were collected between August 2010 and June 2011. The approach to data collection was flexible, to accommodate participants' communication needs and preferences, including face-to-face and telephone interviews, Talking Mats(©) sessions and a focus group. Data were managed using Framework and analysed thematically. Features of good practice were considered at three levels: (i) everyday support; (ii) service organisation; and (iii) commissioning. Findings relating to the first two of these are presented here. Participants emphasised the importance of person-centred ways of working at all levels. Personalisation, as currently implemented in English social care, aims to shift power from professionals to service users through the allocation of personal budgets. This approach focuses very much on the role of the individual in directing his/her own support arrangements. However, participants in this study also stressed the importance of ongoing professional support, for example, from a specialist key worker or case manager to co-ordinate diverse services and ensure good practice at an organisational level. The paper argues that, despite the recent move to shift power from professionals to service users, people with the most complex needs still value support from professionals and appropriate organisational support. Without these, they risk being excluded from the benefits

  15. Communities of practice in support of collaborative multi-disciplinary learning and action in response to climate change

    Science.gov (United States)

    Heimlich, J. E.; Stylinski, C.; Palmquist, S.; Wasserman, D.

    2017-12-01

    Collaborative efforts reaching across interdisciplinary boundaries to address controversial issues such as climate change present significant complexities, including developing shared language, agreeing on common outcomes, and even establishing habits of regular dialogue. Such collaborative efforts should include museums, aquariums, zoos, parks, and youth groups as each of these informal education institutions provides a critical avenue for supporting learning about and responding to climate change. The community of practice framework offers a potential effective approach to support learning and action of diverse groups with a shared interest. Our study applied this framework to the NSF-funded Maryland and Delaware Climate Change Assessment and Education (MADE-CLEAR) project, facilitating informal educators across these two states to advance their climate change education practices, and could provide insight for a building a citywide multi-sector collaborative effort. We found strategies that center on the process of group evolution; support different perspectives, levels of participation, and community spaces; focus on value as defined by members; and balance familiarity and fun produced a dynamic and functional community with a shared practice where none had existed before. Also important was expanding the community-of-practice focus on relationship building to include structured professional development and spin-off opportunities for small-group team-based endeavors. Our findings suggest that this collaborative professional learning approach is well suited to diverse groups seeking creative solutions to complex and even divisive challenges.

  16. Social support in the practices of informal providers: The case of patent and proprietary medicine vendors in Nigeria.

    Science.gov (United States)

    Sieverding, Maia; Liu, Jenny; Beyeler, Naomi

    2015-10-01

    The social and institutional environments in which informal healthcare providers operate shape their health and business practices, particularly in contexts where regulatory enforcement is weak. In this study, we adopt a social capital perspective to understanding the social networks on which proprietary and patent medicine vendors (PPMVs) in Nigeria rely for support in the operation of their shops. Data are drawn from 70 in-depth interviews with PPMVs in three states, including interviews with local leaders of the PPMV professional association. We find that PPMVs primarily relied on more senior colleagues and formal healthcare professionals for informational support, including information about new medicines and advice on how to treat specific cases of illness. For instrumental support, including finance, start-up assistance, and intervention with regulatory agencies, PPMVs relied on extended family, the PPMVs with whom they apprenticed, and the leaders of their professional association. PPMVs' networks also provided continual reinforcement of what constitutes good PPMV practice through admonishments to follow scope of practice limitations. These informal reminders, as well as monitoring activities conducted by the professional association, served to reinforce PPMVs' concern with avoiding negative customer health outcomes, which were perceived to be detrimental to their business reputations. That PPMVs' networks both encouraged practices to reduce the likelihood of poor health outcomes, and provided advice regarding customers' health conditions, highlights the potential impact of informal providers' access to different forms of social capital on their delivery of health services, as well as their success as microenterprises. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Communities of practice: A means to support occupational therapists’ continuing professional development. A literature review

    NARCIS (Netherlands)

    Barry, Margot; Kuijer-Siebelink, Wietske; Nieuwenhuis, Loek; Scherpbier-de Haan, Nynke

    2018-01-01

    Background: This literature review investigates what research reports about the contribution that communities of practice (CoPs) can make in the continuing professional development (CPD) of qualified occupational therapists. Methods: Academic databases (CINAHL, MEDLINE and ERIC) were searched

  18. Improving students' critical thinking : Empirical support for explicit instructions combined with practice

    NARCIS (Netherlands)

    Heijltjes, Anita; Van Gog, Tamara|info:eu-repo/dai/nl/294304975; Paas, Fred

    2014-01-01

    This experiment investigated the impact of different types of critical thinking instruction and dispositions on bias in economics students' (N=141) reasoning performance. The following conditions were compared: (A) implicit instruction; (B) implicit instruction with practice; (C) implicit

  19. Best Practices in Supporting Persistence of Distant Education Students through Integrated Web-Based Systems

    Science.gov (United States)

    McCracken, Holly

    2009-01-01

    The importance of the interconnectedness of academic, student, and technical support processes intrinsic to the provision of on-line instruction has been frequently depicted as a "service Web," with students at the center of the infrastructure. However, as programming to support distance learning continues to develop, such service Webs have grown…

  20. MO-D-211-01: Medical Physics Practice Guidelines - The Minimum Level of Medical Physics Support in Clinical Practice Settings.

    Science.gov (United States)

    Chan, M; Fontenot, J; Halvorsen, P

    2012-06-01

    The American Association of Physicists in Medicine (AAPM) has long advocated a consistent level of medical physics practice, and has published many guidelines and position statements toward that goal, such as Science Council Task Group reports related to calibration and quality assurance, Education Council and Professional Council Task Group reports related to education, training, and peer review, and Board-approved Position Statements related to the Scope of Practice, physicist qualifications, and other aspects of medical physicspractice. Despite these concerted and enduring efforts, the profession does not have a clear and concise statement of the acceptable practice guidelines for routine clinical medical physics. As accreditation of clinical practices becomes more common, Medical Physics Practice Guidelines (MPPGs) will be crucial to ensuring a consistent benchmark for accreditation programs. The AAPM will lead the development of MPPGs in collaboration with other professional societies. The MPPGs will be freely available to the general public. Accrediting organizations, regulatory agencies and legislators will be encouraged to reference these MPPGs when defining their respective requirements. MPPGs are intended to provide the medical community with a clear description of the minimum level of medical physics support that the AAPM would consider to be prudent in all clinical practice settings. Support includes but is not limited to staffing, equipment, machine access, and training. These MPPGs are not designed to replace extensive Task Group reports or review articles, but rather to describe the recommended minimum level of medical physics support for specific clinical services. This course will describe the purpose and scope of MPPGs, the procedure for the development of a MPPG, as well as the progress of Therapy MPPG TG #1 on "Evaluation and quality assurance of x-ray based image guided radiotherapy systems" and Diagnostic MPPG TG #2 on "CT Protocol management

  1. Developing a Web Platform to Support a Community of Practice: A Mixed Methods Study in Pediatric Physiotherapy.

    Science.gov (United States)

    Pratte, Gabrielle; Hurtubise, Karen; Rivard, Lisa; Berbari, Jade; Camden, Chantal

    2018-01-01

    Web platforms are increasingly used to support virtual interactions between members of communities of practice (CoP). However, little is known about how to develop these platforms to support the implementation of best practices for health care professionals. The aim of this article is to explore pediatric physiotherapists' (PTs) perspectives regarding the utility and usability of the characteristic of a web platform developed to support virtual communities of practice (vCoP). This study adopted an explanatory sequential mixed methods design. A web platform supporting the interactions of vCoP members was developed for PTs working with children with developmental coordination disorder. Specific strategies and features were created to support the effectiveness of the platform across three domains: social, information-quality, and system-quality factors. Quantitative data were collected from a cross-sectional survey (n = 41) after 5 months of access to the web platform. Descriptive statistics were calculated. Qualitative data were also collected from semistructured interviews (n = 9), which were coded, interpreted, and analyzed by using Boucher's Web Ergonomics Conceptual Framework. The utility of web platform characteristics targeting the three key domain factors were generally perceived positively by PTs. However, web platform usability issues were noted by PTs, including problems with navigation and information retrieval. Web platform aiming to support vCoP should be carefully developed to target potential users' needs. Whenever possible, users should co-construct the web platform with vCoP developers. Moreover, each of the developed characteristics (eg, newsletter, search function) should be evaluated in terms of utility and usability for the users.

  2. Physical activity practice among children and adolescents with visual impairment--influence of parental support and perceived barriers.

    Science.gov (United States)

    Greguol, Márcia; Gobbi, Erica; Carraro, Attilio

    2015-01-01

    To analyze the practice of physical activity among children and adolescents with visual impairments (VI), regarding the possible influence of parental support and perceived barriers. Twenty-two young people with VIs (10 + 2.74 years old) and one of each of their parents were evaluated. They responded to the Physical Activity Questionnaire for Older Children (PAQ-C), Baecke Questionnaire, the Parental Support Scale and a questionnaire about perceived barriers to physical activity. The independent samples t-test, pearson correlation test and chi-square test were performed. Blind young people showed lower physical activity levels. There were significant correlations both between parents' physical activity and the support offered to children and between the PAQ-C results and the importance given by young people to physical activity, but only for those aged between 8 and 10 years old. The main perceived barriers were lack of security, motivation, professional training and information about available physical activity programs. The influence of parental support seems to be an important factor in the adoption of a physically active lifestyle for young people with VI. Parents and children should have more information about the benefits and opportunities of physical activity. Implications for Rehabilitation Young people with visual impairment should be encouraged by parents to practice physical activity. More information should be provided on the benefits of physical activity to both parents and children. Professional training should be available to help support this group become more active.

  3. The patient's radiological protection in medical practices: Legal support in the Cuban legislation

    International Nuclear Information System (INIS)

    Alonso Gonzalez, I.; Duran Delgado, M.

    2001-01-01

    Peaceful applications of nuclear energy have a great importance in medical practice, for their use in diagnosis and therapeutic procedures. The possibility to detect diseases and the use of radiation as a palliative or curative method, enables the use of such polemic energy. Practices associated with the use of ionizing radiation are under regulatory control, and in this regard it becomes necessary to prescribe a series of administrative requirements aimed at granting the corresponding authorization, once it has been demonstrated that the technical requirements that ensure the safe performance of the practice, without undue risk on life, goods and environment, are met. This includes the protection of any patient who could be under treatment, who is considered the main user of this application. (author)

  4. Design Facilitation as Emerging Practice: Analyzing How Designers Support Multi-stakeholder Co-creation

    Directory of Open Access Journals (Sweden)

    Manuela Aguirre

    Full Text Available Designers increasingly find themselves facilitating large-scale design events. Yet few have explored design facilitation as an emerging practice. This article examines the design facilitation practices used in two Norwegian case studies of multi-stakeholder events. We focus on the contextually designed tools designers create to help them facilitate. We then explore some critical dimensions of design facilitation. When used as visual overlays, facilitators’ explicit knowledge of these dimensions can improve their capacity to analyze, evaluate, and plan how to design and use contextual tools during design events. By plotting how designers use facilitation tools sequentially during events, we render the flow of design facilitation practice visible and accessible. We suggest that an explicit awareness of these dimensions and flows can enable designers to build more inclusive and inspiring tools, orchestrate the flow of long-term participatory processes more deliberately, and better equip participants to work with complex systemic change.

  5. The patient's radiological protection in medical practices, legal support in the cuban legislation

    International Nuclear Information System (INIS)

    Alonso Gonzalez, Ivonne; Duran Delgado, Marlen

    2005-01-01

    Peaceful applications of nuclear energy have a great importance in medical practice, for their use in diagnosis and therapeutic procedures. The possibility to detect diseases and the use of radiation as a palliative or curative method, ennobles the use of such polemic energy. Practices associated with the use of ionizing radiation are under regulatory control, and in this regard it becomes necessary to prescribe a series of administrative requirements aimed at granting the corresponding authorization, once it has been demonstrated that the technical requirements that ensure the safe performance of the practice, without undue risk on life, goods and environment are met. This includes the protection of any patient who could be under treatment, who is considered the main user of this application

  6. A general overview of support materials for enzyme immobilization: Characteristics, properties, practical utility

    DEFF Research Database (Denmark)

    Zdarta, Jakub; Meyer, Anne S.; Jesionowski, Teofil

    2018-01-01

    on the properties of the produced catalytic system. A large variety of inorganic and organic as well as hybrid and composite materials may be used as stable and efficient supports for biocatalysts. This review provides a general overview of the characteristics and properties of the materials applied for enzyme...... immobilization. For the purposes of this literature study, support materials are divided into two main groups, called Classic and New materials. The review will be useful in selection of appropriate support materials with tailored properties for the production of highly effective biocatalytic systems for use...

  7. Supporting Faculty During Pedagogical Change Through Reflective Teaching Practice: An Innovative Approach.

    Science.gov (United States)

    Armstrong, Deborah K; Asselin, Marilyn E

    Given the recent calls for transformation of nursing education, it is critical that faculty be reflective educators. Reflective teaching practice is a process of self-examination and self-evaluation to gain insight into teaching to improve the teaching-learning experience. Limited attention has been given to this notion in the nursing education literature. An innovative reflective teaching practice approach for nursing education is proposed, consisting of question cues, journaling, and a process of facilitated meetings. The authors describe their perceptions of using this approach with faculty during the implementation of a new pedagogy and suggest areas for further research.

  8. Same-same but different: integrating central university support and faculty-specific knowledge for mentor training. A Practice Report

    Directory of Open Access Journals (Sweden)

    Deborah Rodrigo

    2014-08-01

    Full Text Available Mentoring literature often cites a tension between local initiatives that target the needs of specific groups and more efficient centralised programs addressing common concerns across a larger population. For several years, the University of Sydney has had a Mentoring Network consisting of the faculties of Arts and Social Sciences, Health Sciences, Science, Sydney Law School and the Business School. These faculties have worked together to develop a community of best practice for mentoring programs at our large, multi-campus institution, and for the past two years have included a representative from Student Support Services to incorporate a centralised support component into their faculty-specific training programs. This Practice Report showcases the work of the University of Sydney Mentoring Network in combining central university services with faculty-based mentoring.

  9. Validation of the "Quality of Life related to function, aesthetics, socialization, and thoughts about health-behavioural habits (QoLFAST-10)" scale for wearers of implant-supported fixed partial dentures.

    Science.gov (United States)

    Castillo-Oyagüe, Raquel; Perea, Carmen; Suárez-García, María-Jesús; Río, Jaime Del; Lynch, Christopher D; Preciado, Arelis

    2016-12-01

    To validate the 'Quality of Life related to function, aesthetics, socialization, and thoughts about health-behavioural habits (QoLFAST-10)' questionnaire for assessing the whole concept of oral health-related quality of life (OHRQoL) of implant-supported fixed partial denture (FPD) wearers. 107 patients were assigned to: Group 1 (HP; n=37): fixed-detachable hybrid prostheses (control); Group 2 (C-PD, n=35): cemented partial dentures; and Group 3 (S-PD, n=35): screwed partial dentures. Patients answered the QoLFAST-10 and the Oral Health Impact Profile (OHIP-14sp) scales. Information on global oral satisfaction, socio-demographic, prosthetic, and clinical data was gathered. The psychometric capacity of the QoLFAST-10 was investigated. The correlations between both indices were explored by the Spearman's rank test. The effect of the study variables on the OHRQoL was evaluated by descriptive and non-parametric probes (α=0.05). The QoLFAST-10 was reliable and valid for implant-supported FPD wearers, who attained comparable results regardless of the connection system being cement or screws. Both fixed partial groups demonstrated significantly better social, functional, and total satisfaction than did HP wearers with this index. All groups revealed similar aesthetic-related well-being and consciousness about the importance of health-behavioural habits. Several study variables modulated the QoLFAST-10 scores. Hybrid prostheses represent the least predictable treatment option, while cemented and screwed FPDs supplied equal OHRQoL as estimated by the QoLFAST-10 scale. The selection of cemented or screwed FPDs should mainly rely on clinical factors, since no differences in patient satisfaction may be expected between both types of implant rehabilitations. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. The experiences of supporting learning in pairs of nursing students in clinical practice.

    Science.gov (United States)

    Holst, Hanna; Ozolins, Lise-Lotte; Brunt, David; Hörberg, Ulrica

    2017-09-01

    The purpose of this study is to describe how supervisors experience supporting nursing students' learning in pairs on a Developing and Learning Care Unit in Sweden. The present study has been carried out with a Reflective Lifeworld Research (RLR) approach founded on phenomenology. A total of 25 lifeworld interviews were conducted with supervisors who had supervised pairs of students. The findings reveal how supervisors support students' learning in pairs through a reflective approach creating learning space in the encounter with patients, students and supervisors. Supervisors experience a movement that resembles balancing between providing support in learning together and individual learning. The findings also highlight the challenge in supporting both the pairs of students and being present in the reality of caring. In conclusion, the learning space has the potential of creating a relative level of independency in the interaction between pairs of students and their supervisor when the supervisor strives towards a reflective approach. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Supporting Student Nurses Learning in and through Clinical Practice: The Role of the Clinical Guide.

    Science.gov (United States)

    Andrews, Margaret; Roberts, Debbie

    2003-01-01

    A clinical guide is an experienced nurse who supports nursing students throughout the program, particularly in clinical placements. More than a mentor, a guide is fully involved in promoting deep learning in clinical settings. (SK)

  12. Supporting successful inclusive practices for learners with disabilities in high schools: a multisite, mixed method collective case study.

    Science.gov (United States)

    Maciver, Donald; Hunter, Cathleen; Adamson, Amanda; Grayson, Zoe; Forsyth, Kirsty; McLeod, Iona

    2018-07-01

    The increase in the number of individuals with disabilities in general education has led to an increased interest in how to best provide support. Despite an emphasis on inclusion and participation in policy and practice, defining and describing the support provided for these learners is still an important task. This multisite, mixed method collective case study reports on 125 education and other staff from seven schools who took part in interviews and focus groups to reflect on a range of topics related to learners with disabilities in high schools. We focused on what the participants did, what they considered to be successful and what their "best" practices were. Descriptions of practices were rich, nuanced and complex. The analysis identified over 200 "strategies" which were synthesized into two meta-themes and eight subthemes. We discuss the results in the context of an ecological perspective, and the importance of focusing on the full range of influences and outcomes for young people in designing supports. We have drawn on evidence from this study as a basis for professional development activities and identified that focusing on the environment and the role of practitioners has a potential to improve the inclusion outcomes for older learners with disabilities. Implications for Rehabilitation Inclusion is influenced by the physical environment, attitudes, expectations and opportunities, in addition to a learner's skills and abilities. Schools should focus on the environment and teachers' practices, rather than on what an individual learner can or cannot do. The practices discussed in this study reflect those that a range of educators and related services personnel agree are realistic, appropriate and effective. Change may be led by the school management team; however, there are many ways in which all staff can contribute; indeed, approaches will not work effectively unless they are understood and implemented by everyone.

  13. Social justice in education: how the function of selection in educational institutions predicts support for (non)egalitarian assessment practices

    Science.gov (United States)

    Autin, Frédérique; Batruch, Anatolia; Butera, Fabrizio

    2015-01-01

    Educational institutions are considered a keystone for the establishment of a meritocratic society. They supposedly serve two functions: an educational function that promotes learning for all, and a selection function that sorts individuals into different programs, and ultimately social positions, based on individual merit. We study how the function of selection relates to support for assessment practices known to harm vs. benefit lower status students, through the perceived justice principles underlying these practices. We study two assessment practices: normative assessment—focused on ranking and social comparison, known to hinder the success of lower status students—and formative assessment—focused on learning and improvement, known to benefit lower status students. Normative assessment is usually perceived as relying on an equity principle, with rewards being allocated based on merit and should thus appear as positively associated with the function of selection. Formative assessment is usually perceived as relying on corrective justice that aims to ensure equality of outcomes by considering students’ needs, which makes it less suitable for the function of selection. A questionnaire measuring these constructs was administered to university students. Results showed that believing that education is intended to select the best students positively predicts support for normative assessment, through increased perception of its reliance on equity, and negatively predicts support for formative assessment, through reduced perception of its ability to establish corrective justice. This study suggests that the belief in the function of selection as inherent to educational institutions can contribute to the reproduction of social inequalities by preventing change from assessment practices known to disadvantage lower-status student, namely normative assessment, to more favorable practices, namely formative assessment, and by promoting matching beliefs in justice

  14. Social justice in education: how the function of selection in educational institutions predicts support for (non)egalitarian assessment practices.

    Science.gov (United States)

    Autin, Frédérique; Batruch, Anatolia; Butera, Fabrizio

    2015-01-01

    Educational institutions are considered a keystone for the establishment of a meritocratic society. They supposedly serve two functions: an educational function that promotes learning for all, and a selection function that sorts individuals into different programs, and ultimately social positions, based on individual merit. We study how the function of selection relates to support for assessment practices known to harm vs. benefit lower status students, through the perceived justice principles underlying these practices. We study two assessment practices: normative assessment-focused on ranking and social comparison, known to hinder the success of lower status students-and formative assessment-focused on learning and improvement, known to benefit lower status students. Normative assessment is usually perceived as relying on an equity principle, with rewards being allocated based on merit and should thus appear as positively associated with the function of selection. Formative assessment is usually perceived as relying on corrective justice that aims to ensure equality of outcomes by considering students' needs, which makes it less suitable for the function of selection. A questionnaire measuring these constructs was administered to university students. Results showed that believing that education is intended to select the best students positively predicts support for normative assessment, through increased perception of its reliance on equity, and negatively predicts support for formative assessment, through reduced perception of its ability to establish corrective justice. This study suggests that the belief in the function of selection as inherent to educational institutions can contribute to the reproduction of social inequalities by preventing change from assessment practices known to disadvantage lower-status student, namely normative assessment, to more favorable practices, namely formative assessment, and by promoting matching beliefs in justice principles.

  15. Promoting Good Clinical Laboratory Practices and Laboratory Accreditation to Support Clinical Trials in Sub-Saharan Africa

    Science.gov (United States)

    Shott, Joseph P.; Saye, Renion; Diakité, Moussa L.; Sanogo, Sintry; Dembele, Moussa B.; Keita, Sekouba; Nagel, Mary C.; Ellis, Ruth D.; Aebig, Joan A.; Diallo, Dapa A.; Doumbo, Ogobara K.

    2012-01-01

    Laboratory capacity in the developing world frequently lacks quality management systems (QMS) such as good clinical laboratory practices, proper safety precautions, and adequate facilities; impacting the ability to conduct biomedical research where it is needed most. As the regulatory climate changes globally, higher quality laboratory support is needed to protect study volunteers and to accurately assess biological parameters. The University of Bamako and its partners have undertaken a comprehensive QMS plan to improve quality and productivity using the Clinical and Laboratory Standards Institute standards and guidelines. The clinical laboratory passed the College of American Pathologists inspection in April 2010, and received full accreditation in June 2010. Our efforts to implement high-quality standards have been valuable for evaluating safety and immunogenicity of malaria vaccine candidates in Mali. Other disease-specific research groups in resource-limited settings may benefit by incorporating similar training initiatives, QMS methods, and continual improvement practices to ensure best practices. PMID:22492138

  16. Communities of practice: pedagogy and internet-based technologies to support educator's continuing technology professional development in higher education

    OpenAIRE

    Schols, Maurice

    2011-01-01

    Advances in information and communication technologies (ICTs) as well as modern pedagogical perspectives have created new possibilities to facilitate and support learning in higher education (HE). Emerging technologies bring opportunities to reconsider teaching and learning. New ideas and concepts about the educational use of new technologies transform the roles of teachers. In this context the key question of this study is: whether learning as part of a (virtual) community of practice suppor...

  17. An exploration of workplace literacy as a catalyst to support employees in dealing with changing workplace literacy practices

    OpenAIRE

    Mackey, Hester

    2009-01-01

    The changing workplace requires employees to engage with new ways of working that rely increasingly on a variety of literacy skills. This study used action research to answer the research question whether a workplace literacy initiative could act as a catalyst to support employees to manage these new literacy practices in the workplace with confidence. A multi-national high-tech manufacturing plant in Ireland which is in a process of continuous change was selected as research site. A 45 ho...

  18. HPCMP CREATE (trademark)-AV Quality Assurance: Best Practices for Validating and Supporting Computation-Based Engineering Software

    Science.gov (United States)

    2015-09-30

    30/2015 Oct 2008-Sep 2015 HPCMP CREATE™- AV Quality Assurance: Best Practices for Validating and Supporting Computation-Based Engineering Software...2) “Does this tool adequately perform any and all advertised capabilities?” This paper will describe how the HPCMP CREATE Air Vehicles ( AV ...discussed and their strengths and weaknesses within the CREATE- AV framework addressed. Work toward the HPCMP CREATE, Quality Assurance, Aviation

  19. CRITICAL SUCCESS FACTORS FOR IMPLEMENTING LEAN PRACTICES IN IT SUPPORT SERVICES

    Directory of Open Access Journals (Sweden)

    Goutam Kundu

    2012-12-01

    Full Text Available Many studies have been done to identify the critical success factors (CSFs in for successful lean implementation in the manufacturing firms. But, till date, no systematic study has been done to identify the CSFs from the perspective of lean implementation in IT support service sector. This paper aims to address this area. A detailed literature review was undertaken to identify CSFs for lean implementation in manufacturing and services context and to consider their applicability to the IT support services sector. This paper is based on a conceptual discussion of CSFs as applied to the IT support services sector. The authors proposed a set of CSFs which is believed to be suitable for IT support service enterpri ses. The relevance of CSFs will need to be tested and qualitative research is needed to inform further work. The proposed CSFs are aimed at being useful to IT support services sector as a guideline, so as to ensure a positive outcome of the lean implementation process in IT support services sector.

  20. Practical Ways Psychotherapy Can Support Physical Healthcare Experiences for Male Survivors of Childhood Sexual Abuse

    Science.gov (United States)

    Hovey, Angela; Stalker, Carol A.; Schachter, Candice L.; Teram, Eli; Lasiuk, Gerri

    2011-01-01

    Many survivors of child sexual abuse who engage in psychotherapy also experience physical health problems. This article summarizes the findings of a multiphased qualitative study about survivors' experiences in healthcare settings. The study informed the development of the "Handbook on Sensitive Practice for Health Care Practitioners: Lessons…

  1. Connecting Practice, Theory and Method: Supporting Professional Doctoral Students in Developing Conceptual Frameworks

    Science.gov (United States)

    Kumar, Swapna; Antonenko, Pavlo

    2014-01-01

    From an instrumental view, conceptual frameworks that are carefully assembled from existing literature in Educational Technology and related disciplines can help students structure all aspects of inquiry. In this article we detail how the development of a conceptual framework that connects theory, practice and method is scaffolded and facilitated…

  2. Teacher Support, Instructional Practices, Student Motivation, and Mathematics Achievement in High School

    Science.gov (United States)

    Yu, Rongrong; Singh, Kusum

    2018-01-01

    The authors examined the relationships among teacher classroom practices, student motivation, and mathematics achievement in high school. The data for this study was drawn from the base-year data of High School Longitudinal Study of 2009. Structural equation modeling method was used to estimate the relationships among variables. The results…

  3. Creating infrastructure supportive of evidence-based nursing practice: leadership strategies.

    Science.gov (United States)

    Newhouse, Robin P

    2007-01-01

    Nursing leadership is the cornerstone of successful evidence-based practice (EBP) programs within health care organizations. The key to success is a strategic approach to building an EBP infrastructure, with allocation of appropriate human and material resources. This article indicates the organizational infrastructure that enables evidence-based nursing practice and strategies for leaders to enhance evidence-based practice using "the conceptual model for considering the determinants of diffusion, dissemination, and implementation of innovations in health service delivery and organization." Enabling EBP within organizations is important for promoting positive outcomes for nurses and patients. Fostering EBP is not a static or immediate outcome, but a long-term developmental process within organizations. Implementation requires multiple strategies to cultivate a culture of inquiry where nurses generate and answer important questions to guide practice. Organizations that can enable the culture and build infrastructure to help nurses develop EBP competencies will produce a professional environment that will result in both personal growth for their staff and improvements in quality that would not otherwise be possible.

  4. Cultivating Safe and Supportive Schools: The Implementation and Institutionalization of Restorative Justice Practices

    Science.gov (United States)

    Anderson, Eleanor Robinson

    2017-01-01

    Mounting public concern about a school-to-prison pipeline has put schools and districts under increasing pressure to reduce their use of suspensions, expulsions and arrests. Many are turning to restorative justice practices (RJP) as a promising alternative for addressing school discipline and improving school climate. However, implementing RJP in…

  5. Changing practice to support self-management and recovery in mental illness: application of an implementation model.

    Science.gov (United States)

    Harris, Melanie; Jones, Phil; Heartfield, Marie; Allstrom, Mary; Hancock, Janette; Lawn, Sharon; Battersby, Malcolm

    2015-01-01

    Health services introducing practice changes need effective implementation methods. Within the setting of a community mental health service offering recovery-oriented psychosocial support for people with mental illness, we aimed to: (i) identify a well-founded implementation model; and (ii) assess its practical usefulness in introducing a new programme for recovery-oriented self-management support. We reviewed the literature to identify implementation models applicable to community mental health organisations, and that also had corresponding measurement tools. We used one of these models to inform organisational change strategies. The literature review showed few models with corresponding tools. The Promoting Action on Research Implementation in Health Services (PARIHS) model and the related Organisational Readiness to Change Assessment (ORCA) tool were used. The PARIHS proposes prerequisites for health service change and the ORCA measures the extent to which these prerequisites are present. Application of the ORCA at two time points during implementation of the new programme showed strategy-related gains for some prerequisites but not for others, reflecting observed implementation progress. Additional strategies to address target prerequisites could be drawn from the PARIHS model. The PARIHS model and ORCA tool have potential in designing and monitoring practice change strategies in community mental health organisations. Further practical use and testing of implementation models appears justified in overcoming barriers to change.

  6. An Innovative Program to Support Internationally Educated Health Professionals and Their Instructors: Role of the Clinical Practice Facilitator.

    Science.gov (United States)

    Daniel, Sylvia; Lee, Annemarie L; Switzer-McIntyre, Sharon; Evans, Cathy

    2016-01-01

    Internationally educated health professionals immigrating to other countries may experience difficulty in clinical practice, due to linguistic and cultural factors. An important element of bridging is the opportunity for internationally educated health professionals to practice in a clinical environment. To support these health professionals and their clinical instructors, a Clinical Practice Facilitator (CPF) role was created. This study aimed to examine the CPF from internationally educated health professionals and clinical instructors' perspective. A quantitative survey was conducted with two cohorts (2013 and 2015) of internationally educated physical therapists and clinical instructors who were asked about the nature of interaction with CPFs, mentor, and education roles and the benefits and challenges of the role. Thirty-five internationally educated physical therapists and 37 clinical instructors participated and were satisfied with the interaction with CPFs via face-to-face or e-mail communication. There was strong agreement (>80%) that the CPF educator role was to facilitate learner's reflection on clinical practice while the mentor role (>70%) was to answer questions, provide feedback, and investigate clinical concerns and conflicts. There was insufficient time for access to CPFs and resolution of learners' learning needs. There were differences (P = 0.04) in perspective on the benefit of the CPF in assisting with cultural differences. An innovative CPF role provided support encouragement, clinical, and professional advice. There were discordant views regarding the benefits of the CPF role in addressing cultural issues, which requires further examination.

  7. Impact of engaging middle management in practice interventions on staff support and learning culture: a quasi-experimental design.

    Science.gov (United States)

    Henderson, Amanda; Burmeister, Liz; Schoonbeek, Sue; Ossenberg, Christine; Gneilding, Julieanne

    2014-11-01

    This study evaluated the impact of different levels of engaging middle management in ward based strategies implemented by a project educator. The challenge for learning in practice is to develop effective teams where experienced staff engage and foster learning with students and other novice staff. A quasi-experimental pre- and post- intervention four group design was conducted from November 2009 to May 2010 across four general surgical and four general medical inpatient matched units in two settings in South East Queensland, Australia. Staff survey data was used to compare control and intervention groups (one actively engaging nurse managers) before and after 'practice learning' interventions. The survey comprised demographic data and data from two validated scales (support instrument for nurses facilitating learning and clinical learning organisational culture). Number of surveys returned pre- and post-intervention was 336 from 713 (47%). There were significant differences across many subscales pertaining to staff perception of support in the intervention groups, with only one change in the control group. The number of significant different subscales in the learning culture was also greater when middle management supported the intervention. Middle management should work closely with facilitators to assist embedding practice interventions. © 2013 John Wiley & Sons Ltd.

  8. Clinicians, security and information technology support services in practice settings--a pilot study.

    Science.gov (United States)

    Fernando, Juanita

    2010-01-01

    This case study of 9 information technology (IT) support staff in 3 Australian (Victoria) public hospitals juxtaposes their experiences at the user-level of eHealth security in the Natural Hospital Environment with that previously reported by 26 medical, nursing and allied healthcare clinicians. IT support responsibilities comprised the entire hospital, of which clinician eHealth security needs were only part. IT staff believed their support tasks were often fragmented while work responsibilities were hampered by resources shortages. They perceived clinicians as an ongoing security risk to private health information. By comparison clinicians believed IT staff would not adequately support the private and secure application of eHealth for patient care. Preliminary data analysis suggests the tension between these cohorts manifests as an eHealth environment where silos of clinical work are disconnected from silos of IT support work. The discipline-based silos hamper health privacy outcomes. Privacy and security policies, especially those influencing the audit process, will benefit by further research of this phenomenon.

  9. Supporting Tablet Configuration, Tracking, and Infection Control Practices in Digital Health Interventions: Study Protocol.

    Science.gov (United States)

    Furberg, Robert D; Ortiz, Alexa M; Zulkiewicz, Brittany A; Hudson, Jordan P; Taylor, Olivia M; Lewis, Megan A

    2016-06-27

    Tablet-based health care interventions have the potential to encourage patient care in a timelier manner, allow physicians convenient access to patient records, and provide an improved method for patient education. However, along with the continued adoption of tablet technologies, there is a concomitant need to develop protocols focusing on the configuration, management, and maintenance of these devices within the health care setting to support the conduct of clinical research. Develop three protocols to support tablet configuration, tablet management, and tablet maintenance. The Configurator software, Tile technology, and current infection control recommendations were employed to develop three distinct protocols for tablet-based digital health interventions. Configurator is a mobile device management software specifically for iPhone operating system (iOS) devices. The capabilities and current applications of Configurator were reviewed and used to develop the protocol to support device configuration. Tile is a tracking tag associated with a free mobile app available for iOS and Android devices. The features associated with Tile were evaluated and used to develop the Tile protocol to support tablet management. Furthermore, current recommendations on preventing health care-related infections were reviewed to develop the infection control protocol to support tablet maintenance. This article provides three protocols: the Configurator protocol, the Tile protocol, and the infection control protocol. These protocols can help to ensure consistent implementation of tablet-based interventions, enhance fidelity when employing tablets for research purposes, and serve as a guide for tablet deployments within clinical settings.

  10. [Removable partial dentures. Oral functions and types].

    Science.gov (United States)

    Creugers, N H J; de Baat, C

    2009-11-01

    A removable partial denture enables the restoration or improvement of 4 oral functions: aesthetics, mandibular stability, mastication, and speech. However, wearing a removable partial denture should not cause oral comfort to deteriorate. There are 3 types of removable partial dentures: acrylic tissue-supported dentures, dentures with cast metal frameworks en dentures with cast metal frameworks and (semi)precision attachments. Interrupted tooth arches,free-ending tooth arches, and a combination of interrupted as well as free-ending tooth arches can be restored using these dentures. Well-known disadvantages of removable partial dentures are problematic oral hygiene, negative influence on the remaining dentition and limited oral comfort. Due to the advanced possibilities of fixed tooth- or implant-supported partial dentures, whether or not free-ending, or tooth- as well as implant-supported partial dentures, the indication of removable partial dentures is restricted. Nevertheless, for the time being the demand for removable partial dentures is expected to continue.

  11. Introduction to partial differential equations

    CERN Document Server

    Greenspan, Donald

    2000-01-01

    Designed for use in a one-semester course by seniors and beginning graduate students, this rigorous presentation explores practical methods of solving differential equations, plus the unifying theory underlying the mathematical superstructure. Topics include basic concepts, Fourier series, second-order partial differential equations, wave equation, potential equation, heat equation, approximate solution of partial differential equations, and more. Exercises appear at the ends of most chapters. 1961 edition.

  12. Effect of peer counselling by mother support groups on infant and young child feeding practices: the Lalitpur experience.

    Science.gov (United States)

    Kushwaha, Komal P; Sankar, Jhuma; Sankar, M Jeeva; Gupta, Arun; Dadhich, J P; Gupta, Y P; Bhatt, Girish C; Ansari, Dilshad A; Sharma, B

    2014-01-01

    Our primary objective was to evaluate the effect of peer counselling by mother support groups (MSG's) in improving the infant and young child feeding (IYCF) practices in the community. We conducted this repeated-measure before and after study in the Lalitpur district of Uttar Pradesh, India between 2006 and 2011. We assessed the IYCF practices before and after creating MSG's within the community. The feeding practices were reassessed at two time points-2 (T1) and 5 years (T2) after the intervention and compared with that of the pre-intervention phase (T0). The total population covered by the project from the time of its initiation was 105000. A total of 425 (T0), 480 (T1) and 521 (T2) mother infant pairs were selected from this population. There was significant improvement in the following IYCF practices in the community (represented as %; adjOR (95% CI, p) such as initiation of breast feeding within 1 hour at both T1 (71% vs. 11%); 19.6 (13.6, 28.2, p =  counseling by MSG's improved the IYCF practices in the district and could be sustained.

  13. The capabilities and scope-of-practice requirements of advanced life support practitioners undertaking critical care transfers: A Delphi study

    Directory of Open Access Journals (Sweden)

    Monique Venter

    2016-11-01

    Full Text Available Background. Critical care transfers (CCT refer to the high level of care given during transport (via ambulance, helicopter or fixed-wing aircraft of patients who are of high acuity. In South Africa (SA, advanced life support (ALS paramedics undertake CCTs. The scope of ALS in SA has no extended protocol regarding procedures or medications in terms of dealing with these CCTs. Aim. The aim of this study was to obtain the opinions of several experts in fields pertaining to critical care and transport and to gain consensus on the skills and scope-of-practice requirements of paramedics undertaking CCTs in the SA setting. Methods. A modified Delphi study consisting of three rounds was undertaken using an online survey platform. A heterogeneous sample (n=7, consisting of specialists in the fields of anaesthesiology, emergency medicine, internal medicine, critical care, critical care transport and paediatrics, was asked to indicate whether, in their opinion, selected procedures and medications were needed within the scope of practice of paramedics undertaking CCTs. Results. After three rounds, consensus was obtained in 70% (57/81 of procedures and medications. Many of these items are not currently within the scope of paramedics’ training. The panel felt that paramedics undertaking these transfers should have additional postgraduate training that is specific to critical care. Conclusion. Major discrepancies exist between the current scope of paramedic practice and the suggested required scope of practice for CCTs. An extended scope of practice and additional training should be considered for these practitioners.

  14. Stormwater Management Decision Support System for Using Low Impact Development Best Management Practices in Industrial Areas

    Science.gov (United States)

    2015-05-30

    brake dust, which contains copper, zinc , and other contaminants , along with tire wear, oils, and other fluids, which will contain zinc . Some motor...H.E. Allen. 2000. Solid-Solution Partitioning of Metals in Contaminated Soils : Dependence on pH, Total Metal Burden, and Organic Matter. Environ. Sci...in fill applications where deemed necessary by a geotechnical investigation, on sites with contaminated soils , or on the sides of the practice to

  15. Intentions and experiences of effective practice in mental health specific supported accommodation services: a qualitative interview study.

    Science.gov (United States)

    Sandhu, Sima; Priebe, Stefan; Leavey, Gerard; Harrison, Isobel; Krotofil, Joanna; McPherson, Peter; Dowling, Sarah; Arbuthnott, Maurice; Curtis, Sarah; King, Michael; Shepherd, Geoff; Killaspy, Helen

    2017-07-11

    Deinstitutionalisation in Europe has led to the development of community-based accommodation for people with mental health problems. The type, setting, and intensity of support provided vary and the costs are substantial. Yet, despite the large investment in these services, there is little clarity on their aims and outcomes or how they are regarded by staff and the clients. We interviewed 30 staff and 30 clients from the three main types of supported accommodation in England (residential care, supported housing, floating outreach) to explore their perspectives on the purpose of these services, and the components of care considered most helpful. The interviews were coded and analysed using thematic analysis. There were generally consistent understandings amongst clients and staff across service types on the goals and purposes of supported accommodation services as: building independence and confidence; supporting people with their mental health; and providing safety and stability. We also noted a competing theme of anxiety about the continuity of support when clients move on from a service. Themes on the experience of what aided effective practice centred on: the supportive presence of others; incremental steps to progress; working together to avoid deskilling and dependency; feeling known and personally understood; tailoring support for social and community engagement; and building confidence through encouragement. The findings provide an understanding of the commonalities in service approach, and goals of clients in these services, as well as the facilitators of goal attainment. However, they also highlight a common tension between providing safe and supportive living environments, whilst also promoting independence and facilitating rehabilitative change.

  16. Multi-criteria decision support framework for sustainable implementation of effective green supply chain management practices.

    Science.gov (United States)

    Boutkhoum, Omar; Hanine, Mohamed; Boukhriss, Hicham; Agouti, Tarik; Tikniouine, Abdessadek

    2016-01-01

    At present, environmental issues become real critical barriers for many supply chain corporations concerning the sustainability of their businesses. In this context, several studies have been proposed from both academia and industry trying to develop new measurements related to green supply chain management (GSCM) practices to overcome these barriers, which will help create new environmental strategies, implementing those practices in their manufacturing processes. The objective of this study is to present the technical and analytical contribution that multi-criteria decision making analysis (MCDA) can bring to environmental decision making problems, and especially to GSCM field. For this reason, a multi-criteria decision-making methodology, combining fuzzy analytical hierarchy process and fuzzy technique for order preference by similarity to ideal solution (fuzzy TOPSIS), is proposed to contribute to a better understanding of new sustainable strategies through the identification and evaluation of the most appropriate GSCM practices to be adopted by industrial organizations. The fuzzy AHP process is used to construct hierarchies of the influential criteria, and then identify the importance weights of the selected criteria, while the fuzzy TOPSIS process employs these weighted criteria as inputs to evaluate and measure the performance of each alternative. To illustrate the effectiveness and performance of our MCDA approach, we have applied it to a chemical industry corporation located in Safi, Morocco.

  17. Implementing potentially better practices to support the neurodevelopment of infants in the NICU.

    Science.gov (United States)

    Laudert, S; Liu, W F; Blackington, S; Perkins, B; Martin, S; Macmillan-York, E; Graven, S; Handyside, J

    2007-12-01

    The purpose of the Vermont Oxford Neonatal Quality Improvement Collaborative 2005 was to explore improvements related to the physical environment of the newborn intensive care unit (NICU) in order to optimize the neurodevelopmental outcome of newborns. Five centers were involved in a focus group examining NICU environmental design and its impact on the neurodevelopmental outcome of the neonate. Using an evidence-based approach, the group identified 16 potentially better care practices. This article describes the implementation approaches for some of these practices. The practice areas include tactile stimulation, providing early exposure to mother's scent, minimizing exposure to noxious odors, developing a system for noise assessment of the NICU acoustic environment, minimizing ambient noise in the infants environment, and preservation of sleep. Approaches to implementation were center specific. Optimizing neurodevelopment of the newborn was the desired goal, but this outcome is difficult to measure with a limited number of subjects over a short study period. Many of the changes although intuitively beneficial are difficult to measure. Education of all participants was considered essential to the process of implementation. The process of collaborative quality improvement is useful in identifying ways to optimize the physical environment of the NICU to improve the neurodevelopmental outcome of the neonate.

  18. Designing an automated clinical decision support system to match clinical practice guidelines for opioid therapy for chronic pain

    Directory of Open Access Journals (Sweden)

    Clark Michael E

    2010-04-01

    Full Text Available Abstract Background Opioid prescribing for chronic pain is common and controversial, but recommended clinical practices are followed inconsistently in many clinical settings. Strategies for increasing adherence to clinical practice guideline recommendations are needed to increase effectiveness and reduce negative consequences of opioid prescribing in chronic pain patients. Methods Here we describe the process and outcomes of a project to operationalize the 2003 VA/DOD Clinical Practice Guideline for Opioid Therapy for Chronic Non-Cancer Pain into a computerized decision support system (DSS to encourage good opioid prescribing practices during primary care visits. We based the DSS on the existing ATHENA-DSS. We used an iterative process of design, testing, and revision of the DSS by a diverse team including guideline authors, medical informatics experts, clinical content experts, and end-users to convert the written clinical practice guideline into a computable algorithm to generate patient-specific recommendations for care based upon existing information in the electronic medical record (EMR, and a set of clinical tools. Results The iterative revision process identified numerous and varied problems with the initially designed system despite diverse expert participation in the design process. The process of operationalizing the guideline identified areas in which the guideline was vague, left decisions to clinical judgment, or required clarification of detail to insure safe clinical implementation. The revisions led to workable solutions to problems, defined the limits of the DSS and its utility in clinical practice, improved integration into clinical workflow, and improved the clarity and accuracy of system recommendations and tools. Conclusions Use of this iterative process led to development of a multifunctional DSS that met the approval of the clinical practice guideline authors, content experts, and clinicians involved in testing. The

  19. Anatomic partial nephrectomy: technique evolution.

    Science.gov (United States)

    Azhar, Raed A; Metcalfe, Charles; Gill, Inderbir S

    2015-03-01

    Partial nephrectomy provides equivalent long-term oncologic and superior functional outcomes as radical nephrectomy for T1a renal masses. Herein, we review the various vascular clamping techniques employed during minimally invasive partial nephrectomy, describe the evolution of our partial nephrectomy technique and provide an update on contemporary thinking about the impact of ischemia on renal function. Recently, partial nephrectomy surgical technique has shifted away from main artery clamping and towards minimizing/eliminating global renal ischemia during partial nephrectomy. Supported by high-fidelity three-dimensional imaging, novel anatomic-based partial nephrectomy techniques have recently been developed, wherein partial nephrectomy can now be performed with segmental, minimal or zero global ischemia to the renal remnant. Sequential innovations have included early unclamping, segmental clamping, super-selective clamping and now culminating in anatomic zero-ischemia surgery. By eliminating 'under-the-gun' time pressure of ischemia for the surgeon, these techniques allow an unhurried, tightly contoured tumour excision with point-specific sutured haemostasis. Recent data indicate that zero-ischemia partial nephrectomy may provide better functional outcomes by minimizing/eliminating global ischemia and preserving greater vascularized kidney volume. Contemporary partial nephrectomy includes a spectrum of surgical techniques ranging from conventional-clamped to novel zero-ischemia approaches. Technique selection should be tailored to each individual case on the basis of tumour characteristics, surgical feasibility, surgeon experience, patient demographics and baseline renal function.

  20. Moderating effects of nurses' organizational justice between organizational support and organizational citizenship behaviors for evidence-based practice.

    Science.gov (United States)

    Chang, Ching-Sheng

    2014-10-01

    Lack of existing literature on the correlation among organizational justice, organizational support, and organizational citizenship behaviors has created a research gap in previous evidence-based practice (EBP) studies on nursing personnel. To investigate whether organizational justice among nurses has a moderating effect between their organizational support and organizational citizenship behaviors in order to bridge such a gap of existing literature with the EBP study on nursing personnel. Nursing staff of one large and influential hospital in Taiwan was surveyed. Four hundred questionnaires were distributed, and 386 were collected with a valid response rate of 96.50%. SPSS 17.0 and Amos 17.0 statistical software packages were used for data analysis. Nurses' organizational support positively influences their organizational citizenship behaviors, and their organizational justice perception has a positive moderating effect between organizational support and organizational citizenship behaviors. Results call hospitals' attention to the type of individual behaviors that may improve organizational performance. When nursing staff perceive fair and impartial treatment by the organization and supportive emotional attachment, behaviors beneficial for the organization are expressed in return. Subjective perceptions of nursing staff play an important role in organizational exchange relationship; the higher the degree of nursing staff's perceived organizational justice, the higher the degree of their organizational support, perception, and exhibition of organizational citizenship behaviors such as altruistic behavior and dedication to the work. © 2014 Sigma Theta Tau International.

  1. Modern Spirometry Supports Anesthetic Management in Small Animal Clinical Practice: A Case Series.

    Science.gov (United States)

    Calice, Ivana; Moens, Yves

    2016-01-01

    Modern spirometry, like no other monitoring technique, allows insight into breath-to-breath respiratory mechanics. Spirometers continuously measure volume, airway pressure, and flow while calculating and continuously displaying respiratory system compliance and resistance in the form of loops. The aim of this case series is to show how observation of spirometric loops, similar to electrocardiogram or CO2 curve monitoring, can improve safety of anesthetic management in small animals. Spirometric monitoring cases described in this case series are based on use of the anaesthesia monitor Capnomac Ultima with a side stream spirometry sensor. The cases illustrate how recognition and understanding of spirometric loops allows for easy diagnosis of iatrogenic pneumothorax, incorrect ventilator settings, leaks in the system, kinked or partially obstructed endotracheal tube, and spontaneous breathing interfering with intermittent positive-pressure ventilation. The case series demonstrates the potential of spirometry to improve the quality and safety of anesthetic management, and, hence, its use can be recommended during intermittent positive-pressure ventilation and procedures in which interference with ventilation can be expected.

  2. Kickstarting Creativity: Supporting the Productive Faces of Uncertainty in Information Practice

    Science.gov (United States)

    Anderson, Theresa Dirndorfer

    2010-01-01

    Introduction: Examines implications of research suggesting fast access to information may reduce the time needed for creative thinking and reflection. To support human thought through information provision, more opportunities to experience and work with imperfect information and to engage with ambiguities are needed. Method: Four linked arguments…

  3. Emergent Family Support Practices in a Context of Policy Churn: An Example from the Children's Fund

    Science.gov (United States)

    Warren, Simon; Apostolov, Apostol; Broughton, Kevin; Evans, Ruth; MacNab, Natasha; Smith, Penny

    2006-01-01

    What might family support services look like in the reconfigured children and family services after the Children Act? This is the question this article attempts to explore by drawing on evidence from the National Evaluation of the Children's Fund in England. The article describes common features in two case-study sites that might indicate the…

  4. Evaluating electronic performance support systems: A methodology focused on future use-in-practice

    NARCIS (Netherlands)

    Collis, Betty; Verwijs, C.A.

    1995-01-01

    Electronic performance support systems, as an emerging type of software environment, present many new challenges in relation to effective evaluation. In this paper, a global approach to a 'usage-orientated' evaluation methodology for software product is presented, followed by a specific example of

  5. Practicing what we preach: Investigating the role of social support in sport psychologists well-being.

    Directory of Open Access Journals (Sweden)

    Hannah eMcCormack

    2015-12-01

    Full Text Available Well-being and mental health of psychologists and their clients can be strongly linked to the psychologists’ experience of work. We know from general theories of occupational health psychology that certain work factors will have a greater impact on well-being than others. Work engagement is positively related with occupational health, while burnout and workaholic tendencies relate negatively. An individual’s resources can buffer against these negative effects. Specifically, the environmental resource of social support can impede the impact and instance of workaholism and has a positive influence on burnout. Social support is often encouraged by sport psychologists in protecting an athlete’s well-being. Drawing on theory and research from work and organisational, health and social psychology we explore the lived experiences of burnout and work engagement among applied sport psychologists, investigating their perceptions of how these experiences impact their well-being. Thirty participants from five countries were asked, using semi-structured interviews, to recall specific incidents when feelings of work engagement and burnout occurred. We examined the influence of social support and its impact on these incidents. Thematic analysis revealed that burnout is frequently experienced despite high levels of work engagement. Sources of social support differ between groups of high burnout versus low burnout, as does reference to the dimensions of work engagement. Avenues for future research including investigating the role of mindfulness and therapeutic lifestyle changes for practitioners are outlined.

  6. Supporting Tertiary Students with a Disability or Mental Illness. Good Practice Guide

    Science.gov (United States)

    National Centre for Vocational Education Research (NCVER), 2015

    2015-01-01

    Having a disability or ongoing ill health (including mental health conditions) can significantly disrupt an individual's educational attainment and employment prospects, potentially creating lifelong social and economic disadvantage. These students may need additional support to help them successfully complete their studies. In addition, education…

  7. Supporting the Academic Majority: Policies and Practices Related to Part-Time Faculty's Job Satisfaction

    Science.gov (United States)

    Eagan, M. Kevin, Jr.; Jaeger, Audrey J.; Grantham, Ashley

    2015-01-01

    The academic workforce in higher education has shifted in the last several decades from consisting of mostly full-time, tenure-track faculty to one comprised predominantly of contingent, non-tenure-track faculty. This substantial shift toward part-time academic labor has not corresponded with institutions implementing more supportive policies and…

  8. Teachers' Instructional Practices within Connected Classroom Technology Environments to Support Representational Fluency

    Science.gov (United States)

    Gunpinar, Yasemin; Pape, Stephen

    2018-01-01

    The purpose of this study was to investigate the ways that teachers use connected classroom technology (CCT) in conjunction with the Texas Instruments Nspire calculator to potentially support achievement on Algebra problems that require translation between representations (i.e., symbolic to graphical). Four Algebra I classrooms that initially…

  9. The Practices of Admission to School and the Effectiveness of Individualized Supported Education

    Science.gov (United States)

    Kutluca Canbulat, Ayse Nur; Tuncel, Meric

    2012-01-01

    This study has been prepared by assessing students' level of readiness to school about the subjects of Language, Psychomotor, Affective, Social, and Cognition developments and to support the development of students who are incapable in those fields of the first grade students who started primary school. The Kiel Test of Admission to School has…

  10. Learning-Focused Leadership and Leadership Support: Meaning and Practice in Urban Systems

    Science.gov (United States)

    Knapp, Michael S.; Copland, Michael A.; Honig, Meredith I.; Plecki, Margaret L.; Portin, Bradley S.

    2010-01-01

    This report synthesizes what has been learned about how leaders in urban systems focus their leadership on the improvement of learning, and what it takes to support their leadership in these settings. The report brings together findings from three sub-study strands, concerned with efforts in seven urban districts to: a) invest staffing and other…

  11. Stable Roles, Changed Skills: Teacher Candidate Responses to Instruction about Adolescent Psychosocial Support Practices

    Science.gov (United States)

    Phillippo, Kate; Blosser, Allison

    2017-01-01

    By virtue of their day-to-day contact with students, teachers are uniquely positioned to notice and respond to student psychosocial issues, both mental health problems and issues like peer harassment that can contribute to mental health problems. Yet, teachers' opportunities to learn about providing psychosocial support remain scattered. The…

  12. Leadership for Transformational Learning: A Developmental Approach to Supporting Leaders' Thinking and Practice

    Science.gov (United States)

    Drago-Severson, Ellie; Blum-DeStefano, Jessica

    2014-01-01

    Given the complexity of contemporary leadership, scholars and practitioners seek to improve preparation programs so that school leaders can more effectively support adult development. This article describes longitudinal research investigating how a university course on leadership for adult development ("Leadership for Transformational…

  13. Policies to Support Wind Power Deployment: Key Considerations and Good Practices

    Energy Technology Data Exchange (ETDEWEB)

    Cox, Sadie [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Tegen, Suzanne [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Baring-Gould, Ian [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Oteri, Frank A. [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Esterly, Sean [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Forsyth, Trudy [Wind Advisors Team, Golden, CO (United States); Baranowski, Ruth [High Desert Technical Communications LLC, Crestone, CO (United States)

    2015-05-19

    Policies have played an important role in scaling up wind deployment and increasing its economic viability while also supporting country-specific economic, social, and environmental development goals. Although wind power has become cost-competitive in several contexts, challenges to wind power deployment remain. Within the context of country-specific goals and challenges, policymakers are seeking

  14. Middle Managers in UK Higher Education Conceptualising Experiences in Support of Reflective Practice

    Science.gov (United States)

    Birds, Rachel

    2014-01-01

    This paper examines the role of reflexivity in supporting middle managers in understanding and facilitating large-scale change management projects in their organisations. Utilising an example from a UK university, it is argued that the development of a conceptual model to fit local circumstances enables deeper understanding and better informed…

  15. Supporting chemistry teachers in implementing formative assessment of investigative practical work in Botswana

    NARCIS (Netherlands)

    Motswiri, M.

    2004-01-01

    With the assumption that exemplary curriculum materials have the potential to serve as an effective support for teachers implementing an innovative curriculum reform, this study was initiated in September 1999. Its aim was to investigate the characteristics of BGCSE exemplary curriculum materials

  16. Re-Designing University Courses to Support Collaborative Knowledge Creation Practices

    Science.gov (United States)

    Lakkala, Minna; Toom, Auli; Ilomäki, Liisa; Muukkkonen, Hanni

    2015-01-01

    Higher education institutions should not only aim to educate academic experts who master their own fields, but also give their students generic skills important in the current society. New teaching methods are required to support the development of such skills. The study examined how a group of voluntary university lecturers re-designed their…

  17. Care, Empowerment and Self-Determination in the Practice of Peer Support

    Science.gov (United States)

    Scott, Anne; Doughty, Carolyn

    2012-01-01

    The concept of "care" has been fraught with negative connotations within the disability movement; the concepts of empowerment, choice and control have been developed as alternatives. The peer-support movement in the mental health sector draws from this tradition, and is uncomfortable with the provision of care. Drawing on the feminist ethic of…

  18. Partial differential equations

    CERN Document Server

    Sloan, D; Süli, E

    2001-01-01

    /homepage/sac/cam/na2000/index.html7-Volume Set now available at special set price ! Over the second half of the 20th century the subject area loosely referred to as numerical analysis of partial differential equations (PDEs) has undergone unprecedented development. At its practical end, the vigorous growth and steady diversification of the field were stimulated by the demand for accurate and reliable tools for computational modelling in physical sciences and engineering, and by the rapid development of computer hardware and architecture. At the more theoretical end, the analytical insight in

  19. PARTIAL SUPPORT OF THE COMMITTEE OF ATOMIC, MOLECULAR, AND OPTICAL SCIENCES Final Report for the period September 30, 2008 to June 30, 2014

    Energy Technology Data Exchange (ETDEWEB)

    Lancaster, James

    2015-06-29

    This report is the final report for the 2008-2014 cycle of DOE support for the Committee on Atomic, Molecular, and Optical Sciences. Highlights of the committee’s activities over this period included: • Meetings of the committee were held semiannually (Washington, DC in April and Irvine, CA in October) for four of the six years and annually the last two years (Washington, DC in April). • Committee meetings included half-day focus sessions on each of the areas identified in the last AMO decadal survey as having great scientific promise and short summaries of the focus session were prepared and delivered to sponsoring agencies. • CAMOS initiated a study that has been funded on high intensity lasers. DOE support for CAMOS has been of central importance to the committee’s ability to continue to fulfill its mandate to the Board on Physics and Astronomy and to the wider atomic, molecular, and optical sciences research community.

  20. Supporting metacognitive development in early science education: Exploring elementary teachers' beliefs and practices in metacognition

    Science.gov (United States)

    Braund, Heather Leigh-Anne

    Metacognition is the understanding and control of cognitive processes. Students with high levels of metacognition achieve greater academic success. The purpose of this mixed-methods study was to examine elementary teachers' beliefs about metacognition and integration of metacognitive practices in science. Forty-four teachers were recruited through professional networks to complete a questionnaire containing open-ended questions (n = 44) and Likert-type items (n = 41). Five respondents were selected to complete semi-structured interviews informed by the questionnaire. The selected interview participants had a minimum of three years teaching experience and demonstrated a conceptual understanding of metacognition. Statistical tests (Pearson correlation, t-tests, and multiple regression) on quantitative data and thematic analysis of qualitative data indicated that teachers largely understood metacognition but had some gaps in their understanding. Participants' reported actions (teaching practices) and beliefs differed according to their years of experience but not gender. Hierarchical multiple regression demonstrated that the first block of gender and experience was not a significant predictor of teachers' metacognitive actions, although experience was a significant predictor by itself. Experience was not a significant predictor once teachers' beliefs were added. The majority of participants indicated that metacognition was indeed appropriate for elementary students. Participants consistently reiterated that students' metacognition developed with practice, but required explicit instruction. A lack of consensus remained around the domain specificity of metacognition. More specifically, the majority of questionnaire respondents indicated that metacognitive strategies could not be used across subject domains, whereas all interviewees indicated that they used strategies across subjects. Metacognition was integrated frequently into Ontario elementary classrooms; however

  1. Cross-pinning: the philosophy of retrievability applied practically to fixed, implant-supported prostheses.

    Science.gov (United States)

    Gervais, M J; Hatzipanagiotis, P; Wilson, P R

    2008-03-01

    Biologic and technical complications are widely reported in the dental literature and often compromise the functional and/or aesthetic features of fixed, implant-supported prostheses. Managing complications without damaging or destroying a restoration is an obvious advantage of implant-based dentistry where the option of prosthetic retrievability is almost always available. The technique of cross-pinning uses a transverse screw to secure a prosthesis to a milled implant abutment, allowing prosthetic retrievability irrespective of dental implant alignment. This study presents guidelines for cross-pinning implant-supported prostheses based on resistance form, screw mechanics and natural tooth contours. The technical aspects of cross-pinning are also discussed using examples from four implant systems.

  2. Supporting Tablet Configuration, Tracking, and Infection Control Practices in Digital Health Interventions: Study Protocol

    OpenAIRE

    Furberg, Robert D; Ortiz, Alexa M; Zulkiewicz, Brittany A; Hudson, Jordan P; Taylor, Olivia M; Lewis, Megan A

    2016-01-01

    Background Tablet-based health care interventions have the potential to encourage patient care in a timelier manner, allow physicians convenient access to patient records, and provide an improved method for patient education. However, along with the continued adoption of tablet technologies, there is a concomitant need to develop protocols focusing on the configuration, management, and maintenance of these devices within the health care setting to support the conduct of clinical research. Obj...

  3. Optimization Of Methodological Support Of Application Tax Benefits In Regions: Practice Of Perm Region

    Directory of Open Access Journals (Sweden)

    Alexandr Ivanovich Tatarkin

    2015-03-01

    Full Text Available In the article, the problem of the methodological process support of regional tax benefits is reviewed. The method of tax benefits assessment, accepted in Perm Region, was chosen as an analysis object because the relatively long period of application of benefits has allowed to build enough statistics base. In the article, the reliability of budget, economic, investment, and social effectiveness assessments of application benefits, based on the Method, is investigated. The suggestions of its perfection are formulated

  4. The vouchers scheme as a mechanism of public support allocation in theory and practice

    OpenAIRE

    Marek Pavlík

    2013-01-01

    Sport support at the municipal level has a long tradition, especially in Europe. Youth involvement to the sport is usually one of the important aspects of grant policies. There are questions regarding how to allocate public resources more efficiently and how to increase youth participation in sport. We analyze the sport vouchers as a tool for increasing transparency and efficiency as well as the involvement of youth and their parents in sport policy at the local level. Vouchers typically tran...

  5. Life-cycle-Based (LCB) online acquisition framework for supporting Mass Customisation (MC) in practice.

    OpenAIRE

    Tang, S. J.; Tjahjono, Benny; Kay, John M.

    2006-01-01

    Mass Customisation (MC) has been perceived in many articles as a strategy of choice for any company. However, Mass Customisation (MC) can be easily discussed at a strategic level; but it is rather more complicated to undertake it organisationally and operationally. The aim of this paper is to explore an effective framework that can support the development of Mass Customisation approaches. Two main contributions are addressed in this paper. One is to prove the insufficiency o...

  6. Music-supported therapy for stroke motor recovery: theoretical and practical considerations.

    Science.gov (United States)

    Chen, Joyce L

    2018-05-08

    Music may confer benefits for well-being and health. What is the state of knowledge and evidence for a role of music in supporting the rehabilitation of movements after stroke? In this brief perspective, I provide background context and information about stroke recovery in general, in order to spark reflection and discussion for how we think music may impact motor recovery, given the current clinical milieu. © 2018 New York Academy of Sciences.

  7. EHRs Connect Research and Practice: Where Predictive Modeling, Artificial Intelligence, and Clinical Decision Support Intersect

    OpenAIRE

    Bennett, Casey; Doub, Tom; Selove, Rebecca

    2012-01-01

    Objectives: Electronic health records (EHRs) are only a first step in capturing and utilizing health-related data - the challenge is turning that data into useful information. Furthermore, EHRs are increasingly likely to include data relating to patient outcomes, functionality such as clinical decision support, and genetic information as well, and, as such, can be seen as repositories of increasingly valuable information about patients' health conditions and responses to treatment over time. ...

  8. INSPIRE (INvestigating Social and PractIcal suppoRts at the End of life): Pilot randomised trial of a community social and practical support intervention for adults with life-limiting illness.

    Science.gov (United States)

    McLoughlin, Kathleen; Rhatigan, Jim; McGilloway, Sinead; Kellehear, Allan; Lucey, Michael; Twomey, Feargal; Conroy, Marian; Herrera-Molina, Emillio; Kumar, Suresh; Furlong, Mairead; Callinan, Joanne; Watson, Max; Currow, David; Bailey, Christopher

    2015-11-24

    For most people, home is the preferred place of care and death. Despite the development of specialist palliative care and primary care models of community based service delivery, people who are dying, and their families/carers, can experience isolation, feel excluded from social circles and distanced from their communities. Loneliness and social isolation can have a detrimental impact on both health and quality of life. Internationally, models of social and practical support at the end of life are gaining momentum as a result of the Compassionate Communities movement. These models have not yet been subjected to rigorous evaluation. The aims of the study described in this protocol are: (1) to evaluate the feasibility, acceptability and potential effectiveness of The Good Neighbour Partnership (GNP), a new volunteer-led model of social and practical care/support for community dwelling adults in Ireland who are living with advanced life-limiting illness; and (2) to pilot the method for a Phase III Randomised Controlled Trial (RCT). The INSPIRE study will be conducted within the Medical Research Council (MRC) Framework for the Evaluation of Complex Interventions (Phases 0-2) and includes an exploratory two-arm delayed intervention randomised controlled trial. Eighty patients and/or their carers will be randomly allocated to one of two groups: (I) Intervention: GNP in addition to standard care or (II) Control: Standard Care. Recipients of the GNP will be asked for their views on participating in both the study and the intervention. Quantitative and qualitative data will be gathered from both groups over eight weeks through face-to-face interviews which will be conducted before, during and after the intervention. The primary outcome is the effect of the intervention on social and practical need. Secondary outcomes are quality of life, loneliness, social support, social capital, unscheduled health service utilisation, caregiver burden, adverse impacts, and satisfaction

  9. Feasibility of streamlining an interactive Bayesian-based diagnostic support tool designed for clinical practice

    Science.gov (United States)

    Chen, Po-Hao; Botzolakis, Emmanuel; Mohan, Suyash; Bryan, R. N.; Cook, Tessa

    2016-03-01

    In radiology, diagnostic errors occur either through the failure of detection or incorrect interpretation. Errors are estimated to occur in 30-35% of all exams and contribute to 40-54% of medical malpractice litigations. In this work, we focus on reducing incorrect interpretation of known imaging features. Existing literature categorizes cognitive bias leading a radiologist to an incorrect diagnosis despite having correctly recognized the abnormal imaging features: anchoring bias, framing effect, availability bias, and premature closure. Computational methods make a unique contribution, as they do not exhibit the same cognitive biases as a human. Bayesian networks formalize the diagnostic process. They modify pre-test diagnostic probabilities using clinical and imaging features, arriving at a post-test probability for each possible diagnosis. To translate Bayesian networks to clinical practice, we implemented an entirely web-based open-source software tool. In this tool, the radiologist first selects a network of choice (e.g. basal ganglia). Then, large, clearly labeled buttons displaying salient imaging features are displayed on the screen serving both as a checklist and for input. As the radiologist inputs the value of an extracted imaging feature, the conditional probabilities of each possible diagnosis are updated. The software presents its level of diagnostic discrimination using a Pareto distribution chart, updated with each additional imaging feature. Active collaboration with the clinical radiologist is a feasible approach to software design and leads to design decisions closely coupling the complex mathematics of conditional probability in Bayesian networks with practice.

  10. Beyond 'doing': Supporting clinical leadership and nursing practice in aged care through innovative models of care.

    Science.gov (United States)

    Venturato, Lorraine; Drew, Liz

    2010-06-01

    Contemporary health care environments are increasingly challenged by issues associated with the recruitment and retention of qualified nursing staff. This challenge is particularly felt by residential aged care providers, with registered nurse (RN) numbers already limited and resident acuity rapidly rising. As a result, aged care service providers are increasingly exploring creative and alternative models of care. This article details exploratory research into a pre-existing, alternative model of care in a medium sized, regional residential aged care facility. Research findings suggest that the model of care is complex and multi-faceted and is an example of an integrated model of care. As a result of the implementation of this model of care a number of shifts have occurred in the practice experiences and clinical culture within this facility. Results suggest that the main benefits of this model are: (1) increased opportunities for RNs to engage in clinical leadership and proactive care management; (2) improved management and communication in relation to work processes and practices; and (3) enhanced recruitment and retention of both RNs and care workers.

  11. Staff training and outreach support for Cognitive Stimulation Therapy and its implementation in practice: a cluster randomised trial.

    Science.gov (United States)

    Streater, Amy; Spector, Aimee; Hoare, Zoe; Aguirre, Elisa; Russell, Ian; Orrell, Martin

    2017-12-01

    There is evidence that Cognitive Stimulation Therapy and maintenance Cognitive Stimulation Therapy are effective in mild to moderate dementia. There is, however, little evidence available for its implementation in practice and the impact of outreach support on the sustainability of the programme. Two hundred and forty-one staff members were randomised from 63 dementia care settings between outreach support including an online forum, email, and telephone support, compared to usual Cognitive Stimulation Therapy control group. The primary outcome was average number of attendees to the Cognitive Stimulation Therapy and maintenance Cognitive Stimulation Therapy programmes. There was no difference in average number of attendees between the intervention and usual Cognitive Stimulation Therapy control groups for the Cognitive Stimulation Therapy (p = 0.82) or the maintenance Cognitive Stimulation Therapy programme (p = 0.97). Outreach support does not affect the average number of people with dementia attending the Cognitive Stimulation Therapy or maintenance Cognitive Stimulation Therapy programme. Irrespective of outreach support, the programmes remain widely implemented and yield perceived benefits for people with dementia. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  12. Personality characteristics and attributes of international medical graduates in general practice training: Implications for supporting this valued Australian workforce.

    Science.gov (United States)

    Laurence, Caroline O; Eley, Diann S; Walters, Lucie; Elliott, Taryn; Cloninger, Claude Robert

    2016-10-01

    To describe the personality profiles of International Medical Graduates (IMGs) undertaking General Practice (GP) training in Australia. A better understanding of the personal characteristics of IMGs may inform their training and enhance support for their vital contribution to the Australian rural workforce. Cross-sectional self-report questionnaires. Independent variables included socio-demographics, prior training, the Temperament and Character Inventory, and the Resilience Scale. GP registrars (IMGs = 102; AMGs = 350) training in the Australian General Practice Training rural and general pathway and the Australian College of Rural and Remote Medicine independent pathway. Univariate analysis explored the differences in levels of traits between IMG and AMG registrars. Compared to the general population both groups have moderately high resilience, and well-organised characters with high Self-directedness, high Cooperativeness and low Self-transcendence, supported by temperaments which were high in Persistence and Reward Dependence. IMGs were different than AMGs in two temperament traits, Novelty Seeking and Persistence and two character traits, Self-directedness and Cooperativeness. Factors such as cultural and training backgrounds, personal and professional expectations, and adjustments necessary to assimilate to a new lifestyle and health system are likely to be responsible for differences found between groups. Understanding the personality profiles of IMGs provides opportunities for targeted training and support which may in turn impact on their retention in rural areas. © 2016 National Rural Health Alliance Inc.

  13. Operational Decision Support for Material Management in Continuous Mining Systems: From Simulation Concept to Practical Full-Scale Implementations

    Directory of Open Access Journals (Sweden)

    Masoud Soleymani Shishvan

    2017-07-01

    Full Text Available Material management in opencast mines is concerned with planning, organizing, and control of the flow of materials from their extraction points to destinations. It can be strongly affected by operational decisions that have to be made during the production process. To date, little research has focused on the application of simulation modeling as a powerful supportive tool for decision making in such systems. Practical experiences from implementing a simulation model of a mine for the operational support on an industrial scale are not known to the authors. This paper presents the extension of a developed stochastic simulation model by the authors from a conceptual stage (TRL4 to a new Technology Readiness Level (TRL 6 by implementing it in an industrially relevant environment. A framework for modeling, simulation, and validation of the simulation model applied to two large opencast lignite mines is presented in detail. Operational implementation issues, experiences, and challenges in practical applications are discussed. Furthermore, the strength of applying the simulation modeling as an operational decision support for material management in coal mining is demonstrated. Results of the case studies are used to describe the details of the framework, and to illustrate the strength and limitations of its application.

  14. Teachers’ practices to support student work in digital storytelling: A study on Finnish and Chinese school teachers’ experiences

    Directory of Open Access Journals (Sweden)

    Marianna Vivitsou

    2017-10-01

    Full Text Available This study aims to discuss and analyze Finnish and Chinese primary school teachers’ practices when digital storytelling is the teaching method, aiming for student-generated stories in video format. To meet this end, teachers introduce digital storytelling in their practices and guide and support students into building and sharing digital stories in video format with peers in the classroom and online. In addition, they introduce the use of web-based environments and digital technologies, adapt their teaching plan accordingly, and enrich existing instructional material. As a result, teacher’s practices of organizing and facilitating student work and development change.In order to investigate how teaching practices change, this study draws from Chinese and Finnish teachers’ interviews and observation data and uses inductive analysis and constant comparison for more abstract themes and categories. The findings show that the teachers use formal and informal, natural and technological environments to organize student work and aim for freer learning in digital storytelling activities. Also, different aspects of collaborative work are used to facilitate and, mainly, structure student work and development.

  15. "Many miles to go …": a systematic review of the implementation of patient decision support interventions into routine clinical practice.

    Science.gov (United States)

    Elwyn, Glyn; Scholl, Isabelle; Tietbohl, Caroline; Mann, Mala; Edwards, Adrian G K; Clay, Catharine; Légaré, France; van der Weijden, Trudy; Lewis, Carmen L; Wexler, Richard M; Frosch, Dominick L

    2013-01-01

    Two decades of research has established the positive effect of using patient-targeted decision support interventions: patients gain knowledge, greater understanding of probabilities and increased confidence in decisions. Yet, despite their efficacy, the effectiveness of these decision support interventions in routine practice has yet to be established; widespread adoption has not occurred. The aim of this review was to search for and analyze the findings of published peer-reviewed studies that investigated the success levels of strategies or methods where attempts were made to implement patient-targeted decision support interventions into routine clinical settings. An electronic search strategy was devised and adapted for the following databases: ASSIA, CINAHL, Embase, HMIC, Medline, Medline-in-process, OpenSIGLE, PsycINFO, Scopus, Social Services Abstracts, and the Web of Science. In addition, we used snowballing techniques. Studies were included after dual independent assessment. After assessment, 5322 abstracts yielded 51 articles for consideration. After examining full-texts, 17 studies were included and subjected to data extraction. The approach used in all studies was one where clinicians and their staff used a referral model, asking eligible patients to use decision support. The results point to significant challenges to the implementation of patient decision support using this model, including indifference on the part of health care professionals. This indifference stemmed from a reported lack of confidence in the content of decision support interventions and concern about disruption to established workflows, ultimately contributing to organizational inertia regarding their adoption. It seems too early to make firm recommendations about how best to implement patient decision support into routine practice because approaches that use a 'referral model' consistently report difficulties. We sense that the underlying issues that militate against the use of

  16. Managing RTP Console Upgrading Project: Best Practice for Nuclear Malaysia as TSO in Supporting NPP Development

    International Nuclear Information System (INIS)

    Nurfarhana Ayuni Joha; Syahirah Abdul Rahman; Izhar Abu Hussin

    2011-01-01

    Human Resource Development (HRD) is required for Nuclear Power Programme (NPP). To be a Technical Support Organisation (TSO) for NPP, Nuclear Malaysia should be ready to take the responsibility in supporting Nuclear Regulatory Agency (NRA) and NPP Operators. In nurturing Nuclear Malaysia as TSO, the prime important and focus of HRD for the NPP is the reactor engineering technology. Nuclear Malaysia gives various phases of supports needed to build NPP such as during siting, design, planning, licensing, construction, commissioning, operation and maintenance in its own way and capability. The current Nuclear Malaysia unique approach is the TRIGA PUSPATI reactor (RTP) upgrading project. Research reactor plays an important role in Research and Developpement organization as a nuclear facility to assist the development of NPP. Therefore, upgrading the research reactor is needed to build the skills and gain knowledge of workers to work safely. After 29 years of operation, the RTP system is facing aging problems due to many components in the reactor are outdated. Therefore, immediate action should be carried out to mitigate the aging factor of the reactor to prevent the worsening of the aging problem, and to prevent untoward incident from happening. Action should also cover short and long term planning to prevent current situation from recurring. Currently, RTP is upgrading its console from analog to digital system. One of the achievements in this console upgrading project is the development and implementation of project management. This paper comprises the overview on the RTP console upgrading project, the project management and how this project can lead Nuclear Malaysia to be a good TSO for the development of NPP. (author)

  17. Practice-Oriented Formal Methods to Support the Software Development of Industrial Control Systems

    CERN Document Server

    AUTHOR|(CDS)2088632; Blanco Viñuela, Enrique

    Formal specification and verification methods provide ways to describe requirements precisely and to check whether the requirements are satisfied by the design or the implementation. In other words, they can prevent development faults and therefore improve the quality of the developed systems. These methods are part of the state-of-the-practice in application domains with high criticality, such as avionics, railway or nuclear industry. The situation is different in the industrial control systems domain. As the criticality of the systems is much lower, formal methods are rarely used. The two main obstacles to using formal methods in systems with low- or medium-criticality are performance and usability. Overcoming these obstacles often needs deep knowledge and high effort. Model checking, one of the main formal verification techniques, is computationally difficult, therefore the analysis of non-trivial systems requires special considerations. Furthermore, the mainly academic tools implementing different model c...

  18. Considering "Nonlinearity" Across the Continuum in Medical Education Assessment: Supporting Theory, Practice, and Future Research Directions.

    Science.gov (United States)

    Durning, Steven J; Lubarsky, Stuart; Torre, Dario; Dory, Valérie; Holmboe, Eric

    2015-01-01

    The purpose of this article is to propose new approaches to assessment that are grounded in educational theory and the concept of "nonlinearity." The new approaches take into account related phenomena such as "uncertainty," "ambiguity," and "chaos." To illustrate these approaches, we will use the example of assessment of clinical reasoning, although the principles we outline may apply equally well to assessment of other constructs in medical education. Theoretical perspectives include a discussion of script theory, assimilation theory, self-regulated learning theory, and situated cognition. Assessment examples to include script concordance testing, concept maps, self-regulated learning microanalytic technique, and work-based assessment, which parallel the above-stated theories, respectively, are also highlighted. We conclude with some practical suggestions for approaching nonlinearity. © 2015 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.

  19. Computer-Based Methods for Collecting Peer Nomination Data: Utility, Practice, and Empirical Support.

    Science.gov (United States)

    van den Berg, Yvonne H M; Gommans, Rob

    2017-09-01

    New technologies have led to several major advances in psychological research over the past few decades. Peer nomination research is no exception. Thanks to these technological innovations, computerized data collection is becoming more common in peer nomination research. However, computer-based assessment is more than simply programming the questionnaire and asking respondents to fill it in on computers. In this chapter the advantages and challenges of computer-based assessments are discussed. In addition, a list of practical recommendations and considerations is provided to inform researchers on how computer-based methods can be applied to their own research. Although the focus is on the collection of peer nomination data in particular, many of the requirements, considerations, and implications are also relevant for those who consider the use of other sociometric assessment methods (e.g., paired comparisons, peer ratings, peer rankings) or computer-based assessments in general. © 2017 Wiley Periodicals, Inc.

  20. An Experimental and Analytical Evaluation of Wall And Window Retrofit Configurations: Supporting the Residential Retrofit Best Practices Guide

    Energy Technology Data Exchange (ETDEWEB)

    Stovall, Therese K [ORNL; Petrie, Thomas [ORNL; Kosny, Jan [ORNL; Childs, Phillip W [ORNL; Atchley, Jerald Allen [ORNL; Hulvey, Kimberly D [ORNL

    2007-11-01

    A Retrofit Best Practices Guide was developed to encourage homeowners to consider energy conservation issues whenever they modify their siding or windows. In support of this guide, an experimental program was implemented to measure the performance of a number of possible wall siding and window retrofit configurations. Both thermal and air-leakage measurements were made for a 2.4 x 2.4 m (8 x 8 ft) wall section with and without a 0.9 x 1.2 m (3 x 4 ft) window. The windows tested were previously well-characterized at a dedicated window test facility. A computer model was also used to provide information for the Best Practices Guide. The experimental data for walls and windows were used in conjunction with this model to estimate the total annual energy savings for several typical houses in a number of different locations.

  1. Design and implementation of a decision support system for breast cancer treatment based on clinical practice guidelines

    International Nuclear Information System (INIS)

    Skevofilakas, M.T.; Nikita, K.S.; Templaleksis, P.H.; Birbas, K.N.; Kaklamanos, I.G.; Bonatsos, G.N.

    2007-01-01

    Evidence based medicine is the clinical practice that uses medical data and proof in order to make efficient clinical decisions. Information technology (IT) can play a crucial role in exploiting the huge size of raw medical data involved. In an attempt to improve clinical efficacy, health care society nowadays also utilizes a new assistant, clinical guidelines. Our research concerns the medical domain of the breast cancer disease. Our research's focus is twofold; our primary goal is to ensure consistency in clinical practice by importing clinical guidelines in an IT driven decision support system (DSS). Furthermore, we seek to improve visualization of disease specific, clinical data, providing for it's faster and more efficient use. (orig.)

  2. Decision Support System in National Power Companies. A Practical Example (Part I

    Directory of Open Access Journals (Sweden)

    Adela BARA

    2013-05-01

    Full Text Available The paper presents the developing stages of the decision support prototype in which the data warehouse and the presentation level are built and validated. The paper also extends the results published in the 12th international conference on Informatics in Economy (IE 2013 proceedings and will presents the major steps for developing the data warehouse that integrates the sources from the Wind Power Plants (WPP from the national parks and also the interface modules that allow managers to analyze data at a central level.

  3. Safe mining face advance and support installation practice in mechanical miner workings under different geotechnical conditions.

    CSIR Research Space (South Africa)

    Canbulat, I

    2000-03-01

    Full Text Available in this area in order to obtain representative results. A sonic probe extensometer was used to monitor the roof and support performances in the experiment sites. Two holes were drilled and instrumented with sonic probe anchors in each site. The first hole... was drilled and instrumented at the face before any mining took place, and the second hole drilled in the middle of the cut out distance. In order to determine the effect of time on roof deformation, the sites were left for 48 hours unsupported, where...

  4. How can HR practices support front-end innovation and increase the innovativeness of companies?

    DEFF Research Database (Denmark)

    Aagaard, Annabeth; Andersen, Torben

    2014-01-01

    to be reinterpreted in a context of heterogeneity and polyvalence. Finally performance management and talent management should play a greater role in emphasising exclusive values and rational goal-oriented behaviour among employees, compared to the more inclusive mainstream values that characterise much HRM......' innovativeness. If HR is to support these activities, focus should be on broader issues such as team-based organising, founded on a questioning attitude and a management style with a high level of empowerment. In addition, traditional HR themes such as recruitment, training and development have...

  5. A national survey of supportive practices for patients undergoing radiotherapy for oral cancers

    International Nuclear Information System (INIS)

    Osborn, Joanne; Doolan, Caroline

    2013-01-01

    Purpose: Xerostomia and mucositis are two of the main radiation induced toxicities experienced by patients undergoing radiotherapy to the oral cavity. These toxicities can lead to significant weight loss with the potential to cause complications with radiotherapy treatment. Literature has shown that nutritional intervention can help to minimise these side effects. The aim of the survey was to explore current practice across the UK in nutritional intervention for these patients. Method: Postal questionnaires were sent to all 63 radiotherapy departments in the UK in November 2009. Results: 29 responses (43%) were received. 90% (n = 26) of the departments used 3D-Conformal radiotherapy (3D-CRT) as the main technique for treatment of these patients, with 48% (n = 14) of departments having implemented Intensity modulated radiotherapy (IMRT). All departments referred their patients to a dietician. 93% (n = 27) of departments placed percutaneous endoscopic gastrostomy or radiologically-inserted gastrostomy tubes. 55% (n = 16) departments administered nasogastric tubes. Conclusion: This survey verified many common practices regarding dietary care and advice, some variation was evident in the use of feeding tubes. All responding centres referred patients to a dietician with the aim to maintain nutritional status and prevent weight loss that could contribute to uncertainty in treatment setup. This survey also demonstrated that since Macknelly and Day's (2009) study, a greater number of centres have implemented IMRT for patients undergoing radiotherapy to the head and neck. Although IMRT has been shown to reduce xerostomia, this audit found no changes in the dietary care and advice given to these patients

  6. Practical application of decision support metrics for power plant risk-informed asset management

    International Nuclear Information System (INIS)

    Liming, James K.; Johnson, David H.; Kee, Ernest J.; Sun, Alice Y.; Young, Garry G.

    2003-01-01

    The objective of this paper is to provide electric utilities with a concept for developing and applying effective decision support metrics via integrated risk-informed asset management (RIAM) programs for power stations and generating companies. RIAM is a process by which analysts review historical performance and develop predictive logic models and data analyses to predict critical decision support figures-of-merit (or metrics) for generating station managers and electric utility company executives. These metrics include, but are not limited to, the following; profitability, net benefit, benefit-to-cost ratio, projected return on investment, projected revenue, projected costs, asset value, safety (catastrophic facility damage frequency and consequences, etc.), power production availability (capacity factor, etc.), efficiency (heat rate), and others. RIAM applies probabilistic safety assessment (PSA) techniques and generates predictions probabilistically so that metrics information can be supplied to managers in terms of probability distributions as well as point estimates. This enables the managers to apply the concept of 'confidence levels' in their critical decision-making processes. (author)

  7. Practice on medical support in dealing with abandoned chemical weapons by Japanese army in China

    Directory of Open Access Journals (Sweden)

    Liu LIU

    2013-04-01

    Full Text Available Japanese abandoned chemical weapons (JACWs are a momentous and eventful historical issue for both China and Japan. Large quantities of chemical weapons abandoned by the Japanese invaders still remain on Chinese soil after 1945 when Japanese invaders were defeated and surrendered. Up to date, JACWs have been found in 19 provinces (cities or districts of mainland China. The types of JACWs include chemical bombs, chemical aerial bombs, gas cylinders and loose packed barrels. The types of toxic agents include mustard gas, irritant agents, choking agents, systemic poisoning agents and etc. In order to eliminate JACWs to reduce injuries produced by toxic agents, Chinese government, in cooperation with Japanese government, organized a special troop to search, excavate, retrieve, and destroy JACWs. Up to date, about 50,000 pieces of poisonous chemical had retrieved and destroyed. The first operation was officially begun in Nanjing in October 2010. The main points of medical support on the operation of destroying JACWs include proper treatment of the newly discovered patients caused by JACWs, preparedness for handling the emergency medical rescue, and to actively provide routine medical support for JACWs operation field.

  8. Implementing telehealth to support medical practice in rural/remote regions: what are the conditions for success?

    Science.gov (United States)

    Gagnon, Marie-Pierre; Duplantie, Julie; Fortin, Jean-Paul; Landry, Réjean

    2006-08-24

    Telehealth, as other information and communication technologies (ICTs) introduced to support the delivery of health care services, is considered as a means to answer many of the imperatives currently challenging health care systems. In Canada, many telehealth projects are taking place, mostly targeting rural, remote or isolated populations. So far, various telehealth applications have been implemented and have shown promising outcomes. However, telehealth utilisation remains limited in many settings, despite increased availability of technology and telecommunication infrastructure. A qualitative field study was conducted in four remote regions of Quebec (Canada) to explore perceptions of physicians and managers regarding the impact of telehealth on clinical practice and the organisation of health care services, as well as the conditions for improving telehealth implementation. A total of 54 respondents were interviewed either individually or in small groups. Content analysis of interviews was performed and identified several effects of telehealth on remote medical practice as well as key conditions to ensure the success of telehealth implementation. According to physicians and managers, telehealth benefits include better access to specialised services in remote regions, improved continuity of care, and increased availability of information. Telehealth also improves physicians' practice by facilitating continuing medical education, contacts with peers, and access to a second opinion. At the hospital and health region levels, telehealth has the potential to support the development of regional reference centres, favour retention of local expertise, and save costs. Conditions for successful implementation of telehealth networks include the participation of clinicians in decision-making, the availability of dedicated human and material resources, and a planned diffusion strategy. Interviews with physicians and managers also highlighted the importance of considering

  9. Implementing telehealth to support medical practice in rural/remote regions: what are the conditions for success?

    Directory of Open Access Journals (Sweden)

    Duplantie Julie

    2006-08-01

    Full Text Available Abstract Background Telehealth, as other information and communication technologies (ICTs introduced to support the delivery of health care services, is considered as a means to answer many of the imperatives currently challenging health care systems. In Canada, many telehealth projects are taking place, mostly targeting rural, remote or isolated populations. So far, various telehealth applications have been implemented and have shown promising outcomes. However, telehealth utilisation remains limited in many settings, despite increased availability of technology and telecommunication infrastructure. Methods A qualitative field study was conducted in four remote regions of Quebec (Canada to explore perceptions of physicians and managers regarding the impact of telehealth on clinical practice and the organisation of health care services, as well as the conditions for improving telehealth implementation. A total of 54 respondents were interviewed either individually or in small groups. Content analysis of interviews was performed and identified several effects of telehealth on remote medical practice as well as key conditions to ensure the success of telehealth implementation. Results According to physicians and managers, telehealth benefits include better access to specialised services in remote regions, improved continuity of care, and increased availability of information. Telehealth also improves physicians' practice by facilitating continuing medical education, contacts with peers, and access to a second opinion. At the hospital and health region levels, telehealth has the potential to support the development of regional reference centres, favour retention of local expertise, and save costs. Conditions for successful implementation of telehealth networks include the participation of clinicians in decision-making, the availability of dedicated human and material resources, and a planned diffusion strategy. Interviews with physicians and

  10. INSPIRE (INvestigating Social and PractIcal suppoRts at the End of life): Pilot randomised trial of a community social and practical support intervention for adults with life-limiting illness.

    LENUS (Irish Health Repository)

    McLoughlin, Kathleen

    2015-11-24

    For most people, home is the preferred place of care and death. Despite the development of specialist palliative care and primary care models of community based service delivery, people who are dying, and their families\\/carers, can experience isolation, feel excluded from social circles and distanced from their communities. Loneliness and social isolation can have a detrimental impact on both health and quality of life. Internationally, models of social and practical support at the end of life are gaining momentum as a result of the Compassionate Communities movement. These models have not yet been subjected to rigorous evaluation. The aims of the study described in this protocol are: (1) to evaluate the feasibility, acceptability and potential effectiveness of The Good Neighbour Partnership (GNP), a new volunteer-led model of social and practical care\\/support for community dwelling adults in Ireland who are living with advanced life-limiting illness; and (2) to pilot the method for a Phase III Randomised Controlled Trial (RCT).

  11. A Practical Review of Integrated Urban Water Models: Applications as Decision Support Tools and Beyond

    Science.gov (United States)

    Mosleh, L.; Negahban-Azar, M.

    2017-12-01

    The integrated urban water management has become a necessity due to the high rate of urbanization, water scarcity, and climate variability. Climate and demographic changes, shifting the social attitude toward the water usage, and insufficiencies in system resilience increase the pressure on the water resources. Alongside with the water management, modeling urban water systems have progressed from traditional view to comprise alternatives such as decentralized water and wastewater systems, fit-for-purpose practice, graywater/rainwater reuse, and green infrastructure. While there are review papers available focusing on the technical part of the models, they seem to be more beneficial for model developers. Some of the models analyze a number of scenarios considering factors such as climate change and demography and their future impacts. However, others only focus on quality and quantity of water in a supply/demand approach. For example, optimizing the size of water or waste water store, characterizing the supply and quantity of urban stormwater and waste water, and link source of water to demand. A detailed and practical comparison of such models has become a necessity for the practitioner and policy makers. This research compares more than 7 most commonly used integrated urban water cycle models and critically reviews their capabilities, input requirements, output and their applications. The output of such detailed comparison will help the policy makers for the decision process in the built environment to compare and choose the best models that meet their goals. The results of this research show that we need a transition from developing/using integrated water cycle models to integrated system models which incorporate urban water infrastructures and ecological and economic factors. Such models can help decision makers to reflect other important criteria but with the focus on urban water management. The research also showed that there is a need in exploring

  12. 'Practical' resources to support patient and family engagement in healthcare decisions: a scoping review.

    Science.gov (United States)

    Kovacs Burns, Katharina; Bellows, Mandy; Eigenseher, Carol; Gallivan, Jennifer

    2014-04-15

    Extensive literature exists on public involvement or engagement, but what actual tools or guides exist that are practical, tested and easy to use specifically for initiating and implementing patient and family engagement, is uncertain. No comprehensive review and synthesis of general international published or grey literature on this specific topic was found. A systematic scoping review of published and grey literature is, therefore, appropriate for searching through the vast general engagement literature to identify 'patient/family engagement' tools and guides applicable in health organization decision-making, such as within Alberta Health Services in Alberta, Canada. This latter organization requested this search and review to inform the contents of a patient engagement resource kit for patients, providers and leaders. Search terms related to 'patient engagement', tools, guides, education and infrastructure or resources, were applied to published literature databases and grey literature search engines. Grey literature also included United States, Australia and Europe where most known public engagement practices exist, and Canada as the location for this study. Inclusion and exclusion criteria were set, and include: English documents referencing 'patient engagement' with specific criteria, and published between 1995 and 2011. For document analysis and synthesis, document analysis worksheets were used by three reviewers for the selected 224 published and 193 grey literature documents. Inter-rater reliability was ensured for the final reviews and syntheses of 76 published and 193 grey documents. Seven key themes emerged from the literature synthesis analysis, and were identified for patient, provider and/or leader groups. Articles/items within each theme were clustered under main topic areas of 'tools', 'education' and 'infrastructure'. The synthesis and findings in the literature include 15 different terms and definitions for 'patient engagement', 17 different

  13. Supporting safe driving with arthritis: developing a driving toolkit for clinical practice and consumer use.

    Science.gov (United States)

    Vrkljan, Brenda H; Cranney, Ann; Worswick, Julia; O'Donnell, Siobhan; Li, Linda C; Gélinas, Isabelle; Byszewski, Anna; Man-Son-Hing, Malcolm; Marshall, Shawn

    2010-01-01

    We conducted a series of focus groups to explore the information needs of clinicians and consumers related to arthritis and driving. An open coding analysis identified common themes across both consumer and clinician-based focus groups that underscored the importance of addressing driving-related concerns and the challenges associated with assessing safety. The results revealed that although driving is critical for maintaining independence and community mobility, drivers with arthritis experience several problems that can affect safe operation of a motor vehicle. Findings from this study are part of a broader research initiative that will inform the development of the Arthritis and Driving toolkit. This toolkit outlines strategies to support safe mobility for people with arthritis and will be an important resource in the coming years given the aging population.

  14. Pathobiology of myomatosis uteri: the underlying knowledge to support our clinical practice.

    Science.gov (United States)

    Torres-de la Roche, Luz Angela; Becker, Sven; Cezar, Cristina; Hermann, Anja; Larbig, Angelika; Leicher, Lasse; Di Spiezio Sardo, Attilio; Tanos, Vasilis; Wallwiener, Markus; Verhoeven, Hugo; De Wilde, Rudy Leon

    2017-10-01

    Uterine myomatosis, a benign condition, is the most common indication for hysterectomies worldwide, affecting the reproductive goals and quality of health of women. However, gynecologists have been provided with interesting insights on its pathobiology, which are the basis for uterine-preserving therapies. The aim of this paper is to discuss the latest evidence on these mechanisms and its importance in the clinical practice. A comprehensive literature search was made in Pubmed, Medline, the Cochrane Library, Orbis plus and Google Scholar for articles related to the epidemiological, biological, and genetic bases. There is extensive evidence that genetic, epigenetic, hormonal, environmental, proinflamatory, angiogenetic, and growing factors are involved in the biology of myomatosis. Such factors are capable of activating and promoting inhibitory signaling pathways leading to initiation, development, and regression of myomata through changes in myometrial cells and myomata fibers, such as cellular proliferation, differentiation, apoptosis, angiogenesis, and changes in the surrounding environment. A good understanding of the pathobiologic mechanisms of myomatosis gives reasons to physicians to elect conservative or combined therapies, and allow affected women to receive an individualized management, according to age, reproduction desire, and clinical condition.

  15. How the Organic Food System Supports Sustainable Diets and Translates These into Practice.

    Science.gov (United States)

    Strassner, Carola; Cavoski, Ivana; Di Cagno, Raffaella; Kahl, Johannes; Kesse-Guyot, Emmanuelle; Lairon, Denis; Lampkin, Nicolas; Løes, Anne-Kristin; Matt, Darja; Niggli, Urs; Paoletti, Flavio; Pehme, Sirli; Rembiałkowska, Ewa; Schader, Christian; Stolze, Matthias

    2015-01-01

    Organic production and consumption provide a delineated food system that can be explored for its potential contribution to sustainable diets. While organic agriculture improves the sustainability performance on the production side, critical reflections are made on how organic consumption patterns, understood as the practice of people consuming significant amounts of organic produce, may also be taken as an example for sustainable food consumption. The consumption patterns of regular organic consumers seem to be close to the sustainable diet concept of FAO. Certain organic-related measures might therefore be useful in the sustainability assessment of diets, e.g., organic production and organic consumption. Since diets play a central role in shaping food systems and food systems shape diets, the role of organic consumption emerges as an essential topic to be addressed. This role may be based on four important organic achievements: organic agriculture and food production has a definition, well-established principles, public standards, and useful metrics. By 2015, data for organic production and consumption are recorded annually from more than 160 countries, and regulations are in force in more than 80 countries or regions. The organic food system puts the land (agri-cultura) back into the diet; it is the land from which the diet in toto is shaped. Therefore, the organic food system provides essential components of a sustainable diet.

  16. The Development of Assistive Systems to Support Older People: Issues that Affect Success in Practice

    Directory of Open Access Journals (Sweden)

    Jean D. Hallewell Haslwanter

    2017-12-01

    Full Text Available Due to an aging population in Europe, the development of Ambient Assisted Living technologies (AAL is increasingly the target of research financing. These technologies promise to enable older people to remain in their own homes longer, something many people report wanting and which may also reduce the costs of care. To date however there are few systems on the market. Other studies have tried to understand this by looking at user acceptance. However, by looking only at the user acceptance, we may miss important aspects to explain why systems went wrong in the first place, since decisions made during the development may affect the success later. To address this, we report on a study in which we applied qualitative methods, including workshops and an interactive poster, to consult with people who have experience in the development of these technologies. We present the common issues reported across various AAL development projects done in Europe that the participants thought were important to the success or failure of projects. We also describe some ideas from participants for addressing some of these problems. The results demonstrate the importance of issues related to financing with grants for projects but also the need for improved user-centered practice.

  17. How the organic food system supports sustainable diets and translates these into practice

    Directory of Open Access Journals (Sweden)

    Carola eStrassner

    2015-06-01

    Full Text Available Organic production and consumption provide a delineated food system that can be explored for its potential contribution to sustainable diets. While organic agriculture improves the sustainability performance on the production side, critical reflections are made on how organic consumption patterns, understood as the practice of people consuming significant amounts of organic produce, may also be taken as an example for sustainable food consumption. The consumption patterns of regular organic consumers seem to be close to the sustainable diet concept of FAO. Certain organic-related measures might therefore be useful in the sustainability assessment of diets, e.g. organic production and organic consumption. Since diets play a central role in shaping food systems and food systems shape diets, the role of organic consumption emerges as an essential topic to be addressed. This role may be based on four important organic achievements: organic agriculture and food production has a definition, well-established principles, public standards and useful metrics. By 2015 data for organic production and consumption is recorded annually from more than 160 countries, and regulations are in force in more than 80 countries or regions. The organic fo

  18. How the Organic Food System Supports Sustainable Diets and Translates These into Practice

    Science.gov (United States)

    Strassner, Carola; Cavoski, Ivana; Di Cagno, Raffaella; Kahl, Johannes; Kesse-Guyot, Emmanuelle; Lairon, Denis; Lampkin, Nicolas; Løes, Anne-Kristin; Matt, Darja; Niggli, Urs; Paoletti, Flavio; Pehme, Sirli; Rembiałkowska, Ewa; Schader, Christian; Stolze, Matthias

    2015-01-01

    Organic production and consumption provide a delineated food system that can be explored for its potential contribution to sustainable diets. While organic agriculture improves the sustainability performance on the production side, critical reflections are made on how organic consumption patterns, understood as the practice of people consuming significant amounts of organic produce, may also be taken as an example for sustainable food consumption. The consumption patterns of regular organic consumers seem to be close to the sustainable diet concept of FAO. Certain organic-related measures might therefore be useful in the sustainability assessment of diets, e.g., organic production and organic consumption. Since diets play a central role in shaping food systems and food systems shape diets, the role of organic consumption emerges as an essential topic to be addressed. This role may be based on four important organic achievements: organic agriculture and food production has a definition, well-established principles, public standards, and useful metrics. By 2015, data for organic production and consumption are recorded annually from more than 160 countries, and regulations are in force in more than 80 countries or regions. The organic food system puts the land (agri-cultura) back into the diet; it is the land from which the diet in toto is shaped. Therefore, the organic food system provides essential components of a sustainable diet. PMID:26176912

  19. Photogenic partial seizures.

    Science.gov (United States)

    Hennessy, M J; Binnie, C D

    2000-01-01

    To establish the incidence and symptoms of partial seizures in a cohort of patients investigated on account of known sensitivity to intermittent photic stimulation and/or precipitation of seizures by environmental visual stimuli such as television (TV) screens or computer monitors. We report 43 consecutive patients with epilepsy, who had exhibited a significant EEG photoparoxysmal response or who had seizures precipitated by environmental visual stimuli and underwent detailed assessment of their photosensitivity in the EEG laboratory, during which all were questioned concerning their ictal symptoms. All patients were considered on clinical grounds to have an idiopathic epilepsy syndrome. Twenty-eight (65%) patients reported visually precipitated attacks occurring initially with maintained consciousness, in some instances evolving to a period of confusion or to a secondarily generalized seizure. Visual symptoms were most commonly reported and included positive symptoms such as coloured circles or spots, but also blindness and subjective symptoms such as "eyes going funny." Other symptoms described included nonspecific cephalic sensations, deja-vu, auditory hallucinations, nausea, and vomiting. No patient reported any clear spontaneous partial seizures, and there were no grounds for supposing that any had partial epilepsy excepting the ictal phenomenology of some or all of the visually induced attacks. These findings provide clinical support for the physiological studies that indicate that the trigger mechanism for human photosensitivity involves binocularly innervated cells located in the visual cortex. Thus the visual cortex is the seat of the primary epileptogenic process, and the photically triggered discharges and seizures may be regarded as partial with secondary generalization.

  20. Gait pattern of severely disabled hemiparetic subjects on a new controlled gait trainer as compared to assisted treadmill walking with partial body weight support.

    Science.gov (United States)

    Hesse, S; Uhlenbrock, D; Sarkodie-Gyan, T

    1999-10-01

    To investigate to what extent and with how much therapeutic effort nonambulatory stroke patients could train a gait-like movement on a newly developed, machine-supported gait trainer. Open study comparing the movement on the gait trainer with assisted walking on the treadmill. Motion analysis laboratory of a rehabilitation centre. Fourteen chronic, nonambulatory hemiparetic patients. Complex gait analysis while training on the gait trainer and while walking on the treadmill. Gait kinematics, kinesiological EMG of several lower limb muscles and the required assistance. Patients could train a gait-like movement on the gait trainer, characterized kinematically by a perfect symmetry, larger hip extension during stance, less knee flexion and less ankle plantar flexion during swing as compared to treadmill walking (p gait trainer (p gait trainer offered severely disabled hemiparetic subjects the possibility of training a gait-like, highly symmetrical movement with a favourable facilitation of relevant anti-gravity muscles. At the same time, the effort required of the therapists was reduced.

  1. The Role of Soil Solarization in India: How an Unnoticed Practice Could Support Pest Control

    Directory of Open Access Journals (Sweden)

    Harsimran K. Gill

    2017-09-01

    Full Text Available Plant protection represents one of the strategies to fill the yield gap and to achieve food security, a key topic for India development. Analysis of climate risks for crops indicates that South Asia is one of the regions most exposed to the adverse impact on many plants that are relevant to inhabitants exposed to food safety risks. Furthermore, accumulation of pesticide residues in the aquatic and other ecosystems is becoming a significant threat in India. These perspectives require to develop programs of crop protection that can be feasible according to Indian rural development and pollution policy. Here we review the research works done on soil solarization in India. Soil solarization (also called plasticulture is an eco-friendly soil disinfestations method for managing soil-borne plant pathogens. This is the process of trapping solar energy by moist soil covered with transparent polyethylene films and chemistry, biology and physical properties of soil are involved in pest control. So far, this technique is applied in more than 50 countries, mostly in hot and humid regions. India has 29 states and these states fall under five climatic zones, from humid to arid ones. We report pest management application in different climatic zones and their effects on production, weeds, nematodes, and pathogenic microorganisms. The analysis of soil temperatures and crop protection results indicate as environmental requirement for soil solarization fits in most of Indian rural areas. Soil solarization is compatible with future Indian scenarios and may support Indian national food security programs.

  2. Private initiatives, public support, and war practices: development of fertilisers in Russia.

    Science.gov (United States)

    Elina, Olga Y

    2011-03-01

    The scarcity of experiments with fertilisers, the poor domestic industry, and high prices for imported products made Russia lag far behind the leading agrarian countries in the research and use of fertilisers. The first experiments on fertilisers were connected mostly with the private estates of Russian nobility. Things began to change slowly by the turn of the twentieth century, when the Ministry of Agriculture launched a policy of agricultural science promotion, including the development of agricultural chemistry. It was the outbreak of World War I that created a powerful stimulus for fertiliser research in Russia. A specific Russian "symbiosis" emerged between military industry and agricultural chemistry. The numerous factories of explosives set up ad hoc produced vast amounts of waste products; modified, they could serve as fertilisers. In 1915, the Public Committee for Support of Fertilisers was organised. Eventually, this committee gave birth to the Institute of Fertilisers, the first institute founded by the Bolshevik government. Thus, the project of "chemicalisation of agriculture," usually described as a revolutionary endeavour, was firmly rooted in World War I.

  3. Pediatric Basic and Advanced Life Support: An Update on Practice and Education

    Directory of Open Access Journals (Sweden)

    Mohamed Al-Shamsi

    2012-11-01

    Full Text Available This review aims to summarize the major changes in the2010 Heart and Stroke foundation of Canada (HSFC andthe American Heart Association (AHA Pediatric Basic andAdvanced Life Support Guidelines. The Guidelines were based onthe International Liaison Committee on Resuscitation’s (ILCORcomprehensive, evidence-based review of the resuscitationliterature. The key recommendations from the Guidelines include:the removal of “look, listen and feel” and a de-emphasis on theuse of the pulse check by healthcare providers to diagnose cardiacarrest; a change in the sequence of resuscitation for patientsin cardiac arrest from the previously well-known “A-B-C” i.e.Airway, Breathing, and Chest Compressions to “C-A-B” i.e.Chest Compressions first; modification to the appropriate depthof compression (at least 1/3 of the anterior-posterior depth of thechest wall or about 4 cm in infants and 5 cm in children; end-tidalCO2 monitoring (in intubated patients to assess the quality ofchest compressions and optimize cardiopulmonary resuscitation(CPR; and titrating Fi0O2 once “Return of SpontaneousCirculation” (ROSC is achieved to maintain an oxygen saturationbetween 94-99%. Overall, pediatricians, family and communityphysicians who may care for acutely ill children should be aware ofthese updated guidelines in order to provide the best possible careto their patients.

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

    Directory of Open Access Journals (Sweden)

    Megan Doerr

    2014-03-01

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

  5. Joint Intelligence Analysis Complex: DOD Partially Used Best Practices for Analyzing Alternatives and Should Do So Fully for Future Military Construction Decisions

    Science.gov (United States)

    2016-09-01

    EUCOM’s Intelligence Analytic Center, a data processing center, a warehouse , and various supporting facilities. This documentation also explains that...use, and that the shortage degrades the reliability of theater and national communications and intelligence assets. In budget justification documents...1623 of the bill would, if enacted, limit DOD’s fiscal year 2017 obligation or expenditure of funding for intelligence manpower positions for JIAC

  6. Support needs of veterinary surgeons during the first few years of practice: perceptions of recent graduates and senior partners.

    Science.gov (United States)

    Routly, J E; Taylor, I R; Turner, R; McKernan, E J; Dobson, H

    2002-02-09

    Postal surveys or personal interviews of 76 recent veterinary graduates and their 49 employers were undertaken to establish their perceptions of good practice when integrating a new graduate into a business and their preferred methods of assessment and development. Practice type and location were the main influences on graduates looking for their first job. Interviews were mostly informal. Employers expected basic veterinary competence and candidates expected good quality support. Most graduates (93 per cent) had their own consultations on the first day. During early consultations 2 per cent of senior vets accompanied the new graduate, 95 per cent of practices provided senior back-up either in person or by telephone but in 3 per cent no back-up was available. Most new graduates (90 per cent) were satisfied with their workload. Three-fifths were on-call within the first week, and 95 per cent within a month. Graduates received calls directly in 45 per cent of practices, in 9 per cent seniors screened the calls, and the remainder used a third party. Assistance from experienced lay staff varied greatly. Discussion of problems was mainly informal. There was little spontaneous feedback and problems resulted from inadequate communication. One in three new graduates left their first job within two years, and one in six identified lack of support, heavy workload, stress or clashes with staff as a primary reason. This high turnover was a problem for employers. From the new graduates' perspectives, initial problems included: being on call (59 per cent), financial aspects (47 per cent) and surgery (43 per cent). Communicating with clients and learning to prioritise jobs were also difficult. New graduates took longer over procedures (79 per cent of employers commented) and required extra back-up (91 per cent) both of which reduced income (59 per cent). Nearly all the seniors felt that their current new graduates had coped 'quite well', although it was claimed that new graduates

  7. Satisfaction with human resource management practices and turnover intention in a five-star hotel: The mediating role of perceived organizational support

    Directory of Open Access Journals (Sweden)

    A.P. Duarte

    2015-05-01

    Full Text Available Employees’ satisfaction with human resources management (HRM practices has been envisaged as a solid predictor of turnover; nonetheless, how these practices may influence employee’s behavior is still an unclear process. There are suggestions that HRM practices may be distal determinants of turnover, as their effects may be mediated by more proximal variables such as perceived organizational support. This study empirically tested a model of research arising from these theoretical suggestions in a five-star hotel. The data collected from the survey of 152 workers were subjected to structural equation analyses. The results showed that the theoretical model had a strong fit to the data, giving empirical support to the prediction that satisfaction with HRM practices reduces turnover intentions, by increasing perceived organizational support. The importance of these results is discussed and interpreted from the point of view of strategic gains associated to the quality of HRM practices for the management of voluntary turnover.

  8. Succinct partial sums and fenwick trees

    DEFF Research Database (Denmark)

    Bille, Philip; Christiansen, Anders Roy; Prezza, Nicola

    2017-01-01

    We consider the well-studied partial sums problem in succint space where one is to maintain an array of n k-bit integers subject to updates such that partial sums queries can be efficiently answered. We present two succint versions of the Fenwick Tree – which is known for its simplicity...... and practicality. Our results hold in the encoding model where one is allowed to reuse the space from the input data. Our main result is the first that only requires nk + o(n) bits of space while still supporting sum/update in O(logbn)/O(blogbn) time where 2 ≤ b ≤ log O(1)n. The second result shows how optimal...... time for sum/update can be achieved while only slightly increasing the space usage to nk + o(nk) bits. Beyond Fenwick Trees, the results are primarily based on bit-packing and sampling – making them very practical – and they also allow for simple optimal parallelization....

  9. Developing and Evaluating Communication Strategies to Support Informed Decisions and Practice Based on Evidence (DECIDE): protocol and preliminary results.

    Science.gov (United States)

    Treweek, Shaun; Oxman, Andrew D; Alderson, Philip; Bossuyt, Patrick M; Brandt, Linn; Brożek, Jan; Davoli, Marina; Flottorp, Signe; Harbour, Robin; Hill, Suzanne; Liberati, Alessandro; Liira, Helena; Schünemann, Holger J; Rosenbaum, Sarah; Thornton, Judith; Vandvik, Per Olav; Alonso-Coello, Pablo

    2013-01-09

    Healthcare decision makers face challenges when using guidelines, including understanding the quality of the evidence or the values and preferences upon which recommendations are made, which are often not clear. GRADE is a systematic approach towards assessing the quality of evidence and the strength of recommendations in healthcare. GRADE also gives advice on how to go from evidence to decisions. It has been developed to address the weaknesses of other grading systems and is now widely used internationally. The Developing and Evaluating Communication Strategies to Support Informed Decisions and Practice Based on Evidence (DECIDE) consortium (http://www.decide-collaboration.eu/), which includes members of the GRADE Working Group and other partners, will explore methods to ensure effective communication of evidence-based recommendations targeted at key stakeholders: healthcare professionals, policymakers, and managers, as well as patients and the general public. Surveys and interviews with guideline producers and other stakeholders will explore how presentation of the evidence could be improved to better meet their information needs. We will collect further stakeholder input from advisory groups, via consultations and user testing; this will be done across a wide range of healthcare systems in Europe, North America, and other countries. Targeted communication strategies will be developed, evaluated in randomized trials, refined, and assessed during the development of real guidelines. Results of the DECIDE project will improve the communication of evidence-based healthcare recommendations. Building on the work of the GRADE Working Group, DECIDE will develop and evaluate methods that address communication needs of guideline users. The project will produce strategies for communicating recommendations that have been rigorously evaluated in diverse settings, and it will support the transfer of research into practice in healthcare systems globally.

  10. Basic linear partial differential equations

    CERN Document Server

    Treves, Francois

    1975-01-01

    Focusing on the archetypes of linear partial differential equations, this text for upper-level undergraduates and graduate students features most of the basic classical results. The methods, however, are decidedly nontraditional: in practically every instance, they tend toward a high level of abstraction. This approach recalls classical material to contemporary analysts in a language they can understand, as well as exploiting the field's wealth of examples as an introduction to modern theories.The four-part treatment covers the basic examples of linear partial differential equations and their

  11. Assessment of alternative land management practices using hydrological simulation and a decision support tool: Arborea agricultural region, Sardinia

    Directory of Open Access Journals (Sweden)

    P. Cau

    2007-11-01

    Full Text Available Quantifying the impact of land use on water supply and quality is a primary focus of environmental management. In this work we apply a semidistributed hydrological model (SWAT to predict the impact of different land management practices on water and agricultural chemical yield over a long period of time for a study site situated in the Arborea region of central Sardinia, Italy. The physical processes associated with water movement, crop growth, and nutrient cycling are directly modeled by SWAT. The model simulations are used to identify indicators that reflect critical processes related to the integrity and sustainability of the ecosystem. Specifically we focus on stream quality and quantity indicators associated with anthropogenic and natural sources of pollution. A multicriteria decision support system is then used to develop the analysis matrix where water quality and quantity indicators for the rivers, lagoons, and soil are combined with socio-economic variables. The DSS is used to assess four options involving alternative watersheds designated for intensive agriculture and dairy farming and the use or not of treated wastewater for irrigation. Our analysis suggests that of the four options, the most widely acceptable consists in the transfer of intensive agricultural practices to the larger watershed, which is less vulnerable, in tandem with wastewater reuse, which rates highly due to water scarcity in this region of the Mediterranean. More generally, the work demonstrates how both qualitative and quantitative methods and information can assist decision making in complex settings.

  12. Local Governments Supporting Local Energy Initiatives: Lessons from the Best Practices of Saerbeck (Germany and Lochem (The Netherlands

    Directory of Open Access Journals (Sweden)

    Thomas Hoppe

    2015-02-01

    Full Text Available The social dimension of the transition to a low carbon economy is a key challenge to cities. The establishment of local energy initiatives (LEIs has recently been attracting attention. It is of great importance to draw lessons from best practices when LEIs have been facilitated by local governments and made a substantial contribution to greening local energy systems. The main research questions in this paper are: What lessons can be drawn from successful local low carbon energy transition cases, and which strategies proved successful to support LEIs? We have used analytical notions from the Strategic Niche Management (SNM and grassroots innovation literature to analyze two best-practice cases: Saerbeck (Germany and Lochem (The Netherlands. Data collection involved a set of fourteen in-depth interviews and secondary data. The results show that three key factors from SNM (building networks, managing expectations, and facilitation of learning are of great importance. However, to a great degree it is also strategic, community serving, responsive, reflexive leadership and proper process management by public officials that spurred success, which would not have been possible without close interaction and mutual trust between local government and representatives of the local communities.

  13. Practical considerations in clinical strategy to support the development of injectable drug-device combination products for biologics.

    Science.gov (United States)

    Li, Zhaoyang; Easton, Rachael

    2018-01-01

    The development of an injectable drug-device combination (DDC) product for biologics is an intricate and evolving process that requires substantial investments of time and money. Consequently, the commercial dosage form(s) or presentation(s) are often not ready when pivotal trials commence, and it is common to have drug product changes (manufacturing process or presentation) during clinical development. A scientifically sound and robust bridging strategy is required in order to introduce these changes into the clinic safely. There is currently no single developmental paradigm, but a risk-based hierarchical approach has been well accepted. The rigor required of a bridging package depends on the level of risk associated with the changes. Clinical pharmacokinetic/pharmacodynamic comparability or outcome studies are only required when important changes occur at a late stage. Moreover, an injectable DDC needs to be user-centric, and usability assessment in real-world clinical settings may be required to support the approval of a DDC. In this review, we discuss the common issues during the manufacturing process and presentation development of an injectable DDC and practical considerations in establishing a clinical strategy to address these issues, including key elements of clinical studies. We also analyze the current practice in the industry and review relevant and status of regulatory guidance in the DDC field.

  14. A pilot Diabetic Support Service based on family practice attenders: comparison with diabetic clinics in east London.

    Science.gov (United States)

    Boucher, B J; Claff, H R; Edmonson, M; Evans, S; Harris, B T; Hull, S A; Jones, E J; Mellins, D H; Safir, J G; Taylor, B

    1987-01-01

    A pilot Diabetic Support Service (DSS) based on a computer register was devised for diabetic patients identified within three group practices in an inner city district of London. Of 159 eligible diabetics, 142 were followed over 2 years. Glycosylated haemoglobin (GHb) monitoring and adequacy of clinic reviews were audited. Care achieved by the DSS was compared with conventional Diabetic Clinic (DC) management of a sample of 200 diabetics from the same district. Serial GHb measurements were made on 66.2% of DSS and 44.5% of DC patients: GHb fell significantly only in DSS patients (13.1% to 11.4%). Proportional falls in GHb were comparable in each DSS treatment group (diet alone, oral hypoglycaemic agents, and insulin) and for hospital attenders and non-attenders equally. The planned clinical reviews were achieved in 40.1% of DSS patients entered (29% GP only, 54% of clinic attenders) and in 15% of DC patients (plus 75% fundal and blood pressure examination). The study led to provision of a formal diabetic clinic annual review system, diabetic mini-clinics in two of the three group practices, and the appointment of two Diabetic Liaison Sisters. With administrative simplification the system is to be made available to all diabetics in the District through their GPs during 1986-8.

  15. Practical considerations in clinical strategy to support the development of injectable drug-device combination products for biologics

    Science.gov (United States)

    Easton, Rachael

    2018-01-01

    ABSTRACT The development of an injectable drug-device combination (DDC) product for biologics is an intricate and evolving process that requires substantial investments of time and money. Consequently, the commercial dosage form(s) or presentation(s) are often not ready when pivotal trials commence, and it is common to have drug product changes (manufacturing process or presentation) during clinical development. A scientifically sound and robust bridging strategy is required in order to introduce these changes into the clinic safely. There is currently no single developmental paradigm, but a risk-based hierarchical approach has been well accepted. The rigor required of a bridging package depends on the level of risk associated with the changes. Clinical pharmacokinetic/pharmacodynamic comparability or outcome studies are only required when important changes occur at a late stage. Moreover, an injectable DDC needs to be user-centric, and usability assessment in real-world clinical settings may be required to support the approval of a DDC. In this review, we discuss the common issues during the manufacturing process and presentation development of an injectable DDC and practical considerations in establishing a clinical strategy to address these issues, including key elements of clinical studies. We also analyze the current practice in the industry and review relevant and status of regulatory guidance in the DDC field. PMID:29035675

  16. Closing the Gap: Communicating to Change Gardening Practices in Support of Native Biodiversity in Urban Private Gardens

    Directory of Open Access Journals (Sweden)

    Yolanda M. van Heezik

    2012-03-01

    Full Text Available Private gardens collectively comprise the largest green space in most cities and the greatest potential for increasing the extent of wildlife-friendly and native-dominated habitat, improving the quality of ecosystem services, and providing opportunities for urban dwellers to reconnect with nature. Because attitudes and values driving landscape preferences in gardens are complex and often not conducive to biodiversity, and a gap exists between the possession of knowledge or values and the expression of pro-environmental behavior, facilitating change in gardening behavior is challenging. We attempted to improve knowledge and influence values, attitudes, and gardening behavior of 55 householders in favor of native biodiversity and environmentally friendly practices, through a two-way communication process, or interactive dialog, during a process of biodiversity documentation of their gardens. Informative feedback on their garden with a normative component was also provided. Despite being well educated and knowledgeable about common species at the start of the study, an increase in knowledge and shift in attitude was detected in 64% of householders: 40% reported a greater understanding of wildlife, and 26% made changes in their gardens, 13% to support native biodiversity. The normative component of our feedback information was of particular interest to 20% of householders. Because neighborhood norms influence gardening practices, changes adopted by a proportion of householders should be perpetuated across neighborhoods. The process of biodiversity assessment, dialog, and feedback was effective in improving knowledge of wildlife and native species, and stimulated a shift in attitude that resulted in native-friendly gardening practices. These changes were detected primarily through open self-report questions, rather than quantitative measures.

  17. Relational use of an electronic quality of life and practice support system in hospital palliative consult care: A pilot study.

    Science.gov (United States)

    Krawczyk, Marian; Sawatzky, Richard

    2018-03-08

    This study is part of an overarching research initiative on the development and integration of an electronic Quality of Life and Practice Support System (QPSS) that uses patient-reported outcome and experience measures in clinical practice. The current study focused on palliative nurse consultants trialing the QPSS with older hospitalized adults receiving acute care. The primary aim of the study was to better understand consultants' and patients' experiences and perspectives of use. The project involved two nurse specialists within a larger palliative outreach consult team (POCT) and consenting older adult patients (age 55+) in a large tertiary acute care hospital in western Canada. User-centered design of the QPSS was informed by three focus groups with the entire POCT team, and implementation was evaluated by direct observation as well as interviews with the POCT nurses and three patients. Thematic analysis of interviews and field notes was informed by theoretical perspectives from social sciences. Result Over 9 weeks, the POCT nurses used the QPSS at least once with 20 patients, for a total of 47 administrations. The nurses most often assisted patients in using the QPSS. Participants referenced three primary benefits of relational use: enhanced communication, strengthened therapeutic relations, and cocreation of new insights about quality of life and care experiences. The nurses also reported increased visibility of quality of life concerns and positive development as relational care providers. Significance of results Participants expressed that QPSS use positively influenced relations of care and enhanced practices consistent with person-centered care. Results also indicate that electronic assessment systems may, in some instances, function as actor-objects enabling new knowledge and relations of care rather than merely as a neutral technological platform. This is the first study to examine hospital palliative consult clinicians' use of a tablet-based system

  18. Partial Support of MAST Academy Outreach Program

    Science.gov (United States)

    1993-05-25

    Another very positive aspect of the student-mentor relationship occured when young women served their internship with a woman scientist or the... siences has indirectly led to the initiation of similar programs in other academic areas. APPENDIX A JOB DESCRIPTIONS FOR MAST ACADEMY OUTREACH PROGRAM

  19. THE ROLE OF HUMAN RESOURCE PRACTICES ON PROFITS GENERATED BY THE INNOVATIONS: THE ROLE OF TOP MANAGEMENT SUPPORT AND REGULARITY OF EMPLOYEES MEETINGS

    Directory of Open Access Journals (Sweden)

    Tatjana Stanovcic

    2016-12-01

    Full Text Available Previous scholars argue that human resource practices advance valuable knowledge what could be reflected positively on innovations. Accordingly, we empirically investigate whether human resource related practices such as top management support and regularity of employees meetings are related to profit generated by the innovation activities. Using survey data of Montenegrin firms, we find that firms in which top management supports employees' idea and have regular employees meetings related to innovation activities are likely to report higher profit generated by innovations. Therefore, our results underline the crucial role of human resource practices in the process of innovation that generates profitability for firms.

  20. Multi-criteria decision making to support waste management: A critical review of current practices and methods.

    Science.gov (United States)

    Goulart Coelho, Lineker M; Lange, Liséte C; Coelho, Hosmanny Mg

    2017-01-01

    Solid waste management is a complex domain involving the interaction of several dimensions; thus, its analysis and control impose continuous challenges for decision makers. In this context, multi-criteria decision-making models have become important and convenient supporting tools for solid waste management because they can handle problems involving multiple dimensions and conflicting criteria. However, the selection of the multi-criteria decision-making method is a hard task since there are several multi-criteria decision-making approaches, each one with a large number of variants whose applicability depends on information availability and the aim of the study. Therefore, to support researchers and decision makers, the objectives of this article are to present a literature review of multi-criteria decision-making applications used in solid waste management, offer a critical assessment of the current practices, and provide suggestions for future works. A brief review of fundamental concepts on this topic is first provided, followed by the analysis of 260 articles related to the application of multi-criteria decision making in solid waste management. These studies were investigated in terms of the methodology, including specific steps such as normalisation, weighting, and sensitivity analysis. In addition, information related to waste type, the study objective, and aspects considered was recorded. From the articles analysed it is noted that studies using multi-criteria decision making in solid waste management are predominantly addressed to problems related to municipal solid waste involving facility location or management strategy.

  1. Integrating Art and Creative Practices into a Programme of Support for Nigerian Students Studying in UK Higher Education Institutions

    Directory of Open Access Journals (Sweden)

    Elizabeth Achinewhu-Nworgu

    2017-05-01

    Full Text Available This scoping paper explores the experiences of overseas students from Nigeria studying in Higher Education Institutions (HEIs in the United Kingdom. It considers the context for these students and some of the particular pressures and challenges they experience in making the transition from education in Nigeria to achieving academic success and adapting to life as a student in the UK. With reference to the work of Professor Claudio-Rafael Vásquez-Martínez, at the outset of a collaborative project to explore these issues further, this paper considers whether the use of painting and other creative practices could assist these students in managing the transition more effectively and ultimately in succeeding in their academic studies. For the present study, qualitative data was gathered using interviews with Nigerian students who came to study in the UK with the assistance of a London-based organisation, Focus Learning Support Ltd, which assists Nigerian students in their applications to UK HEIs, and which supports them throughout their studies.

  2. The organizational social context of mental health medicaid waiver programs with family support services: implications for research and practice.

    Science.gov (United States)

    Glisson, Charles; Williams, Nathaniel J; Green, Philip; Hemmelgarn, Anthony; Hoagwood, Kimberly

    2014-01-01

    Peer family support specialists (FSS) are parents with practical experience in navigating children's mental health care systems who provide support, advocacy, and guidance to the families of children who need mental health services. Their experience and training differ from those of formally trained mental health clinicians, creating potential conflicts in priorities and values between FSS and clinicians. We hypothesized that these differences could negatively affect the organizational cultures and climates of mental health clinics that employ both FSS and mental health clinicians, and lower the job satisfaction and organizational commitment of FSS. The Organizational Social Context measure was administered on site to 209 FSS and clinicians in 21 mental health programs in New York State. The study compared the organizational-level culture and climate profiles of mental health clinics that employ both FSS and formally trained clinicians to national norms for child mental health clinics, assessed individual-level job satisfaction and organizational commitment as a function of job (FSS vs. clinician) and other individual-level and organizational-level characteristics, and tested whether FSS and clinicians job attitudes were differentially associated with organizational culture and climate. The programs organizational culture and climate profiles were not significantly different from national norms. Individual-level job satisfaction and organizational commitment were unrelated to position (FSS vs. clinician) or other individual-level and organizational-level characteristics except for culture and climate. Both FSS' and clinicians' individual-level work attitudes were associated similarly with organizational culture and climate.

  3. Managing complex therapies outside hospitals. An analysis of GPs practices of how to support medication at home.

    Science.gov (United States)

    Piras, Enrico Maria; Miele, Francesco; Bruni, Attila; Coletta, Claudio; Zanutto, Alberto

    2014-01-01

    Support systems for the management of prescriptions are commonplace in hospitals, whilst they are rarely found in general practice. This exploratory study draws on a qualitative survey conducted with focus groups to investigate the information needs of General Practitioners (GPs) in regard to the therapeutic management of complex patients, the purpose being to identify possible areas of application. The question addressed is whether the systems existing in hospitals can be usefully adapted and used by GPs or if a different approach needs to be adopted to design other tools. The analysis shows that the information needs of GPs relative to medication management are significantly different from those of their hospital colleagues because the former are not directly responsible for the administration but instead operate within a care network on which they cannot exercise direct control. This study suggests that support systems for therapy management should be designed on the assumption that it derives from cooperative work by a heterogeneous network of actors, and therefore with functionalities intended to satisfy the coordination needs of all the actors involved in the process.

  4. Incidence of Parental Support and Pressure on Their Children’s Motivational Processes towards Sport Practice Regarding Gender

    Science.gov (United States)

    Amado, Diana

    2015-01-01

    Grounded in Self-Determination Theory, structural equation modeling (SEM) with the aim of examining how parental support/pressure could influence their children´s motivational processes in sport was conducted, as well as the models´ differences in operability regarding gender. The sample size was 321 children ranging in age from 10 to 16 years old who were athletes from Extremadura, and 321 parents (included only the father or mother more involved with the sport of his or her child). 175 participants were male and 146 were female from individual (n = 130), and team sports (n=191). A questionnaire was conducted to assess parental perception of support/pressure and another questionnaire was conducted to measure satisfaction of basic psychological needs, type of motivation and enjoyment/boredom showed by their children towards sport practice. Results revealed that parental pressure negatively predicted satisfaction of the basic psychological needs. It also emerged as a strong positive predictor of intrinsic motivation and negative predictor of amotivation. Moreover, intrinsic motivation emerged as positive predictor of enjoyment and a negative predictor of boredom, whereas amotivation positively predicted boredom and negatively predicted enjoyment. Furthermore, results showed there were mean differences by gender: male athletes perceived greater parental pressure. Hence, it is necessary to decrease parental pressure towards their children in sport, with the aim of making them more motivated and enjoy, promoting positive consequences. PMID:26039062

  5. Use of empirically supported interventions for psychopathology: can the participatory approach move us beyond the research-to-practice gap?

    Science.gov (United States)

    Becker, Carolyn Black; Stice, Eric; Shaw, Heather; Woda, Susan

    2009-04-01

    Dissemination, or distribution, of empirically supported interventions (ESIs) for psychopathology remains a significant challenge. This paper reviews the principles of community-partnership research (CPR) and explores why CPR might improve distribution of psychological ESIs. Benefits of CPR include building trust, pooling resources and knowledge, and better serving a community by directly involving its members in the design and implementation of research. In addition, after establishing a community's trust using CPR, researchers are likely to be better positioned to partner with communities in the further distribution of ESIs via community networks. This paper reviews the case of dissonance-based eating disorder prevention interventions to provide an example of how CPR can facilitate the adoption and distribution of an ESI by a community, in this case, sororities. CPR also presents a number of challenges, however, because it is time consuming and does not always align with funding mechanisms and research designs used in randomized controlled trials. Further, CPR does not necessarily solve the challenge of training providers, though it may help with problem solving. Ultimately, we suggest that the benefits of CPR far outweigh the challenges, and hope that more researchers will adopt these practices so that more individuals can benefit from empirically supported psychological interventions.

  6. Is Europe putting theory into practice? A qualitative study of the level of self-management support in chronic care management approaches

    NARCIS (Netherlands)

    Elissen, A.M.J.; Nolte, E.; Knai, C.; Brunn, M.; Chevreul, K.; Conklin, A.; Durand-Zaleski, I.; Erler, A.; Flamm, M.; Frølich, A.; Fullerton, B.; Jacobsen, R.; Saz-Parkinson, Z.; Sarria-Santamera, A.; Sönnichsen, A.; Vrijhoef, H.J.M.

    2013-01-01

    Background Self-management support is a key component of effective chronic care management, yet in practice appears to be the least implemented and most challenging. This study explores whether and how self-management support is integrated into chronic care approaches in 13 European countries. In

  7. Working group reports: Evaluation of the evidence to support practice guidelines for nutritional care of preterm infants-the Pre-B Project

    Science.gov (United States)

    The "Evaluation of the Evidence to Support Practice Guidelines for the Nutritional Care of Preterm Infants: The Pre-B Project" is the first phase in a process to present the current state of knowledge and to support the development of evidence-informed guidance for the nutritional care of preterm an...

  8. [Acrylic resin removable partial dentures].

    Science.gov (United States)

    de Baat, C; Witter, D J; Creugers, N H J

    2011-01-01

    An acrylic resin removable partial denture is distinguished from other types of removable partial dentures by an all-acrylic resin base which is, in principle, solely supported by the edentulous regions of the tooth arch and in the maxilla also by the hard palate. When compared to the other types of removable partial dentures, the acrylic resin removable partial denture has 3 favourable aspects: the economic aspect, its aesthetic quality and the ease with which it can be extended and adjusted. Disadvantages are an increased risk of caries developing, gingivitis, periodontal disease, denture stomatitis, alveolar bone reduction, tooth migration, triggering of the gag reflex and damage to the acrylic resin base. Present-day indications are ofa temporary or palliative nature or are motivated by economic factors. Special varieties of the acrylic resin removable partial denture are the spoon denture, the flexible denture fabricated of non-rigid acrylic resin, and the two-piece sectional denture. Furthermore, acrylic resin removable partial dentures can be supplied with clasps or reinforced by fibers or metal wires.

  9. Is Europe putting theory into practice? A qualitative study of the level of self-management support in chronic care management approaches.

    Science.gov (United States)

    Elissen, Arianne; Nolte, Ellen; Knai, Cécile; Brunn, Matthias; Chevreul, Karine; Conklin, Annalijn; Durand-Zaleski, Isabelle; Erler, Antje; Flamm, Maria; Frølich, Anne; Fullerton, Birgit; Jacobsen, Ramune; Saz-Parkinson, Zuleika; Sarria-Santamera, Antonio; Sönnichsen, Andreas; Vrijhoef, Hubertus

    2013-03-26

    Self-management support is a key component of effective chronic care management, yet in practice appears to be the least implemented and most challenging. This study explores whether and how self-management support is integrated into chronic care approaches in 13 European countries. In addition, it investigates the level of and barriers to implementation of support strategies in health care practice. We conducted a review among the 13 participating countries, based on a common data template informed by the Chronic Care Model. Key informants presented a sample of representative chronic care approaches and related self-management support strategies. The cross-country review was complemented by a Dutch case study of health professionals' views on the implementation of self-management support in practice. Self-management support for chronically ill patients remains relatively underdeveloped in Europe. Similarities between countries exist mostly in involved providers (nurses) and settings (primary care). Differences prevail in mode and format of support, and materials used. Support activities focus primarily on patients' medical and behavioral management, and less on emotional management. According to Dutch providers, self-management support is not (yet) an integral part of daily practice; implementation is hampered by barriers related to, among others, funding, IT and medical culture. Although collaborative care for chronic conditions is becoming more important in European health systems, adequate self-management support for patients with chronic disease is far from accomplished in most countries. There is a need for better understanding of how we can encourage both patients and health care providers to engage in productive interactions in daily chronic care practice, which can improve health and social outcomes.

  10. On the partiality of procreative beneficence: a critical note.

    Science.gov (United States)

    Petersen, Thomas Søbirk

    2015-09-01

    The aim of this paper is to criticise the well-discussed principle of Procreative Beneficence (PB) lately refined by Julian Savulescu and Guy Kahane. First, it is argued that advocates of PB leave us with an implausible justification for the moral partiality towards the child (or children) which reproducers decide to bring into existence as compared with all other individuals. This is implausible because the reasons given in favour of the partiality of PB, which are based on practical reason and common-sense morality, can just as well be used to guide reproducers to make choices that do not support partiality towards one's possible children. This seems to be true as least in some situations. Second, it is argued that Jakob Elster's recent critique of PB is problematic and specifically that a counterexample designed by Elster to criticise PB because of its partiality towards one's own children misses the target. Finally, a genuine counterexample to PB is developed in order to show that the partiality of PB leads to the wrong answer in a specific case. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  11. HOBE+, a case study: a virtual community of practice to support innovation in primary care in Basque Public Health Service.

    Science.gov (United States)

    Abos Mendizabal, Galder; Nuño Solinís, Roberto; Zaballa González, Irune

    2013-11-05

    A virtual professional community of practice (VCoP), HOBE+, has been set up to foster and facilitate innovation in primary care. It is aimed at all primary care professionals of the Basque Public Health Service (Osakidetza) in the provinces of Biscay and Araba. HOBE + is a VCoP that incorporates innovation management from the generation of ideas to their implementation in primary care practice. We used a case study method, based on the data provided by the technology platform that supports the VCoP, and from a survey completed by HOBE + users. The target population was all primary care staff (including all professional categories) from Araba and Biscay provinces of the Basque Country (Spain), who represent the target users of the VCoP. From a total of 5190 professionals across all the professional categories invited to join, 1627 (31.3%) actually registered in the VCoP and, during the study period, 90 (5.5% of the registered users) participated actively in some way. The total number of ideas proposed by the registered users was 133. Of these, 23 ideas (17.2%) are being implemented. Finally, 80% of the users who answered the satisfaction survey about their experience with HOBE + considered the initiative useful in order to achieve continuous improvement and real innovation in clinical and managerial processes. The experience shows that it is possible to create a virtual CoP for innovation in primary care where professionals from different professional categories propose ideas for innovation that are ultimately implemented.This manuscript objectives are to assess the process of developing and implementing a VCoP open to all primary care professionals in Osakidetza, including the take-up, participation and use of this VCoP in the first 15 months after its launch in October 2011. In addition, the usefulness of the VCoP was assessed through a survey gathering the opinions of the professionals involved.

  12. Partial tooth gear bearings

    Science.gov (United States)

    Vranish, John M. (Inventor)

    2010-01-01

    A partial gear bearing including an upper half, comprising peak partial teeth, and a lower, or bottom, half, comprising valley partial teeth. The upper half also has an integrated roller section between each of the peak partial teeth with a radius equal to the gear pitch radius of the radially outwardly extending peak partial teeth. Conversely, the lower half has an integrated roller section between each of the valley half teeth with a radius also equal to the gear pitch radius of the peak partial teeth. The valley partial teeth extend radially inwardly from its roller section. The peak and valley partial teeth are exactly out of phase with each other, as are the roller sections of the upper and lower halves. Essentially, the end roller bearing of the typical gear bearing has been integrated into the normal gear tooth pattern.

  13. [Removable partial dentures. Oral functions and types

    OpenAIRE

    Creugers, N.H.J.; Baat, C. de

    2009-01-01

    A removable partial denture enables the restoration or improvement of 4 oral functions: aesthetics, mandibular stability, mastication, and speech. However, wearing a removable partial denture should not cause oral comfort to deteriorate. There are 3 types of removable partial dentures: acrylic tissue-supported dentures, dentures with cast metal frameworks en dentures with cast metal frameworks and (semi)precision attachments. Interrupted tooth arches,free-ending tooth arches, and a combinatio...

  14. The Organizational Social Context of Mental Health Medicaid Waiver Programs with Family Support Services: Implications for Research and Practice

    Science.gov (United States)

    Glisson, Charles; Williams, Nathaniel J.; Green, Philip; Hemmelgarn, Anthony; Hoagwood, Kimberly

    2013-01-01

    Introduction Peer family support specialists (FSS) are parents with practical experience in navigating children’s mental health care systems who provide support, advocacy and guidance to the families of children who need mental health services. Their experience and training differ from those of formally trained mental health clinicians, creating potential conflicts in priorities and values between FSS and clinicians. We hypothesized that these differences could negatively affect the organizational cultures and climates of mental health clinics that employ both FSS and mental health clinicians, and lower the job satisfaction and organizational commitment of FSS. Method The Organizational Social Context (OSC) measure was administered on site to 209 FSS and clinicians in 21 mental health programs in New York State. The study compared the organizational-level culture and climate profiles of mental health clinics that employ both FSS and formally trained clinicians to national norms for child mental health clinics, assessed individual-level job satisfaction and organizational commitment as a function of job (FSS vs. clinician) and other individual-level and organizational-level characteristics, and tested whether FSS and clinicians’ job attitudes are differentially associated with organizational culture and climate. Results The programs’ organizational culture and climate profiles were not significantly different from national norms. Individual-level job satisfaction and organizational commitment were unrelated to position (FSS vs. clinician) or other individual-level and organizational-level characteristics except for culture and climate. Conclusions Organizational culture and climate are not related to the employment of FSS. Both FSS’ and clinicians’ individual-level work attitudes are associated similarly with organizational culture and climate. PMID:24065458

  15. Essays on partial retirement

    NARCIS (Netherlands)

    Kantarci, T.

    2012-01-01

    The five essays in this dissertation address a range of topics in the micro-economic literature on partial retirement. The focus is on the labor market behavior of older age groups. The essays examine the economic and non-economic determinants of partial retirement behavior, the effect of partial

  16. Mentor mother support for mothers experiencing intimate partner violence in family practice: A qualitative study of three different perspectives on the facilitators and barriers of implementation.

    Science.gov (United States)

    Loeffen, Maartje J W; Daemen, Jasper; Wester, Fred P J F; Laurant, Miranda G H; Lo Fo Wong, Sylvie H; Lagro-Janssen, Antoine L M

    2017-12-01

    Intimate partner violence (IPV) is highly prevalent and associated with physical and mental health problems. Mentor mother support is a low threshold intervention in family practice consisting of support by non-professionals trained to support mothers experiencing IPV. A mentor mother support study showed reduced exposure to IPV and decreased symptoms of depression. Identify factors determining implementation success of mentor mother support in family practice. Individual interviews were conducted with 12 family physicians, 16 abused mothers and three mentor mothers. Four mentor mothers participated in a focus group. Qualitative content analysis was used to analyse the data. The identification and discussion of abuse is hindered by family physicians' attitudes because they considered mothers experiencing IPV as a difficult target group with a responsibility of their own to break out of their violent situation. Some family physicians doubted the partner's violence because he was known as a patient as well. Acceptance of mentor mother support is related to the readiness for change of mothers experiencing IPV. Mentor mothers facilitate acceptance and completion of their support by connecting as a friend who is equal and less threatening than professionals. To improve successful implementation of mentor mother support in primary care, we should focus on family physicians' attitudes towards IPV. To change these attitudes, we recommend continuous training of family physicians. By being paraprofessional friends, mentor mothers offer low threshold support that is complementary to professional support and should be embedded more widely in primary care. [Box: see text].

  17. Exploring the practicing-connections hypothesis: using gesture to support coordination of ideas in understanding a complex statistical concept.

    Science.gov (United States)

    Son, Ji Y; Ramos, Priscilla; DeWolf, Melissa; Loftus, William; Stigler, James W

    2018-01-01

    In this article, we begin to lay out a framework and approach for studying how students come to understand complex concepts in rich domains. Grounded in theories of embodied cognition, we advance the view that understanding of complex concepts requires students to practice, over time, the coordination of multiple concepts, and the connection of this system of concepts to situations in the world. Specifically, we explore the role that a teacher's gesture might play in supporting students' coordination of two concepts central to understanding in the domain of statistics: mean and standard deviation. In Study 1 we show that university students who have just taken a statistics course nevertheless have difficulty taking both mean and standard deviation into account when thinking about a statistical scenario. In Study 2 we show that presenting the same scenario with an accompanying gesture to represent variation significantly impacts students' interpretation of the scenario. Finally, in Study 3 we present evidence that instructional videos on the internet fail to leverage gesture as a means of facilitating understanding of complex concepts. Taken together, these studies illustrate an approach to translating current theories of cognition into principles that can guide instructional design.

  18. Bridging the Research to Practice Gap: A Case Study Approach to Understanding EIBI Supports and Barriers in Swedish Preschools

    Directory of Open Access Journals (Sweden)

    Lise ROLL-PETTERSSON

    2016-12-01

    Full Text Available The present study examined proximal and distal barriers and supports within the Swedish service system that may affect implementation of early and intensive behavioral intervention (EIBI for children with autism. A case study approach with roots in ethnography was chosen to explore this issue. Two preschools exemplifying ‘high quality practice’ were studied and information was collected through multiple sources during a 12 month period, this included participant observations, direct observations, semi-structured interviews with key informants; paraprofessionals, parents, special educators, habilitation specialists and a focus group interview. Interview transcripts and field notes were combined and analyzed using an abductive grounded theory approach. Findings highlight the relevance of researchers understanding and taking into consideration the effect that distal variables have on implementation within proximal settings. A theoretical model of factors affecting implementation was conceptualised to include: staff entry knowledge and competence, development through supervision, the role of the preschool administrator, as well as distal influences and inter-organizational tensions, values, and bridges. Findings are discussed within the context of implementation science. Implications for future research are discussed as well as areas in need of further development to bridge the gap between research and practice.

  19. Field Evidence Supporting Conventional Onion Curing Practices as a Strategy To Mitigate Escherichia coli Contamination from Irrigation Water.

    Science.gov (United States)

    Wright, Daniel; Feibert, Erik; Reitz, Stuart; Shock, Clint; Waite-Cusic, Joy

    2018-03-01

    The Produce Safety Rule of the U.S. Food Safety Modernization Act includes restrictions on the use of agricultural water of poor microbiological quality. Mitigation options for poor water quality include the application of an irrigation-to-harvest interval of onion production includes an extended irrigation-to-harvest interval (onion fields (randomized block design; n = 5) via drip tape on the final day of irrigation. Onions remained undisturbed for 7 days and were then lifted to the surface to cure for an additional 21 days before harvest. Water, onions, and soil were tested for presence of rifampin-resistant E. coli. One day after irrigation, 13.3% of onions (20 of 150) receiving the poorest quality water (3 log CFU/mL) tested positive for E. coli; this prevalence was reduced to 4% (6 of 150 onions) after 7 days. Regardless of inoculum level, E. coli was not detected on any onions beyond 15 days postirrigation. These results support conventional dry bulb onion curing practices as an effective strategy to mitigate microbiological concerns associated with poor quality irrigation water.

  20. Recurrent Partial Words

    Directory of Open Access Journals (Sweden)

    Francine Blanchet-Sadri

    2011-08-01

    Full Text Available Partial words are sequences over a finite alphabet that may contain wildcard symbols, called holes, which match or are compatible with all letters; partial words without holes are said to be full words (or simply words. Given an infinite partial word w, the number of distinct full words over the alphabet that are compatible with factors of w of length n, called subwords of w, refers to a measure of complexity of infinite partial words so-called subword complexity. This measure is of particular interest because we can construct partial words with subword complexities not achievable by full words. In this paper, we consider the notion of recurrence over infinite partial words, that is, we study whether all of the finite subwords of a given infinite partial word appear infinitely often, and we establish connections between subword complexity and recurrence in this more general framework.

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

    Science.gov (United States)

    Longpré, Caroline; Dubois, Carl-Ardy

    2017-11-29

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

  2. A global health partnership's use of time-limited support to catalyze health practice change: the case of GAVI's Injection Safety Support.

    Science.gov (United States)

    Levin, Ann; Fang, Arnold; Hansen, Peter M; Pyle, David; Dia, Ousmane; Schwalbe, Nina

    2010-09-27

    This paper presents the findings of a study to assess the effectiveness and sustainability of a GAVI (Global Alliance of Vaccines and Immunization) sponsored, time-limited Injection Safety (INS) support. The support came in two forms: 1) in-kind, in the form of AD syringes and safety boxes, and 2) in cash, for those countries that already had a secure, multi-year source of AD syringes and safety boxes, but proposed to use INS support to strengthen their injection safety activities. In total, GAVI gave INS support for a three-year period to 58 countries: 46 with commodities and 12 with cash support. To identify variables that might be associated with financial sustainability, frequencies and cross-tabulations were run against various programmatic and socio-economic variables in the 58 countries. All but two of the 46 commodity-recipient countries were able to replace and sustain the use of AD syringes and safety boxes after the end of their GAVI INS support despite the fact that standard disposable syringes are less costly than ADs (10-15 percent differential). In addition, all 12 cash-recipient countries continued to use AD syringes and safety boxes in their immunization programs in the years following GAVI INS assistance. At the same time, countries were often not prepared for the increased waste management requirements associated with the use of the syringes, suggesting the importance of anticipating challenges with the introduction of new technologies. The sustained use of AD syringes in countries receiving injection safety support from GAVI, in a majority of cases through government financing, following the completion of three years of time-limited support, represents an early indication of how GHPs can contribute to improved health outcomes in immunization safety in the world's poorest countries in a sustainable way.

  3. A global health partnership's use of time-limited support to catalyze health practice change: the case of GAVI's Injection Safety Support.

    Directory of Open Access Journals (Sweden)

    Ann Levin

    Full Text Available This paper presents the findings of a study to assess the effectiveness and sustainability of a GAVI (Global Alliance of Vaccines and Immunization sponsored, time-limited Injection Safety (INS support. The support came in two forms: 1 in-kind, in the form of AD syringes and safety boxes, and 2 in cash, for those countries that already had a secure, multi-year source of AD syringes and safety boxes, but proposed to use INS support to strengthen their injection safety activities. In total, GAVI gave INS support for a three-year period to 58 countries: 46 with commodities and 12 with cash support. To identify variables that might be associated with financial sustainability, frequencies and cross-tabulations were run against various programmatic and socio-economic variables in the 58 countries. All but two of the 46 commodity-recipient countries were able to replace and sustain the use of AD syringes and safety boxes after the end of their GAVI INS support despite the fact that standard disposable syringes are less costly than ADs (10-15 percent differential. In addition, all 12 cash-recipient countries continued to use AD syringes and safety boxes in their immunization programs in the years following GAVI INS assistance. At the same time, countries were often not prepared for the increased waste management requirements associated with the use of the syringes, suggesting the importance of anticipating challenges with the introduction of new technologies. The sustained use of AD syringes in countries receiving injection safety support from GAVI, in a majority of cases through government financing, following the completion of three years of time-limited support, represents an early indication of how GHPs can contribute to improved health outcomes in immunization safety in the world's poorest countries in a sustainable way.

  4. Removable partial dentures: clinical concepts.

    Science.gov (United States)

    Bohnenkamp, David M

    2014-01-01

    This article provides a review of the traditional clinical concepts for the design and fabrication of removable partial dentures (RPDs). Although classic theories and rules for RPD designs have been presented and should be followed, excellent clinical care for partially edentulous patients may also be achieved with computer-aided design/computer-aided manufacturing technology and unique blended designs. These nontraditional RPD designs and fabrication methods provide for improved fit, function, and esthetics by using computer-aided design software, composite resin for contours and morphology of abutment teeth, metal support structures for long edentulous spans and collapsed occlusal vertical dimensions, and flexible, nylon thermoplastic material for metal-supported clasp assemblies. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Preventing work-related stress among staff working in children's cancer Principal Treatment Centres in the UK: a brief survey of staff support systems and practices.

    Science.gov (United States)

    Beresford, B; Gibson, F; Bayliss, J; Mukherjee, S

    2018-03-01

    Growing evidence of the association between health professionals' well-being and patient and organisational outcomes points to the need for effective staff support. This paper reports a brief survey of the UK's children's cancer Principal Treatment Centres (PTCs) regarding staff support systems and practices. A short on-line questionnaire, administered in 2012-2013, collected information about the availability of staff support interventions which seek to prevent work-related stress among different members of the multi-disciplinary team (MDT). It was completed by a member of staff with, where required, assistance from colleagues. All PTCs (n = 19) participated. Debriefs following a patient death was the most frequently reported staff support practice. Support groups were infrequently mentioned. There was wide variability between PTCs, and between professional groups, regarding the number and type of interventions available. Doctors appear to be least likely to have access to support. A few Centres routinely addressed work-related stress in wider staff management strategies. Two Centres had developed a bespoke intervention. Very few Centres were reported to actively raise awareness of support available from their hospital's Occupational Health department. A minority of PTCs had expert input regarding staff support from clinical psychology/liaison psychiatry. © 2016 The Authors. European Journal of Cancer Care Published by John Wiley & Sons Ltd.

  6. An evaluation of fitness for practice curricula: self-efficacy, support and self-reported competence in preregistration student nurses and midwives.

    Science.gov (United States)

    Lauder, William; Watson, Roger; Topping, Keith; Holland, Karen; Johnson, Martin; Porter, Mary; Roxburgh, Michelle; Behr, Aga

    2008-07-01

    This element of the larger Scottish evaluation aimed to explore differences between access routes, cohorts and higher education institutes (HEI) (universities and colleges) in levels of self-efficacy, student support and self-reported competence in a nationally representative sample of student nurses and midwives. This paper reports findings from the National Review of Pre-Registration Nursing and Midwifery Programmes in Scotland. Fitness for practice curricula have been the heart of many recent developments in nurse and midwifery education. Fitness for practice set out to map out the future direction of preregistration nursing and midwifery education with the aim of ensuring fitness for practice based on healthcare need. There have been no national evaluations of the effectiveness of this strategic objective. Previous major evaluations in the 1990s suggested that students may not have had the skills needed to be fit for practice. The study design was a cross-sectional survey of a stratified random sample of student nurses and midwives (n = 777). Data collected included demographic information, generalised perceived self-efficacy, student support and self-reported competency. Students reported high levels of self-reported competency. There were no significant differences between two cohorts or between students with different access routes. Students rated support from family and friends highest and support from HEI lowest. There was a significant difference in support levels between HEI. Self-efficacy scores were similar to other population means and showed small-moderate correlations with self-report competence. Similarly, self-reported competency appears to be at the higher end of the spectrum, although older students may have a more realistic perception of their competence. However, support from HEI was seen as less satisfactory and varied from one institution to another. This study portrays a relatively positive picture of preregistration fitness for practice

  7. [Medical practice in support of hypertension as risk factor kidney in general medical practice, and primary prevention in children in schools, and the pregnant woman in Annaba (Algeria)].

    Science.gov (United States)

    Rayane, R

    2014-06-01

    To study medical practice in the management of hypertension as a factor in renal risk in general medical practice and primary prevention in children at school, and pregnant women under prenatal monitoring. The longitudinal study, observational over a year, focused on medical practice in schools, maternal health and medical practice among 100 physicians (general practitioner and specialist practitioner) in Annaba (Algeria). In children in schools, measurement of blood pressure is never done on the grounds because this gesture is considered unnecessary in 100% of cases. In pregnant women, the measurement of blood pressure is not performed in more than 26% of pregnant women because it is deemed unnecessary by the midwife in 89% of pregnant women and default material in 11% of they. In current medical practice, 69% of doctors routinely take blood pressure. For the rest, represented mainly by specialists, it is the patient who does not justify. Sixty-two percent of physicians, that is hypertension, above 140/90mmHg, and 15% of physicians that is hypertension, above 145/95mmHg. Among the physicians, 58.7% did not use urinary strip, either, because they think that this review should be done in a laboratory (64.8%), or because the urinary strip are not available at even consulting (35.2%). Inadequacies in the coverage (care) of the HTA are real. Their effects on the progress of prevalence of the renal insufficiency chronic terminal treated are possibly important. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  8. Development and implementation of a clinical needs assessment to support nursing and midwifery students with a disability in clinical practice: part 1.

    Science.gov (United States)

    Howlin, Frances; Halligan, Phil; O'Toole, Sinead

    2014-09-01

    Equality and disability legislation, coupled with increasing numbers of students with a disability, and inadequate supports in clinical practice, acted as catalysts to explore how best to support undergraduate nursing and midwifery students on clinical placements. Historically, higher education institutions provide reasonable accommodations for theoretical rather than clinical modules for practice placements. This paper describes the development and implementation of a Clinical Needs Assessment designed to identify the necessary supports or reasonable accommodations for nursing and midwifery students with a disability undertaking work placements in clinical practice. The existing literature, and consultation with an expert panel, revealed that needs assessments should be competency based and clearly identify the core skills or elements of practice that the student must attain to achieve proficiency and competence. The five Domains of Competence, advocated by An Bord Altranais, the Nursing and Midwifery Board of Ireland, formed the framework for the Clinical Needs Assessment. A panel of experts generated performance indicators to enable the identification of individualised reasonable accommodations for year 1 nursing and midwifery students in one Irish University. Development and implementation of the Clinical Needs Assessment promoted equality, inclusion and a level playing field for nursing and midwifery students with a disability in clinical practice. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Online Learning in Divorce: How the Formation of a Community of Practice in a Divorce Support Website Enables and Inhibits Learning

    Science.gov (United States)

    Paechter, Carrie

    2012-01-01

    This article is about the informal learning that took place in an online divorce support and advice forum. In it, the author discusses the formation of a community of practice among the members during the first nine months of the site's operation. The author shows how the key markers of mutual engagement, joint enterprise and shared repertoire…

  10. Supporting Reflective Practices in Social Change Processes with the Dynamic Learning Agenda: An Example of Learning about the Process towards Disability Inclusive Development

    Science.gov (United States)

    van Veen, Saskia C.; de Wildt-Liesveld, Renée; Bunders, Joske F. G.; Regeer, Barbara J.

    2014-01-01

    Change processes are increasingly seen as the solution to entrenched (social) problems. However, change is difficult to realise while dealing with multiple actors, values, and approaches. (Inter)organisational learning is seen as a way to facilitate reflective practices in social change that support emergent changes, vicarious learning, and…

  11. The Emotional and Academic Consequences of Parental Conditional Regard: Comparing Conditional Positive Regard, Conditional Negative Regard, and Autonomy Support as Parenting Practices

    Science.gov (United States)

    Roth, Guy; Assor, Avi; Niemiec, Christopher P.; Deci, Edward L.; Ryan, Richard M.

    2009-01-01

    The authors conducted 2 studies of 9th-grade Israeli adolescents (169 in Study 1, 156 in Study 2) to compare the parenting practices of conditional positive regard, conditional negative regard, and autonomy support using data from multiple reporters. Two socialization domains were studied: emotion control and academics. Results were consistent…

  12. An e-learning supported Train-the-Trainer program to implement a suicide practice guideline. Rationale, content and dissemination in Dutch mental health care.

    NARCIS (Netherlands)

    Groot, M. de; Beurs, D.P. de; Keijser, J. de; Kerkhof, A.F.J.M.

    2015-01-01

    An e-learning supported Train-the-Trainer program was developed to implement the Dutch suicide practice guideline inmental health care. Literature on implementation strategies has been restricted to the final reporting of studieswith little opportunity to describe relevant contextual, developmental

  13. Principals Management Support Practices to Promote Teachers' Instructional Improvement for Sustainable Development in Secondary Education in Anambra State, Nigeria

    Science.gov (United States)

    Victor, Akinfolarin Akinwale; Emetarom, Uche Grace

    2017-01-01

    This study ascertained the principals management support practices to promote teachers instructional improvement for sustainable development in secondary education in Anambra State. Two specific purposes were formulated and two research questions guided the study. The study adopted a descriptive survey design. The study was conducted in the six…

  14. Review of the Visiting Teachers Service for Children with Hearing and Visual Impairment in Supporting Inclusive Educational Practice in Ireland: Examining Stakeholder Feedback through an Ecological Systems Theory

    Science.gov (United States)

    McLinden, Mike; McCracken, Wendy

    2016-01-01

    In line with recent developments in inclusive practice in Ireland, children with sensory needs are increasingly educated in mainstream rather than specialist provision. Educational supports are provided by a range of practitioners and include input from the visiting teachers service for children with hearing and visual impairment. This paper…

  15. Designing, Supporting, and Sustaining an Online Community of Practice: NASA EPO Workspace as an Ongoing Exploration of the Value of Community

    Science.gov (United States)

    Davey, B.; Davis, H. B.

    2015-12-01

    Increasingly, geographically diverse organizations, like NASA's Science Mission Directorate Education and Public Outreach personnel (SMD EPO), are looking for ways to facilitate group interactions in meaningful ways while limiting costs. Towards this end, of particular interest, and showing great potential are communities of practice. Communities of practice represent relationships in real-time between and among people sharing a common practice. They facilitate the sharing of information, building collective knowledge, and growing of the principles of practice. In 2010-11, SMD EPO established a website to support EPO professionals, facilitate headquarters reporting, and foster a community of practice. The purpose of this evaluation is to examine the design and use of the workspace and the value created for both individual community members and SMD EPO, the sponsoring organization. The online workspace was launched in 2010-11 for the members of NASA's SMDEPO community. The online workspace was designed to help facilitate the efficient sharing of information, be a central repository for resources, help facilitate and support knowledge creation, and ultimately lead to the development of an online community of practice. This study examines the role of the online workspace component of a community in the work of a community of practice. Much has been studied revealing the importance of communities of practice to organizations, project success, and knowledge management and some of these same successes hold true for virtual communities of practice. Additionally, we look at the outcomes of housting the online community for these past years in respect to knowledge building and personal and organizational value, the affects on professional dvelopment opportunities, how community members have benefited, and how the workspace has evolved to better serve the community.

  16. Engaging general practice nurses in chronic disease self-management support in Australia: insights from a controlled trial in chronic obstructive pulmonary disease.

    Science.gov (United States)

    Walters, Julia A E; Courtney-Pratt, Helen; Cameron-Tucker, Helen; Nelson, Mark; Robinson, Andrew; Scott, Jenn; Turner, Paul; Walters, E Haydn; Wood-Baker, Richard

    2012-01-01

    The growing burden of chronic disease will increase the role of primary care in supporting self-management and health behaviour change. This role could be undertaken to some extent by the increased practice nurse workforce that has occurred over recent years. Mixed methods were used to investigate the potential for general practice nurses to adopt this role during a 12-month randomised controlled study of telephone-delivered health mentoring in Tasmanian practices. Nurses (general practice and community health) were trained as health mentors to assist chronic obstructive p